^{Photo: The Washinton Post}

Panel Postpones Critical Vote

Health and Human Services Secretary Robert F. Kennedy Jr.’s newly reconstituted vaccine advisory committee postponed its vote on the universal hepatitis B vaccine for newborns until Friday, citing the need for additional time to review proposed voting language. The delay comes amid ongoing debate over whether the so-called “birth dose” should remain mandatory for babies whose mothers test negative for the virus.

The Advisory Committee on Immunization Practices (ACIP) had previously tabled the vote in September to allow for more robust discussion. Dr. Cody Meissner, a pediatrician at Dartmouth’s Geisel School of Medicine, moved to defer the vote after confusion arose within the panel over the precise wording of the measure.

Potential Public Health Consequences

Currently, the Centers for Disease Control and Prevention (CDC) recommends that all newborns receive the hepatitis B vaccine within 24 hours of birth. Experts warn that reducing or delaying vaccinations could reverse decades of progress in preventing chronic hepatitis B infections in children.

Hepatitis B, which can be transmitted from mother to child during childbirth, can lead to liver disease and early death. There is no cure. Neil Maniar, a public health professor at Northeastern University, emphasized that the vaccine is “highly effective at preventing an incurable disease” and credited the birth dose recommendation, introduced in 1991, with reducing childhood infections by 99%.

Safety and Scientific Consensus

Extensive research supports the safety and effectiveness of the hepatitis B birth dose. A recent review of over 400 studies spanning four decades found no evidence that delaying the vaccine improves outcomes or prevents adverse effects. Dr. Sean O’Leary of the American Academy of Pediatrics noted that the vaccine is “incredibly safe with minimal risks,” and the AAP continues to recommend the universal birth dose as a life-saving measure.

CDC studies indicate that the current vaccination schedule has prevented more than 6 million hepatitis B infections and nearly 1 million related hospitalizations.

Industry and Supply Considerations

Hepatitis B vaccines, manufactured by Merck and GSK, are not major revenue drivers for the companies but any sudden change in the recommendation could disrupt vaccine supply chains. John Grabenstein, a former Merck vaccine executive, warned that unexpected policy shifts could create shortages due to the companies’ carefully calculated production and reserve plans.

Merck has publicly opposed altering the established schedule, highlighting the risk to public health and the potential for a resurgence of preventable infections.

Next Steps and Wider Implications

While ACIP’s recommendations are not legally binding—states ultimately determine immunization mandates—they heavily influence coverage under private insurance and government programs. The committee’s decision will be closely watched by public health experts, parents, and healthcare providers, as it could have significant implications for infant vaccination rates and overall community immunity.

The panel’s final vote on Friday will determine whether the longstanding hepatitis B birth dose remains the standard of care for U.S. newborns, potentially shaping vaccine policy for years to come.