WHEREAS, Hepatitis B is a liver infection caused by the hepatitis B virus, and recent modeling estimates indicate that approximately 1,700,000 to 1,800,000 people in the United States are living with hepatitis B infection, corresponding to a prevalence of about 0.5 to 0.55 percent of the population; and
WHEREAS, State-level analyses estimate that California has the largest number of people living with hepatitis B of any state, with approximately 347,100 people living with hepatitis B infection and an overall prevalence of about 0.9 percent, and that about 86 percent of these infections occur among people who are foreign born; and
WHEREAS, the State Department of Public Health (CDPH) estimates that between 0.4 and 1.0 percent of California’s population-approximately 149,716 to 381,966 people-are living with chronic hepatitis B, and that more than two-thirds of these infections have not been diagnosed and reported to public health authorities; and
WHEREAS, CDPH reports that in 2023 there were 95 acute hepatitis B cases and 10,928 newly reported chronic hepatitis B cases in California, and that male Californian adults over 40 years of age identifying as Black or African American are disproportionately affected by acute hepatitis B, while male Californian adults over 50 years of age identifying as Asian American or Pacific Islander are overrepresented among newly reported chronic hepatitis B cases; and
WHEREAS, Hepatitis B spreads from person to person via contact with infected blood and body fluids; transmission may occur through perinatal exposure, sexual contact, injection drug use, and other blood exposures; and
WHEREAS, Hepatitis B infection can range from an acute, mild, short-term illness to a chronic, serious, long-term infection that can lead to cirrhosis, liver failure, and liver cancer, and is associated with premature mortality in California; and
WHEREAS, CDPH reports that hepatitis B-related mortality in California, though declining, remained 1.7 times higher than the overall United States rate in 2021, and that more than 70 percent of hepatitis B deaths in California occurred in people younger than 75 years of age, with Asian American and Hispanic or Latino Californians dying on average 18 years earlier than expected due to hepatitis B; and
WHEREAS, An estimated 76 percent of all people living with hepatitis B in the United States are foreign born, and California’s burden falls disproportionately on immigrant and Asian and Pacific Islander communities, which underscores the need for culturally specific, community-engaged approaches to prevention, testing, and care; and
WHEREAS, Many people with chronic hepatitis B are asymptomatic. National data indicate that a large share of people living with hepatitis B remain unaware of their infection, and California’s own analysis finds that more than two-thirds of estimated chronic hepatitis B infections have not been diagnosed and reported, which leaves many at risk for preventable liver disease and liver cancer; and
WHEREAS, Infants and young children face a particularly high risk; perinatal and early childhood infection is associated with up to a 90-percent risk of developing chronic hepatitis B and greatly increased lifetime risk of cirrhosis and liver cancer, which makes prevention of perinatal transmission and early vaccination a critical public health priority; and
WHEREAS, Vaccination against hepatitis B is safe and highly effective and, when administered as a timely birth dose followed by completion of the vaccine series, has contributed to dramatic declines in pediatric hepatitis B infections nationwide and in California; and
WHEREAS, California has implemented and sustained robust prevention efforts, including perinatal hepatitis B prevention programs and newborn vaccination, and CDPH reports that since 2017 fewer than five confirmed perinatal hepatitis B cases have been reported annually statewide, which demonstrates the effectiveness of coordinated vaccination and prophylaxis strategies; and
WHEREAS, National and state-level analyses show that failing to provide timely hepatitis B vaccination, screening, and linkage to care could result in thousands of avoidable infections, continued under diagnosis, and substantial preventable health care costs and productivity losses over time; and
WHEREAS, The federal Centers for Disease Control and Prevention have recommended universal screening for hepatitis B among adults, and California has adopted additional screening requirements (including Assembly Bill 789 of Chapter 470 of the Statutes of 2021) to expand access to testing and early diagnosis, as reflected in increased hepatitis B testing and positive surface antigen reports in recent years; and
WHEREAS, Despite the availability of effective antiviral treatments that can reduce the risk of cirrhosis and liver cancer among people with chronic hepatitis B, treatment uptake remains suboptimal nationally, and many Californians living with hepatitis B face barriers to screening, diagnosis, treatment, and long-term care; and
WHEREAS, CDPH’s California Hepatitis B Landscape Analysis, supported by state budget investments in 2022 to 2024, inclusive, emphasizes the need for culturally specific and sensitive approaches to hepatitis B prevention, detection, and linkage to care to reduce disparities, particularly among Asian and Pacific Islander communities and other disproportionately impacted groups; and
WHEREAS, The recently published state- and county-level modeling analysis of the hepatitis B burden in the United States provides local estimates that can support California agencies, local health jurisdictions, and community-based organizations in planning targeted interventions, including in counties such as Los Angeles, Santa Clara, Alameda, Orange, and San Diego, which have among the largest numbers of people living with hepatitis B in the nation; and
WHEREAS, Several states have developed viral hepatitis strategic plans, such as the New York State Viral Hepatitis Strategic Plan, to coordinate immunization, screening, treatment, and health equity strategies among diverse partners, which provide models that may inform California’s efforts; now, therefore, be it
Resolved by the Assembly of the State of California, the Senate thereof concurring, That the Legislature declares hepatitis B prevention, screening, treatment, and linkage to care to be important public health priorities for the State of California; and be it further
Resolved, That the Legislature encourages the State Department of Public Health, in collaboration with local health jurisdictions, health care providers, health plans, community-based organizations, and affected communities, to continue to promote hepatitis B vaccination as a safe and highly effective public health measure, including timely infant vaccination and completion of vaccine series for children, adolescents, and adults at risk, and to expand public awareness about the importance of hepatitis B vaccination for all eligible Californians; and be it further
Resolved, That the Legislature encourages all stakeholders to identify, review, and work to remove barriers to hepatitis B vaccination, screening, diagnostic testing, and treatment, including barriers related to coverage, cost sharing, provider reimbursement, language access, and geographic access; and be it further
Resolved, That the Legislature encourages state health agencies and stakeholders to use the California Hepatitis B Landscape Analysis and state- and county-level burden estimates as foundational data to guide targeted outreach, testing, vaccination, and linkage to care efforts, particularly in communities and counties with high numbers or high prevalence of hepatitis B infection and among populations that experience disproportionate burden, including Asian and Pacific Islander, Black or African American, Hispanic or Latino, and foreign-born communities; and be it further
Resolved, That the Legislature encourages the use of multidisciplinary advisory or working group structures-comprising representatives of state and local health agencies, health systems, health plans, community health centers, providers, researchers, and community and patient advocates-to inform the development, implementation, and evaluation of hepatitis B strategies, including establishing recommended goals, reviewing progress, and sharing best practices; and be it further
Resolved, That the Legislature encourages continued collaboration between California and regional or national partners, including the West Coast Health Alliance and other professional and community organizations, to support evidence-based hepatitis B vaccination policies, including maintaining access to the birth dose of hepatitis B vaccine for newborns and promoting completion of the hepatitis B vaccine series in accordance with leading medical and public health guidelines; and be it further
Resolved, That the Legislature encourages state agencies and stakeholders to align hepatitis B efforts with California’s broader goals for viral hepatitis and liver health, including initiatives to reduce liver cancer and cirrhosis and to eliminate viral hepatitis as a public health threat, which is consistent with national and global strategies; and be it further
Resolved, That, in order to support ongoing public education and to encourage vaccination, screening, and linkage to care, the Legislature declares the month of June 2026 as Hepatitis B Awareness Month in California in alignment with national and global awareness activities, and encourages state agencies, local health jurisdictions, community-based organizations, health care providers, and other stakeholders to observe this month with appropriate educational and outreach activities focused on hepatitis B prevention, testing, treatment, and health equity; and be it further
Resolved, That the Chief Clerk of the Assembly transmit copies of this resolution to the State Department of Public Health, the State Department of Health Care Services, the Department of Managed Health Care, the Department of Insurance, the Office of the Surgeon General, and to other relevant departments, organizations, and stakeholders as evidence of the Legislature’s intent to support comprehensive, equitable efforts to prevent, diagnose, and treat hepatitis B in California and to the author of this resolution for distribution.