The state’s vaccine advisory committee voted Tuesday to reaffirm and continue the practice of administering the hepatitis B vaccine to all healthy and stable infants within 24 hours of birth in Illinois.
The recommendation once again puts the state at odds with federal health officials who this month voted to end longstanding guidance to give newborns the vaccine to prevent liver infection and chronic disease.
The committee’s recommendations will move to the Illinois Department of Public Health to be formally adopted. The recommendations were reached unanimously Tuesday without any dissent. Earlier this month, Dr. Sameer Vohra, director of the state agency, issued a statement that the guidance wouldn’t change because of the federal committee.
Dr. Marielle Fricchione, chair of the Illinois Immunization Advisory Committee, told the committee during a virtual meeting Tuesday that she did not see any evidence of a public health problem that warranted the change in vaccine recommendation.
“To me, it looked like a successful public health policy, and appropriate for our country and the health care system we have,” Fricchione said. “Looking at the Illinois and the Chicago data, I continue to think that given the gaps in care that we have, this is the appropriate policy.”
The hepatitis B vaccine recommendation is part of the growing division between federal and health officials in Illinois and other states. Tuesday’s vote marked the second time the state has broken with the administration of U.S. Health Secretary Robert F. Kennedy Jr., who has been an outspoken critic of vaccines. In September, the state’s committee recommended the COVID-19 vaccine for almost anyone in Illinois while federal officials declined to recommend it for anyone. Gov. JB Pritzker signed into law earlier this month a bill that enabled the state to follow vaccine guidance from the newly empowered committee rather than the federal government.
For decades, health officials had recommended the hepatitis B vaccine for newborns. But the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices voted to only recommend the dose for newborns whose mothers test positive or weren’t tested. For other babies, it will be up to the parents and their doctors to decide. When a family elects to wait, the CDC committee voted that the vaccination series could begin when the child is 2 months old.
The state’s vaccine committee voted to continue recommending the dose within 24 hours of birth for all medically stable infants who weigh four pounds or more. The committee also unanimously voted in favor of recommending all infants complete the routine hepatitis B vaccine series, which usually includes a second dose when the child is one or two months old followed later by a third dose.
Experts say hepatitis B is more infectious than HIV. The virus, in particular in very young children, can lead to chronic liver disease and cancer.
During Tuesday’s meeting, public health officials from the state and Chicago presented data about hepatitis B along with prevention efforts. Since at least 2018, the state has logged only one confirmed case of a newborn infected with hepatitis B.
“I think this is a testament to the vaccination and post-exposure prophylaxis and follow-up practices that we have had in place,” said Dr. Jennifer Seo, a pediatric medical advisor at the Illinois Department of Public Health, who presented the data to the committee.
In Chicago, health officials use various measures ranging from lab reports to hospital records to birth certificates to identify which newborns could be exposed to hepatitis B, said Dr. Brian Borah, medical director at the Chicago Department of Public Health. He pointed out during his presentation of city data that about 43% of possible cases aren’t identified until after birth.
The demographics of Chicago babies at-risk of contracting hepatitis B has changed over the past decade. In 2015, Asians accounted for about 59% of hepatitis B exposed births, Borah told the committee. That figure decreased over time and last year African Americans accounted for the largest percentage — about 33% — of exposed births.
He noted those demographics differ in other parts of the state.
“Stressing the importance of local public health data to really engage with the needed communities and identify those who are most at risk in every corner of the state,” Borah said.
As members moved to vote on their recommendations, many expressed concern about what they could do to quell the confusion caused by the federal recommendations that will now contradict the state’s own vaccine guidance.
“I think confusion now is going to be the generalized state of being,” said Dr. Edward Linn, a committee member. “... The Illinois Department of [Public] Health and all professional societies should work really hard to constantly educate the public and providers to be able to answer these questions because the federal government agency has thrown it out there. It’s going to come bouncing back to us.”