Marin health leaders defend vaccines against federal skeptics

Marin County health officials are pushing back against moves by the federal Centers for Disease Control and Prevention to sow doubt regarding the safety and effectiveness of vaccines.

This month the Advisory Committee on Immunization Practices voted to change its recommendation on when infants born to women who test negative for hepatitis B, a serious viral liver disease, should be vaccinated for the virus.

For the last 30 years, the advice was that they should receive their first dose within 24 hours of birth. The committee’s new recommendation is that vaccinations be delayed until the child is 2 months old.

“This vote represents another step backward for child health at the national level, but it does not change what we know to be true,” Marin County Public Health Officer Dr. Lisa Santora said in a statement.

“The hepatitis B vaccine at birth has a well-established safety and effectiveness record and is consistently supported by medical and scientific evidence,” Santora said. “Our responsibility is to base newborn care on sound science, not political considerations, to prevent vaccine-preventable diseases.”

Vaccination within 24 hours of birth has been considered essential since the hepatitis B virus can be transmitted during delivery, and mothers may be unknowingly infected or receive false-negative test results.

Santora said that waiting until later in life does not offer the same protection. Ninety percent of infected infants develop lifelong infection, a rate far higher than in older children or adults. Lifelong infection greatly increases the risk of cirrhosis, liver cancer and premature death.

The change in the recommendation for hepatitis B vaccinations, however, is just the latest CDC shift in vaccine policy since Secretary of Health and Human Services Robert F. Kennedy Jr. “retired” all 17 previous members of the Advisory Committee on Immunization Practices in June.

“Remember, ACIP was overhauled this spring, when experts were replaced by mostly vaccine skeptics,” Marin’s former health officer, Dr. Matt Willis, said of the Advisory Committee on Immunization Practices in an online newsletter.

In September, the Advisory Committee on Immunization Practices changed its recommendations for receiving the COVID-19 vaccine and the MMRV vaccine, a combination shot protecting against Measles, Mumps, Rubella, and chickenpox. The committee advised that children aged 3 and younger should receive a standalone chickenpox vaccine rather than the MMRV vaccine. The committee recommended that patients consult their health care provider before seeking a COVID-19 vaccination.

Santora doesn’t expect the Advisory Committee on Immunization Practices to stop there with its revision of vaccine recommendations. She said the committee’s recent discussion regarding the potential danger of aluminum in vaccines leads her to believe it may review the entire schedule of vaccines routinely administered during childhood. Aluminum in the form of aluminum salts have been added to vaccines in small quantities for more than 70 years to help boost the immune system response to the vaccines.

“I think they’re moving through a playbook,” Santora said.

The new recommendation for the hepatitis B vaccine is unlikely to have any immediate repercussions for people living in California, Santora said.

“We’re buffered because we have the West Coast Health Alliance,” she said.

In response to the CDC’s change of direction under RFK, the governors of California, Oregon and Washington launched the West Coast Health Alliance in September to provide evidence-based recommendations to their residents regarding who should receive immunizations.

Santora is concerned, however, that if the Advisory Committee on Immunization Practices changes its recommendations for additional vaccines that federal funding under the Vaccines for Children program will be affected. More than half of all childhood vaccines administered in Marin County are provided through that program.

Most of the children in Marin whose vaccinations are funded by the program have parents who are uninsured or on Medi-Cal. The vaccinations are provided through the Marin Community Clinics.

“Almost 100% of our vaccines for children come through the VFC program,” Elizabeth Shaw, MCC’s chief medical officer said of the Vaccines for Children program. “Most of our pediatric population is on Medi-Cal.”

Santora said the Advisory Committee on Immunization Practices’ new recommendation on COVID-19 vaccines has already resulted in reduced access to the vaccine for low-income children in Marin.

Shaw said, “We’re concerned about the funding for the vaccines. I think we’re equally concerned about the impact on parents’ confidence in vaccines and just the confusion that these decisions cause.”

“COVID is a good example of a vaccine where misinformation and disinformation has impacted the uptake from the very beginning,” she said. “The more recent change in the COVID recommendations has continued to impact families’ willingness to get their children vaccinated for COVID.”

In an email Willis wrote, “It’s interesting to watch what is happening nationally today because it’s reminiscent of conversations in Marin 10 years ago. A lot of the same themes are coming up. RFK Jr’s perspective on vaccines is familiar, because it’s similar to the themes that came up here years ago when we had some of the lowest vaccinations in the state.”

By the time that the COVID-19 pandemic arrived, however, perspectives had changed, and Marin had the highest vaccination rate in the state for that virus.

To help families make informed choices on vaccines, Marin County has launched marinhhs.org/vaccine-resources, a new online hub with hepatitis B and other childhood vaccines.

“We are committed to sharing what we know and to updating our guidance if credible new evidence emerges,” Santora said in a statement. “Science evolves, and so does our understanding. Our responsibility is to ensure that families in Marin have accurate, evidence-based information to make informed health decisions.”