In this episode, Pennsylvania Secretary of Health and ASTHO member Dr. Debra Bogen joins us to break down a major change in national vaccine guidance, and why it has sparked concern among pediatric and public health leaders. Dr. Bogen explains the recent ACIP vote that weakened the long-standing recommendation for all newborns to receive the hepatitis B vaccine within 24 hours of birth, a practice that has nearly eliminated the disease in young children since the early 1990s. She shares why this shift could create confusion for parents, what’s at stake for infant health, and how Pennsylvania is doubling down on clarity, access, and science-based information, including through a recent executive order from Pennsylvania Governor Josh Shapiro. Dr. Bogen also speaks to the broader moment facing public health, from rising misinformation to the importance of unified, evidence-driven messaging.
Cultivating a Culture of Community and Belonging in the Workplace | ASTHO
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This is Public Health Review
Morning Edition for Thursday,
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December 11th, 2025.
I'm John Sheehan with news from
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the Association of State and
Territorial Health Officials.
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Today we continue to discuss.
The recent.
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Change in guidance to the
administration of the hepatitis
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B.
Vaccine.
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As voted on by the CDC's
advisory.
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Committee on.
Immunization Practices.
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We know from experience that
when vaccines are recommended
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and accessible, diseases
decline, and when access
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falters, preventable infections
return.
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This is.
Our guest, Pennsylvania
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Secretary of Health, Doctor
Deborah Bogan.
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The Federal Vaccine Advisory
Committee really voted to weaken
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the long standing
recommendations that every
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newborn received the hepatitis B
vaccine within 24 hours of birth
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instead of strengthening access.
Their decision really shows a
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lot of confusion at a time when
parents really need certainty,
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you know, they have a newborn
and they need a good strong
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recommendation.
We are committed to ensuring
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that children continue to have
access to that vaccine here in
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Pennsylvania to ensure that we
can protect children from
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hepatitis B, which can be a
lifelong liver disease.
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And so we know from past
experience that targeted vaccine
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efforts did not eliminate
hepatitis B from children and
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infants.
But since 1991, we've had a
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universal recommendation to give
the vaccine at birth, and we
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have essentially eliminated
hepatitis B from our young
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children and infants in the
United States through this
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effort.
We are truly blessed to have had
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that amazing outcome and we want
to ensure that that continues.
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Yeah.
Based on that history, can you
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give us some idea of what some
possible impacts could be from
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this decision?
Children are at particular risk
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for hepatitis B if they acquire
it in infancy, as a young child.
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If a young infant gets hepatitis
B infection either through
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transmission from mother to baby
or through close family contact
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or caregiver contact in the
first year of life, that they
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have a 90% chance of developing
chronic hepatitis and that
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chronic hepatitis leads to young
age, liver failure and liver
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cancer.
If you're an adult and you get
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hepatitis B, you only have about
a 5% chance of developing
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chronic hepatitis.
So our concern of course by
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eliminating this birth dose is
that we will return to pre 1990
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data where we have children who
acquire this infection who
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didn't need to that we could
have prevented through a
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vaccination effort.
And so we are all concerned that
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in a few years down the road as
fewer and fewer children get a
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hepatitis B vaccine that we will
return to that prior state.
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We know it's completely
preventable through our approach
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that has worked since the 19,
early 1990s, 50% of adults who
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have hepatitis B are not aware
of it.
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And as a result, they are
putting the the people they
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associate with that risk
unknowingly.
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So again, if there's a caregiver
in the home who's got close
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contact with a young infant,
they can inadvertently, through
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just general contact, pass that
infection to a young infant and
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child.
For parents who are looking for
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more of that sort of clear,
concise guidance, what would you
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say in this case?
So I would recommend that
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parents use the American Academy
of Pediatrics as their go to
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source for vaccine guidance.
And I say that because actually
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the American Academy of
Pediatrics has been putting out
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advice for families on
vaccinations for close to 100
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years now, and they base their
recommendations on science and
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evidence.
And they are the organization
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for pediatricians across the
country.
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I am a pediatrician and I can
tell you that our number one
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focus is the safety and
well-being of children.
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Is that the approach that
Pennsylvania is taking?
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In Pennsylvania, our governor,
Governor Shapiro signed on
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October 1st of this year an
executive order to ensure that
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families continue to have access
to vaccines and vaccine
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information across the
Commonwealth.
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And that executive order has
done a number of things.
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One is it made us required the
department to put all of our
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vaccine information in a single
place so that families have a
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single source of information
that we have done and is
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available.
The executive order also
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requires us to provide education
to healthcare providers and to
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families and to create a
workgroup to bring forth best
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practices in that information.
So that is moving forward.
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We have also aligned all of our
state agencies to make sure that
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any role that we play in
vaccination efforts, whether
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it's Medicaid, private insurers,
schools, etcetera, all are
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working together to ensure
access and that we're reducing
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any barriers.
And finally, to ensure that
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there's access to vaccines, if
in the future there is a removal
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of vaccines access in our
communities.
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It strikes me that Pennsylvania
is sort of very representative
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of the larger nation.
It has very, very rural areas.
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It has very urban areas.
Can you sort of describe how
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those challenges that
Pennsylvania faces in sort of
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communicating this information
sort of is representative of the
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nation?
Yeah.
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Pennsylvania is kind of a little
microcosm of the United States
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in that we have diversity in
many areas.
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But I think the message is clear
that people, no matter where you
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live, that you need accurate
information to make good
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decision, right?
As parents, as caregivers, we
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need good scientific information
to be able to make
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recommendations and to make
decisions.
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The challenge we all face in
public health and in medicine is
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that people have choice on where
they get their information.
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And there is unfortunately a lot
of disinformation and
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misinformation that families
receive.
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And so we need to present data
with clarity and honesty so that
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people can make the best
informed decisions they can.
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And that's what we are working
to do, at least at the
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Department of Health and with
all of our other state agencies
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and with all the community
partners that we work with
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across the state.
And do you have any final
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thoughts or maybe some
reflections on this situation?
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It sounds like a very specific
set of guidance for a specific
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vaccine, but it also feels like
a larger moment.
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In public health.
Right.
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The a step meeting that happened
at the beginning of December was
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really focused a lot on
hepatitis B.
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And again I want to reinforce to
people that hepatitis B vaccine
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is available and should continue
to remain available and that
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it's a safe and effective
vaccine at preventing this
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illness in children.
I do think there is a larger
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issue of creating confusion for
families around vaccines in
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general.
And we know that upcoming
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meetings will have other
challenges for us to address in
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public health.
And so making sure that we
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continue to work together as a
community to provide public
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health information that is
consistent.
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And again, all the medical
associations across the country
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and the public health
associations have really spoken
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with one voice about the
importance of vaccines.
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And we need to continue to do
that as a group, really
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countering the disinformation
that that we know is out there
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for families.
And that confusion will
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unfortunately lead to lower
rates of vaccination, which will
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lead to return of infectious
diseases that we have largely
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eliminated if we're not
thoughtful and careful in that
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process.
And so we are all working hard
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to make sure that that isn't
what happens in our country.
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And me personally working here
in Pennsylvania.
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Doctor Deborah Bogan is an ASTO
member and the Pennsylvania
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Secretary of Health.
Be sure to tune in to the FIG
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Impact Report on Tuesday,
December 16th.
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We'll review a FIG Impact Report
interview with ASTO Member
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Patricia Tilley, Associate
Commissioner of the New
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Hampshire Department of Health
and Human Services, on the
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critical needs the Public Health
Infrastructure Grant has helped
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with in her state.
Our latest ASTO brief, Creating
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a Culture of Community and
Belonging in the Workplace,
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reveals how leaders can break
down silos, build trust, and
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create environments where every
employee feels valued,
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supported, and empowered to
grow.
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Discover practical strategies to
boost innovation, engagement,
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and team connection.
Learn how to cultivate a culture
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of community and belonging by
visiting asto.org to read the
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brief or find a link in our show
notes.
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This has been Public Health
review MORNING edition.
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I'm John Sheehan for the
Association of State and
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Territorial Health Officials.
