Vaccine advisory panel decides to stop universal newborn hep B shot in significant change

A federal vaccine advisory committee has decided to discontinue recommending a universal hepatitis B vaccine for all newborns, marking a significant change to the U.S. childhood immunization schedule under Health Secretary Robert F. Kennedy Jr.

The Advisory Committee on Immunization Practices (ACIP) voted to limit the newborn hepatitis B shot to infants whose parent tests positive for the virus or whose infection status is unknown, focusing on a high-risk population. Previously, the vaccine was given to all infants within 24 hours of birth. Medical experts warn this targeted approach may miss infections.

The committee suggested that parents who still wish to vaccinate their newborns should make individualized decisions with a healthcare provider. They also recommended delaying vaccination for those who decline the birth dose until the child is at least two months old, a schedule some medical professionals say lacks scientific support. These changes may cause confusion for families and complicate logistics for healthcare providers.

Experts fear this decision could fuel vaccine hesitancy amid misleading government messaging. Michael Ninburg, former president of the World Hepatitis Alliance, said public doubts could increase, stating, The sowing of doubt is probably the most dangerous part.

ACIP members debated the issue over two days in Atlanta, postponing votes due to confusion about the scope of the recommendations. The final vote was influenced in part by outside speakers, some holding anti-vaccine views, who claimed hepatitis B infections are overstated and the vaccine is less safe than believed. These claims have been widely criticized by multiple medical groups.

Some committee members questioned delaying the first shot to two months. Dr. Joseph Hibbeln remarked on the lack of data supporting this change, calling it unconscionable. Dr. Cody Meissner warned the adjustment could lead to more infections among children, adolescents, and adults.

The alteration of the childhood vaccine schedule, which gradually protects children against preventable diseases, may increase hepatitis B infections, chronic illness, and death. Emily R. Smith, interim chair at George Washington Universitys Milken Institute School of Public Health, emphasized that universal newborn vaccination has been a global health success, potentially preventing thousands of deaths. She noted that the universal approach ensures all children are protected, not just those whose parents opt in.

While some ACIP members supported the change for parental choice, Smith argued that parents already have the option to decline vaccines. Adjusting the schedule could create obstacles for those seeking protection, disrupt combined vaccine doses, and raise future out-of-pocket costs. Federal officials say no new costs are expected, and private insurers plan to cover shots through 2026.

The hepatitis B vaccine is highly effective when given at birth, preventing up to 90% of perinatal infections. Since its universal adoption in the early 1990s, infant infections have dropped by 95%, saving an estimated 90,000 lives. Delaying the first dose could result in over 1,400 infections, 300 cases of liver cancer, and 480 deaths per year among high-risk infants.

Critics of the decision note that hepatitis B can be transmitted during delivery, through caregivers, or unknown exposures. Many pregnant individuals are not consistently tested for hepatitis B, leaving gaps in protection. Michaela Jackson from the Hepatitis B Foundation highlighted that prior to universal vaccination, only half of infected children were exposed through their parent.

Some panel members controversially attributed existing cases to immigrants, sparking criticism from medical groups. Experts urged ACIP to maintain the proven birth dose, warning that removing it endangers the most vulnerable infants.

Dr. Jason Goldman of the American College of Physicians called the vote an unnecessary measure that increases risk without solving real problems. ACIPs decisions come amid rising vaccine hesitancy promoted by Kennedy, who has also replaced experienced panelists with new members, some endorsing conspiracy theories. Recent changes under Kennedys leadership have included scaling back COVID-19 and measles vaccine recommendations and promoting unsupported claims about vaccine safety.

Senator Bill Cassidy criticized the panel as totally discredited and failing to protect children. The recent votes indicate that additional changes to vaccine policy may follow, including revisiting the overall childhood vaccine schedule.

Author: Maya Henderson