The West Coast Health Alliance (WCHA), in partnership with the California Department of Public Health (CDPH) and several national medical organizations, continues to recommend that all newborns receive the hepatitis B vaccine within 24 hours of birth. This position follows recent changes by the Advisory Committee on Immunization Practices (ACIP), which voted to end the universal recommendation for infant hepatitis B vaccination at birth.
According to WCHA, this change departs from a strategy that has reduced pediatric hepatitis B infections in the United States by 99 percent. The ACIP also advised that parents consult healthcare providers about blood tests after each dose of the vaccine series. WCHA asserts there was no credible evidence presented for these modifications.
“Delaying the birth dose of hepatitis B vaccine and using blood tests to guide vaccination will lead to more children and adults developing preventable liver disease and liver cancer with no evidence of a safety benefit,” states WCHA.
A review conducted by the Vaccine Integrity Project concluded that there are no safety advantages to delaying the first dose, regardless of timing. Delaying increases infection risk and may compromise completion of the full series needed for long-term protection. The report notes many individuals with chronic hepatitis B are unaware they are infected, and infants can contract it from household contacts shortly after birth. The initial vaccine dose is described as an essential safeguard against infection.
WCHA further warns that recommending blood tests to determine dosing would expose infants to unnecessary procedures, raise healthcare costs, delay immunization, and reduce protection levels. Completion of the full vaccine series is cited as providing optimal defense against infection.
Hepatitis B is characterized as a highly infectious virus affecting the liver, potentially leading to chronic illness or death. It can be transmitted even without visible fluids and survive on surfaces for up to seven days. Before universal infant vaccination began in 1991, thousands of children were infected annually in the U.S., often at birth or during childhood. Up to 90 percent of infants infected at birth develop chronic infection; one quarter die prematurely due to related diseases.
Medical organizations such as the American Academy of Pediatrics, American College of Obstetricians and Gynecologists, and Infectious Diseases Society of America support continuing routine newborn vaccination practices.
WCHA was established by California, Oregon, Washington, and Hawaii with a focus on ensuring public health decisions are informed by science and best practices amid concerns about federal transparency and advisory panel integrity. The alliance’s charter emphasizes principles including access to care, scientific rigor, transparency, public responsibility, equity—including respect for Tribal sovereignty—and advocacy for preventive services coverage.
Its objectives include sharing information with the public; coordinating messaging among states; providing evidence-based recommendations; aligning with respected professional groups; exchanging tools; reviewing emerging threats; analyzing data from clinical sources; developing unified policy statements; addressing misinformation; and promoting access across communities.
