A revamped panel of US vaccine advisers appointed by the health secretary, Robert F Kennedy Jr, on Friday decided not to go ahead with a planned vote that would have delayed the first hepatitis B vaccine dose for newborns, citing inconsistency in the proposed policy changes.
It was not clear how the committee would now proceed on the issue.
The group, which advises the Centers for Disease Control and Prevention on US vaccination schedules, on Thursday discussed changing the nation’s more than three-decades-old recommendation that babies receive the shot at birth, which has led to a dramatic decrease in rates of the disease.
While many committee members appeared to support the change during that discussion, medical experts and patient advocates warned during the public comment period that it would leave infants vulnerable to disease.
Some committee members early on Friday raised new concerns about some of the data CDC presented and wanted to extend the recommendations from one month to two to three months. During Thursday’s discussion, it was not clear how the one month criterion had been chosen.
Dr Catherine Troisi, infectious disease epidemiologist at UTHealth Houston, said the US birth-dose policy drove a 97% decline in acute hepatitis B among Americans under 19.
Panel considers changes to Covid vaccine recommendations
The panel did, however, vote unanimously to recommend universal hepatitis B testing for all pregnant women. The meeting will also later consider updates to Covid-19 vaccine guidance.
The votes came as the advisory committee on immunization practices (ACIP) reconvened for a second day of meetings that have highlighted deep divisions over the future of US immunization schedules under Kennedy, who has long promoted claims about vaccine harms that run contrary to scientific evidence.
On Thursday, the panel rejected use of the combined measles-mumps-rubella-varicella shot in children under four, citing a small increase in seizure risk, opting instead for separate doses.
Committee member explains benefit v risk calculation
CDC experts presenting at the meeting have defended the longstanding policy of giving hepatitis B vaccine within 24 hours of birth, noting that 12% to 16% of pregnant women in the US have no record of hepatitis B testing.
Pediatrician Dr Cody Meissner, a panel member, warned that delaying the birth dose could “increase the risk of harm based on no evidence of benefit”. He added that while no vaccine was completely risk-free or fully effective, clinicians must weigh the benefits against potential side-effects.
“For the newborn hepatitis B vaccine, there is no doubt the protective benefits far outweigh any possible risks,” Meissner said.
The ACIP, reconstituted this year by Kennedy, includes several members who have previously raised concerns about routine vaccines. Kennedy has also steered broader policy shifts: cutting routine Covid-19 shots for children and pregnant women and halting nearly $500m in mRNA projects. Five of the members began their terms on Monday.
