A federal vaccine panel handpicked by Health and Human Services Secretary Robert F. Kennedy, Jr. voted Friday to stop recommending immediate immunization for all newborns against hepatitis B, a dangerous virus that leads to chronic liver disease in more than 90 percent of infected infants.
Earlier this year, Kennedy — a longtime vaccine skeptic who nevertheless vowed during his confirmation hearings to do nothing that would “make it harder or harder for people to get vaccines” — fired all 17 previous members of the Advisory Committee on Immunization Practices (ACIP), replacing them with people who share his views and who mostly have no vaccine research or clinical experience.
Kennedy’s panel had postponed three previous attempts at a vote amid “division and dysfunction,” according to the New York Times. On Friday, panel members voted 8-3 that women who test negative for the hepatitis virus should consult with their health care provider and decide when or if their child will be vaccinated. These parents and their providers should “consider the benefits of the vaccine, the risks of the vaccine, and the risks of infection” and administer the vaccine “no earlier than 2 months,” the group added.
The group did not change the existing recommendation to immunize newborns of mothers known to be infected or whose status is unknown.
Experts opposed the new guidelines, noting that hepatitis B vaccines have nearly eliminated cases among U.S. newborns — and that there is no evidence they harm anyone.
“We know it’s safe and we know it’s very effective,” said Dr. Cody Meissner, professor of pediatrics at Dartmouth Geisel School of Medicine. But now “we will see more children, teenagers and adults infected with hepatitis B.”
Here’s everything you need to know to understand the change.
Where did this change come from?
Beyond claiming that babies are getting too many vaccines and that the current vaccination schedule must be somehow unhealthy — a claim the American Academy of Pediatrics describes as “dangerous and inaccurate” — anti-vaccine critics have focused specifically on hepatitis B because of how it tends to be transmitted.
“Hepatitis B is sexually transmitted, there’s no reason to give it to a child who was almost born with hepatitis B,” President Trump said in September. “So I’d say wait until the child is 12 and forming.”
Critics have also suggested that “the risk of infection during the early stages of life, and probably most of childhood, is extremely low,” as Retsef Levi, an ACIP panelist and professor of operations management at the Massachusetts Institute of Technology, said Friday. “To quantify how low it is, it’s probably one in a few million.”
Why should we vaccinate all newborns against hepatitis B?
Experts say the group’s reasoning is flawed.
First, testing is not foolproof. Each year, more than 17,000 babies are born in the U.S. to women who have hepatitis B. But nearly one in five pregnant women are not tested for the virus, and only about one in three women who test positive receive care, according to a report released Tuesday by the Vaccine Integrity Project.
In general, about half of people infected with hepatitis B do not know they have the virus.
And even if a mother do what Test negative, her child can still get hepatitis B. Before the U.S. began universal newborn vaccination against hepatitis B in 1991, about 18,000 children a year were infected before the age of 10. Only half of these infections were from the mother at birth. The rest got infected elsewhere.
“There have been cases of infections in kindergarten,” Dr. Andrew Pavia, a professor of pediatrics and medicine at the University of Utah and a specialist in infectious diseases for children and adults, recently told NPR. “There have been cases of infection in sports teams. Infections from common toothbrushes and common razors have been documented.”
That means 9,000 children who would be missing out on the new guide.
The risks of childhood hepatitis B infection are too serious to ignore, experts say – even if cases are rare. Only 5% of people infected as adults develop chronic hepatitis B. But that number skyrockets to 90% among infants. The result? An increased risk of cirrhosis, liver failure and liver cancer during your lifetime. About 25% of children who develop chronic hepatitis B end up dying from the infection.
“As a liver doctor who has treated hepatitis B patients for decades, this change to the vaccination schedule is a mistake,” wrote U.S. Sen. Bill Cassidy of Louisiana, a Republican and physician, on X. “The hepatitis B vaccine is safe and effective. The birth dose is a recommendation, NOT a mandate. . . . Ending the caseload will begin again. sicker.”