Dr. Michelle Taylor, Baltimore’s new health commissioner, expressed worry Monday that the substantial progress made by the city to reduce cases of hepatitis B could be threatened by new federal guidelines downplaying the need for childhood vaccines.

Taylor joined other public health officials in pushing back against a federal advisory panel’s decision to narrow the recommendation that every newborn be vaccinated against hepatitis B, a devastating infection that can lead to liver disease and even death.

Baltimore hasn’t had a new case of hepatitis B in newborns in a decade, a public health achievement for a city that long struggled to contain other infectious diseases.

Hepatitis B is a particularly threatening type of hepatitis, spread through blood and other fluids and through birth. But without early symptoms, infections often go unnoticed in newborns, so cases become chronic — and incurable.

While the city has stamped out cases among babies, Taylor said hepatitis B infections are still a threat because there are still cases in adults in Baltimore. The city has a third of all cases among Maryland adults, who can become infected through sex and IV drug use.

Maryland Department of Health data shows statewide that there are dozens of cases each year in adults, but no more than one case per year in newborns.

Taylor is the incoming chair of the Big Cities Health Coalition, which denounced a vote by a federal advisory panel to the U.S. Centers for Disease Control and Prevention to roll back the 30-year-old recommendation to vaccinate every infant within 24 hours of birth and again two more times before they turn 18 months old.

The Advisory Panel on Immunization Practices instead called for vaccination only after consultation with a doctor and not at birth. It was similar to the approach the same panel recently took on COVID-19 vaccinations.

The CDC director must sign off on the panel’s hepatitis B recommendation.

Doctors can still give the hepatitis B vaccine and insurers will still pay for it. But Taylor and the other officials are concerned that the new guidance will confuse parents, leading some to forgo the shots altogether.

“I believe right now our job in public health is to cut through the noise,” and provide evidence-based guidance, Taylor said.

Taylor noted that state Health Secretary Meena Seshamani issued an advisory last week to medical providers directing them to reiterate the importance of the full vaccination series beginning at birth.

“The hepatitis B infant vaccine helps prevent a chronic and potentially fatal infection, which can lead to serious liver disease and liver cancer later in life,” Seshamani said in a statement.

The move by the city and state is another step local governments have taken to band together to counter increasing criticism of vaccines by federal health officials led by U.S. Secretary of Health and Human Services Robert F. Kennedy Jr.

Kennedy and his advisors say they now plan to review the entire child vaccination schedule.