On December 5, during my shift at the hospital, I discovered that the ACIP had voted against universal hepatitis B vaccination at birth, a procedure that has been endorsed by specialists for many years. This decision triggered memories of Sam, a healthy newborn who was diagnosed with biliary atresia, resulting in liver failure despite undergoing surgery. Observing Sam and his family endure the emotional strain of waiting for a transplant underscored the critical role of immunizations in averting distressing outcomes.

In my role as a pediatric hospitalist, I find myself alternating between caring for healthy infants and treating critically ill children. Diseases can spread rapidly, particularly among the youngest patients, and we frequently feel helpless against numerous infections. However, immunizations provide a preventive solution where effective treatments are lacking; the hepatitis B vaccine serves as a prime illustration.

Hepatitis B leads to chronic liver disease in children, and newborns infected during birth are at a heightened risk of severe complications. The virus can be transmitted from mother to child or through contact within the community, and symptoms may not be evident for years. Since the switch to universal newborn vaccination in 1991, the United States has witnessed a notable decline in hepatitis B infections.

Given the constraints of our healthcare system in delivering risk-based care, a widespread vaccination strategy is backed by its safety profile—only a single allergic reaction is reported per 2-3 million doses. The ACIP’s choice appears to be less about health outcomes and more focused on political agendas, employing fear to diminish trust.

For numerous children, being born in a hospital constitutes one of the rare encounters with healthcare, particularly as many lack access to a primary care physician. Eliminating universal vaccination threatens to exacerbate healthcare disparities.

As a healthcare provider, I have witnessed the triumphs of medical interventions as well as the devastation wrought by disease. While we confront political decisions that undermine our efforts, we continue as advocates for children. We may not be able to eliminate all suffering, but we can commit to safeguarding children from preventable illnesses through unwavering vigilance and compassion, gradually restoring trust.

A. Lane Baldwin is a pediatric hospitalist.