The state’s top public health official expressed confidence about maintaining access to vaccines in Massachusetts on Wednesday, a day before a federal advisory panel meets and potentially drastically upends the pediatric immunization landscape.
“For many of us, what is happening tomorrow at ACIP’s meeting is painful,” said Department of Public Health Commissioner Dr. Robbie Goldstein, referring to the CDC’s Advisory Committee on Immunization Practices.
Goldstein, an infectious disease physician, previously worked at the CDC.
During its two-day meeting on Thursday and Friday, ACIP members will discuss and potentially vote on delaying the hepatitis B vaccine birth dose to one month after delivery. The panel will also discuss potential changes to the childhood and adolescent immunization schedule.
Hepatitis B infections can cause serious long-term health issues, such as liver disease. ACIP postponed its vote on the vaccine during its September meeting.
Wary of how the upcoming meeting could exacerbate vaccine hesitancy and misinformation, Goldstein, Gov. Maura Healey and health care providers gathered at DPH’s downtown Boston office Wednesday with the aim of hashing out strategies to restore public trust.
“I think in many ways, no matter what is decided tomorrow, no matter what vote happens, I think the damage to trust has already happened, and so we need to do everything we can to rebuild,” Goldstein said.
The governor thanked providers, telling them, “I know you’re spending a lot of time having to talk to people, having to explain things to people that you never had to explain before because there wasn’t so much sowing of misinformation out there.”
Exercising its new authority to extricate Massachusetts from ACIP policymaking, DPH last week issued a recommendation to maintain universal hepatitis B vaccines for all newborns. Delaying the birth dose would be “disastrous,” Goldstein said, as he noted that pediatric infection rates have dropped by 99% nationwide since 1991 when the CDC recommended that all babies receive the hepatitis B vaccine within 24 hours of birth.
Goldstein also voiced concern about possible shifts to the broader childhood vaccine schedule, warning changes could “introduce confusion, widen disparities and undermine decades of progress.”
The commissioner, asked how DPH will ensure vaccine availability should federal guidance change, said, “I’ll first call out that we have in the room here some of the manufacturers of the vaccines, and they’ve been great partners in our work to maintain access here in Massachusetts.”
“We’re going to continue to work with the manufacturers, many of which are based here, so that we can purchase the vaccines that are necessary, and we can get those out to communities as they need them,” Goldstein said. “For the hepatitis B vaccine, we work closely with the birthing hospitals — those are the folks that give that first dose — and then work with the pediatricians, many of which are here and represented here, so that they can have access to the vaccines.”
Goldstein noted that Massachusetts has a program that provides universal vaccine access for children.
“We’re going to continue to rely on that infrastructure to get vaccines out for children, whether they have Medicaid or MassHealth insurance, they’re commercially insured, or if they’re uninsured in the state,” he said. “But we have some work to do on the back end, and we’ve been doing that diligently over the past six to eight months, so that we’d be prepared for this moment.”
Kennedy in June terminated all 17 ACIP members and reconstituted the panel, stoking criticism among state leaders like Goldstein and Healey.
“ACIP safeguards the health of Americans by issuing objective, evidence-based vaccine recommendations,” Kennedy said in September.
Asked about the possibility of Massachusetts experiencing federal retaliation for defying hepatitis B guidance, Goldstein said the commonwealth didn’t face pushback for issuing its own COVID vaccine recommendations earlier this year.
“What we’re doing is the right thing for individuals, it’s the right thing for newborns, it’s the right thing for families, so we don’t want to back down from doing what’s right just because of the fear of what might come back to us,” Goldstein said.
