CDC advisers postpone important decision on hepatitis B vaccination during tense meeting

During a meeting marked by tension and uncertainty, the independent advisers to the US Centers for Disease Control and Prevention once again postponed a significant vote that could reshape how hepatitis B vaccines are administered to newborns in the United States. The Advisory Committee on Immunization Practices (ACIP) had been expected to decide whether to revise current guidance for infant vaccination, but confusion over shifting wording and unclear voting language led members to delay the decision until Friday.

This vote, already postponed from September, would represent the most consequential adjustment to the US childhood vaccine schedule since the appointment of Health and Human Services Secretary Robert F. Kennedy Jr., who previously dismissed the full committee and installed new members.

Confusion Over Voting Language

Thursdays session quickly became mired in uncertainty. Members struggled with multiple last-minute revisions to the voting questions, prompting frustration about the lack of clarity on what they were being asked to approve. When updated language could not be presented promptly, the committee voted 63 to postpone the decision to allow more time for review.

Questions About Revisiting the Policy

The core issue behind the debate is why the longstanding recommendationroutine hepatitis B vaccination at birthshould be reconsidered at all. The disease can remain dormant for decades before causing severe liver damage. Since universal newborn vaccination began in 1991, annual infant infections have dropped from roughly 18,000 to around 20.

Some members expressed concern that changing a policy credited with virtually eliminating infant hepatitis B infections requires substantial justification. Others noted that advocacy groups had pressed for reconsideration, and that ACIP has a responsibility to periodically re-evaluate its recommendations.

Contentious Presentations and Expert Pushback

The meeting featured presentations from outside contributors whose conclusions questioned both the threat posed by hepatitis B to infants and the value of the birth dose. Several public health experts criticized these presentations as scientifically unsound and warned that key studies were misinterpreted.

Dr. Jason Goldman, representing the American College of Physicians, argued that the discussion was not grounded in established evidence and urged the committee to end the meeting outright rather than proceed with a flawed vote. Other experts stressed that decades of research support the importance of administering the vaccine at birth to prevent transmission from infected mothers.

Debates Over Evidence Standards

The meeting closed with a heated exchange over how scientific evidence should be evaluated. Some participants urged a return to comprehensive, systematic review rather than selective examination of individual studies. Others claimed that important data were being dismissed as low-quality.

What Happens on Friday

On Friday, ACIP is expected to vote on three key issues:

• Whether infants born to mothers who test positive for hepatitis B should continue to receive both a vaccine dose and immunoglobulin at birth, while allowing individualized decision-making for infants of mothers who test negative.
• Whether to reaffirm the existing recommendation for a birth dose when a mothers hepatitis B status is unknown.
• Whether parents should consult their health care providers to determine if their children need hepatitis B testing before receiving additional doses.

The committee will also review the overall childhood and adolescent vaccine schedule. A scheduled presentation by attorney Aaron Siri, known for challenging vaccine mandates, has drawn criticism from lawmakers concerned about the direction of ACIP under the current administration.

Author: Caleb Jennings