West Coast Health Alliance challenges new hepatitis B vaccine guidance
Alliance says ending birth dose recommendation increases infection risk
– The West Coast Health Alliance said hepatitis B vaccination should continue to be routinely offered to all newborns, with the first dose given within 24 hours of birth for newborns weighing at least 2,000 grams, or 4 pounds, 7 ounces, followed by completion of the vaccine series. The recommendation aligns with the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the Infectious Diseases Society of America.
The organization disagreed with recent changes made by the Advisory Committee on Immunization Practices. The committee voted to end the universal recommendation for hepatitis B vaccination at birth, a strategy that has reduced pediatric hepatitis B infections in the United States by 99 percent. The committee also voted that parents should consult their provider regarding blood tests following each dose of the vaccine series. The West Coast Health Alliance stated that no credible evidence was presented to support either change. Officials said delaying the birth dose and using blood tests to guide vaccination will lead to more children and adults developing preventable liver disease and liver cancer, with no evidence of a safety benefit.
A review by the Vaccine Integrity Project found that the vaccine is safe regardless of when it is given and that delaying the first dose increases the risk of infection and jeopardizes completion of the full series. Officials said many with chronic hepatitis B do not know they are infected, and infants may unknowingly be infected by household and other contacts after birth. They stated the birth dose acts as a critical safety net to protect newborns from infection. It is not known how long or how strongly children are protected if they do not receive a complete series. The recommendation to obtain blood tests to guide the number of shots will subject infants to unnecessary blood draws, increase health care costs, delay immunization, and reduce protection against infection. Completion of the vaccine series offers the best protection, according to the organization.
Hepatitis B is a highly infectious virus that attacks the liver and can cause chronic liver disease, liver cancer, liver failure, and death. It spreads easily, even without visible blood or body fluids, and can survive on surfaces for up to seven days. Before universal infant vaccination began in 1991, thousands of children in the United States were infected each year, both at birth and during childhood. Up to 90 percent of infants infected at birth develop chronic infection, and 25 percent of infected children die prematurely from hepatitis-related disease.
Officials stated that the hepatitis B vaccine is effective and well-tolerated, with decades of global data supporting its safety. They said it should continue to be offered to all parents at birth. Universal vaccination within 24 hours of birth, followed by completion of the series, is essential to protecting infants and young children.
The West Coast Health Alliance was formed to ensure that public health recommendations are guided by science, effectiveness, and safety. The organization said changes in federal leadership, reduced transparency, and the compromise of advisory panels have raised concerns about the federal government’s ability to address public health challenges.
California, Oregon, Washington, and Hawaii formed the alliance to uphold the integrity of public health strategies. Through this partnership, members will collaborate on reviewing science and evidence to make unified recommendations supporting safety, efficacy, transparency, access, and trust.
The alliance established goals that include working together to ensure the public has access to credible information, coordinating to reduce confusion and increase trust in public health, providing evidence-based position statements and policy recommendations, seeking alignment with national professional organizations, and sharing tools and best practices.
The alliance also outlined shared principles. These include affirming access to quality health care and information, committing to science-based policies supported by research and clinical expertise, maintaining transparent communication to build trust, recognizing the responsibility to promote public health, prioritizing equitable access to care, affirming Tribal sovereignty, and advocating for coverage of preventive services.
The planned scope of work includes evaluating and responding to threats to national public health policy, reviewing evidence-based scientific information, developing unified public health recommendations, and addressing communication needs, including countering misinformation.
More information is available at www.cdph.ca.gov.
