CDC advisory panel delays vote on hepatitis B vaccines

In a chaotic meeting Thursday rife with misinformation, the CDC’s vaccine advisory committee — whose members were fired in June by Health Secretary Robert F. Kennedy Jr. and replaced by a group that has widely expressed skepticism about vaccines — once again delayed an expected vote on hepatitis B vaccines.

Due to disagreements and confusion over the language of the vote, the Centers for Disease Control and Prevention panel, formally known as the Advisory Committee on Immunization Practices, decided to postpone the vote until Friday morning instead of holding it Thursday afternoon as planned. The commission had already submitted a vote in September on the hepatitis B vaccination schedule.

The meeting constituted, in many respects, a radical departure from past practices. Typically, ACIP evaluates new vaccines or new indications for them, not vaccines that have been administered in the same way for decades.

The CDC has recommended for 34 years that all newborns receive a first dose of the hepatitis B vaccine within 24 hours of birth. But the committee is considering whether to rescind those guidelines and instead suggest that women who test negative for hepatitis B decide, in consultation with a health care provider, whether their baby should receive the dose at birth.

If adopted, this recommendation would run counter to a broad consensus among public health experts, who before the meeting had made a strong appeal not to change the hepatitis B vaccination schedule.

On Thursday, the advisory committee met in the CDC’s broadcast studio, under bright lights and in front of large television cameras, instead of its typical conference room — giving the appearance of a television show rather than a scientific discussion. Asked about the location, Andrew Nixon, a spokesman for the Department of Health and Human Services, said it was intended to “respond to increased public interest in the committee.”

The debates were marked by a deluge of misleading assertions and cherry-picked data.

Several presenters and panel members asserted that there was little evidence for the safety or effectiveness of the hepatitis B vaccine, ignoring decades of evidence to the contrary. In previous meetings, CDC medical experts have presented data on the risks of a given disease and the safety and effectiveness of vaccines that target it. But Thursday’s presentations were made by two anti-vaccine activists and a climate scientist who wrote for an anti-vaccine publication.

The meeting is the most egregious example yet of the extent to which the group has strayed from its original mission, which was to determine who should get vaccinated – and when – based on a comprehensive scientific analysis of the risks and benefits.

In a safety presentation, anti-vaccine activist Mark Blaxill — a businessman and author without a medical degree recently hired at the CDC — suggested that symptoms identified in babies who received the hepatitis B vaccine, such as fatigue, weakness, diarrhea or irritability, were “possibly related” to brain swelling or encephalitis.

Dr. Cody Meissner, the only ACIP member to ever serve on the committee, countered: “It’s absolutely not encephalitis,” he said. “That’s not a statement a doctor would make. They’re not related to encephalitis, and you can’t say that.”

Early in the afternoon, several committee members expressed confusion about what they were voting on and pointed out issues with voting language.

“Maybe this was written by the termination department,” joked ACIP member Dr. Joseph Hibbeln, a psychiatrist and neuroscientist.

Committee Chairman Dr. Kirk Milhoan was not present during the decision to postpone the hepatitis B vote. Vice Chairman Dr. Robert Malone said Milhoan was “about to jump on a plane to go to Asia and would not be available, I believe, to [the discussion] tomorrow.”

Dr. Jason Goldman, president of the American College of Physicians, said at the meeting that the debates amounted to “political theater.”

“You’re wasting taxpayer dollars by not having scientific, rigorous discussions about issues that really matter,” Goldman said. “The best thing you can do is adjourn the meeting and discuss the vaccine issues that actually need to be addressed. »

Sen. Bill Cassidy, R-La., said on X before the meeting began that the advisory committee was “totally discredited” and “doesn’t protect children.” Cassidy, a liver specialist who has treated patients with hepatitis B, chairs the Senate health committee and voted to confirm Kennedy as health secretary.

Hepatitis B is an incurable infection that can lead to liver disease, cancer and death. The virus can be passed from mother to child during childbirth, and not all pregnant women are tested. So public health experts say delaying injections could lead to more infections.

The prevailing medical consensus is that hepatitis B vaccines are extremely safe, based on decades of real-world data. A CDC analysis of children born between 1994 and 2023 estimated that hepatitis B vaccination prevented more than 6 million infections and nearly 1 million hospitalizations.

In addition to its vote on hepatitis B vaccines Friday, the CDC advisory committee is also expected to discuss the overall childhood immunization schedule, as well as the presence of aluminum salts found in many childhood vaccines, which help boost the immune response and reduce the number of doses required.

Both topics are hot topics among anti-vaccine activists, who often argue that children get too many vaccines and that the aluminum salts they contain increase the risk of autoimmune diseases or neurodevelopmental disorders. None of these claims are supported by scientific evidence.

Aaron Siri, an anti-vaccine lawyer who represented Kennedy, is expected to make a presentation Friday. Siri advocated for the Food and Drug Administration to revoke its approval of the polio vaccine. It was his presence on the ACIP agenda that angered Cassidy.

In response to Cassidy’s post on X, which targeted Siri, Siri fired back in her own post, challenging Cassidy to a lengthy debate.

Aria Bendix reported from New York and Erika Edwards from CDC headquarters in Atlanta.