CDC panel drops hepatitis B shot recommendation for some infants

An advisory panel on vaccines handpicked by Health Secretary Robert F. Kennedy Jr. on Friday voted to drop the decades-old federal recommendation that all infants receive the hepatitis B vaccine at birth.

Why it matters: The move enshrines a top agenda item of vaccine critics as government policy and marks the biggest change to the childhood vaccination schedule since Kennedy was sworn in.

• The idea of changing the recommendation drew intense criticism from the medical establishment and public health leaders, who warned that it will lead to more preventable cases of hepatitis B, which can cause liver failure, cancer and even death.

Driving the news: The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices voted 8-3 to drop the policy of recommending that all infants get the shot at birth.

• Instead, it recommended that mothers who test negative for hepatitis could get their infants vaccinated after at least two months of age after consulting with doctors. Mothers testing positive would continue to be recommended to have their infants vaccinated.
• Panel members who backed the change argued that the vaccine is not necessary for children born to mothers who test negative.
• "I suggest to parents to be very, very suspicious when people tell them that something is safe, especially a vaccine," said Retsef Levi, a professor of operations management at MIT.

Yes, but: Many medical experts warn that the testing system is not perfect and that some infants will go unprotected when the the hepatitis B vaccine has overwhelmingly shown to be safe.

The panel's recommendations are non-binding and still have to be formally approved by CDC leadership.

• The CDC and its advisers under Kennedy have emphasized "individual-based decision-making" as it reshapes decades of vaccine policy.

What they're saying: The American Academy of Pediatrics pointed to data showing that since 1991, when the birth dose recommendation began, annual hepatitis B cases in the U.S. have dropped 99%, from 16,000 to less than 20.

• Cody Meissner, a panel member and pediatric infectious disease expert, warned the change would result in more cases. "There is no evidence in regard to lack of safety [of the vaccine]," he said.

• "We're giving it to protect the infant against a potentially fatal disease," he added.

Leading public health groups and medical associations assailed the policy change after the vote.

• The National Association of County and City Health Officials, which represents local health departments, said removing the universal recommendation will make it harder for parents who chose to vaccinate to access care in a timely way.
• American Academy of Pediatrics president Susan Kressly said the change was "the result of a deliberate strategy to sow fear and distrust among families." The group said it continues to recommend all infants receive a first dose of hepatitis B vaccine within 24 hours of birth.

The big picture: The CDC panel postponed the planned vote on hepatitis B vaccine on Thursday amid confusion over the wording of the recommendation.

• ACIP also heard on Friday from leading anti-vaccine lawyer Aaron Siri in a broader discussion of the childhood vaccine schedule, though no votes are scheduled on that front.

The story has been updated with comment from medical and public health groups.