Academic Journal
A vaccine emergency-when to overrule parental refusal of vaccination at birth for prevention of vertical transmission of hepatitis B virus?
| Τίτλος: | A vaccine emergency-when to overrule parental refusal of vaccination at birth for prevention of vertical transmission of hepatitis B virus? |
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| Συγγραφείς: | Basu Roy R; Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, London, UK.; Department of Paediatric Infectious Diseases and Immunology, Children's Hospital, The Royal London Hospital, London, UK., Paulus S; Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.; Department of Paediatric Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, Oxford, UK., Kelly DF; Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.; Department of Paediatric Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, Oxford, UK., Brrang H; Formerly of Children's Liver Disease Foundation, Winchester, UK., Taylor A; Formerly of Children's Liver Disease Foundation, Winchester, UK., Tudor-Williams G; Imperial College London Centre for Paediatrics and Child Health, London, UK., Nastouli E; UCL GOS Institute of Child Health, London, UK.; Advanced Pathogen Diagnostics Unit, University College London Hospitals NHS Foundation Trust, London, UK., Banerjee A; Vaccinations and Screening, NHS England - Midlands, Nottingham, UK., Horne M; Children and Families Legal Service, Warwickshire County Council, Warwick, UK., Parker EPK; Clinical Research Department and the Vaccine Centre, London School of Hygiene & Tropical Medicine, London, UK., ElSharkawy A; Department of Hepatology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.; British Liver Trust, Ringwood, UK., Mandal S; Public Health Programmes, UK Health Security Agency, London, UK., Ramsay ME; Public Health Programmes, UK Health Security Agency, London, UK., Pollard AJ; Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.; Department of Paediatric Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, Oxford, UK., Savulescu J; Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.; Uehiro Oxford Institute, University of Oxford, Oxford, UK., Wilkinson D; Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore dominic.wilkinson@uehiro.ox.ac.uk.; Uehiro Oxford Institute, University of Oxford, Oxford, UK.; Neonatal Intensive Care Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. |
| Πηγή: | Archives of disease in childhood [Arch Dis Child] 2025 Nov 19; Vol. 110 (12), pp. 940-945. Date of Electronic Publication: 2025 Nov 19. |
| Τύπος έκδοσης: | Journal Article; Review |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: BMJ Pub. Group [etc.] Country of Publication: England NLM ID: 0372434 Publication Model: Electronic Cited Medium: Internet ISSN: 1468-2044 (Electronic) Linking ISSN: 00039888 NLM ISO Abbreviation: Arch Dis Child Subsets: MEDLINE |
| Imprint Name(s): | Publication: London :, BMJ Pub. Group [etc.] Original Publication: London : British Medical Association |
| Ιατρικοί όροι (MeSH): | Infectious Disease Transmission, Vertical*/prevention & control , Hepatitis B Vaccines*/administration & dosage , Pregnancy Complications, Infectious*/prevention & control , Hepatitis B*/prevention & control , Hepatitis B*/transmission , Vaccination Refusal*/ethics , Vaccination Refusal*/legislation & jurisprudence , Parents*/psychology, Humans ; Pregnancy ; Female ; Infant, Newborn ; United Kingdom ; Vaccination |
| Περίληψη: | Hepatitis B virus (HBV) is a potentially chronic infection that can be transmitted from mother to child with the risk of developing cirrhosis, liver failure and hepatocellular carcinoma. There is a safe and effective vaccine to prevent vertical transmission that is recommended to be given as soon as possible after birth and within 24 hours.When a woman with HBV refuses the birth dose of HBV vaccine for her baby, infectious diseases and safeguarding teams are asked to provide urgent opinions on whether this crosses the threshold for triggering child protection mechanisms.We consider a low-infectivity HBV vertical transmission scenario where there is parental refusal of HBV vaccination and focus on ethical arguments for and against overruling parental refusal in the child's best interests. As an additional resource for clinical and safeguarding teams, we also include the anonymised transcript of the only available UK court judgement to our knowledge that addresses the issue of decline of HBV vaccine to prevent vertical transmission.We propose a dialogue process for managing scenarios where a pregnant woman with HBV has concerns about vaccinating her baby when born, which is the basis of the current UK Health Security Agency guidance. (© Author(s) (or their employer(s)) 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.) |
| Competing Interests: | Competing interests: GT-W is Chair of London-Central Research Ethics Committee, Health Research Authority. AME has received consulting fees from GSK, consulting fees and honoraria from Gilead and consulting fees, honoraria and support for attending meetings from Ipsen. MER’s directorate at UKHSA has provided vaccine manufacturers with post-marketing surveillance reports on meningococcal, Haemophilus influenzae, and pneumococcal infections, which the companies are required to submit to the UK Licensing Authority in compliance with their risk management strategy. A cost recovery charge is made for these reports. AJP is Chair of UK Dept. Health and Social Care’s (DHSC) Joint Committee on Vaccination & Immunisation (JCVI), Chair of WHOs Salmonella TAG and was Member of WHOs SAGE until 2022. He is a contributor to intellectual property licensed by Oxford University Innovation to AstraZeneca. He has received grants from: Bill and Melinda Gates Foundation, Wellcome Trust, Coalition for Epidemic Preparedness, Medical Research Council, National Institute for Health and Care Research, AstraZeneca, European Commission, and Serum Institute of India. He has received mRNA materials from Moderna and Consulting fees for Shionogi. The views expressed in this article do not necessarily represent the views of DHSC, JCVI, NIHR or WHO. JS is a consultant for Bayer Bioethics Committee and an advisor of AminoChain, Inc. and a Bioethics Advisor to the Hevolution Foundation. All other authors have no conflicts of interest. |
| Contributed Indexing: | Keywords: Child Health; Communicable Diseases; Ethics; Virology |
| Substance Nomenclature: | 0 (Hepatitis B Vaccines) |
| Entry Date(s): | Date Created: 20250908 Date Completed: 20251119 Latest Revision: 20260714 |
| Update Code: | 20260715 |
| DOI: | 10.1136/archdischild-2025-328641 |
| PMID: | 40921482 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1468-2044 |
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| DOI: | 10.1136/archdischild-2025-328641 |