CDC panel makes most sweeping revision to child vaccine schedule under RFK Jr.

ATLANTA - An influential vaccine advisory panel on Friday voted to lift a long-standing recommendation that all newborns receive a vaccine for hepatitis B, marking the most significant change to the childhood immunization schedule under Health Secretary Robert F. Kennedy Jr.

The Advisory Committee on Immunization Practices approved the change despite fierce objections from medical groups who said the recommendation had proved a successful public health strategy, nearly eradicating the dangerous virus among U.S. children.

The committee voted 8-3 to eliminate a recommendation dating to 1991 for every child to receive a first dose of a hepatitis B vaccine shortly after birth. The panel said the newborn shot is no longer necessary for babies born to mothers who test negative for the virus. They suggested parents of those children delay the first dose for at least two months and consult with their doctors about whether or when to begin administering the three-dose series.

Supporters of the change said the universal recommendation regardless of risk was overly broad and undermined informed choice. Retsef Levi, an ACIP panelist who voted to change the language, said he believes the intention is to push parents to consider whether they want to give another vaccine to their child.

“It’s actually suggesting a fundamental change in their approach to this vaccine and maybe more broadly,” said Levi, a professor of operations management at MIT.

The recommendation from the group of outside government advisers goes to the acting director of the Centers for Disease Control and Prevention for final approval.

Medical experts have argued that it’s important to vaccinate all newborns for hepatitis B, even if their mothers test negative, because babies are at risk of infection if their mothers receive a false negative or become infected after testing. Some of the dissenting panel members pushed back on the change - one called the revised guidance on hepatitis B unconscionable, while another said the move was rooted in “baseless skepticism.”

“We will see hepatitis B infections come back,” said panelist Cody Meissner, a professor of pediatrics at the Geisel School of Medicine at Dartmouth. “The vaccine is so effective, it does not make sense in my mind to change the immunization schedule.”

Under the revised recommendations, parents would still be able to vaccinate their newborns for hepatitis B if they want to, and insurance would still pay for it. But public health advocates said the new approach would cause confusion and create unnecessary fears about the vaccine.

The vote came one day after the committee heard presentations on that issue Thursday but delayed a vote to review proposed language.

Kennedy has long criticized childhood vaccines, including for hepatitis B, and appointed fellow critics to the vaccine committee. On Thursday, prominent vaccine critics recently hired by the CDC questioned the safety and necessity of the vaccine series for infants, despite broad consensus among medical experts that the vaccine is safe and effective.

The decision on the hepatitis B shot could portend broader changes to come.

On Friday, the panel was also expected to launch a sweeping reexamination of the nation’s childhood immunization schedule that includes a presentation by a prominent lawyer for anti-vaccine causes. Friday’s agenda includes discussions on how U.S. vaccine recommendations compare with those in other countries.

An earlier version of the agenda listed presentations on a possible link between asthma in young children and aluminum components in vaccines long deemed safe and necessary to improve immune responses. But on Thursday evening, those agenda items were dropped.

Other than the vote on the hepatitis B vaccine, no other votes are scheduled for Friday.

In the past, the committee has often invited outside speakers with differing opinions. But speakers scheduled Friday have promoted skepticism about routine childhood shots.

Some health experts and representatives of medical organizations said the topics will sow confusion while offering a government-sponsored forum to theories long rejected by mainstream science. They warn that revisiting the schedule could undermine hard-won trust in vaccines as the United States experiences regional outbreaks of preventable diseases such as measles and whooping cough.

“Allowing these people to speak is an egregious attack on public health,” said Elizabeth Jacobs, a professor emeritus of epidemiology at the University of Arizona and founding member of Defend Public Health, an advocacy organization.

The discussion Friday is expected to question whether the U.S. schedule has grown too large and revive claims that the nation’s safety testing and surveillance systems are insufficient. Federal agencies before the Trump administration, as well as independent researchers, have repeatedly rebutted those claims.

The lead presentation is slated to be delivered by Aaron Siri, a Kennedy ally and lawyer for the anti-vaccine movement. Siri is set to discuss the evolution of the childhood immunization schedule, probably including the number of shots children receive, and how the U.S. schedule compares with those in other developed countries, according to a meeting agenda.

Kennedy-aligned activists argue that the cumulative number of shots places an undue burden on child immune systems. Scientists counter that the schedule is designed to protect infants and young children at moments when they are most vulnerable, and that the immune system can safely handle far more antigens than vaccines contain.

Siri petitioned the government in 2022 on behalf of the anti-vaccine group Informed Consent Action Network, which is run by Kennedy’s former communications director, to reconsider its approval of Sanofi’s stand-alone polio vaccine. Siri argued that the government had relied on inadequate data, a claim regulators rejected.

His scheduled appearance rankled Sen. Bill Cassidy (R-Louisiana), a pediatrician and chair of the Senate’s Health Committee, who voted to confirm Kennedy despite concerns about his vaccine stance. In an X post Thursday, Cassidy said that Siri “makes his living suing vaccine manufacturers. He is presenting as if an expert on childhood vaccines. The ACIP is totally discredited.”

Siri replied that federal law limits lawsuits against vaccine makers. “If vaccines are so safe, why do they need this protection?” he wrote on X.

Another scheduled speaker is Tracy Beth Hoeg, a critic of broad childhood coronavirus vaccination and a close aide to Food and Drug Administration Commissioner Marty Makary. She is scheduled to brief the committee on the difference between the U.S. and Danish vaccine schedules. Critics of U.S. vaccine policy often note that European countries recommend fewer shots for children, but public health experts counter that those countries are smaller and have better health care systems to test for and treat disease.