NEW YORK (AP) โ A federal vaccine advisory committee voted on Friday toย end the longstanding recommendationย that all U.S. babies get the hepatitis B vaccine on the day theyโre born.
A loud chorus of medical and public health leaders decried the actions of the panel, whose current members were all appointed by U.S. Health Secretary Robert F. Kennedy Jr. โ a leading anti-vaccine activist before this year becoming the nationโs top health official.
โThis is the group that canโt shoot straight,โ said Dr. William Schaffner, a Vanderbilt University vaccine expert who for decades has been involved with ACIP and its workgroups.
Several medical societies and state health departments said they would continue to recommend them. While people may have to check their policies, the trade group AHIP, formerly known as Americaโs Health Insurance Plans, said its members still will cover the birth dose of the hepatitis B vaccine.
For decades, the government has advised that all babies be vaccinated against the liver infection right after birth. The shots are widely considered to be a public health success for preventing thousands of illnesses.
But Kennedyโs Advisory Committee on Immunization Practices decided to recommend the birth dose only for babies whose mothers test positive, and in cases where the mom wasnโt tested.
For other babies, it will be up to the parents and their doctorsย to decideย if a birth dose is appropriate. The committee voted 8-3 to suggest that when a family elects to wait, then the vaccination series should begin when the child is 2 months old.
President Donald Trump posted a message late Friday calling the vote a โvery good decision.โ
The acting director of the Centers for Disease Control and Prevention, Jim OโNeill, is expected to decide later whether to accept the committeeโs recommendation.
The decision marks a return to a health strategy abandoned more than three decades ago
Asked why the newly-appointed committee moved quickly to reexamine the recommendation, committee member Vicky Pebsworth on Thursday cited โpressure from stakeholder groups,โ without naming them.
Committee members said the risk of infection for most babies is very low and that earlier research that found the shots were safe for infants was inadequate.
They also worried that in many cases, doctors and nurses donโt have full conversations with parents about the pros and cons of the birth-dose vaccination.
The committee members voiced interest in hearing the input from public health and medical professionals, but chose to ignore the expertsโ repeated pleas to leave the recommendations alone.
The committee gives advice to the director of theย Centers for Disease Control and Preventionย on how approved vaccines should be used. CDC directors almost always adopted the committeeโs recommendations, which were widely heeded by doctors and guide vaccination programs. But the agency currently has no director, leaving acting director OโNeill to decide.
In June, Kennedyย fired the entire 17-memberย panel earlier this year and replaced it with a group that includesย several anti-vaccine voices.
Hepatitis B and delaying birth doses
Hepatitis B is a serious liver infection that, for most people, lasts less than six months. But for some, especially infants and children, it can become a long-lasting problem that can lead to liver failure, liver cancer and scarring called cirrhosis.
In adults, the virus is spread through sex or through sharing needles during injection drug use. But it can also be passed from an infected mother to a baby.
In 1991, the committee recommended an initial dose of hepatitis B vaccine at birth. Experts say quick immunization is crucial to prevent infection from taking root. And, indeed, cases in children have plummeted.
Still, several members of Kennedyโs committee voiced discomfort with vaccinating all newborns. They argued that past safety studies of the vaccine in newborns were limited and itโs possible that larger, long-term studies could uncover a problem with the birth dose.
But two members said they saw no documented evidence of harm from the birth doses and suggested concern was based on speculation.
Three panel members asked about the scientific basis for saying that the first dose could be delayed for two months for many babies.
โThis is unconscionable,โ said committee member Dr. Joseph Hibbeln, who repeatedly voiced opposition to the proposal during the sometimes-heated two-day meeting.
The committeeโs chair, Dr. Kirk Milhoan, said two months was chosen as a point where infants had matured beyond the neonatal stage. Hibbeln countered that there was no data presented that two months is an appropriate cut-off.
Dr. Cody Meissner also questioned a second proposal โ which passed 6-4 โ that said parents consider talking to pediatricians about blood tests meant to measure whether hep B shots have created protective antibodies.
Such testing is not standard pediatric practice after vaccination. Proponents said it could be a new way to see if fewer shots are adequate.
A CDC hepatitis expert, Adam Langer, said results could vary from child to child and would be an erratic way to assess if fewer doses work. He also noted thereโs no good evidence that three shots pose harm to kids.
Meissner attacked the proposal, saying the language โis kind of making things up.โ
Health experts say this could โmake America sickerโ
Health experts have noted Kennedyโs hand-picked committee is focused on the pros and cons of shots for the individual getting vaccinated, and has turned away from seeing vaccinations as a way to stop the spread of preventable diseases among the public.
The second proposal โis right at the center of this paradox,โ said committee member Dr. Robert Malone.
Some observers criticized the meeting, noting recent changes in how they are conducted. CDC scientists no longer present vaccine safety and effectiveness data to the committee. Instead, people who have been prominent voices in anti-vaccine circles wereย given those slots.
The committee โis no longer a legitimate scientific body,โ said Elizabeth Jacobs, a member of Defend Public Health, an advocacy group of researchers and others that has opposed Trump administration health policies. She described the meeting this week as โan epidemiological crime scene.โ
Republican Sen. Bill Cassidy, a liver doctor who chairs the Senate health committee, called the committeeโs vote on the hepatitis B vaccine โa mistake.”
โThis makes America sicker,” he said, inย a postย on social media.
The committee heard a 90-minute presentation from Aaron Siri, a lawyer who has worked with Kennedy on vaccine litigation. He ended by saying that he believes there should no ACIP vaccine recommendations at all.
In a lengthy response, Meissner said, โWhat you have said is a terrible, terrible distortion of all the facts.” He ended by saying Siri should not have been invited.
The meetingโs organizers said they invited Siri as well as a few vaccine researchers โ who have been vocal defenders of immunizations โ to discuss the vaccine schedule. They named two: Dr. Peter Hotez, who said he declined, and Dr. Paul Offit, who said he didn’t remember being asked but would have declined anyway.
Hotez, of the Texas Childrenโs Hospital in Houston, declined to present before the group โbecause ACIP appears to have shifted its mission away from science and evidence-based medicine,โ he said in an email to The Associated Press.
