A medical board has voted to discontinue a 30-year recommendation for all newborns in the US receive a hepatitis B vaccine, in a move one member decried as bowing to “baseless scepticism”.
The Advisory Committee on Immunization Practices (ACIP), largely appointed by the Trump administration’s vaccine-sceptic health secretary, returned the vote on Friday local time.
The move to end the three-decade-old recommendation is the panel’s latest contentious decision overturning longstanding medical advice since its overhaul by Health Secretary Robert F Kennedy Jr., who has spent decades spreading anti-vaccine rhetoric.
US health authorities previously recommended all babies receive the first of three hepatitis B shots just after birth, mainly to prevent infections from mothers who unknowingly had the liver disease or had falsely tested negative.
The approach has virtually eradicated hepatitis B infections among young people in the US.
Hepatitis B is a viral liver disease that can be transmitted by the mother during childbirth and puts those affected at high risk of death from cirrhosis or liver cancer.
Dr Cody Meissner, an internationally recognised expert in pediatric infectious disease epidemiology and vaccine development, accused members of the board of acting on “baseless scepticism”.
“The hepatitis B vaccine recommendation is very well established,” Dr Cody Meissner said before voting no.
“We know it’s safe and we know it’s very effective. And to make the changes that are being proposed, we will see more children and adolescents and adults infected with hepatitis B.”
After delaying the vote by a day, the panel eventually passed its new recommendation for “individual-based decision-making,” in consultation with a health care provider, when children are born to mothers testing negatively for the disease.
The decision should “consider vaccine benefits, vaccine risks, and infection risks”. It also recommends that babies who are not vaccinated at birth wait at least two months to get the initial dose.
Under Mr Kennedy, ACIP is now composed largely of figures criticised by the scientific community for lack of expertise or their promotion of vaccine-sceptic theories.
The vote was 8-3. Trump-appointed officials at the Centers for Disease Control and Prevention (CDC) are widely expected to formally adopt the recommendations at a later date.
Since 1991, US health officials have recommended the hepatitis B vaccine for newborns, as is done in countries including China and Australia and is recommended by the World Health Organisation.
In Australia the vaccine is recommended for infants, Aboriginal and Torres Strait Islander people, those who are immunocompromised and workers in some industries.
“After acute infection with hepatitis B virus, some people become chronically infected. For those whose infection resolves, the virus remains in latent form in liver cells and can reactivate,” the Department of Health, Disability and Ageing website states.
“People with chronic hepatitis B can transmit the disease, including from mother to child.”
But several ACIP members have argued that Friday’s decision aligns the US vaccination schedule with those of other economically developed countries such as France and Britain.
Medical experts say such a change is risky in the United States, pointing to shortcomings in maternal screening, with delays likely to cause a drop in vaccination rates in a country where access to health care can be complicated.
“This irresponsible and purposely misleading guidance will lead to more hepatitis B infections in infants and children,” American Academy of Pediatrics President Susan J Kressly said in a statement.
The repercussions of the ACIP’s vaccine recommendations are broad because federal guidelines often dictate whether vaccines are paid for by health insurance companies in the United States, where a vaccine can cost hundreds of dollars.
On Friday, the panel is set to begin a broader review of the childhood vaccination schedule and the composition of vaccines.
But the committee’s influence is waning amid withering criticism from the US scientific and medical community, with Democratic-led states announcing they will no longer follow its recommendations.
Some in Mr Trump’s own Republican Party have also pushed back against the ACIP’s actions, including Louisiana Senator Bill Cassidy.
Mr Cassidy, a medical doctor who provided a key vote to allow Mr Kennedy’s nomination to succeed, condemned the ACIP’s decision, noting the original recommendation was “NOT a mandate” to get the jab.
CDC officials “should not sign these new recommendations and instead retain the current, evidence-based approach,” he said on X.
“As a liver doctor who has treated patients with hepatitis B for decades, this change to the vaccine schedule is a mistake,” he said in a statement.
Ahead of the vote, Dr Meissner, one of the few dissenting voices on the advisory committee, urged his colleagues not to change the current recommendations.
“Do no harm is a moral imperative. We are doing harm by changing this wording,” he warned.
