Experts fear for US childhood vaccine schedule after hepatitis B guideline change | US healthcare

The entire U.S. childhood immunization program is now open to scrutiny, experts say, after government vaccine advisers began discussions about the safety and effectiveness of vaccines and their components and changed their recommendations on crucial prevention.

Several of the vaccine advisers are longtime anti-vaccine activists, and they were all chosen by Donald Trump’s controversial Health Secretary Robert F. Kennedy after firing previous advisers in an unprecedented move to make sweeping changes to U.S. vaccination policy. Kennedy frequently criticized vaccines.

The Advisory Committee on Immunization Practices (ACIP) makes recommendations to the director of the U.S. Centers for Disease Control and Prevention, who decides whether to change official policy. The recommendations also have far-reaching effects on state-level insurance policies and coverage. Some states have laws based on recommendations made by the ACIP.

The panel’s historic vote to change the hepatitis B recommendation will create confusion and access issues for families, and questions about routine vaccines point to a worrying trend more broadly, experts said.

“It’s really, really devastating to see what happened today,” said Susan Wang, a pediatrician and former head of perinatal hepatitis B prevention at the CDC. “It also lays the groundwork for destroying the rest of the childhood immunization schedule.”

Robert Malone, ACIP vice president and staunch vaccine critic, raised doubts about the vaccination schedule, calling it the “elephant in the room” on Friday.

“The specific problem, in this case, is related to the cumulative risk across the entire childhood immunization program – and that is a risk for which we do not have adequate data,” he said. Vaccines have been given safely in combination to children for decades, and no risks have been observed, according to the CDC.

Malone and other advisers also looked at aluminum adjuvants, which help vaccines work effectively and which several studies have shown are safe.

Aaron Siri, a lawyer who is currently engaged in several lawsuits against the U.S. government over vaccines, gave a 90-minute selective history of vaccine trials and questioned the long-term effects of vaccination — arguing, without evidence, that some effects might not appear for years.

“What you’re saying is a terrible, terrible misrepresentation of all the facts,” said Cody Meissner, a counselor and professor of pediatrics at Dartmouth College’s Geisel School of Medicine, sharply criticizing Siri’s presentation.

Siri also claimed that Paul Offit and Peter Hotez, both well-known vaccine experts, were invited but chose not to attend the meeting alongside her.

Offit, reached by phone, said he was “never contacted” to speak before ACIP. But, he said, he would have refused.

“It’s no longer an ACIP. It’s an anti-vaccine organization,” he said. He pointed to previous decisions to limit thimerosal-containing flu vaccines and Covid vaccines for vulnerable populations as unscientific decisions.

The hepatitis B decision is a major misstep, he said. The virus lives on surfaces for a week, which is concerning for anyone who comes into contact with it – but young children are particularly vulnerable to long-term illness and death.

“There’s no doubt in my mind that this shortens children’s lives. Why should I be a part of that?” » said Offit. “It’s a travesty of public health. It’s a clown show.”

Recommending new restrictions on established vaccines without any evidence of harm means any vaccine is now up for debate, he said.

For Raksha Raheja, the committee’s decisions are professional and personal. She is a pediatrician whose child is living with cancer.

The erosion of access to and confidence in vaccines puts her immunocompromised son at greater risk, she said.

“When enough people in a community are vaccinated, it protects those who cannot be vaccinated, like my son who has cancer,” Raheja said. “With declining vaccination rates, we are putting vulnerable populations at risk and we are seeing a resurgence of preventable diseases, like measles. »

The United States is currently experiencing the worst measles outbreak in three decades; two unvaccinated children and one adult have died from measles in the United States this year. If the outbreak is not contained by mid-January, the United States will lose its measles elimination status.

At the meeting, several presenters and advisers repeated myths and misinformation about vaccines, including inaccurate claims that they had not been adequately studied or that they caused allergies and autism, links that have been clearly debunked over decades of research.

Yet debates over established vaccines, long proven to be safe and effective, have begun to drive down public confidence in vaccines.

Vicky Pebsworth, a counselor and nurse who has reportedly been “anti-vax longer than RFK,” appeared to argue Thursday that the hepatitis vaccine should not be given because the United States has a low prevalence of the virus — but that this drop in prevalence is largely due to “newborn vaccination efforts,” said Kevin Ault, an obstetrician and gynecologist and former ACIP member.

Despite this, 2 million people in the United States have hepatitis B, indicating the need to continue the vaccination program, Ault said. Ending or preventing widespread vaccination will lead to more illnesses, he added.

Insurers are required to cover vaccines recommended in the childhood immunization schedule, although they may also choose to cover optional vaccines. Vaccines for Children, a federal program, covers vaccination for more than half of children (52%) in the United States and must follow ACIP recommendations.

Changing vaccine recommendations “will generate a lot of confusion for parents,” Wang said.

In recent weeks, she has taken care of several children who arrived sick and unvaccinated.

“Mothers say they are not against vaccines, but are worried about their safety, don’t know which ones to give to their children and need to do their own research,” Wang said.

Declining vaccination rates not only pose a danger to children who are not protected by vaccinations: they also make preventable diseases an even greater threat to everyone, she said. “You have to worry about things that we didn’t have to worry about in the past. »