1/ After years of watching the spread of disinformation on this platform, here’s what I’ve learned… 🧵

Special thank you to @doritmi when I get so discouraged and feel “what’s the point,” she uses her brilliance to hammer away at it point by point, a modern day Hannah Arendt educating us, she’s an intellectual giant, and I’m grateful for her advice and wisdom in these dark times

Khao Phi Phi. Monkey Beach

TWiV 1277: Vaccine talk with Jake Scott https://t.co/zTvqL4NoaV via @YouTube

7/ So yes—Hep B vaccination is cheap. What’s expensive? Lifelong antiviral therapy, liver scans, biopsies, hospitalizations, and transplants. Preventing a chronic, cancer-causing virus for $10–30 is one of the best deals in public health history.

6/ Economists call Hep B vaccination a “high-value intervention.” Every dollar spent on Hep B vaccines saves more than $10–20 in avoided medical costs, depending on the model. This is before you even account for productivity, disability, or lost income.

5/ When you add it all up, the lifetime cost of chronic Hepatitis B infection in the U.S. is often estimated at $200,000–$500,000 per patient, and can exceed $1 million if advanced liver disease develops. Compare that to a vaccine that costs less than dinner.

4/ Chronic Hep B leads to cirrhosis or liver cancer in 15–40% of patients. Treating these complications is expensive: • Liver cancer care routinely reaches $50,000–$200,000+ • A liver transplant? Typically $500,000–$1,000,000 including post-operative care.

3/ Antiviral medications alone (e.g., tenofovir, entecavir) can cost $300–$1,200 per year depending on the country and insurance. Since therapy is often lifelong, the cost quickly exceeds tens of thousands of dollars per patient.

2/If someone becomes chronically infected with Hep B, the cost burden is enormous. Chronic HBV requires lifelong monitoring, repeat lab tests, antiviral therapy, liver imaging, and sometimes hospitalization. Annual medical costs average $3,000–$6,000/year in high-income countries

The Hepatitis B vaccine is one of the cheapest, most cost-effective medical interventions ever developed. A full 3-dose series for an infant typically costs $10–30 globally (even less in some programs). Now compare that to the cost of not vaccinating…

https://t.co/Q4bBg5iei3

Under RFK Jr., the CDC provides a megaphone to the anti-vaccine movement. My comments with ⁦@bylenasun⁩ ⁦@washingtonpost⁩

As a liver doctor who has treated patients with hepatitis B for decades, this change to the vaccine schedule is a mistake. The hepatitis B vaccine is safe and effective. The birth dose is a recommendation, NOT a mandate. Before the birth dose was recommended, 20,000 newborns a

~260M ppl worldwide have chronic HepB Prior to mass vax ~18K kids <10 were infected/year. About half came from vert transmission ~2K ppl die each year in the U.S. nowadays from HepB Vaccine profile is extremely safe She doesn’t know what she’s talking about🙄

Clowning On Pseudoscience Frauds with Dave Farina @ProfessorDaveExplains https://t.co/zUB2rs8NYJ via @YouTube

Today seems like a good day to revisit why screening for hepatitis B and selectively offering newborn vaccinations sounds like a good idea, but has fallen short in the past, and is likely to fall short - and cause more harm than good to children- in the future…

10/ Bottom line: • Infection risk in infancy is severe (90% chronic). • Vaccine effectiveness is >95%. • Serious AEs are ~1 per 1,000,000 doses. This is one of the highest benefit–lowest risk interventions in modern medicine.

9/ Multiple large studies find no causal link between the Hep B vaccine and GBS, MS, seizures, or autoimmune disease. Refs: Verstraeten et al., Pediatrics 2008; DeStefano et al., Pharmacoepidemiol Drug Saf 2012; Mouchet et al., Vaccine 2018.

8/ Serious adverse reactions are extremely rare. Anaphylaxis: 1.1 per million doses. Ref: McNeil et al., J Allergy Clin Immunol 2016 (25 million-dose VSD analysis). No evidence of increased neurological or autoimmune risk.

7/ Safety: The largest review—14 million doses—found no unexpected safety signals. Ref: McNeil et al., Vaccine 2019 (VSD). Across 3 decades, Hep B vaccine consistently ranks among the safest vaccines ever deployed.