RFK Jr.’s vaccine panel postpones vote on hepatitis B shot for babies

Health and Human Services Secretary Robert F. Kennedy Jr.’s hand-picked vaccine panel on Friday postponed a vote on whether to delay the primary dose of the hepatitis B shot from birth to at the very least one month for many babies born within the U.S.

The choice implies that the committee’s current suggestion – that every one infants receive a hepatitis B vaccine inside 24 hours of birth – will stay in place until the group meets again at a later date. It’s unclear when the panel, called the Advisory Committee on Immunization Practices, or ACIP, will convene again to debate the hepatitis B shot.

ACIP was considering whether to delay the primary dose of the vaccine until at the very least one month of age for babies of ladies who test negative for hepatitis B. That will change a secure and highly effective birth dose suggestion that was introduced in 1991 and is credited with virtually eliminating the disease in young kids. 

Some advisors defended the birth dose suggestion through the meeting, saying that delaying it could introduce potential risks to babies, including more infections. But others, particularly those that are known vaccine critics, solid doubt on the protection of administering the vaccine to babies so soon.

Dr. Robert Malone, who gained notoriety for promoting Covid misinformation, brought the motion to postpone the vote.

“I imagine that there is enough ambiguity here and enough remaining discussion about safety, effectiveness and timing that I imagine that a vote today could be premature,” Malone said.

All 12 members supported the motion. Dr. Cody Meissner, a professor of pediatrics on the Dartmouth Geisel School of Medicine, said, “I do not think there’s any query in any way that the profit [of the birth dose] far outweighs any opposed unwanted effects.”

The postponed vote only affects the timing of the primary dose of the hepatitis B vaccine series. The second would still be given one-to-two months after birth, with a 3rd dose between six and 18 months of age. 

Also on Friday, the group voted to recommend hepatitis B testing for all pregnant women. The Centers for Disease Control and Prevention, whose most up-to-date director was ousted by the Trump administration, has to log out on the committee’s recent and future recommendations.

The panel’s closely watched two-day meeting in Atlanta comes after Kennedy gutted the committee and appointed 12 recent members, including some well-known vaccine critics. ACIP sets recommendations on who should receive certain shots and which vaccines insurers must cover for gratis, raising concerns amongst health experts that Kennedy’s reshaped panel could curb access to secure and effective immunizations.

The hepatitis B shot has been a life-saving public health intervention against the disease, which may result in severe health problems, including liver cancer and failure, and death. Acute hepatitis B infections reported amongst children and youths dropped by 99% between 1990 and 2019, some studies said. The American Academy of Pediatrics says that the so-called birth dose is critical to scale back chronic hepatitis B later in life. 

On Thursday, advisors and other scientific experts clashed over the protection of the birth dose.

“I imagine that this vaccine is completely critical for babies which might be treated,” said member Retsef Levi, who has been vocal about his opposition to RNA vaccines. “But this notion that we sit here with very lousy evidence and argue there isn’t any problem in any way [with administering the shot at birth] will not be constructing trust, and it isn’t scientific and it isn’t what the general public here should expect from us.”

But Meissner said that changing the suggestion will “increase the chance of harm based on no evidence of profit.” He said there shall be fewer children who get the complete hepatitis B vaccine series, adding that administering the shot at birth within the hospital ensures that babies at the very least receive their first dose.

“As people have asked, why would we pick one month? Why two? There is no evidence that it’s safer at a later time,” Meissner said. “It’s a particularly secure vaccine, a really pure vaccine. So I believe we shall be creating recent doubts within the minds of the general public that are usually not justified.”

Ahead of the vote, the American Medical Association strongly urged the panel to maintain the birth dose suggestion in place. Other experts outside of the panel also expressed concern about changing the guidance.

“I even have not seen any data that claims that there may be profit to the infant of waiting a month but there are a lot of potential harms to the incident of waiting a month,” said Dr. Adam Langer, a CDC epidemiologist who gave a presentation on the hepatitis B birth dose, ahead of the vote.

During his presentation, Langer said, “the earlier that the hepatitis B vaccine is provided after birth, the greater its effectiveness in stopping perinatal transmission.” That refers to when an infant becomes infected from its mother during birth.

Merck, which manufactures considered one of the vaccines used starting at birth, pushed back on the proposed suggestion ahead of the panel’s official vote on Thursday. 

“The reconsideration of the newborn Hepatitis B vaccination on the established schedule poses a grave risk to the health of kids and to the general public, which may lead to a resurgence of preventable infectious diseases,” Dr. Richard Haupt, Merck’s head of world medical and scientific affairs for vaccines and infectious diseases, said through the meeting. 

GSK manufactures one other hepatitis B shot starting at birth.