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Hepatitis vaccines credited as life-saving for Alaska children may be upended

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Hepatitis vaccines credited as life-saving for Alaska children may be upended


Dr. Brian McMahon, medical and research director of the liver and hepatitis program at the Alaska Native Tribal Health Consortium, stands outside at the consortium’s campus on Oct. 8. (Yereth Rosen / Alaska Beacon)

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.

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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.

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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.

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Hepatitis B virus particles, in orange, are seen in this microscopic image captured in 1981. (Dr. Erskin Palmer / U.S. Centers for Disease Control and Prevention)

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.

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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.

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“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.

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Epidemic Intelligence Service Officer Victoria Balta of the U.S. Centers for Disease Control and Prevention prepares to ride a snowmachine between villages in rural Alaska in 2024. She and other epidemiologists traveled to villages to draw blood from participants in a long-term study of the hepatitis B vaccine. (Jonathan Steinberg / U.S. Centers for Disease Control and Prevention)

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.

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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.

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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.

Changes in the incidence rate of acute hepatitis B from 1980 to 2015 are shown in this graph. The rate is for all Alaskans and based on state health data. The graph notes key dates in the development and use of the hepatitis B vaccine. (Graph provided by Epidemiology Section of the Alaska Division of Public Health / Alaska Department of Health)

Originally published by the Alaska Beacon, an independent, nonpartisan news organization that covers Alaska state government.





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‘Ticking time bomb’: Extreme snowfall fuels avalanche danger around Haines

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‘Ticking time bomb’: Extreme snowfall fuels avalanche danger around Haines


Avalanche professionals are warning backcountry adventurers to stay out of risky terrain after snow slammed the Upper Lynn Canal in late December.

National Weather Service data shows the storm dumped at least 44 inches of snow in Haines, making it the sixth snowiest five-day period in more than two decades. Other reports documented closer to six or seven feet.

“It was definitely one of the higher snowfalls you’ve gotten in five days, pretty much out of all your time that the station’s been there,” said Juneau-based meteorologist Edward Liske.

The dumping has created a risky situation in the backcountry that warrants extreme caution, said Jeff Moskowitz, the director of the Haines Avalanche Center.

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His main message: “Avoid being in or around avalanche terrain.”

Earlier this week, Moskowitz dug a snow pit in town – in front of Haines’ historic Fort Seward – that confirmed his assessment. Standing chest-deep in the pit, he pointed out layers of snow stacked on top of each other, each representing a different storm.

There was a somewhat fluffy layer on top, from the snowfall in early January. Below that, there was a roughly three-foot-deep layer that was more compact, from the late December storm.

And then there was a thin, feeble layer of snow just inches from the ground that crumbled like sugar when Moskowitz ran his hand through it. That snow was on the ground before the big storm – it’s the layer that could collapse and trigger an avalanche under the weight of more precipitation, snowmachines or humans.

“We have about a meter of really strong snow just sitting over this sugar,” Moskowitz said, calling it a “dangerous combination for avalanches.”

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Jeff Moskowitz directs the Haines Avalanche Center, the Chilkat Valley’s primary source of avalanche information.

Starting Dec. 27, the situation prompted the center to issue warnings about high avalanche risk in the Haines area. Moskowitz said people should stay off slopes that are greater than 30 degrees – and avoid traveling beneath them.

“It’s just a tricky situation, because there’s lots of snow, and we want to go play,” he said. “But we still have this strong-over-weak layering in most places.”

In some places, he said, the weak layer may be buried so deep that a human or snowmachine wouldn’t trigger it. But in shallower areas, like near trees or rocks. the layer would be closer to the surface and more likely to trigger an avalanche.

“People could ride that slope numerous times until one person finds that weak spot,” he said.

The deluge has stopped for now. But the situation could get worse before it gets better, as temperatures rise and the top layer of snow consolidates into a heavier, thicker slab. New precipitation or other conditions could trigger a natural avalanche cycle, wiping that weak layer out.

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“Otherwise, it’s a little bit like a ticking time bomb,” Moskowitz said.

Haines Avalanche Center

The Haines Avalanche Center is a nonprofit and the main source of avalanche information in the Chilkat Valley, which draws backcountry adventurers from around the world. Moskowitz emphasized the importance of donations, grants and borough funding to make that work possible.

In the past, the Haines Borough has asked nonprofits to apply for funding from a $100,000 bucket. But Haines Mayor Tom Morphet said that, amid a steep budget deficit, the assembly discontinued that grant process for fiscal year 2026, which runs through June.

That has meant less funding than usual for the Avalanche Center, which has just three part-time employees, including Moskowitz.

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“Less funding means less staff time,” Moskowitz said. “And staff time means that locals who are avalanche professionals and have certifications are out there, digging in the snow, making assessments, posting that information publicly.”

The center posts a general avalanche information product every week, plus a weather forecast and season summary. They also issue advisories when avalanche danger is high, including three days in a row in late December.

But the center does not currently have the funding or staff capacity to consistently publish advisories when avalanche risk is low, moderate or considerable.

“What we don’t want, is that there’s an accident that sparks the public interest in supporting the Avalanche Center,” Moskowitz said. “We just need to maintain the services we provide and just keep it going year after year after year.”

Morphet, the mayor, said the borough and assembly are “acutely aware” of the center’s importance.

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Moskowitz said people who recreate in the backcountry can help by paying close attention to their surroundings – and he urged them to send in their observations online.

That could mean details about a human-triggered or natural avalanche, about where the sun has hit the mountains on a particular day, or an observation that feathery crystals – known as surface hoar – have started forming on the snow’s surface.

“There’s very little information that we’re not going to find useful,” Moskowitz said. “All of that is very valuable, and it helps to inform this bigger picture.”



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Alaska delegation mixed on Venezuela capture legality, day before presidential war powers vote

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Alaska delegation mixed on Venezuela capture legality, day before presidential war powers vote


ANCHORAGE, Alaska (KTUU) – Alaska’s congressional delegation had mixed reactions Wednesday on the legality of the Trump administration’s actions in Venezuela over the weekend, just a day before they’re set to vote on a bill ending “hostilities” in Venezuela.

It comes days after former Venezuelan Nicolás Maduro was captured by American forces and brought to the United States in handcuffs to face federal drug trafficking charges.

All U.S. Senators were to be briefed by the administration members at 10 a.m. ET Wednesday, including Secretary of State Marco Rubio and Secretary of Defense Pete Hegseth, according to CBS News.

Spokespersons for Alaska Sens. Lisa Murkowski, R-Alaska, and Dan Sullivan, R-Alaska, say they were at that meeting, but from their responses, the two shared different takeaways.

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Sullivan, who previously commended the Trump administration for the operation in Venezuela, told KDLL after his briefing that the next steps in Venezuela would be done in three phases.

“One is just stabilization. They don’t want chaos,” he said.

“The second is to have an economic recovery phase … and then finally, the third phase is a transition to conduct free and fair elections and perhaps install the real winner of the 2024 election there, which was not Maduro.”

Murkowski spokesperson Joe Plesha said she had similar takeaways to Sullivan on the ousting of Maduro, but still held concerns on the legality.

“Nicolás Maduro is a dictator who led a brutally oppressive regime, and Venezuela and the world are better places without him in power,” Plesha said in a statement Wednesday. “While [Murkowski] continues to question the legal and policy framework that led to the military operation, the bigger question now is what happens next.”

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Thursday, the Senate will decide what happens next when they vote on a war powers resolution which would require congressional approval to “be engaged in hostilities within or against Venezuela,” and directs the president to terminate the use of armed forces against Venezuela, “unless explicitly authorized by a declaration of war or specific authorization for use of military force.”

Several House leaders have also received a briefing from the administration according to CBS News. A spokesperson for Rep. Nick Begich, R-Alaska, said he received a House briefing and left believing the actions taken by the administration were legal.

“The information provided in today’s classified House briefing further confirmed that the actions taken by the Administration to obtain Maduro were necessary, time-dependent, and justified; and I applaud our military and the intelligence community for their exceptional work in executing this operation,” Begich said in a statement.

Looming vote

Sen. Tim Kaine, D-VA, authored the war powers resolution scheduled for debate Thursday at 11 a.m. ET — 7 a.m. AKST.

It’s a resolution which was one of the biggest topics of discussion on the chamber floors Wednesday.

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Sen. Rand Paul, R-KY, said on the Senate floor Wednesdya that the actions taken by the administration were an “act of war,” and the president’s capture of Maduro violated the checks and balances established in the constitution, ending his remarks by encouraging his colleagues to vote in favor of the resolution.

“The constitution is clear,” Paul said. “Only Congress can declare a war.”

If all Democrats and independents vote for the Kaine resolution, and Paul keeps to his support, the bill will need three more votes to pass. If there is a tie, the vice president is the deciding vote.

“It’s as if a magical dust of soma has descended through the ventilation systems of congressional office buildings,” Paul continued Wednesday, referring to a particular type of muscle relaxant.

“Vague faces in permanent smiles and obedient applause indicate the degree that the majority party has lost its grip and have become eunuchs in the thrall of presidential domination.”

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Legality of actions under scrutiny

U.S. forces arrested Maduro and his wife, Cilia Flores, from their Caracas home in an overnight operation early Saturday morning, Alaska time. Strikes accompanying the capture killed about 75 people, including military personnel and civilians, according to U.S. government officials granted anonymity by The Washington Post.

Maduro pleaded not guilty Monday in a New York courtroom to drug trafficking charges that include leading the “Cartel of the Suns,” a narco-trafficking organization comprised of high-ranking Venezuelan officials. The U.S. offered a $50 million reward for information leading to his capture.

Whether the U.S. was legally able to capture Maduro under both domestic and international law has been scrutinized in the halls of Congress. Members of the administration, like Secretary of State Marco Rubio, have been open in defending what they say was a law enforcement operation carrying out an arrest warrant, The Hill reports. Lawmakers, like Paul or Sen. Chuck Schumer, D-NY, say the actions were an act of war and a violation of the constitution.

While the president controls the military as commander in chief, Congress constitutionally has the power to declare wars. Congressional Democrats have accused Trump of skirting the Constitution by not seeking congressional authorization before the operation.

Murkowski has not outright condemned or supported the actions taken by the administration, saying in a statement she was hopeful the world was safer without Maduro in power, but the way the operation was handled is “important.”

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Sullivan, on the other hand, commended Trump and those involved in the operation for forcing Maduro to “face American justice,” in an online statement.

Begich spokesperson Silver Prout told Alaska’s News Source Monday the Congressman believed the operation was “a lawful execution of a valid U.S. arrest warrant on longstanding criminal charges against Nicolás Maduro.”

The legality of U.S. military actions against Venezuela has taken significant focus in Washington over the past several months, highlighted by a “double-tap” strike — a second attack on the same target after an initial strike — which the Washington Post reported killed people clinging to the wreckage of a vessel after the military already struck it. The White House has confirmed the follow-up attack.

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Sullivan, who saw classified video of the strike, previously told Alaska’s News Source in December he believed actions taken by the U.S. did not violate international law.

“I support them doing it, but they have to get it right,” he said. “I think so far they’re getting it right.”

Murkowski, who has not seen the video, previously said at an Anchorage press event the takeaways on that strike’s legality seem to be divided along party lines.

“I spoke to a colleague who is on the Intelligence Committee, a Republican, and I spoke to a colleague, a Democrat, who is on the Senate Armed Services Committee … their recollection or their retelling of what they saw [was] vastly different.”

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National Native helpline for domestic violence and sexual assault to open Alaska-specific service

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National Native helpline for domestic violence and sexual assault to open Alaska-specific service


A national support line for Native survivors of domestic violence and sexual assault has begun work to launch an Alaska-specific service. Strong Hearts Native Helpline is a Native-led nonprofit that offers 24-hour, seven-day-a-week support for anonymous and confidential calls from people who have experienced domestic violence or sexual assault. The line is staffed by Native […]



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