WCHA disagrees with CDC’s Advisory Committee’s change to decades-long vaccine recommendation that has reduced pediatric Hepatitis B infections by 99 percent 

• What you need to know: Hepatitis B is a highly infectious virus that attacks the liver and can cause serious illness and death. The hepatitis B vaccination is an effective way to prevent infection and its complications. New ACIP recommendations could lead to more children and adults getting liver disease and liver cancer.

PORTLAND, Ore.—The West Coast Health Alliance (WCHA) strongly supports that hepatitis B vaccination continue to be routinely offered to all newborns, with the first dose of the vaccine given within 24 hours of birth for newborns weighing at least 2,000 grams (4 pounds, 7 ounces), followed by completion of the vaccine series. This recommendation aligns with trusted national medical organizations including the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the Infectious Diseases Society of America.  

ACIP’s change to hepatitis B immunization lacks credible evidence

The Advisory Committee on Immunization Practices has voted to end the universal recommendation for hepatitis B vaccination for all infants at birth—a strategy that has reduced pediatric hepatitis B infections in the United States by 99 percent. The ACIP also voted that parents should consult their provider regarding blood tests following each dose of the vaccine series. There was no credible evidence presented to support either of these changes. Delaying the birth dose of hepatitis B vaccine 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 there are no safety benefits to delaying the first dose. Delaying the first dose increases the risk of infection and jeopardizes completion of the full vaccine series, which is required for long-lasting protection. Many with chronic hepatitis B do not know they are infected, and infants may unknowingly be infected by household and other contacts following birth. The birth dose acts as a critical safety net to protect newborns from infection. It is not known for how long and how strongly children are protected against hepatitis B infection if they don't receive a complete vaccine series. The unproven recommendation to obtain blood tests to guide the number of hepatitis B shots will subject infants to painful and unnecessary blood draws, increase health care costs, delay immunization, and risks decreased protection against infection. Completion of the vaccine series has been shown to offer the best protection. 

Importance of the hepatitis B “birth dose” vaccine

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 the United States adopted a recommendation for universal infant hepatitis B vaccination in 1991, thousands of children were infected each year — both at birth and during childhood. Infants and young children are especially vulnerable: up to 90 percent of infants infected at birth develop chronic infection and 25 percent of infected children die prematurely from hepatitis-related disease.

The hepatitis B vaccine is effective, well tolerated, and decades of global data support its safety. It should continue to be offered to all parents at birth. Universal vaccination of newborns within 24 hours of birth, followed by completion of the vaccination series, is essential to protecting infants and young children, who are at greatest risk from complications from hepatitis B.

“The birth of a child is a precious occasion that should be the start of many years of happiness for a family,” said Dean Sidelinger, M.D., M.S.Ed., health officer and state epidemiologist at OHA. “That happiness should not be marred by an increased risk of a preventable hepatitis B infection. Years of scientific evidence supports hepatitis B vaccination for newborns within 24 hours of birth, which can prevent serious illness and premature death.”

The West Coast Health Alliance

The West Coast Health Alliance was formed to ensure that public health recommendations are guided by science, effectiveness and safety at a time when CDC leadership changes, reduced transparency and the compromise of key advisory panels have called into question the federal government’s capacity to address the nation’s public health challenges.  

New WCHA charter

WCHA has established a charter that lays out the shared principles and scope that guides its work. California, Oregon, Washington, and Hawaii formed the West Coast Health Alliance to uphold integrity of effective public health strategies to protect the health of our communities. Through this partnership, WCHA will collaborate on the review of the best available science and evidence to make unified recommendations that support safety, efficacy, transparency, access, and trust.  

WCHA goals and objectives

The goals and objectives of the WCHA include the following: 

• Work together to ensure the public has access to credible information
• Coordinate to reduce confusion and increase trust in public health
• Provide evidence-based position statements, policy recommendations and guidance
• Seek alignment with respected national professional organizations
• Share tools and best practices 

WCHA Shared Principles

To protect the health of our communities, the West Coast Health Alliance will work to ensure that our public health strategies are based on the best available science. We will independently pursue strategies shaped by our unique laws, geographies, histories, and peoples, using these shared principles as the foundations of our Alliance: 

1. Health as a right: We affirm that all members of our communities should have access to quality health care and information.
2. Science and integrity: We are committed to leading with science and to grounding our policies and recommendations in rigorous research, clinical expertise, and decades of proven public health practice. We commit to reevaluating our recommendations as new data becomes available.
3. Transparency and trust: Our communities deserve clear, transparent communication about health, rooted in science. We will safeguard public trust through honesty, clarity, and accountability.
4. Public health responsibility: We recognize the responsibility entrusted to us to protect and promote the health of the public. We will serve in a manner worthy of that trust, prioritizing prevention and evidence-based care to save lives.
5. Equity at our core: We are committed to giving everyone in our communities the opportunity to attain their highest level of health, and to eliminating barriers to evidence-based care especially for disproportionately impacted or marginalized communities.
6. Tribal sovereignty: We affirm and respect Tribal sovereignty, recognizing Tribes’ authority over their health services. We also acknowledge health disparities impacting Indigenous peoples.
7. Coverage and access: We advocate for full coverage by payors of preventive services. 

WCHA’s planned scope of work

The scope of the WCHA will focus on the following: 

• Evaluating and responding to threats to national public health policy and recommendations
• Reviewing data, information, and reports from credible clinical and scientific professional organizations that use evidence-based methodologies and source materials to assess changes in public health policy
• Develop unified public health position statements, policy recommendations and guidance
• Addressing communications needs and countering mis- and dis-information 

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