RFK Jr.’s panel weakens guidance
Health and Human Services Secretary Robert F. Kennedy Jr.’s hand-picked vaccine committee voted Friday to eliminate the long-running vaccine shot. universal recommendation Giving all babies the hepatitis B vaccine at birth provides weaker guidance for some babies.
The group, called the Advisory Committee on Immunization Practices (ACIP), recommended that parents make individual decisions, consulting with a healthcare professional, to determine when and whether to give the hepatitis B birth dose to an infant whose mother has tested negative for the virus. The committee recommended that babies who did not receive the birth dose wait until they are at least 2 months old to receive the first vaccine.
The acting director of the Centers for Disease Control and Prevention still has to sign this new recommendation. The CDC currently recommends that every infant be vaccinated against hepatitis B within 24 hours of birth, regardless of the mother’s testing status.
The move overturns that guidance, widely regarded as a public health success story, credited with reducing infections in children by 99 percent since it was first introduced three decades ago. Some members and public health experts warn that this change could have far-reaching consequences, such as a rise in infections among children.
The vote only affects the timing of the first dose of the hepatitis B vaccine series. The second dose will be given one to two months after birth, and the third dose will be given between six and 18 months.
All pregnant people should be tested for hepatitis B during pregnancy. In previous meetings, some advisors had questioned the need to vaccinate babies if their mothers tested negative.
However, test results may produce false negatives; Some people become infected after being tested later in pregnancy, and babies can also become infected from other members of the household.
The panel’s closely watched two-day meeting in Atlanta came after Kennedy gutted the committee and appointed 12 new members, including some prominent vaccine critics. ACIP makes recommendations about who should receive certain vaccines and which vaccines insurance companies should cover free of charge.
Eight members voted yes, while three members voted no. Some advisers pushed back strongly on the new guidance ahead of the vote.
Psychiatrist and voting member Dr. “This has the potential to cause great harm, and I hope the committee accepts responsibility when it causes that harm,” Joseph Hibbeln said.
Dr. D., a voting fellow and professor of pediatrics at Dartmouth Geisel School of Medicine. Cody Meissner said he hopes pediatricians will continue to administer the birth dose in the first 24 hours after birth and before discharge from the hospital.
“It’s not in the best interest of babies to follow any other path,” she said.
Meissner added that more children will be injured and contract hepatitis B infection. Hepatitis B, which can be passed from mother to baby during birth, can cause liver disease and early death. Babies are more vulnerable to chronic hepatitis B infections, for which there is no cure.
“We will see Hepatitis B coming back,” he said. “The vaccine is so effective that changing the vaccination schedule does not make sense to me.”
The American Medical Association said in a statement Friday that the vote was “reckless and undermines decades of public confidence in a proven, life-saving vaccine.” The group added that the decision was not based on scientific evidence and “created confusion for parents about how best to protect their newborn babies.”
Meanwhile, Retsef Levi, a voting fellow and professor at the Massachusetts Institute of Technology, claimed during meetings that experts “never properly” tested the hepatitis B vaccine.
Some members expressed concerns about vaccination during the so-called neonatal period, which is a critical developmental window for the brain and immune system. However, decades of evidence show that the hepatitis B vaccine is administered safely to newborns.
Other consultants said there was no evidence to support delaying the birth dose by two months.
“We must make decisions with the data we have and use only reliable data when making decisions, not speculations or hypotheses,” Hibbeln said.
2024 CDC study showed that the current vaccination program has helped prevent more than 6 million hepatitis B infections and nearly 1 million hepatitis B hospitalizations.
Merck and GSK produce hepatitis B vaccines for use from birth. None of these decisions are a significant source of revenue for companies; therefore, the new proposals should not have a significant impact on the companies’ business.
Still, Merck said in a statement Friday that it was “deeply concerned” by the vote and that it risked “reversing this progress and putting babies at unnecessary risk of chronic infection, liver cancer and even death.” The company added that there was “no evidence to suggest any benefit to children.”
“We are awaiting additional information and formal adoption of today’s recommendations from the CDC to fully understand the potential impact,” GSK said in a statement.
Andrew Johnson, chief policy analyst for the Centers for Medicare and Medicaid, told members during the meeting that the panel’s vote would not affect insurance coverage of vaccines, including those covered by Medicaid and the Children’s Health Insurance Program.
