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Peer-reviewedCC BY-NC 4.0Journal of Pediatric Gastroenterology and Nutrition

Immunization and the hepatitis B virus: A view from the ESPGHAN Hepatology Committee

  • Benno Kohlmaier1
  • Giuseppe Indolfi2,3
  • Ulrich Baumann4
  • Cristina Gonçalves5
  • Emmanuel Gonzales6,7
  • Norman Junge4
  • Emanuele Nicastro8
  • Tudor Lucian Pop9
  • Jesus Quintero10
  • Xavier Stephenne11
  • Bethany Tucker12
  • Hubert Van Der Doef13
2 more authors
  • Orith Waisbourd‐Zinman14
  • Emer Fitzpatrick15
15 affiliations
  1. 1Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics Medical University of Graz Graz Austria
  2. 2Pediatric Unit, Meyer Children's Hospital IRCCS Florence Italy
  3. 3NEUROFARBA Department University of Florence Florence Italy
  4. 4Department of Pediatric Kidney Liver and Metabolic Diseases, Division for Pediatric Gastroenterology and Hepatology, Hannover Medical School Hannover Germany
  5. 5Hospital Dona Estefânia, Lisbon Lisbon Portugal
  6. 6Pediatric Hepatology and Pediatric Liver Transplant Department Reference Center for Biliary Atresia and Genetic Cholestasis, FSMR FILFOIE, ERN RARE LIVER, AP‐HP, Paris‐Saclay University, Bicêtre Hospital Kremlin‐Bicêtre France
  7. 7INSERM UMR‐S 1193, Paris‐Saclay University, Hépatinov Orsay France
  8. 8Pediatric Hepatology Gastroenterology and Transplantation Unit, ASST Papa Giovanni XXIII Bergamo Italy
  9. 9Second Pediatric Discipline, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj‐Napoca, Center of Expertise in Pediatric Liver Rare Disorders, Emergency Clinical Hospital for Children Cluj‐Napoca Cluj‐Napoca Romania
  10. 10Pediatric Hepatology and Liver Transplant Unit, Hospital Universitari Vall d'Hebron Barcelona Spain
  11. 11Pediatric Gastroenterology and Hepatology Division Cliniques Universitaires Saint‐Luc, UCLouvain Brussels Belgium
  12. 12Paediatric Liver, GI & Nutrition Centre and MowatLabs King's College Hospital London UK
  13. 13Department of Pediatric Gastroenterology and Hepatology University Medical Center Groningen, University of Groningen Groningen The Netherlands
  14. 14Schneider Children's Medical Centre, Gray Faculty of Medical and Health Sciences, Tel‐Aviv University Tel‐Aviv Israel
  15. 15Department of Gastroenterology Hepatology and Nutrition, Children's Health Ireland and University College Dublin Dublin Ireland
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Abstract

Hepatitis B virus (HBV) infection remains a global health challenge, with more than 250 million people chronically infected worldwide and >2000 daily deaths from HBV‐related disease. Early‐life acquisition is the primary driver of chronic infection; up to 90% of infants infected perinatally progress to chronic HBV infection compared with markedly lower rates in older children and adults. Universal infant immunization, including the birth‐dose, has been central to global elimination, resulting in a substantial reduction in chronic HBV infection, cirrhosis, and hepatocellular carcinoma. Recent statements from the Centers for Disease Control and Prevention question the evidence‐base for early‐life vaccination and recommend deferring HBV immunization until later in childhood. These claims reflect misconceptions about HBV epidemiology and reference a perceived association between infant vaccination and autism. This communication summarizes evidence demonstrating the risks of early‐life HBV transmission leading to chronic infection. We argue that delaying or foregoing immunization would leave infants at unnecessary risk. We reference two decades of research in which large‐scale studies have not identified an association between vaccination, including HBV vaccination, and autism.

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Cite

BibTeXRIS
BibTeX
@article{kohlmaier2026immunization,
  title = {{Immunization and the hepatitis B virus: A view from the ESPGHAN Hepatology Committee}},
  author = {Benno Kohlmaier and Giuseppe Indolfi and Ulrich Baumann and Cristina Gonçalves and Emmanuel Gonzales and Norman Junge and Emanuele Nicastro and Tudor Lucian Pop and Jesus Quintero and Xavier Stephenne and Bethany Tucker and Hubert Van Der Doef and Orith Waisbourd‐Zinman and Emer Fitzpatrick},
  journal = {Journal of Pediatric Gastroenterology and Nutrition},
  year = {2026},
  month = aug,
  doi = {10.1002/jpn3.70543},
  url = {https://doi.org/10.1002/jpn3.70543},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Immunization and the hepatitis B virus: A view from the ESPGHAN Hepatology Committee
AU  - Benno Kohlmaier
AU  - Giuseppe Indolfi
AU  - Ulrich Baumann
AU  - Cristina Gonçalves
AU  - Emmanuel Gonzales
AU  - Norman Junge
AU  - Emanuele Nicastro
AU  - Tudor Lucian Pop
AU  - Jesus Quintero
AU  - Xavier Stephenne
AU  - Bethany Tucker
AU  - Hubert Van Der Doef
AU  - Orith Waisbourd‐Zinman
AU  - Emer Fitzpatrick
PY  - 2026
DA  - 2026/08/31
JO  - Journal of Pediatric Gastroenterology and Nutrition
DO  - 10.1002/jpn3.70543
UR  - https://doi.org/10.1002/jpn3.70543
AB  - Hepatitis B virus (HBV) infection remains a global health challenge, with more than 250 million people chronically infected worldwide and >2000 daily deaths from HBV‐related disease. Early‐life acquisition is the primary driver of chronic infection; up to 90% of infants infected perinatally progress to chronic HBV infection compared with markedly lower rates in older children and adults. Universal infant immunization, including the birth‐dose, has been central to global elimination, resulting in a substantial reduction in chronic HBV infection, cirrhosis, and hepatocellular carcinoma. Recent statements from the Centers for Disease Control and Prevention question the evidence‐base for early‐life vaccination and recommend deferring HBV immunization until later in childhood. These claims reflect misconceptions about HBV epidemiology and reference a perceived association between infant vaccination and autism. This communication summarizes evidence demonstrating the risks of early‐life HBV transmission leading to chronic infection. We argue that delaying or foregoing immunization would leave infants at unnecessary risk. We reference two decades of research in which large‐scale studies have not identified an association between vaccination, including HBV vaccination, and autism.
SN  - 0277-2116
SN  - 1536-4801
ER  -