The Centers for Disease Control and Prevention's vaccine advisory panel met Thursday for the first of two days of discussions about childhood vaccine schedules and recommendations. The panel is focusing on the hepatitis B vaccine and plans to vote on whether to continue recommending it be given to all children at birth or delay the first dose.
However, that vote was postponed until Friday amid confusion on the exact wording of the questions the committee was set to vote on.
The hepatitis B vaccine has been universally recommended for newborns in the U.S. since 1991. Since then, research shows hepatitis B infections among infants and children have dropped 99%.
Hepatitis B is an incurable infection that can lead to liver disease, cancer and early death.
The shot has become a target of vaccine skeptics, including Health and Human Services Secretary Robert F. Kennedy Jr., who falsely claimed on a podcast in June that the birth dose is a "likely culprit" in autism . Kennedy has appointed all of the members of the Advisory Committee on Immunization Practices, or ACIP, during his tenure as HHS secretary.
Here's what to know about the meetings and the hepatitis B vaccine.
What happened at Thursday's ACIP meeting?
The panel postponed until Friday its plans to vote on whether or not to continue recommending the first dose of hepatitis B vaccine be given within 24 hours of birth — known as the birth dose.
At one point in Thursday's session, committee member Dr. Joseph Hibbeln said that the group had seen three different versions of questions to vote on in the past 72 hours. A technical issue prevented the new voting language from being put up on slides. The presentation was later moved to the end of the agenda, to be displayed just before the vote. There were questions of how many questions members would be asked to vote on. There were no hard copies of the language available.
"We're trying to evaluate a moving target," Hibbeln said.
Similar confusion pervaded ACIP's September meeting, when members admitted they didn't know what they were voting on when they rejected a combined measles-mumps-rubella-chickenpox vaccine before voting to keep it funded, then reversing the funding vote the next day.
A motion to delay the vote until Friday morning was agreed upon by a 6-3 margin.
The meeting was contentious at points. Vicky Pebsworth, the ACIP Childhood and Adolescent Immunization Schedule Workgroup Chair and a regional director of the National Association of Catholic Nurses, said in introductory remarks that the panel was reviewing the vaccine because of "concerns raised by some groups."
Panel members presented information on the prevalence of acute and chronic hepatitis B, and discussed transmission and safety data. Former board members and liaisons to medical organizations sharply criticized the presentations and said some data was mischaracterized.
Dr. Jason Goldman, liaison to the ACIP for the American College of Physicians, called the meeting "completely inappropriate" and accused the panel of "wasting taxpayer dollars by not having scientific, rigorous discussion on issues that truly matter." Goldman also highlighted that the hepatitis B birth dose is not mandated and that parents are encouraged to make decisions in consultation with their doctor.
Why is the hepatitis B vaccine given to newborns?
The hepatitis B virus is primarily transmitted through blood and bodily fluids and is highly contagious. The virus can also survive on surfaces for a week; research shows it can be transmitted through indirect contact with infected fluids.
Hepatitis B can be passed from mother to child and can also be transmitted to infant children by caregivers, according to the American Academy of Pediatrics.
Infected adults often have few to no symptoms and can spread it without even knowing they have the virus. The CDC has estimated that of the 2.4 million people in the U.S. with hepatitis B, about half do not know they are infected.
When the hepatitis B vaccine is given to newborns soon after birth it is up to 90% effective at preventing infection from the mother. If babies receive the full three-dose vaccination series, 98% of them have immunity from the illness, according to the AAP.
Newborns who become infected with hepatitis B at birth and infants who contract the virus within the first year of their life have a 90% chance of developing chronic hepatitis B, an illness that can cause life-threatening issues including cirrhosis, liver failure and liver cancer. About 25% of those patients end up dying prematurely as a result.
