Health and Human Services Secretary Robert F. Kennedy Jr.'s influential vaccine advisory panel on Friday, Dec. 5, voted to no longer universally recommend the first dose of the hepatitis B vaccine for newborns within 24 hours of birth, a sweeping overhaul of vaccine policy.

One day after tabling the vote during a contentious meeting, the Advisory Committee on Immunization Practices recommended "individual-based decision making" for parents of babies born to mothers who test negative for hepatitis B. For parents who decline the birth dose, the panel recommended the first shot be delayed to "no earlier than two months of age."

Committee members who supported the change emphasized the panel still recommended newborns get vaccinated at birth when born to a mother with hepatitis B. The panel's recommendations are sent to the Centers for Disease Control and Prevention director. The committee does not have regulatory authority, but states often consider the panel's recommendation when requiring vaccines for school-age children and other groups.

The panel also recommended parents consult with their doctor or other health provider on whether to get an antibody test during the course of the three-dose vaccine, and that insurance companies cover the cost of the test.

Robert Malone, the committee's vice chairman, characterized the vote to no longer universally recommend a birth dose vaccine as one that pitted individual rights against societal obligations.

"We're torn by these two conflicting points of views," Malone said. "There are these two fundamental differences of opinion about the rights of individuals versus the rights of society."

Committee member Cody Meissner rejected the changes. He said hepatitis B cases are dropping due to the effectiveness of the vaccine. Since the current three-dose regimen was adopted in 1991, hepatitis B infections among children and teens have dropped sharply. A 2023 study in the official journal of the U.S. Surgeon General credited the three-dose vaccine beginning at birth as preventing chronic hepatitis cases that can lead to cirrhosis and liver cancer.

"It's a mistake to say, because we're not seeing so much disease, we can alter the ... frequency or the schedule for administration because we will see hepatitis B infections come back," Meissner said.

Committee member Joseph Hibbeln said the committee lacked the data to support wording to delay the first dose, noting there isn't enough evidence to suggest some babies might be better protected by such a delay. He also noted the wording of the questions had been changed four times over four days.

Committee member Retsef Levi, who supported the change, said the risk for children born to a mom without hepatitis b is extremely low.

“Do you want to expose your baby to an intervention that could have some potential harms," Levi said.

Panel's hepatitis B recommendation draws criticism

U.S. Sen. Bill Cassidy, R-Louisiana, has been critical of efforts to change the hepatitis b vaccine schedule. In a social media statement posted shortly after the vote, Cassidy, a liver doctor, said the panel's recommendation was a mistake.

"Acting CDC Director (Jim) O’Neill should not sign these new recommendations and instead retain the current, evidence-based approach," Cassidy said.

On Thursday, he criticized the committee's decision to invite Aaron Siri to discuss vaccinations, calling him a "trial attorney who makes his living suing vaccine manufacturers. He is presenting as if an expert on childhood vaccines."

"The ACIP (committee) is totally discredited," Cassidy said in a social media post on Thursday. "They are not protecting children."

Dr. Richard Besser, president and CEO of the Robert Wood Johnson Foundation and former acting director of the Centers for Disease Control and Prevention, said the vote puts childrens’ health at risk.

“This vote opens the door to a resurgence of hepatitis B infections and is one more step in the administration’s concerted efforts to dismantle the recommended childhood vaccination schedule,” Besser said.

He added more babies and infants will suffer from severe illness and some will die.

“Those of us who care about children’s health cannot allow this to happen,' Besser said. "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."

This article originally appeared on USA TODAY: RFK Jr. panel ends recommendation of hepatitis b vaccine for newborns

Reporting by Ken Alltucker, USA TODAY / USA TODAY

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