Santa Barbara County Department of Public Health ‘Definitely Concerned’ by Federal Withdrawal of Vaccine Recommendation 

The Center for Disease Control’s (CDC) panel of vaccine advisors made the controversial decision last week to scratch the universal hepatitis B birth dose from childhood vaccine recommendations.

In an 8-3 vote, the federal committee ended the recommendation that all newborn babies be immunized at birth against hepatitis B — a highly contagious virus linked to severe liver disease, cancer, and even death.

What this means for the health of Santa Barbara County, and the nation, is yet to be seen, but experts worry about future implications. 

For decades, starting in 1991, it was recommended that newborns in the U.S. be immunized at birth against hepatitis B. Now, at-birth vaccinations against the virus will only be recommended if their mother is known to be infected with hepatitis B or her status is unknown. 

Called the Advisory Committee on Immunization Practices, this federal panel decided that women who test negative for hepatitis B should consult with their doctor and decide “when or if” their child will receive the vaccine at birth. They suggested that an infant get the vaccine no earlier than two months after birth.

While it’s “hard to predict the future,” hepatitis B is very infectious and very deadly, warned Joy Jacobsen, the senior epidemiologist with the Santa Barbara County Public Health Department. Because it’s so infectious, the state of California has long required children be vaccinated against hepatitis B to attend school or daycare, with limited available exemptions. 

The virus is most commonly passed from an infected mother to her child, through blood or bodily fluids. But otherwise, anti-vaccination advocates claim that the infection is primarily spread through sexual contact or drug use. Therefore, they argue, immunizing newborns is unnecessary if their mothers test negative for the virus.

This argument is echoed by RFK Jr. and his allies. One panelist, Retsef Levi, a professor at the Massachusetts Institute of Technology, has claimed that the risk of childhood infection is “extremely low.” 

It ties into RFK Jr.’s expressed desire to trim the childhood vaccine schedule, which he has suggested is bloated with unnecessary shots.

In reality, the hepatitis B virus has been shown to survive on surfaces for up to seven days, meaning an infant could be exposed if anyone in their household is infected. The risk is made worse by the fact that about 70 percent of Americans with hepatitis B are unaware they have the virus.

“For example, someone who doesn’t wash their hands properly could still have traces of fecal matter on them, and that could accidentally infect a baby or child and cause serious problems,” Jacobsen said. “So we are definitely concerned.”

She cited the American Academy of Pediatrics, noting that 90 percent of infants infected at birth will develop chronic hepatitis B infection. Among those with chronic infection, 25 percent will die prematurely from disease at some point in their life. 

“That doesn’t mean as a child, that could be even a middle aged adult who died sooner than they should have, if they had been protected and didn’t have Hepatitis B infection,” she explained. 

She added, “We stand in alignment with the West Coast Health Alliance, the California Department of Public Health and the American Academy of Pediatrics and continue to recommend hepatitis B vaccinations at birth in order to keep our community healthy.”

While the county health department does not have data on infections from before the vaccine recommendation went into effect in 1991, the numbers it does have show extremely low case numbers. Since 2010, the earliest the county’s data goes back, only one case of perinatal hepatitis B has been recorded in the entire county (it was in 2013). 

The original recommendation from the federal vaccine panel that all infants be vaccinated against hepatitis B was followed by a significant drop in pediatric cases across the country, falling 98 percent from 1990 to 2006 in children under 15.

This recent decision being so at-odds with the majority opinion of the medical community could be blamed on Health and Human Services Secretary Robert F. Kennedy Jr., who recently changed the entire makeup of the vaccine panel to better align with his anti-vaccine sentiments. The presenters who made the case against the birth dose to the panel were not medical doctors — nor were their presentations vetted by experts, according to Politico. 

“We know it’s [the vaccine] safe, and we know it’s very effective,” said Dr. Cody Meissner, a panelist and professor of pediatrics at the Dartmouth Geisel School of Medicine, during the December 5 meeting. If this new recommendation goes into effect, he warned, “we will see more children and adolescents and adults infected with hepatitis B.”

The change will take effect only if the CDC approves it and is not anticipated to impact insurance coverage.