A federal panel picked by RFK Jr. voted to end Hepatitis B vaccines for newborns

In a move that is sure to increase criticism of Health and Human Services Secretary Robert F. Kennedy Jr., a federal vaccine advisory panel 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 stacked the committee with vaccine skeptics. After a day of contentious hearings on Thursday, the committee voted 8-3 to recommend that parents discuss with their doctors whether to give the hepatitis B vaccine at birth, or at all, and that those who choose to do so wait to begin the 3-vaccine series until their baby is at least 2 months old.

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

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

Since Kennedy, a long time vaccine opponent, was confirmed in January, he has doggedly pursued his goal of ending what he calls “pharmaceutical capture” of America’s health agencies. He regularly claims that staffers at the agencies under his purview are too friendly to the companies they regulate.

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

After the Thursday hearing Cassidy posted on X that “The ACIP is totally discredited.” After Friday’s vote, he took to X again, posting that “this change to the vaccine schedule is a mistake. The hepatitis B vaccine is safe and effective…Before the birth dose was recommended, 20,000 newborns a year were infected with hepatitis B. Now, it’s fewer than 20. Ending the recommendation for newborns makes it more likely the number of cases will begin to increase again. This makes America sicker. Acting CDC Director O’Neill should not sign these new recommendations.”

The CDC is not required to adopt ACIP’s recommendations, although it almost always does. And although the CDC recommendations are not a mandate, they do influence what shots insurers will or will not pay for. Former CDC Director Susan Monarez said she was fired in August because she refused to promise Kennedy she would accept any recommendation that came 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. “This irresponsible and purposely misleading guidance will lead to more hepatitis B infections in infants and children,” AAP President Dr. Susan J. Kressly said.

And Richard Besser, MD, president and chief executive of the influential Robert Wood Johnson Foundation and a former acting director of the CDC, issued a statement saying that “policymakers, physicians, and families must turn to reputable medical and public health groups for guidance, and health insurers should do the same for informing what vaccines they will cover.”

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

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 plan coverage decisions for immunizations are grounded in each plan’s ongoing, rigorous review of scientific and clinical evidence, and continual evaluation of multiple sources of data,” said AHIP (formerly America’s Health Insurance Plans).