North East Medical Services Issues Public Comment on CDC Notice

WASHINGTON, Oct. 19 -- Amy Tang, primary care physician and director of immigrant health at North East Medical Services, San Francisco, California, has issued a public comment on the Centers for Disease Control and Prevention notice entitled "Advisory Committee on Immunization Practices: October 20-21, 2021". The comment was posted on Oct. 15, 2021:

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Hello. My name is Dr. Amy Tang, and I am a primary care physician and Director of Immigrant Health at North East Medical Services, a federally funded health center in the San Francisco Bay Area.

I thank the Committee for their consideration of a recommendation for universal adult hepatitis B vaccination, and urge them to vote in favor of this proposed update.

The U.S. government made a goal to eliminate hepatitis B by 2030 with hepatitis B vaccination serving as the strongest tool to accomplish this goal. And yet only 25% of the U.S. adult population is fully vaccinated against hepatitis B. As someone who is committed to hepatitis B education and awareness among patients and primary care providers, it is disheartening to see the rise in acute hepatitis B infections associated with the opioid epidemic when we have the tools to prevent new infections and eliminate viral hepatitis B.

As a primary care provider, I am all too familiar with the competing demands of busy front-line clinicians and the challenges in remembering the long list of indications for vaccines that are not universally recommended. While age cutoff recommendations, e.g. Shingrix vaccine for adults over all adults over 50 years old or PPSV23 for all adults over 65 are simple enough to remember, the current laundry list of risk-based indications for hepatitis B vaccine are an impediment to hepatitis B vaccination as providers are less likely to recommend vaccination and patients less likely to accept, when the risk-based indications may be taboo or overly specific. These missed opportunities for vaccination can be costly. One in four individuals living with chronic hepatitis B will develop serious liver conditions such as liver cancer or cirrhosis--both of which are conditions that are expensive to treat even if a person has insurance.

Many of the groups who are at-risk for hepatitis B do not have access to traditional healthcare facilities or may experience significant barriers to care. This includes people experiencing homelessness, people who inject drugs, and immigrant communities.

We have the tools to achieve hepatitis B elimination for future generations; it is up to us to use them. As a trusted authority and guiding body for the country's immunization response, the hepatitis B community needs the support of ACIP in order to work towards eliminating viral hepatitis in the U.S.

Thank you again for the opportunity to provide comment.

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The notice can be viewed at: https://www.regulations.gov/document/CDC-2021-0098-0001

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