NEW YORK: A federal vaccine advisory committee voted on Friday to end the longstanding recommendation that all US babies get the hepatitis B vaccine on the day they\u2019re born.<\/p>\n
A loud chorus of medical and public health leaders decried the actions of the panel, whose current members were all appointed by US Health Secretary Robert F. Kennedy Jr. \u2014 a leading anti-vaccine activist before this year becoming the nation\u2019s top health official.<\/p>\n
\u201cThis is the group that can\u2019t shoot straight,\u201d said Dr. William Schaffner, a Vanderbilt University vaccine expert who for decades has been involved with ACIP and its workgroups.<\/p>\n
Several medical societies and state health departments said they would continue to recommend them. While people may have to check their policies, the trade group AHIP, formerly known as America\u2019s Health Insurance Plans, said its members still will cover the birth dose of the hepatitis B vaccine.<\/p>\n
For decades, the government has advised that all babies be vaccinated against the liver infection right after birth. The shots are widely considered to be a public health success for preventing thousands of illnesses.<\/p>\n
But Kennedy\u2019s Advisory Committee on Immunization Practices decided to recommend the birth dose only for babies whose mothers test positive, and in cases where the mom wasn\u2019t tested.<\/p>\n
For other babies, it will be up to the parents and their doctors to decide if a birth dose is appropriate. The committee voted 8-3 to suggest that when a family elects to wait, then the vaccination series should begin when the child is 2 months old.<\/p>\n
President Donald Trump posted a message late Friday calling the vote a \u201cvery good decision.\u201d<\/p>\n
The acting director of the Centers for Disease Control and Prevention, Jim O\u2019Neill, is expected to decide later whether to accept the committee\u2019s recommendation.<\/p>\n
The decision marks a return to a health strategy abandoned more than three decades ago<\/p>\n
Asked why the newly-appointed committee moved quickly to reexamine the recommendation, committee member Vicky Pebsworth on Thursday cited \u201cpressure from stakeholder groups,\u201d without naming them.<\/p>\n
Committee members said the risk of infection for most babies is very low and that earlier research that found the shots were safe for infants was inadequate.<\/p>\n
They also worried that in many cases, doctors and nurses don\u2019t have full conversations with parents about the pros and cons of the birth-dose vaccination.<\/p>\n
The committee members voiced interest in hearing the input from public health and medical professionals, but chose to ignore the experts\u2019 repeated pleas to leave the recommendations alone.<\/p>\n
The committee gives advice to the director of the Centers for Disease Control and Prevention on how approved vaccines should be used. CDC directors almost always adopted the committee\u2019s recommendations, which were widely heeded by doctors and guide vaccination programs. But the agency currently has no director, leaving acting director O\u2019Neill to decide.<\/p>\n
In June, Kennedy fired the entire 17-member panel earlier this year and replaced it with a group that includes several anti-vaccine voices.<\/p>\n
Hepatitis B and delaying birth doses<\/p>\n
Hepatitis B is a serious liver infection that, for most people, lasts less than six months. But for some, especially infants and children, it can become a long-lasting problem that can lead to liver failure, liver cancer and scarring called cirrhosis.<\/p>\n
In adults, the virus is spread through sex or through sharing needles during injection drug use. But it can also be passed from an infected mother to a baby.<\/p>\n
In 1991, the committee recommended an initial dose of hepatitis B vaccine at birth. Experts say quick immunization is crucial to prevent infection from taking root. And, indeed, cases in children have plummeted.<\/p>\n
Still, several members of Kennedy\u2019s committee voiced discomfort with vaccinating all newborns. They argued that past safety studies of the vaccine in newborns were limited and it\u2019s possible that larger, long-term studies could uncover a problem with the birth dose.<\/p>\n
But two members said they saw no documented evidence of harm from the birth doses and suggested concern was based on speculation.<\/p>\n
Three panel members asked about the scientific basis for saying that the first dose could be delayed for two months for many babies.<\/p>\n
\u201cThis is unconscionable,\u201d said committee member Dr. Joseph Hibbeln, who repeatedly voiced opposition to the proposal during the sometimes-heated two-day meeting.<\/p>\n
The committee\u2019s chair, Dr. Kirk Milhoan, said two months was chosen as a point where infants had matured beyond the neonatal stage. Hibbeln countered that there was no data presented that two months is an appropriate cut-off.<\/p>\n
Dr. Cody Meissner also questioned a second proposal \u2014 which passed 6-4 \u2014 that said parents consider talking to pediatricians about blood tests meant to measure whether hep B shots have created protective antibodies.<\/p>\n
Such testing is not standard pediatric practice after vaccination. Proponents said it could be a new way to see if fewer shots are adequate.<\/p>\n
A CDC hepatitis expert, Adam Langer, said results could vary from child to child and would be an erratic way to assess if fewer doses work. He also noted there\u2019s no good evidence that three shots pose harm to kids.<\/p>\n
Meissner attacked the proposal, saying the language \u201cis kind of making things up.\u201d<\/p>\n
Health experts say this could \u2018make America sicker\u2019<\/p>\n
Health experts have noted Kennedy\u2019s hand-picked committee is focused on the pros and cons of shots for the individual getting vaccinated, and has turned away from seeing vaccinations as a way to stop the spread of preventable diseases among the public.<\/p>\n
The second proposal \u201cis right at the center of this paradox,\u201d said committee member Dr. Robert Malone.<\/p>\n
Some observers criticized the meeting, noting recent changes in how they are conducted. CDC scientists no longer present vaccine safety and effectiveness data to the committee. Instead, people who have been prominent voices in anti-vaccine circles were given those slots.<\/p>\n
The committee \u201cis no longer a legitimate scientific body,\u201d said Elizabeth Jacobs, a member of Defend Public Health, an advocacy group of researchers and others that has opposed Trump administration health policies. She described the meeting this week as \u201can epidemiological crime scene.\u201d<\/p>\n
Republican Sen. Bill Cassidy, a liver doctor who chairs the Senate health committee, called the committee\u2019s vote on the hepatitis B vaccine \u201ca mistake.\u201d<\/p>\n
\u201cThis makes America sicker,\u201d he said, in a post on social media.<\/p>\n
The committee heard a 90-minute presentation from Aaron Siri, a lawyer who has worked with Kennedy on vaccine litigation. He ended by saying that he believes there should no ACIP vaccine recommendations at all.<\/p>\n
In a lengthy response, Meissner said, \u201cWhat you have said is a terrible, terrible distortion of all the facts.\u201d He ended by saying Siri should not have been invited.<\/p>\n
The meeting\u2019s organizers said they invited Siri as well as a few vaccine researchers \u2014 who have been vocal defenders of immunizations \u2014 to discuss the vaccine schedule. They named two: Dr. Peter Hotez, who said he declined, and Dr. Paul Offit, who said he didn\u2019t remember being asked but would have declined anyway.<\/p>\n
Hotez, of the Texas Children\u2019s Hospital in Houston, declined to present before the group \u201cbecause ACIP appears to have shifted its mission away from science and evidence-based medicine,\u201d he said in an email to The Associated Press.<\/p>\n","protected":false},"excerpt":{"rendered":"
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