Despite a vote Friday by the Centers for Disease Control and Prevention's vaccine advisory committee to remove a recommendation for the hepatitis B vaccine at birth, Los Angeles County officials affirmed they will continue following existing state health guidelines.
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The Los Angeles County Department of Public Health stated it will adhere to the California Department of Public Health guidelines on hepatitis B vaccination, which recommends that all children receive hepatitis B vaccine as early as possible. There are no modifications to immunizations schedules or vaccine availability for county residents, at this time, according to officials.
For more than three decades, universal hepatitis B birth dose vaccination has been a cornerstone of perinatal hepatitis B prevention in the United States, according to DPH.
"As with all other immunizations, medical providers work with each family to ensure families are informed of the recommendations and reasoning for the vaccine before any medical services are provided to infants," DPH said in a statement. "Because of the implementation of the universal birth dose vaccine strategy, the U.S. has been on the path of eventual elimination of hepatitis B as a major public health threat."
On Friday, the CDC's Advisory Committee on Immunization Practices voted to make vaccine recommendations based on the mother's testing status. In other words, if a mother tests negative for hepatitis B, parents should decide, with the guidance of their doctor, whether the vaccine is appropriate for their newborn.
The recommendation noted that newborns who do not receive the hepatitis B vaccine at birth can get an initial dose no earlier than 2 months old.
As part of the advisory committee's vote, there was no change to guidance for babies born to women who test positive for hepatitis B or have unknown status to be vaccinated.
L.A. County DPH criticized the decision and described it as a "return to selective, risk-based newborn vaccination," which officials argued was "not based on new evidence suggesting that hepatitis B vaccine birth dose is unsafe or ineffective."
In Los Angeles County, due to the implementation of the universal birth dose and the partnership between DPH, health providers and parents, perinatal hepatitis B infection is extremely rare. DPH recorded only one case in the past five years.
DPH officials argued that a risk-based strategy was shown to be inadequate more than 35 years ago, and can reintroduce preventable risks, in particular in communities such as L.A. County where hepatitis B prevalence and risks are higher.
Infants infected at birth with hepatitis B can face a high risk of lifelong consequences. Up to 90% develop chronic hepatitis B infection, compared with 5%-10% of adults, and at least 25% die prematurely from cirrhosis or hepatocellular cancer -- which can be preventable when early immunization is reliably delivered.
Universal hepatitis B vaccination at birth serves as a critical safety net, according to DPH, noting the policy helped the county and the United States make significant progress toward eliminating perinatal hepatitis B transmission.
The vaccine carries minimal risks while preventing lifelong conditions such as chronic liver disease and liver cancer. Adverse events following hepatitis B vaccine administration are mild and include pain, redness or swelling at the site of injection and mild systemic reactions which are signs of a normal immune response, DPH said.
"Public Health remains committed to ensuring that all people who live in Los Angeles County have continued access to affordable, safe and effective vaccines and will continue to advocate for vaccine recommendations that are grounded in credible, transparent and science-based evidence. Individuals with questions about the hepatitis B vaccine should contact their health care provider," according to a statement from DPH.
More information on hepatitis B vaccination can be reached at ph.lacounty.gov/perinatalhepb.
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