RFK Jr.'s selected vaccine panel votes against recommending hepatitis B shots for newborns. Expert opinions differ.

A federal vaccine advisory group, appointed by Health and Human Services Secretary Robert F. Kennedy Jr., voted Friday to stop recommending universal hepatitis B immunization for newborns. Hepatitis B is a serious virus that can lead to chronic liver disease in over 90% of infected infants.

Earlier this year, Kennedy, known for his skepticism of vaccines but having pledged not to discourage vaccination during his confirmation hearings, dismissed all 17 members of the Advisory Committee on Immunization Practices (ACIP) and replaced them with individuals who largely share his views and have limited experience in vaccine research or clinical care. The panel had postponed three previous votes due to internal disagreements.

In the recent vote, panelists decided 8-3 that infants born to mothers who test negative for hepatitis B should have their vaccination timing determined through consultation with their healthcare provider. The guidance suggests parents consider the benefits and risks of the vaccine, along with infection risks, and to delay the first dose until the child is at least two months old.

The recommendation remains unchanged for newborns whose mothers are infected or whose hepatitis B status is unknown.

Experts criticized the new guidance, emphasizing that hepatitis B vaccination has nearly eradicated newborn cases in the U.S., with no evidence of harm. We know its safe and very effective, said Dr. Cody Meissner, a pediatrics professor. Concerns were raised that more children, adolescents, and adults may become infected as a result.

Background on the Change

Some anti-vaccine critics argue that infants receive too many vaccines and that the current schedule is unhealthy, a claim the American Academy of Pediatrics calls dangerous and inaccurate. Hepatitis B has been targeted due to its primary mode of transmission. Some have suggested that because hepatitis B is typically sexually transmitted, newborn vaccination is unnecessary, while others argue the risk of early-life infection is extremely low.

Why Universal Newborn Vaccination Matters

Health experts argue that the panels rationale is flawed. Testing for hepatitis B during pregnancy is not foolproof. Each year, over 17,000 infants are born in the U.S. to infected mothers, yet nearly 20% of pregnant women are not tested, and only one-third of those who test positive receive care. Around half of those infected with hepatitis B are unaware of their status. Even infants born to mothers who test negative can still contract the virus.

Before universal newborn vaccination began in 1991, roughly 18,000 children per year contracted hepatitis B before age 10, with only half infected at birth. Other cases occurred through daycare, sports, shared personal items, and other exposures, leaving an estimated 9,000 children at risk under the new guidance.

The consequences of childhood hepatitis B are severe. While only 5% of adults infected develop chronic hepatitis B, the rate jumps to 90% for infants, increasing the likelihood of cirrhosis, liver failure, and liver cancer. About 25% of children with chronic infection eventually die from the disease.

As a liver doctor who has treated hepatitis B patients for decades, this change is a mistake, wrote Senator Bill Cassidy, a physician. The birth dose is a recommendation, not a mandate. Removing it increases the risk of cases rising again, making America sicker.

Author: Harper Simmons