CDC panel overturns 1991 newborn vaccine policy, triggering warnings of a public health backslide

A powerful advisory group within the CDC voted Friday to overturn a longstanding precaution designed to protect newborn babies.

If the change is approved by the acting director of the agency, the government will no longer universally recommend the hepatitis B vaccine at birth. The shot, which provides protection from the leading cause of liver cancer, has been standard practice for newborns since 1991. 

Friday’s 8-3 vote is a milestone for Health and Human Services Secretary Robert F. Kennedy Jr., who quickly began reshaping the public health agency to reflect his personal views on vaccines after being sworn in early this year. Kennedy has long been a prominent voice among anti-vaccine activists, a position that sparked broad concern that the CDC might break with scientific consensus around vaccines under his guidance.

In August, the FDA narrowed its approval for the COVID vaccine to people 65 and older or those with underlying health conditions. In spite of the FDA’s changes, many insurers said that they would follow previous guidance and cover the shots widely for anyone who wanted one 

In a press release following Friday’s vote, the CDC defended its decision to support “individual-based decision-making” which would encourage parents and their doctors to opt into childhood vaccines based on the risk of infection. The committee will now only recommend the vaccine at birth for newborns born to mothers who test positive for hepatitis B. 

“The American people have benefited from the committee’s well-informed, rigorous discussion about the appropriateness of a vaccination in the first few hours of life,” CDC Acting Director Jim O’Neill said.

Battle at the CDC

O’Neill, an entrepreneur and investor with prior experience at HHS, was chosen for the post after the dramatic ouster of former director Susan Monarez, who was herself nominated by The President. Monarez was fired after refusing to back Kennedy’s preferred changes to the agency’s vaccine policy, prompting a wave of high profile resignations at the CDC.

“They are essentially trying to undo a lot of the science that has been settled for vaccine policies,” Dr. Daniel Jernigan, former director of the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, said following the flurry of resignations.

Former CDC Director Susan Monarez testified in the Senate in September, issuing grave warnings about Kennedy’s influence on U.S. health policy. “Given what I have seen, if we continue down this path, we are not prepared—not just for pandemics, but for preventing chronic health disease. And we’re going to see kids dying of vaccine-preventable diseases,” Monarez said.

The Advisory Committee on Immunization Practices, also known as ACIP, has been a particular nexus of concern given Kennedy’s history of spreading vaccine misinformation. Kennedy fired all of the committee’s previous members earlier this year and installed new members friendlier to anti-vaccine policies. 

At the time, Kennedy stressed that the agency should “care as much about every child who could be injured by one of these products as we do every child who could be injured by an infectious disease,” referencing a talking point common in anti-vaccine misinformation.

Doctors reject the CDC changes

In spite of Kennedy’s claim that the remade panel would feature no “ideological anti-vaxxers,” its new members include vaccine skeptics and other members with no prior vaccine experience. The changes were consequential enough to prompt a lawsuit from the American Academy of Pediatrics (AAP), the largest professional association of pediatricians in the country.

“Pediatricians have seen firsthand the harm created by the disruptive and politicized decisions to overturn decades of evidence-based federal guidance on immunizations,” AAP President Susan J. Kressly, M.D. said. “These changes have caused fear, decreased vaccine confidence, and barriers for families to access vaccines.”

Friday’s vote won’t be official until the CDC’s acting director signs the new recommendations, which is very likely to happen. At least one Republican expressed his concerns about the rollback to 30 years of U.S. vaccine policy on Friday, encouraging the acting director to reject the changes. Louisiana Senator Bill Cassidy, a physician who supported Kennedy to lead HHS, also called the ACIP “totally discredited” on X leading up to the vote. 

“As a liver doctor who has treated patients with hepatitis B for decades, this change to the vaccine schedule is a mistake,” Cassidy wrote on X. “… Before the birth dose was recommended, 20,000 newborns a year were infected with hepatitis B. Now, it’s fewer than 20. Ending the recommendation for newborns makes it more likely the number of cases will begin to increase again.”

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