A Centers for Disease Control and Prevention panel that advises the agency on recommendations for vaccines delayed a vote planned for Thursday until Friday on changes for the hepatitis B shot, which it has long recommended for newborns, with major implications for the Bay Area.
The CDC’s Advisory Committee on Immunization Practices is scrutinizing the hepatitis B vaccine for newborns, as part of U.S. Health Secretary Robert F. Kennedy Jr.’s campaign to reduce the vaccinations that Americans receive. Kennedy argues that vaccines have health risks, including the development of autism, and he has singled out the hepatitis vaccine that babies receive. However, respected medical associations call his assertions dangerous and not grounded in evidence.
Hepatitis B is a common viral infection, but it can lead to chronic cases bringing cancer and liver disease. It’s highly infectious and is usually transmitted from mother to child.
In the Bay Area, more than 100,000 people have hepatitis B, a 2018 study found. Asian American and Pacific Islander residents are disproportionately affected — often, because they’re immigrants who came to California from another country where they were not vaccinated.
In Santa Clara County, nearly 95% of people with hepatitis B are Asian American or Pacific Islander, according to the study by researchers at Stanford University.
The CDC has recommended for decades that all infants should be vaccinated to protect against hepatitis B, as well as older children and adults who have not received the shots.
“The best way to prevent hepatitis B is by getting vaccinated,” the CDC’s website read on Thursday. “You need to get all shots in the series to be fully protected.”
The vaccine panel on Thursday was expected to rescind the CDC’s recommendation that newborns receive a vaccine. The panel’s members delayed that decision during a meeting in Atlanta, with some saying they were confused about the proposal and others expressing concern.
The panel’s members “didn’t quite know what they were voting on, which is why they delayed the vote until tomorrow,” said Dorit Reiss, a law professor at UCSF who studies vaccine policies.
Reiss said she expected the advisory panel to do away with the vaccine recommendation for newborns on Friday, when it will meet again.
“It’s been demoralizing, to put it bluntly,” she said. “I think what you’re seeing is a committee that is biased, unscientific and doesn’t quite know their role.”
Dr. Samuel So, a Stanford School of Medicine professor and surgeon whose specialty is managing chronic hepatitis B infections and the treatment of liver cancer, called the CDC panel’s scrutiny of the vaccine for newborns “ridiculous” and “amazing.”
“There’s no scientific rationale for withholding the vaccine for newborns,” he said.
So said the CDC’s recommendation, in the 1990s, prevented a generation of children from becoming infected in the U.S. Most cases of hepatitis B, he said, are in adults who were not vaccinated as children — often because they were born in another country.
“The benefit is so huge,” the doctor said.
And people who are infected as babies, So said, have the highest risk of developing a chronic case of the virus. From there, the statistics are grim: one in four chronic cases leads to liver cancer, he said; the survival rate of that cancer is 20% after five years.
The Stanford doctor and other experts said that parents should continue to have their child vaccinated to protect against hepatitis B, regardless of what the CDC advisory panel may decide on Friday.
For months, the panel has considered if it should recommend the shot only for newborns with infected mothers. The panel had punted a vote in September, when some members also expressed confusion over their plans. That same month, the panel rolled back recommendations for the COVID-19 vaccine and for the combined measles, mumps, rubella and varicella vaccine for children under 4 years old.
In the Bay Area, Santa Clara County saw 13,254 new diagnoses of hepatitis B from 2014 to 2023, with a disproportionate number in Asian American and Pacific Islander residents. The 2018 study found that the county had the second-highest rate of hepatitis B in California, second only to San Francisco.
“We know we have a population at outsized risk,” said Sarah Rudman, who leads the Santa Clara County public health department.
The CDC panel’s recommendations aren’t legally binding, but the agency and insurers typically follow its lead. An exception came this fall, when major health insurers in Northern California pledged to continue covering COVID-19 shots for younger adults and children.
And Gov. Gavin Newsom, as part of his policy wars with the Trump administration, joined a “health alliance” with neighboring Democratic states that issued different vaccination guidelines than the CDC’s. Those guidelines on COVID-19 vaccines aligned closely with those of major medical associations.
It wasn’t immediately clear if the West Coast Health Alliance would again buck the CDC and maintain the recommended hepatitis B dose for babies. The governor’s office did not respond to a request for comment.
If the CDC panel changes course, Rudman said the county’s public health strategists will evaluate the best science and stances of medical associations, experts and other groups to decide what to recommend to patients in the South Bay. Santa Clara County has high vaccination rates for hepatitis B, she said, and local health care providers “continue to follow the science.”
