Federal panel votes to end Hepatitis B vaccines for newborns

In a move sure to increase criticism of Health and Human Services Secretary Robert F. Kennedy Jr., a federal vaccine advisory committee hand-picked by him voted Friday to end a 34-year-old policy to vaccinate all babies at birth against hepatitis B, going against the recommendations of virtually all medical and public health experts.

After taking office earlier this year, Kennedy fired all 17 members of the Advisory Committee on Immunization Practices (ACIP), which advises the Centers for Disease Control and Prevention (CDC) on vaccine policy, and filled the committee with vaccine skeptics. After a day of contentious hearings Thursday, the commission voted 8-3 to recommend that parents talk with their doctors about whether to give the hepatitis B vaccine at birth, or not at all, and that those who choose to do so wait to start the three-vaccine series until their baby is at least 2 months old.

Hepatitis B is a highly infectious virus that can cause chronic liver disease in most infected children and even death. The CDC currently recommends that all babies receive the first dose of the hepatitis B vaccine within 24 hours of birth, or within 12 hours if born to mothers infected with hepatitis B. Since the CDC introduced its universal recommendation of hepatitis B vaccine for all newborns in 1991, the incidence of hepatitis B virus in children has fallen by 99%.

A second vote, passed 6-4 with 1 abstention, recommended that parents who decide to vaccinate their baby against hepatitis B consider having the child tested after a first dose to see if additional doses are needed, even though several speakers cautioned the committee that there is no evidence showing that any one dose confers long-term protection.

Since Kennedy, a longtime vaccine opponent, was confirmed in January, he has doggedly pursued his goal of ending what he calls “pharmaceutical capture” of U.S. health agencies. He regularly claims that staff at agencies under his jurisdiction are too friendly toward the businesses they regulate.

The committee vote drew immediate criticism from U.S. Sen. Bill Cassidy, MD (R-LA), chairman of the Senate Health, Education, Labor and Pensions Committee, as well as the tie-breaking vote to confirm Kennedy to the HHS post. He said he voted for it only after Kennedy assured him he would not change the vaccination schedule. Cassidy is a liver specialist who has long supported the hepatitis B vaccine for newborns.

After Thursday’s hearing, Cassidy posted on X that “ACIP is totally discredited.” After Friday’s vote, he addressed Acting CDC Director O’Neill should not sign these new recommendations.

The CDC is not required to adopt ACIP recommendations, although it almost always does. And while the CDC’s recommendations aren’t a mandate, they influence which vaccines insurers will or won’t pay for. Former CDC Director Susan Monarez said she was fired in August because she refused to promise Kennedy that she would accept any recommendations coming from ACIP.

The American Academy of Pediatrics said in a statement that it would continue to recommend hepatitis B vaccination for all newborns despite the vote. “These irresponsible and intentionally misleading guidelines will lead to more hepatitis B infections in infants and children,” said AAP President Dr. Susan J. Kressly.

And Richard Besser, MD, president and CEO of the influential Robert Wood Johnson Foundation and former acting director of the CDC, issued a statement saying that “policymakers, doctors, and families should look to reputable medical and public health groups for guidance, and health insurers should do the same for guidance on which vaccines they will cover.”

Meanwhile, an ACIP task force of 13 people, including some with ties to vaccine-skeptical groups, is currently reviewing the entire childhood immunization schedule. Health insurers are required to make vaccines free if they are recommended by the ACIP and then adopted by the CDC, so any changes the committee makes to vaccine policy could have a significant impact on vaccine affordability and accessibility.

However, the nation’s largest health insurance association said in September that its members would continue to cover all vaccines currently recommended by the federal government. “Health plans’ coverage decisions for vaccinations are based on each plan’s ongoing and rigorous review of scientific and clinical evidence, as well as ongoing evaluation of multiple data sources,” said AHIP (formerly America’s Health Insurance Plans).