Without data to support their decision and defying warnings from doctors, medical associations and public health groups, a federal advisory panel stocked with loyalists to Health and Human Services Secretary Robert F. Kennedy Jr. has voted to stop recommending a life-saving vaccine to infants at birth.
The Centers for Disease Control and Prevention will stop recommending the hepatitis B birth dose for infants — specifically those born to mothers who test negative for the virus — until they’re at least 2 months old, following a vote on Friday morning by the Advisory Committee on Immunization Practices (ACIP). Eight panel members voted to stop the recommendation, with three dissenting.
“‘Do no harm’ is a moral imperative. We are doing harm by changing this wording. And I vote no,” Dr. Cody Meissner, a Dartmouth University professor of pediatrics, said before the vote.
The group also voted to approve a second, last-minute change to the hepatitis B schedule: a recommendation that babies get a blood test to determine whether they should receive additional doses after the first. The suggestion was criticized by several members as unrealistic and ineffective at determining immunity.
“Vote two is kind of making things up,” Meissner said. “I mean, it’s like never-never land.”
The decision follows a chaotic and ultimately unproductive meeting Thursday for the panel, which has been marked by controversy since Kennedy ousted its veteran members in June and replaced them with vaccine critics and ideological allies.
The ACIP is totally discredited.
They are not protecting children.”
— Louisiana Sen. Bill Cassidy
ACIP’s meetings have been dominated by anti-vaccine activists whose testimony was frequently off-topic and ill-informed. Panel members blamed immigrants and gay men for disease and relied on fear-mongering anecdotes over scientific data to provide evidence for their claims. Thursday’s session devolved into infighting between Kennedy’s band of activists and the few experts present, ending in confusion over what exactly the panel was voting on and, ultimately, a vote to postpone.
“You are wasting taxpayer dollars by not having scientific, rigorous discussion on issues that truly matter,” Jason Goldman, president of the American College of Physicians and liaison to the panel, said at one point. “The best thing you can do is adjourn the meeting.”
Following the vote Friday, the panel was set to open its discussion to the childhood vaccine schedule. Anti-vaccine lawyer and Kennedy adviser Aaron Siri was scheduled to present during that session.
The panel has been widely regarded by experts as illegitimate since Kennedy’s takeover. At ACIP’s last meeting in September — similarly marked by confusion, name-calling, and a last-minute decision to delay the hepatitis B vote — the panel voted to stop recommending a combined vaccine against measles, mumps, rubella and chicken pox for children under 4, and restricted access to Covid-19 vaccines for some groups.
“The ACIP is totally discredited. They are not protecting children,” Louisiana Sen. Bill Cassidy, a liver doctor whose initial support helped Kennedy get confirmed at HHS, said in a post on X on Thursday morning.
Medical experts and national agencies have effectively turned their backs on the panel. The American Academy of Pediatrics has boycotted recent ACIP meetings and now publishes its own vaccine recommendations for parents and providers.
“No creditable group takes them seriously anymore,” said Dr. Georges Benjamin, executive director of the American Public Health Association. Benjamin told MS NOW that overturning the hepatitis B recommendations was “the definition of insanity.”
Experts warn that most babies infected with hepatitis B near birth will likely suffer chronic infection, and one-quarter of that group will die from liver disease or cancer.
Since 1991, the CDC has recommended a birth dose of hepatitis B and two more doses, some administered in combination shots, over the next 15 months. It’s not clear how a disruption in the birth dose might affect the others. Experts credit the universal dose with the near-elimination of hepatitis B in babies — from about 16,000 cases per year to fewer than 20.
A vote to stop recommending the vaccine will cause cases to skyrocket, according to a recent analysis, and could have disastrous implications for availability of the vaccine, as private insurance providers and federal programs typically rely on CDC recommendations to determine coverage.
Insurance companies have said they’ll continue to cover the schedule of vaccines recommended by the panel before Kennedy, but ACIP serves an important role in a federal program, Vaccines for Children, which pays for vaccines recommended by the panel and helps provide poor children access to those vaccines. About half of American children qualify for the program and could be affected by ACIP’s changes.
Thursday’s meeting highlighted how disjointed and secretive the ACIP process has become under Kennedy’s leadership. In an unusual move, Kennedy’s CDC didn’t release preliminary information on the individual working groups — smaller offshoot panels usually composed of CDC scientists and ACIP members — that assembled subject reports and presented findings before the vote. But the presentations offered some insight into those groups’ makeup and ideologies.
First to present was ACIP member Vicky Pebsworth, a registered nurse and a longtime research director at the National Vaccine Information Center, one of the country’s oldest anti-vaccine organizations. Pebsworth argued that nebulous “dissatisfaction” over the vaccine was reason to reexamine the schedule for children. Pebsworth attributed risk from hepatitis B to gay men, drug users and immigrants — a claim that both misinforms and stigmatizes disease. A final slide from one activist captured the proceedings best: “The safety concern may be more theoretical than real.” Another working group member, Cynthia Nevison, a researcher and contributor to the anti-vaccine nonprofit Kennedy founded, suggested that the CDC’s data on hepatitis B cases was wrong, that the vaccines were ineffective and that certain conditions — like multiple sclerosis and arthritis — may be caused by the vaccine. Nevison offered no evidence for her claims, which are unsupported by scientific research. Anti-vaccine activist and current senior adviser to the CDC Mark Blaxill rounded out the morning’s presentations with a suggestion that not enough research had been done to declare the vaccine safe. (A robust body of scientific research has found that the vaccine is extremely safe for newborns.) But even among Kennedy’s stacked ACIP panel, there were dissenters. Two panel members — Meissner, one of the few panel members with relevant expertise, and Dr. Joseph Hibbeln, a nutrition scientist and seafood industry adviser — pushed back against the others’ testimony. “I take strong positions against each of the three presentations that have been made,” Meissner said. He then listed a series of facts detailing the safety and efficacy of the vaccine. “There is no evidence of harm.” he concluded. Hibbeln called on any of the presenters to provide “solid reproducible evidence of harm.” When no one responded, he replied: “So speculation and limited evidence. OK, got it.” Anti-vaccine activists argue that women who aren’t infected with hepatitis B are unlikely to pass it to their babies. Experts counter that the vaccine is safe, and that the current recommendation provides blanket protection for babies whose mothers are not tested or whose test results are incorrect. Experts note that most babies infected near birth will likely suffer chronic infection, and one-quarter of that group will die from liver disease or cancer. Activists also argue that the birth dose is unnecessary because hepatitis B is a sexually transmitted disease, but experts note the highly infectious virus can remain on surfaces for up to seven days and is transmitted outside sexual contact, including at daycares and from family members. “It’s an infectious disease like any other,” Dr. Benjamin told MS NOW. “Yes, there are people who are substance abusing individuals, yes, it is true that people with underlying chronic diseases and autoimmune diseases can get infectious diseases. But the evidence shows everybody is at risk, and anyone who thinks they’re not at risk is fooling themselves.” ACIP member Dr. Evelyn Griffin, a Louisiana obstetrician who practices “holistic health” and has publicly supported Kennedy, said babies born to mothers without hepatitis B shouldn’t have to protect others. Instead, she suggested that “illegal immigration” was the “elephant in the room” that should be addressed. A final slide from one activist captured the proceedings best: “The safety concern may be more theoretical than real.”
Brandy Zadrozny is a senior enterprise reporter for MS NOW. She was a previously a senior enterprise reporter for NBC News, based in New York. Recommended
