Alaska
Hepatitis vaccines credited as life-saving for Alaska children may be upended
Western Alaska, where almost all the residents are Indigenous, used to have the world’s highest rate of childhood liver cancer caused by hepatitis B. After decades of screenings and vaccinations, that problem has been eliminated; since 1995, only one person under the age of 30 has been diagnosed with hepatitis-caused cancer.
Now the Trump administration is seeking to end one of the key tools credited with accomplishing that goal: hepatitis B vaccinations of newborns.
The federal Advisory Committee on Immunization Practices on Friday voted to drop a longstanding recommendation for universal hepatitis vaccines for newborns. That is in accordance with the controversial views of U.S. Health Secretary Robert F. Kennedy Jr., a vaccine skeptic who fired all members of the previous committee and appointed like-minded members to replace them.
Current federal childhood hepatitis B vaccination guidelines recommend one dose of the vaccine at birth, followed by additional doses at intervals through 18 months. The recommendation for newborn vaccinations has been in place since 1991.
The advisory committee, part of the U.S. Centers for Disease Control and Prevention, determined that children under 2 months should not be vaccinated unless their mothers are infected or could be infected by hepatitis B.
Some vaccine critics in the administration, including Kennedy and President Donald Trump themselves, argue — contradicting medical experts and years of medical research — that hepatitis B vaccines for young children are unnecessary, claiming that it is spread primarily or exclusively through adult behavior like sex and sharing of needles for illegal drug use.
“Hepatitis B is sexually transmitted. There’s no reason to give a baby that’s almost just born hepatitis B. So I would say wait till the baby is 12 years old and formed and take hepatitis B,” Trump said at a Sept. 22 news conference.
Those claims are false, said Dr. Brian McMahon, medical and research director of the liver and hepatitis program at the Alaska Native Tribal Health Consortium.
There is no credible evidence of a link between the vaccine and autism of any other health problem, McMahon said.
And sexual transmissions accounted for only a tiny percentage of Alaska’s hepatitis B cases, he said.
Aside from mother-to-infant transmissions, which occur during childbirth, hepatitis B was predominantly spread in Western Alaska through normal daily activities. That is because, unlike the HIV virus or other hepatitis viruses, the hepatitis B virus can live for seven days on surfaces in schools and homes, like tables and personal-grooming items.
“The virus can be found all over, on school luncheon tabletops, counters and homes,” McMahon said. “Kids have open cuts and scratches from bug bites or anything else, and then they shed millions of particles of the virus on environmental surfaces. And then another kid comes along with an open cut or scratch.”
Such risks are exacerbated in rural Alaska, he said, where homes can be crowded and people pursue traditional subsistence lifestyles with a lot of outdoor activities.
“They’re hunting, fishing, cutting up meat, et cetera, and mosquito bites are real prominent,” he said.
Nationally, only 12.6% of chronic hepatitis B cases recorded from 2013 to 2018 were attributable to sexual transmission, according to a 2023 CDC study. Transmissions of all forms of hepatitis, including hepatitis B, are possible through contact sports like football, rugby and hockey, researchers have found.
Alaska’s disease and vaccination success
Before the past decades of vaccination and screening, hepatitis B was so prevalent in Western Alaska that it was classified as endemic there. It was the only part of the United States with such a classification. In some villages, 20% to 30% of the residents were infected, McMahon said.
Geography and ancient migration patterns accounted for historically high rates of the disease in Western Alaska, as well as other Indigenous regions of the Arctic.
Various strains have been carried from Asia to Alaska over millennia, according to scientists. And the remoteness of Indigenous communities meant isolation from medical services, making early diagnosis difficult in the past, allowing infections to linger and be passed down through generations, according to scientists.
In Alaska, children infected with the virus early in life had a high likelihood of winding up with chronic infections that caused serious complications later, such as liver failure. The worst cases resulted in cancer, and even death.
For McMahon, now in his 80s, treating cancer-stricken children in the Yukon-Kuskokwim region, where he worked in the 1970s, was harrowing.
One of his patients was a 17-year-old high school valedictorian. A few months earlier, she started having abdominal pains, but she ignored them.
“She was really busy with school, and she’d gotten a full ride scholarship and was excited about going to the University of Alaska, representing her community,” McMahon said.
The pains turned out to be cancer, caused by a hepatitis B infection that she had not known she had. Too sick to be flown home, she died in the Bethel hospital.
“It was horrible,” McMahon said.
Another patient was an 11-year-old boy, also diagnosed after he complained of similar abdominal pain. McMahon visited him at home, where the boy was “in horrible pain” and yellow from jaundice.
“He was just crying. He said, ‘I know I’m going to die. Just help me with my pain,’” McMahon said.
“My wife was with me. She was a public health nurse. She was in tears. The community health aide practitioner was in tears. I was fighting my tears and pulling everything I could out of my bag to try to help this patient sedate. It was just something I’ll never forget. Never,” McMahon said.
He has relayed these and other experiences to the vaccine advisory committee in hopes of persuading members to keep the infant recommendations in place.
“I said, ‘Do you want to be responsible for children getting liver cancer because of this decision?’” McMahon said. “So I’m probably not very popular right now.”
Alaska was one of the first places in the world where the hepatitis B vaccine was used as soon as it became available in 1981.
The pilot vaccination project was at the insistence of Alaska Native organizations, along with the state government and the Alaska congressional delegation. Under that pilot program, according to newly published study by McMahon and other researchers from ANTHC and the CDC’s Arctic program, tribal health organizations and their partners screened 53,860 Alaska Native people for infection and gave vaccines to 43,618 Alaska Native people who tested negative, along with starting the universal newborn vaccinations.
Health officials have followed the outcomes since then, and the new study lists several achievements 40 years after universal newborn vaccination started.
Since 1995, according to the study, there have been no new symptomatic cases of hepatitis B among Alaska Natives under 20 anywhere in the state. Since 2000, no new cases of hepatitis-related liver cancer have been identified among Alaska Natives of any age in the Yukon-Kuskokwim Delta, a region where prevalence was concentrated in the past, the study said. And follow-up surveillance has revealed that childhood hepatitis B vaccinations remain effective for at least 35 years, the study said.
Successes are also reflected in the trend of acute hepatitis, the form of infection that is short-lived and can be cleared from the body.
There have been no identified cases of acute hepatitis among Alaska Native children since 1992, according to Johns Hopkins University. The rate of acute hepatitis among Alaskans of all ages and ethnicities dropped from 12.1 cases per 100,000 people to 0.9 per 100,000 in the 2002-2015 period, according to the state Department of Health’s epidemiology section.
Alaska’s rate of chronic hepatitis B — the long-term and persistent infection that can lead to serious liver problems — remains higher than the national average. As of 2020, Alaska’s rate of chronic hepatitis B was 14.2 cases per 100,000 people, nearly triple the national rate of 5 cases per 100,000 people, according to a report by the state Department of Health’s epidemiology section.
McMahon said that is partly because of the legacy of infections in the older Native population, people whose childhood predated widespread vaccination, and prevalence among foreign-born residents who come from countries without widespread vaccination.
Debate over hepatitis B risks
This year, vaccine skeptics who are members of the Advisory Committee on Immunization Practices, however, along with people who are advising the committee, have argued that the risks of hepatitis B among children are too low to justify universal infant vaccination.
One of the officials making that argument at Thursday’s committee meeting was Dr. Cynthia Nevison, a vaccine skeptic hired as a CDC consultant. She contradicted McMahon’s description of children spreading the virus through casual contact with contaminated surfaces — a process known as “horizontal transmission.”
“There’s very little evidence that horizontal transmission has ever been a significant threat to the average American child, and the risk probably has been overstated,” she said at the meeting. Also overstated, she said, are the risks of “vertical transmission,” the viral transmission between mothers and their newborns.
The committee’s new recommendation must be approved by the CDC administrator before it becomes federal policy.
McMahon said that no matter how national policy might change, Alaska Native tribal health organizations will continue administering hepatitis B vaccines to newborns.
“I know they’re not going to stop. Even if they have to pay for it. They’re so aware of this,” he said.
His fears, he said, are for low-income families who depend on free vaccinations through state programs that might lose funding and for parents who are getting conflicting messages that may lead to conclusions that the vaccine is not necessary.
“It could be a real mess,” he said.
Originally published by the Alaska Beacon, an independent, nonpartisan news organization that covers Alaska state government.
Alaska
The Alarming Prices Of Groceries In Rural Alaska — And Why They’re So Expensive – Tasting Table
Many households across America have been struggling with their grocery bills due to inflation that hit the global markets after the COVID-19 pandemic, but for families in Alaska, especially in rural communities, the prices of basic goods have reached alarming heights. Alongside inflation, the main issue for the climbing prices is Alaska’s distance from the rest of the U.S., which influences the cost of transport that’s required to deliver the supplies.
Given that Alaska is a non-contiguous state, any trucks delivering grocery stock have to first cross Canada before reaching Alaska, which requires a very valuable resource: time. According to Alaska Beacon, “It takes around 40 hours of nonstop driving to cover the more than 2,200 highway miles from Seattle to Fairbanks” on the Alaska Highway. That’s why a fairly small percentage of the state’s food comes in on the road. For the most part, groceries are shipped in on barges and are then flown to more remote areas, since “82% of the state’s communities are not reachable by road,” per Alaska Beacon. As such, even takeout in Alaska is sometimes delivered by plane.
Planes, trucks, and boats all cost money, but they are also all vulnerable to extreme weather conditions, which are not uncommon in Alaska. Sometimes local stores are unable to restock basic staples like bread and milk for several weeks, so Alaskans struggle with high food insecurity.
How much do groceries cost in Alaska?
Groceries in Alaska cost significantly more than in the rest of the U.S., but even within the state itself, the prices vary based on remoteness. You’ll find that prices of the same items can double or even triple, depending on how inaccessible a certain area is. The New Republic reported that prices in Unalakleet, a remote village that’s only accessible by plane, can be up to 80% higher than in Anchorage, Alaska’s most populated city. For example, the outlet cited Campbell’s Tomato Soup costing $1.69 in Anchorage and $4.25 in Unalakleet. Even more staggering is the price of apple juice: $3.29 in the city, $10.65 in the village. Such prices might make our jaw drop, but they’re a daily reality for many Alaskans.
As one resident shared on TikTok, butter in his local store costs $8 per pound — almost twice the national average. Fresh produce is even more expensive, with bananas going for $3 a pound, approximately five times the national average. It’s therefore not surprising that most of the people who live in Alaska have learned to rely on nature to survive.
Subsistence living has great importance for many communities. They hunt their own meat, forage for plants, and nurture their deep cultural connection to sourdough. For rural Alaskans, living off the land is a deep philosophy that embraces connection with nature and hones the survival knowledge that’s passed down through generations — including how to make Alaska’s traditional akutaq ice cream.
High avalanche danger in the mountains around much of Southcentral Alaska prompted officials to issue a backcountry avalanche warning Saturday for areas from Anchorage to Seward.
The Chugach National Forest Avalanche Information Center said that a combination of heavy snowfall, strong winds and low-elevation rain Saturday “will overload a weak snowpack, creating widespread areas of unstable snow.”
The warning is in effect from 6 a.m. Saturday to 6 a.m. Sunday.
Human-triggered and natural slides are likely, and avalanche debris may run long distances into the bottoms of valleys and other lower-angle terrain, the center said.
In Saturday’s avalanche forecast, which noted high avalanche danger at all elevations in the Turnagain Pass and Girdwood areas, the center said avalanches were likely to fail on weak layers about 1.5 to 3 feet deep.
Forecasters recommended that people avoid traveling in avalanche terrain, staying clear of slopes steeper than 30 degrees.
“Avalanche conditions will remain very dangerous immediately after the snow finishes,” the avalanche center said in its warning.
The center also said conditions may cause roofs to shed snow, and urged that people watch for overhead hazards, use care in choosing where to park vehicles and watch out for children and pets.
Areas covered under the backcountry avalanche warning include the mountains around Anchorage, Girdwood, Portage, Turnagain Pass, Lost Lake and Seward.
Farther north, the Hatcher Pass Avalanche Center in its forecast Saturday said danger was considerable at upper elevations and moderate at middle elevations.
Snowfall in Anchorage and Mat-Su
A winter weather advisory remained in effect until 9 a.m. Sunday from Anchorage up to the lower Matanuska Valley, including the cities of Eagle River, Palmer and Wasilla.
The National Weather Service said total accumulations of 4 to 8 inches of snow were possible, with localized areas potentially receiving up to a foot of snow.
The snowfall was expected to peak Saturday evening before tapering off Sunday morning, the weather service said.
Alaska’s appointed attorney general on Friday filed a friends of the court brief in a case before the U.S. Supreme Court involving whether absentee ballots that arrive after Election Day can be counted.
The filing does not side with either party in the case, which arose in Mississippi.
Instead, it informs the court of the logistical hurdles in Alaska — far-flung villages, lack of roads and severe weather — that make it difficult to receive absentee ballots by Election Day.
Alaska, like roughly half the other states in the U.S., allows some ballots cast by Election Day to be received later, the brief says.
The case, Watson v. Republican National Committee, challenges a law in Mississippi that allows absentee ballots received shortly after Election Day to count if they are postmarked by Election Day.
The Republican National Committee, the Mississippi Republican Party, the Libertarian Party of Mississippi and a Mississippi voter challenged the law in 2024. They argue that under federal law, ballots must received by state officials by Election Day to be counted.
The case could have national implications by influencing midterm elections, and comes amid baseless assertions from President Donald Trump that mail-in voting results in “MASSIVE VOTER FRAUD.”
The Alaska brief was filed by Jenna Lorence, the first Alaska solicitor general after Attorney General Stephen Cox created the role and appointed the Indiana attorney in October to fill it.
The 14-page brief says it does not support either party in the case.
The state’s impartiality drew criticism from an elections attorney, Scott Kendall, one of the main architects of the state’s ranked choice voting and open primary system.
“If you’re going to file something, take a position in favor of Alaska’s laws because they’re there for a very good reason,” Kendall said.
If the U.S. Supreme Court strikes down the law in Mississippi, that could lead to the disenfranchisement of many Alaska voters whose ballots arrive after Election Day, he said.
“Thousands upon thousands of Alaskans, through no fault of their own, wouldn’t be able to vote, and that’s not the democracy I signed up for,” Kendall said.
Under Alaska law, absentee ballots sent in state are counted if they are received “by the close of business on the 10th day after the election,” the filing says. Ballots from overseas must be received by the 15th day after the election.
Asked why the solicitor general did not take a position defending Alaska’s law or siding with either party, the Department of Law said in a statement emailed by spokesperson Sam Curtis:
“The State is committed to providing fair elections for Alaskans and will do so whatever rule the Court adopts. Alaska has previously filed these factual briefs to ensure courts understand the State’s unique perspective. Here, we wanted to ensure the Supreme Court knew how circumstances in Alaska make rules that might be simple in Mississippi more complicated in our State. We’re asking for clarity, so the Division of Elections and Alaska voters have straightforward rules to apply in the 2026 election.”
The filing notes that most Alaska communities are hard to reach.
“With over 80 percent of Alaskan communities off the road system, and extreme weather making access by boat or plane unreliable during certain months, including November, Alaska’s Division of Elections will continue to establish processes unlike any other State to ensure that its geography does not limit its citizens’ ability to vote,” the filing says. “Alaska asks that as this Court crafts a rule in this case, it provide clear parameters for Alaska to apply.”
The filing provides examples of how determining when a ballot was “received” by the Division of Elections is not always clearly defined, the Department of Law said.
In some cases, even in-person votes can struggle to reach the state elections division due to weather and geographical challenges, the filing says.
In 2024, poll workers in Atqasuk in northern Alaska tallied the votes cast on Election Day, but could not reach the elections division by phone that night.
So they “placed the ballots and tally sheets into a secure package and mailed them to the Division, who did not receive them until nine days later,” the filing says. “This exemplifies the hurdles that the Division regularly faces to receive and count votes from rural areas.”
The 5th Circuit Court of Appeals held that ballots must “be both cast by voters and received by state officials” by Election Day, the filing says.
“While that rule may invalidate laws like Mississippi’s delayed receipt deadline, what does it do in a situation like Atqasuk, where votes were cast and received by some poll workers on election day, but state officials did not receive the physical ballots or vote tallies until days later?” the filing says.
“Even more standardized voting situations in Alaska raise these questions,” the filing says.
“For example, when a voter casts an in-person absentee ballot in a remote area shortly before election day, the absentee voting official must send the ballot (in its unopened absentee ballot envelope) to the regional office, which may take some time,” the filing says. “Is the ballot ‘received’ the day it is turned over to the voting official? Or is it ‘received’ only once it reaches the regional office, where, for the first time, the Division evaluates eligibility before opening the envelope and counting the ballot within?”
“While it is clear when a ballot is ‘cast’ in Alaska (meaning that the vote cannot be changed), when certain ballots are actually ‘received’ is open to different interpretations, especially given the connectivity challenges for Alaska’s far-flung boroughs,” the filing says.
Alaska Lt. Gov. Nancy Dahlstrom, who oversees elections, said in a prepared statement that Alaska wants the Supreme Court “to provide clear guidance that protects election integrity while recognizing Alaska’s logistical challenges, so every eligible voter can make their voice heard.”
Cox said in the statement that Alaska wants the court to “consider how a rule that seems straightforward in some states might raise more questions in others. All we want is clarity in the rules.”
The filing also points out that for absentee ballots, many voters rely on the United States Postal Service.
“But unlike in other states, where mail delivery can be accomplished by simply driving to someone’s house via a continuous road system, USPS must use creative solutions to reach 82 percent of Alaskan communities,” the filing says.
In a separate matter, new guidelines from the U.S. Postal Service could also lead to votes not being counted across the U.S.
The postal service said on Dec. 24 it cannot guarantee that it will postmark ballots the same day they are put into a mailbox.
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