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lite.cnn.com - on gopher - inofficial
ARTICLE VIEW:
RFK Jr.’s vaccine panel expected to recommend delaying hepatitis B
shot for newborns
By Jackie Fortiér, KFF Health News
Updated:
11:33 AM EDT, Tue September 16, 2025
Source: CNN
A key federal vaccine advisory panel whose members were recently
replaced by Health and Human Services Secretary Robert F. Kennedy Jr.
is expected to vote to recommend delaying until age 4 the hepatitis B
vaccine that’s currently given to newborns, according to two former
senior Centers for Disease Control and Prevention officials.
“There is going to likely be a discussion about hepatitis B vaccine,
very specifically trying to dislodge the birth dose of hepatitis B
vaccine and to push it later in life,” said Demetre Daskalakis, of
the National Center for Immunization and Respiratory Diseases.
“Apparently this is a priority of the secretary’s.”
The vote is expected to take place during the next meeting of the
CDC’s Advisory Committee on Immunization Practices, scheduled for
Sept. 18-19.
For more than 30 years, the first of three shots of hepatitis B vaccine
has been recommended for infants shortly after birth. In that time, the
potentially fatal disease has been virtually eradicated among American
children. Pediatricians warn that waiting four years for the vaccine
opens the door to more children contracting the virus.
“Age 4 makes zero sense,” pediatrician Eric Ball said. “We
recommend a universal approach to prevent those cases where a test
might be incorrect or a mother might have unknowingly contracted
hepatitis. It’s really the best way to keep our entire population
healthy.”
In addition to the hepatitis B vaccine, the panel and vote on
recommendations for the combined measles, mumps, rubella, and varicella
vaccine and covid-19 vaccines. Pediatricians worry changes to the
schedules of these vaccines will limit access for many families,
leaving them vulnerable to vaccine-preventable diseases.
Typically, ACIP would undertake an analysis of the data before
recommending a change to vaccine guidelines. As of the end of August,
this process had not begun for the hepatitis B vaccines, Daskalakis and
another former official said.
“This is an atypical situation. There’s been no work group to
discuss it,” Daskalakis said.
The second former senior official spoke to NPR and KFF Health News on
the condition of anonymity.
In response to questions from KFF Health News, HHS spokesperson Andrew
Nixon wrote, “ACIP exists to ensure that vaccine policy is guided by
the best available evidence and open scientific deliberation. Any
updates to recommendations will be made transparently with gold
standard science.”
The draft agenda for the upcoming ACIP meeting was released to the
public less than a week before it is scheduled to begin.
At the last ACIP meeting, in June, Martin Kulldorff, the chair and one
of seven new members handpicked by Kennedy, questioned the need to
vaccinate every newborn, citing only two of the many ways the virus can
spread. Kulldorff is a former Harvard Medical School professor who
became known for during the pandemic.
“Unless the mother is hepatitis B positive, an argument could be made
to delay the vaccine for this infection, which is primarily spread by
sexual activity and intravenous drug use,” he said.
The virus spreads via direct exposure to an infected bodily fluid like
blood or semen. The disease has no cure and can lead to serious
conditions like cirrhosis and liver cancer later in life. The CDC
advisory panel may maintain the recommendation to inoculate newborns
whose mothers have hepatitis B or are considered at high risk of the
disease, the former officials said.
Protection from birth
In 1991, federal health officials determined it was advisable for
newborns to receive their first dose of the hepatitis B vaccine within
, which blocks the virus from taking hold if transmitted during
delivery. While parents may opt out of the shots, many day care centers
and school districts of hepatitis B vaccination for enrollment.
The prospect of ACIP’s altering the recommendation has left some
people living with the virus deeply unsettled.
“I am goddamn frustrated,” said Wendy Lo, who has lived with the
liver disease, likely since birth. Years of navigating the
psychological, monetary, medical, and social aspects of chronic
hepatitis B has touched almost every aspect of her life.
“I would not want anyone to have to experience that if it can be
prevented,” she said. Lo learned she had the disease due to a routine
screening to study abroad in college.
Lo credits the vaccines with protecting her close family members from
infection.
“I shared with my partner, ‘If you get vaccinated, we can be
together,’” she said. He got the vaccine, which protects him from
infection, “so I’m grateful for that,” she said.
The CDC estimates half of people with hepatitis B they are infected. It
can range from an acute, mild infection to a chronic infection, often
with . Most people with chronic hepatitis B were born outside of the
U.S., and Asians and Pacific Islanders Black people have the highest
rates of newly reported chronic infections.
When her children were born, Lo was adamant that they receive the
newborn dose, a decision she says prevented them from contracting the
virus.
The earlier an infection occurs, , according to the CDC. When
contracted in infancy or early childhood, hepatitis B is far more
likely to become a chronic infection, silently damaging the liver over
decades.
Those who become chronic carriers can also unknowingly spread the virus
to others and face an increased risk of long-term complications
including cirrhosis and liver cancer, which may not become evident
until much later in life.
Treatments like the antivirals Lo now takes weren’t available until
the 1990s. Decades of the virus’s replicating unchecked damaged her
liver. Every six months she gets scared of what her blood tests may
reveal.
“Now I’m in my 50s, one of my big concerns is liver cancer. The
vaccine is safe and effective, it’s lifesaving, and it protects you
against cancer. How many vaccines do that?” Lo said.
Thirty years of universal vaccination
After a vaccine was approved in the 1980s, public health officials
initially focused vaccination efforts on people thought to be at
highest risk of infection.
“I, and every other doctor, had been trained in medical school to
think of hepatitis B as an infection you acquired as an adult. It was
the pimps, the prostitutes, the prisoners, and the health care
practitioners who got hepatitis B infection. But we’ve learned so
much more,” said , a professor of infectious diseases at the
Vanderbilt University School of Medicine and a former voting member of
ACIP.
As hepatitis B rates remained stubbornly high in the 1980s, scientists
realized an entire vulnerable group was missing from the vaccination
regime — newborns. The virus is from an infected mother to baby in
late pregnancy or during birth.
“We may soon hear, ‘Let’s just do a blood test on all pregnant
women.’ We tried that. That doesn’t work perfectly either,”
Schaffner said.
Some doctors didn’t test, he said, and some pregnant women falsely
tested negative while others acquired hepatitis B after they had been
tested earlier in their pregnancies.
In 1991, Schaffner was a liaison representative to ACIP when it voted
to for hepatitis B before an infant leaves the hospital.
“We want no babies infected. Therefore, we’ll just vaccinate every
mom and every baby at birth. Problem solved. It has been brilliantly
successful in virtually eliminating hepatitis B in children,” he
said.
In 1990, there were 3.03 cases of hepatitis B per 100,000 people 19
years old or under in the U.S., according to the CDC.
Since the federal recommendation to vaccinate all infants, cases have
dramatically decreased. shows that in 2022 the rate among those 19 or
under was less than 0.1 per 100,000.
While hepatitis B is often associated with high-risk behaviors such as
injection drug use or having multiple sexual partners, note that it is
possible for the virus to be transmitted in ordinary situations too,
including among young children.
The virus can survive for outside the body. During that time, even
microscopic traces of infected blood on a can pose a risk. If the virus
comes into contact with an open wound or the mucous membranes of the
eyes, an infection can occur. This means that unvaccinated children not
considered at high risk can still be exposed in everyday environments.
Future access uncertain
If the CDC significantly alters its recommendation, health insurers
would no longer be required to cover the cost of the shots. That could
leave parents to pay out-of-pocket for a vaccine that has long been
provided at no charge. Children who get immunizations through the
federal program would lose free access to the shot as soon as any new
ACIP recommendations get approved by the acting CDC director.
The two former CDC officials said that plans were underway to push back
the official recommendation for the vaccine as of August, when they
both left the agency, but may have changed.
Schaffner is still an alternate liaison member of ACIP, and hopes to
express his support for universal newborn vaccination at the next
meeting.
“The liaisons have now been excluded from the vaccine work groups.
They are still permitted to attend the full meetings,” he said.
Schaffner is worried about the next generation of babies and the
doctors who care for them.
“We’ll see cases of hepatitis B once again occur. We’ll see
transmission into the next generation,” he said, “and the next
generation of people who wear white coats will have to deal with
hepatitis B, when we could have cut it off at the pass.”
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