CDC vaccine advisers postpone hepatitis B vote due to confusion

A federal advisory committee on vaccines has postponed a vote on whether to revise guidance recommending that all newborns receive the hepatitis B vaccine immediately after birth. Members cited insufficient time to fully review the proposal. The vote is now scheduled for Friday.

The confusion arose from last-minute edits to the proposed language regarding the hepatitis B vaccination. The vaccine prevents a virus that can lead to severe liver disease, though some critics have questioned administering it universally. While mothers can transmit the virus to their infants, the disease is primarily spread through sexual contact and needle sharing. Medical experts affirm the vaccine is safe and serves as an important precaution for newborns.

During the meeting, Robert Malone, vice chair of the Advisory Committee on Immunization Practices (ACIP), presented a proposal suggesting that children born to mothers who test negative for hepatitis B might not need the birth dose. This version differed from the CDCs website update posted Wednesday, causing confusion among panel members.

The ACIP provides recommendations to the CDC, which ultimately sets the national vaccine schedule. The proposal presented by Malone advises parents of infants born to hepatitis B-negative mothers to discuss vaccination with their physician. It also recommends that families choosing to delay the birth dose wait at least two months before starting the standard three-dose series, which is typically completed by 18 months of age.

The panel had planned a second vote regarding children whose mothers infection status is unknown. Earlier CDC guidance suggested consulting a doctor in these cases, whereas the new proposal recommends vaccination for all infants with uncertain maternal status.

If adopted, the CDC would remove the birth dose requirement for infants of hepatitis B-negative mothers but maintain it for infants of mothers who are positive or whose status is unknown. ACIP has advised universal infant vaccination since 1991, with a 2005 update emphasizing birth administration. These recommendations contributed to a 98% decline in hepatitis B cases among children under 15 between 1990 and 2006.

Joseph Hibbeln, a psychiatrist and former acting chief at the National Institute on Alcohol Abuse and Alcoholism, likened the process to trying to evaluate a moving target, noting the rapid succession of three different question versions in just 72 hours without clear guidance slides.

Seven panel members voted to delay the vote until Friday, while three favored proceeding Thursday. This marks the second delay for the hepatitis B birth dose vote, following a similar postponement in September.

ACIPs membership has undergone significant changes recently. Members were appointed by HHS Secretary Robert F. Kennedy Jr., who replaced the previous panel in June. These shifts have contributed to organizational confusion and repeated delays in voting on vaccine policies, including a previous vote regarding the Vaccines for Children program. The ACIP chair at that meeting, Martin Kulldorff, resigned earlier this week for a position in the health department.

Author: Lucas Grant