Advisory panel appointed by Health Secretary Robert F. Kennedy Jr. voted Thursday to stop recommending that all newborns in the United States routinely receive a Hepatitis B vaccine, a major reversal of three decades of federal guidance that public health experts say could increase infections in infants and children.
The Advisory Committee on Immunization Practices voted 8-3 to shift to “individual-based decision-making” for the birth dose when mothers test negative for Hepatitis B, recommending that parents consult a health care provider to weigh “vaccine benefits, vaccine risks, and infection risks.” The panel also advised that babies who are not vaccinated at birth should wait at least two months before receiving the first dose.
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The change, expected to be formally adopted later by Trump-appointed officials at the Centers for Disease Control and Prevention, overturns the 1991 recommendation that has guided U.S. practice and is credited with virtually eliminating Hepatitis B infections among young people in the country.
Supporters of the decision argued it aligns the U.S. schedule with those of some other high-income countries such as France and Britain. But public health officials and pediatricians warned the move risks lower vaccination coverage in the United States, where maternal screening can be inconsistent and access to care is uneven.
“This irresponsible and purposely misleading guidance will lead to more Hepatitis B infections in infants and children,” said American Academy of Pediatrics President Susan J. Kressly in a statement after the vote.
The panel’s composition has changed markedly since Kennedy, who has a long record of promoting vaccine-skeptic views, became health secretary. Several new members have been criticized by scientists for lacking relevant expertise or for endorsing positions outside mainstream public health guidance.
Dr. Cody Meissner, one of three dissenters on the committee, urged colleagues before the vote not to alter the long-standing recommendation. “Do no harm is a moral imperative. We are doing harm by changing this wording,” he said.
Federal vaccine recommendations affect insurance coverage and state policies; a change to the ACIP guidance could influence which vaccines insurers pay for in the United States, where individual vaccine costs can be high. Several Democratic-led states have already signaled they will not follow the committee’s new recommendation.
The ACIP vote comes as the committee prepares a broader review of the childhood vaccination schedule and vaccine composition. The decision has drawn criticism across party lines, including from some Republicans who supported Kennedy’s confirmation, such as Sen. Bill Cassidy of Louisiana, who urged CDC officials not to adopt the new language and to retain the existing evidence-based approach.
The debate underscores a tension between efforts to tailor care to individual risk and concerns from public health experts that changing a universal birth-dose policy will reverse decades of progress against a vaccine-preventable liver infection.
By Abdiwahab Ahmed
Axadle Times international–Monitoring.
