Dr. Debra Bogen and Dr. Val Arkoosh: Protect Pa. children from hepatitis B infection

This week, the Advisory Committee on Immunization Practices (ACIP), the group that advises the U.S. Centers for Disease Control and Prevention (CDC) on vaccines for all Americans, will discuss whether to change its recommendations for the hepatitis B vaccine. Their vote could negatively affect the health of children and families across the commonwealth.

Hepatitis B is a bloodborne virus that can infect children and adults, but infants are uniquely vulnerable to this infection. The hepatitis B virus can be transmitted to infants in the womb but can also be acquired by infants after birth through close contact with the virus. Infants who become infected have a 90% chance of developing lifelong infection, compared to less than a 5% chance for adults who get infected. Chronic hepatitis B infection has a high chance of leading to scarring of the liver, liver failure, liver cancer, and even death.

Proper vaccination, however, starting with a dose at birth, can prevent those chronic symptoms and fatalities altogether. Since 1991, when the CDC and the American Academy of Pediatrics (AAP) first recommended hepatitis B vaccination of newborns, hepatitis B infections in children decreased by 99%. In fact, no child under 4 years old in Pennsylvania has contracted hepatitis B since 2019.

The tremendous decrease in hepatitis B infections speaks for itself — hepatitis B vaccination prevents disease and saves lives. It is one of the great public health successes of our lifetimes.

Now, ACIP is considering changing its hepatitis B vaccine recommendations — including delaying the first dose currently given at birth – which we know have prevented thousands of children from being infected with the hepatitis B virus.

The Shapiro administration strongly urges the CDC — and ACIP — to maintain current recommendations for the hepatitis B vaccine, including the birth dose.

Hepatitis B vaccination is a cornerstone of public health and one of the most effective tools in preventing chronic liver disease and liver cancer. Decades of evidence demonstrates its safety, effectiveness and essential role in reducing transmission to infants and toddlers. Weakening or removing current hepatitis B vaccine recommendations risks reversing hard-won, lifesaving progress and would have serious implications for public health and vaccine confidence nationwide.

Because tens of thousands of adults in Pennsylvania and across the nation continue to live with chronic hepatitis B infection, infants remain at risk for exposure in their earliest months of life. Routine vaccination at birth — followed by completion of the full childhood series — provides the strongest protection against infection, preventing lifelong chronic disease and future community transmission.

The evidence from Pennsylvania is clear: When vaccines are recommended and accessible, disease declines; when access falters, preventable infections return.

Any weakening or removal of the CDC and ACIP recommendation for hepatitis B vaccination would carry grave implications. A shift in recommendation could translate into reduced insurance coverage and access, confusion among patients and clinicians — like ACIP caused earlier this year around the covid-19 vaccine — and ultimately reduced infection prevention. If ACIP abandons the birth dose recommendation of the hepatitis B vaccine, it will be harder for individuals wanting to protect their children from highly contagious hepatitis B.

Join us in promoting healthy communities across Pennsylvania. Visit pa.gov/vaccines to learn more about the latest vaccine recommendations from the Pennsylvania Department of Health and make sure that you and your family are current with the hepatitis B vaccine series and other life-saving immunizations. If you have any questions about vaccines, we encourage you to speak with your primary care provider.

As physicians serving in the Shapiro Administration, we strongly urge that the CDC and ACIP reaffirm the current, broad, universal recommendation for hepatitis B vaccination. This will ensure uninterrupted access to preserve the health of individuals, families, and our community at large.

Dr. Debra Bogen is Pennsylvania secretary of health. Dr. Val Arkoosh is Pennsylvania secretary of human services.