Babies should continue to get the hepatitis B vaccine shortly after birth, the West Coast Health Alliance said late Friday afternoon — disagreeing with a federal vaccine advisory committee's new recommendation to delay the shots.
The multistate group, which includes Washington, Oregon, California and Hawaiʻi, said it strongly supports the guidance that's been in place for 30 years, that all newborns weighing at least 4 pounds, 7 ounces should receive the first dose of the vaccine within 24 hours of birth.
The West Coast Health Alliance's recommendation pushes back against an 8-3 decision earlier Friday from the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices, which says parents should first discuss with providers whether to give the vaccine at all, and if so, wait to begin the three-shot series until their baby is at least 2 months old.
The federal committee's change lacks credible evidence" and will lead to more children and adults developing liver disease and cancer, the alliance said in a statement. The states' group aligns with guidance from other professional medical organizations in the U.S., including the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists and the Infectious Diseases Society of America.
Dr. Helen Chu, an infectious disease doctor and vaccine researcher at UW Medicine, said in a news conference after the decision that she worries the vote will further erode public perception and trust in the CDC.
"A lot of the data that was discussed over the course of the last two days was not true," said Chu, who used to serve on the vaccine committee before all 16 previous members were fired by Health Secretary Robert F. Kennedy Jr. this year. "And to put that on a public platform and have it available to everyone, it just legitimizes it and creates a sense of distrust in the entire system."
The federal guidance, if adopted, should still allow the vaccine to remain available to those who want it and continue to be covered by insurance, Chu noted.
The change still has to be approved by Kennedy or Jim O'Neill, acting director of the CDC, before it becomes part of the agency's immunization schedule.
The new federal guidance does not change recommendations for babies born to mothers who test positive for hepatitis B during pregnancy or whose hepatitis B status is unknown. Those infants should still receive a dose of the vaccine within 12 hours of birth, the guidance says.
But an end to the universal vaccination policy for hepatitis B will likely mean the virus that attacks the liver will become more widespread, infectious disease doctors say.
Following the adoption of the policy in 1991, the U.S. saw pediatric hepatitis B infections drop by 99%, Chu said.
Hepatitis B can cause chronic infection and progress to liver disease or cancer, said Dr. Shireesha Dhanireddy, UW Medicine's associate chief medical officer and an infectious disease physician.
Infants are especially vulnerable; about 25% of children with infections die prematurely from hepatitis-related disease, according to the West Coast Health Alliance. The vaccine is effective, safe and well-tolerated, the alliance said.
Dhanireddy said the ACIP's Friday vote was disappointing, but not unexpected.
"It becomes an issue of equity," she said in an interview. "Somebody has to have the time to discuss risk and benefits. For parents who may not be knowledgeable about previous recommendations and rationale, that's going to lead to inequity.
The West Coast Health Alliance was created in September to issue public health recommendations that are unified and evidence-based, after federal regulators shifted U.S. approval on COVID-19 vaccines to include just a portion of the population. The alliance has also issued recommendations around immunizations for respiratory viruses this fall.
Other states throughout the country, including in the Northeast, have formed similar coalitions to coordinate public health response following this year's changes in CDC leadership and policy.
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