Advocacy

On December 5, 2025, the Center for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) voted to overturn guidelines for universal hepatitis B virus (HBV) vaccinations at birth despite decades of evidence-based recommendations. Hepatitis B vaccinations are highly successful at reducing the incidence of acute hepatitis B infection by 99% in the United States and preventing progression to chronic HBV infection. 

Current guidelines recommend that all infants receive a series of 3 doses of the HBV vaccine, starting immediately after birth and followed by two additional shots at 1 to 2 months and 6 months of age. The newly voted rules will only recommend HBV vaccinations at birth for infants born to mothers with positive or unknown hepatitis B status. Infants born to mothers with negative hepatitis B status will no longer receive a HBV dose at birth. Instead, mothers will need to discuss with their physicians to decide to vaccinate at birth or delay until at least 2 months old. By delaying vaccination by 2 months, this policy creates a window of infection that puts undue risk upon infants of mothers with negative hepatitis B status.

What is Hep B? 

Hepatitis B virus is a bloodborne pathogen that can be passed down from mother to child. Acute infection can manifest as jaundice and nonspecific symptoms like fever, fatigue, nausea, and vomiting an average of 90 days after exposure. Infected children and adults can also be completely asymptomatic. Two in three individuals living with hepatitis B infection do not know they are infected.

Unvaccinated children can acquire the virus and develop chronic hepatitis B, which has no cure. Children are especially at risk to develop chronic hepatitis B infection:

• 90% of infants when infected at birth 
• 50% of children between age 1 to 5 

In the United States, Asian American, Native Hawaiian, and Pacific Islander (AANHPI) individuals represent half of all chronic hepatitis B infections in the United States despite making up 7.5% of the U.S. population. 

Why is this a concern?

HBV causes permanent damage to the liver over time, causing cirrhosis and liver cancer. In fact, chronic hepatitis B is responsible for more than half of all hepatocellular carcinomas in the world. The risk of developing hepatocellular carcinoma increases with every year of chronic HBV infection. 

Call to Action

National APAMSA strongly condemns the ACIP decision to roll back universal hepatitis B vaccination at birth. Institutionalized vaccine hesitancy is a disservice to our communities, especially to Asian American, Native Hawaiian and Pacific Islander communities who face a disproportionate burden of chronic hepatitis B infections. These rules will undoubtedly reverse the decades-long progress in reducing hepatitis B in the United States and hurt all communities that we, as future physicians, swear to serve. As mentioned in our policy compendium and Hepatitis Initiative, APAMSA is committed to advocating for universal hepatitis B vaccinations and increased funding and awareness for hepatitis screening. We urge that ACIP and policymakers reconsider their decision to pivot from evidence-based recommendations that can potentially harm the next generation of Americans. 

Our Current Work

1. National Hepatitis B Pledge:  Inspired by Stanford’s Asian Liver Center and San Francisco’s Hep B Free, we hope to encourage all medical students to develop habits of screening and advocacy for hepatitis that will follow them in their careers as physicians. 
2. 2025 Advocacy Day and Hepatitis, Equity, Advocacy, and Leadership (HEAL) Summit – APAMSA hosted the inaugural Advocacy Day on Capitol Hill and the HEAL Summit (formerly known as Hepatitis Conference) in Washington, D.C. During this two-day event, students sat down with Congressional members to advocate for increased awareness and funding for Hepatitis B and heard from the nation’s leading experts on hepatitis and advocacy. 
3. Grants for Hepatitis Screening: – Apply today to receive up to $1500 for hepatitis screening and education events – applications accepted on a rolling basis.
4. Curated list of resources for hepatitis education and screening tools

On September 3, 2025, Dr. Joseph A. Ladapo, Florida’s surgeon general, announced plans to end all vaccine mandates in the state of Florida, including vaccination requirements set for schoolchildren. While earlier efforts in Florida have focused on banning COVID-19 vaccinations for children, this new effort will be the first in the country to stop requiring vaccinations for children enrolling and attending school. This decision follows a recent drop in Florida’s kindergarten vaccination rates to 88.7% in 2025, a 4.8% decrease from 93.5% in 2020. 

The Proposed Changes

Current guidelines in Florida for school and daycare require 7 vaccinations: Diphtheria-tetanus-acellular pertussis (DTaP), Inactivated polio vaccine (IPV), Measles-mumps-rubella (MMR), Varicella (chickenpox), Haemophilus influenzae type b (Hib), Pneumococcal conjugate (PCV15/20), and Hepatitis B (Hep B). The Florida’s Department of Health aims to first eliminate mandates for Varicella, Hib, Hep B, and pneumococcal vaccinations with plans to seek legislative approval to end vaccine mandates for polio, MMR, and DTaP.

The Role of Vaccines

Vaccinations have long provided protection for communities worldwide, accounting for over 150 million lives saved in the past 50 years according to recent research published in the Lancet. As a cornerstone in maintaining herd immunity, vaccinations are crucial in protecting vulnerable populations such as the elderly, immunocompromised, pregnant individuals, and children. By vaccinating a large portion of the population, diseases are less likely to spread to subsets of the population who may not be able to get vaccinated themselves. 

Potential Public Health Risks

Rolling back several decades of strong immunization policies could lead to a resurgence of preventable infections such as pneumonia, hepatitis B, and measles in patients of all ages. Elimination of these mandates poses undue risk of infection for common, but deadly diseases, especially in a state where one in five adults are over the age of 65. For example, Texas has seen measles infections in unvaccinated communities where over 750 people became infected. This policy change will also inject uncertainty for parents entrusting their children to schools and for future insurance coverage for vaccinations. In response to recent national policy changes at the Centers for Disease Control and Prevention aimed at weakening immunization recommendations, some states have formed alliances to issue evidence-based, public health guidance aligned with national medical associations. 

Call for Action

National APAMSA strongly condemns any attempt to undo decades of evidence-based vaccination mandates. As mentioned in our policy compendium, APAMSA remains focused on promoting vaccinations as a safe and effective way to prevent disease. We urge health care professionals including physicians and medical students, policymakers, parents, and other stakeholders to remain steadfast in protecting vaccine mandates through education and advocacy.

On July 3, 2025, the House of Representatives passed H.R. 1 One Big Beautiful Bill (OBBB) along mostly party lines following the Senate’s amendments earlier this week. President Donald Trump signed the bill into law on July 4, 2025. Over the next decade, the bill will extend $2.9 trillion for tax breaks for the wealthy at the expense and detriment of children, families, and hard-working Americans. Billions of dollars will be funneled toward federal agencies for detaining immigrants, constructing walls along the southern border, and military weapons manufacturing. 

Rather than reducing barriers in accessing healthcare and ensuring food security for Americans, this bill will require Medicaid patients to pay up to $35 copays for medical services and institute additional work requirements to qualify for Supplemental Nutrition Assistance Program (SNAP) benefits while simultaneously cutting funding for the SNAP by over $300 billion over the next decade. Rural communities and communities of color will be deeply affected by these cuts, severely limiting access to affordable care.

How will some of these changes affect you as medical students and physicians?

National APAMSA strongly condemns the signing of this cruel bill that primarily benefits the wealthy while leaving millions of Americans without healthcare or food on the table. As expressed in our previous Joint Statement with SNMA, LMSA, AMSA, SOMA, and MSDCI, we are deeply disappointed by these decisions that will harm patients and exacerbate the physician shortage. OBBB will have lasting repercussions on American health and well-being, further deepening inequities in healthcare and socioeconomic success. These provisions represent a stark disconnect between national leaders and public interests despite polls that indicate almost two-third of Americans view this bill unfavorably. We urge policymakers to rectify and reverse these changes and work with constituents to produce new legislation that will strengthen our nation and alleviate health disparities.

Take action:

1. Register to Vote: Exercise your privilege to vote and shape the future by electing officials that reflect your priorities. 
   1. The Medicaid cuts are not projected to be enacted until after the 2026 Midterms, which makes 2026 a crucial moment for voters to show their elected officials that voting against their constituents’ best interest will have consequences.
2. Become civic engagement advocates through Vot-ER’s Healthy Democracy Campaign
3. Please contact your members of Congress to express your opposition towards these policies. You can use 5 Calls to quickly locate your representatives’ numbers and be prepared with prompts that can help you discuss this particular bill and other issues at ease. 

The first day of June marks a month-long celebration of the LGBTQIA+ community. Honoring the progress and the vibrance of this community has been especially important with escalating attacks on the LGBTQIA+ community’s rights. 

On June 18, 2025, the Trump Administration announced the termination of the 988 national suicide prevention hotline’s support for LGBTQIA+ callers beginning July 17, 2025. Through providers like the Trevor Project, the 988 Lifeline has served almost 1.3 million youth since the launch of the program in September 2022. Soon, calls/texts will be routed to general crisis centers without LGBTQIA+ specialization. The shutdown of this hotline will have an enormous impact, considering that 1.8 million LGBTQIA+ young people consider suicide every year and are four times more likely to commit suicide than their peers. 

On the same day, transgender rights were also seriously curtailed by the new Supreme Court ruling United States v. Skrmetti, in which they upheld Tennessee’s ban on gender affirming care for transgender youth. This decision has wide-ranging implications: it maintains similar bans on gender affirming care across 25 states, which range from prohibiting providers from administering hormones or puberty blockers to prohibiting gender-affirming care surgeries. Although some states have enacted policies to shield patients receiving and/or providers practicing gender affirming care from civil or criminal charges, over 100,000 transgender youth living outside these areas will still face significant barriers to care. 

National APAMSA condemns these egregious and cruel decisions against the LGBTQIA+ community, who are already a vulnerable and marginalized population. As we approach the end of this month of celebration, this community faces even greater challenges that infringe on the right to exist and to thrive as their authentic self. Guided by our policy compendium, we stand firm in the belief that all patients, including but not limited to those based on their age, color, sex, gender, and sexual orientation, deserve equitable, evidence-based care. We call on medical professionals and trainees to continue advocating for sexual and gender minorities, and implore local, state, and federal leaders to promote health equity and fight inequities affecting the LGBTQIA+ community. 

Please contact your members of Congress to express your opposition against these efforts that degrade and inflict pain on LGBTQIA+ youth. You can use 5 Calls to quickly locate your representatives’ numbers and be prepared with prompts that can help you discuss this particular bill and other issues at ease. 

Sign the petition to voice your concern about the end of the LGBTQ Youth 988 Hotline: https://actionnetwork.org/petitions/protect-988-suicide-and-crisis-lifeline-for-lgbtq-youth/ 

LGBTQIA+ Care Is Under Attack.

Patients and professionals are at risk. These are recent federal actions as of June 27, 2025:

• Bans on gender-affirming care sweeping across our nation 
• Terminating crisis lifelines for LGBTQIA+ youth
• Pressuring providers into silence

Criminalizing Providers: H.R. 3492

Congress is advancing H.R. 3492, which would:

• Make it a federal crime to provide gender-affirming care to minors
• Penalize clinicians with up to 10 years in prison

This is not about safety. It’s about eroding medical autonomy and the duty of healthcare providers!

Take action now: action.aclu.org/send-message/protect-trans-care-now

The “Chilling Effect” Is Already Here

The phenomenon describes providers and institutions withdrawing from offering LGBTQIA+ care out of fear of legal, professional, or political consequences. 

Across the U.S., providers are:

• Asking to be removed from LGBTQIA+ directories
• Canceling trainings and support programs
• Backing away from DEI partnerships

Protect Your Patients and Yourself

Even in restrictive states, we urge providers to use your voice and position to support LGBTQIA+ patients further by:

• Documenting decisions clearly and legally
• Using encrypted, secure communication tools
• Sharing vetted provider referral lists confidentially
• Consulting with organizations like GLMA, ACLU, or Lambda Legal if in doubt

Ask your employers for clear legal guidance and know your rights.

Students: Don’t Be Discouraged

We are the next generation of providers.

• Keep learning about gender-affirming care best practices
• Seek out affirming preceptors or telehealth shadowing
• Use platforms and private peer networks to build experience
• Document and report any discriminatory practices during your training. You are protected.

How to Push Back as Providers (Legally + Ethically)

• Advocate for inclusive care policies and language
• Push for policy reviews on gender and identity
• Join or form affirming clinician coalitions locally and nationally
• Know how to refer patients to care in other states or via Telehealth

What Can You Still Do as Healthcare Professionals

Clinical Practice

• Affirm: Use patients’ names/pronouns. Document care transparently.
• Refer Safely: Maintain a trusted network of LGBTQIA+ providers (start with OutCare).
• Provide Access: Offer virtual mental health services where care is restricted.
• Trauma-Informed Approach: Acknowledge lived experiences. Normalize emotional responses to discrimination.

Education & Advocacy

• Train colleagues in LGBTQIA+ cultural competency (OutCare, GLMA offer free modules)
• Advocate within your institution for inclusive policies, even when statewide law is regressive
• Build cross-discipline alliances: social workers, nurses, legal counsel, DEI officers

Resources for LGBTQIA+ Youth & Their Support Circles

If you are LGBTQIA+ youth, parents, teachers, and/or allies, we stand with you.

Crisis Support & Hotlines

• The Trevor Project — 24/7 Crisis Support independent of 988.
  1-866-488-7386 | Text “START” to 678678
  thetrevorproject.org/get-help
• Trans Lifeline — Peer-run and confidential.
  1-877-565-8860
  translifeline.org
• LGBT National Help Center — Youth and senior talk lines.
  1-800-246-7743
  lgbthotline.org
• Love is Respect — National teen dating violence support including LGBTQIA+ relationships.

1-866-331-9474 | Text “LOVEIS” to 22522

loveisrespect.org

Support & Education for Families

• PFLAG Chapters
  pflag.org
• Q Chat Space – Peer-moderated online groups for LGBTQIA+ teen
  qchatspace.org

References

“We’re Not Going Anywhere: LGBTQ+ Health Equity Must Not Be Abandoned”

OutCare Health (2025). https://www.queerty.com/were-not-going-anywhere-lgbtq-health-equity-must-not-be-abandoned-20250605

“Trump Administration Orders Termination of National LGBTQ+ Youth Suicide Lifeline Effective July 17th”

The Trevor Project – 988 Shutdown Report. Published: June 18, 2025.

https://www.thetrevorproject.org/blog/trump-administration-orders-termination-of-national-lgbtq-youth-suicide-lifeline-effective-july-17th/

“Protect Trans Care Now: Tell Congress to Oppose the Criminalization of Gender-Affirming Care”

ACLU Action Page – H.R. 3492

https://action.aclu.org/send-message/protect-trans-care-now

“UC Berkeley experts react to U.S. Supreme Court ruling on medical care for trans minors”

UC Berkeley News. Published: June 18, 2025.

https://news.berkeley.edu/2025/06/18/uc-berkeley-experts-react-to-u-s-supreme-court-ruling-on-medical-care-for-trans-minors/

Fenway Health – The Fenway Institute

https://fenwayhealth.org/about/commitment-to-lgbts/

GLMA On-Demand CE/CME Access

https://www.glma.org/on-demand_ce_cme.php

Campaign for Southern Equality

https://southernequality.org/emergency-help/

Lambda Legal — State Specific Policies

https://lambdalegal.org/search/?keyword=webinar+&issue-area%5B%5D=21724&start-date=&end-date=&sort=desc