CDC advisers delay vote on major change to the childhood vaccine schedule until Friday

Dr. Tracy Beth Hoeg is seen during a meeting of the CDC's Advisory Committee On Immunization Practices at the Center for Disease Control (CDC) headquarters in Atlanta, Georgia, on Thursday.

Dr. Tracy Beth Hoeg, who was named Wednesday as the third chief of the US Food and Drug Administration’s prescription drug division since July, appeared to joke about the rapid-fire personnel changes at her agency Thursday.

“There’s not much happening at the Food and Drug Administration,” ACIP Vice Chair Dr. Robert Malone said as he introduced Hoeg for FDA updates. “Do you wish to share any recent events?”

“Nothing dramatic or salacious or anything has been happening,” Hoeg replied.

Hoeg is a physician and epidemiologist who practiced sports medicine before joining the FDA as a senior adviser to Commissioner Dr. Marty Makary. She was appointed acting director of the Center for Drug Evaluation and Research a day after Dr. Richard Pazdur, the longtime cancer czar at the agency, said he planned to retire.

Pazdur had been chosen for the post after the previous director, Dr. George Tidmarsh, resigned in November amid what the US Department of Health and Human Services described as “serious concerns about his personal conduct.” Tidmarsh had been named to the role in July.

At Thursday’s meeting, Hoeg outlined vaccine initiatives underway at the FDA that were first telegraphed by FDA biologics chief Dr. Vinay Prasad in an internal memo last week.

“We are revising our framework for safety surveillance of vaccines right now,” Hoeg said. “We’re going to be looking for more potential safety issues with vaccines – so basically, widening the net of potential outcomes that we’re looking at.”

​After a day punctuated by frustration and confusion, the CDC vaccine advisers adjourned about 5 p.m. ET. They’ll reconvene at 8:30 a.m. ET Friday for the second session of the two-day meetings.

On Friday’s agenda: the crucial vote on hepatitis B vaccine recommendations for newborns and infants, as well as discussions of vaccine ingredients and timing.

The Hepatitis B Foundation said in a statement that it was “deeply disappointed and extremely concerned” about Thursday’s discussion. “Overall, the meeting lacked transparency, with many of the presentations showing one-sided data, and several points made by Committee members clearly showed that they have a very specific agenda.”

The foundation “will be paying close attention to tomorrow’s vote,” it said. “As we work to determine the best ways to mitigate the likely damage caused by the future vote, our top priority remains the health and well-being of the up to 2.4 million people living with hepatitis B in the U.S., and the nearly 300 million people with the disease worldwide. We must protect future generations from hepatitis B, hepatitis D and liver cancer.”

The first day of the CDC vaccine committee’s two-day meeting closed with a fiery debate about evidence and how it’s evaluated.

“There’s been a lot of data and some misinformation presented today,” said Dr. Amy Middleman, a pediatrician from Oklahoma who attended the meeting as a representative of the Society of Adolescent Health and Medicine, as she urged the committee members to return to a process of systematic review that doesn’t focus on specific studies or data points, but takes into account all the scientific evidence that’s available on a policy question.

“These decisions really affect a lot of people’s lives, and we really are obligated to our countrymen to make sure that we do this in an organized process,” she said.

“We can’t just dump a pile of unfolded laundry on the floor and then try to determine from that whether or not we need more T-shirts or more pants.”

Committee member Dr. Retsef Levi, a management professor at MIT, told her they had not considered the totality of the evidence because the committee had deemed much of it to be low quality.

“I appreciate beliefs and feelings, but the data presented to us by the CDC, not misinformation, is telling a different story than what you believe in,” Levi said.

“This is not beliefs and feelings. This is looking at the data,” Middleman responded.

Middleman had challenged committee members on their interpretation of data compiled by the CDC that showed infection rates dropping in young adults after the implementation of the universal birth dose. Some presenters suggested that the data proved that other factors beyond the universal vaccination of newborns had driven down infections.

But Middleman said that interpretation was incorrect because it ignored other measures implemented at the time to try to prevent infections.

“This is where sort of historical vaccine policy knowledge is really important,” Middleman said.

Frustrations emerged Thursday afternoon between outside doctors who serve as liaisons to the CDC vaccine advisory committee and the newly installed members, as one panelist, Dr. Retsef Levi, made a lengthy comment questioning the safety of vaccines.

“This is supposed to be liaison time; respectfully, the ACIP members have had their chance,” broke in Dr. Jason Goldman, who’s served as a liaison to the committee for the American College of Physicians for almost a decade.

“I know you want to give another speech to tell us how good we are,” Levi, a professor of management at the Massachusetts Institute of Technology who has suggested the Covid-19 vaccines are deadly and should be pulled from the market, shot back, presumably sarcastically.

Dr. Robert Malone, the vice chair of the committee, noted there are “tensions here,” and moved the discussion along.

Minutes later, another outside liaison, Dr. Judith Shlay, representing the National Association of County and City Health Officials, got the floor.

“Thank you very much,” she said. “I’ve been waiting a long time to talk.”

Parents will still be able to obtain the hepatitis B vaccine for their children at no cost, regardless of whether the CDC’s vaccine advisers recommend any changes to the immunization practice, at least for now.

Two major health insurance industry groups, the Blue Cross Blue Shield Association and AHIP, reiterated Thursday that they will continue to cover all vaccines recommended by the committee as of earlier this year, with no cost-sharing, through 2026.

BCBS companies will cover all immunizations recommended by ACIP as of January 1, 2025, while operating within federal and state laws and meeting program and customer requirements, a spokesperson told CNN. AHIP members will do so for all vaccines recommended by ACIP as of September 1, 2025, a spokesperson said.

Both groups released these statements earlier in the fall, before ACIP announced changes to recommendations for the Covid-19 vaccine and the combined measles, mumps, rubella and varicella (MMRV) vaccine.

A CDC official said that if the vaccine advisers decide to recommend that parents consult with a health care provider – a process known as shared clinical decision-making – before getting their children the hepatitis B vaccine, those immunizations would be covered by the Vaccines for Children program. The program provides a variety of immunizations at no cost to children who are eligible for Medicaid, are uninsured or are underinsured.

Earlier Thursday, a Centers for Medicare and Medicaid Services official said the inclusion of individual-based decision-making language would not affect coverage of the vaccine without any cost-sharing.

Dr. Evelyn Griffin speaks during Thursday's meeting in Atlanta.

“Another issue, that elephant in the room that I’ll mention, is immigration,” said vaccine committee member Dr. Evelyn Griffin, an obstetrician-gynecologist in Louisiana.

“We have had years of illegal immigration, undocumented people,” coming from countries where hepatitis B infections are more common than the United States, she said.

Griffin said she and her family went through the legal immigration process when they moved to the United States from Canada.

“The legal immigration process … is very voluntary in terms of documenting your hepatitis B status, in terms of being tested for it, in terms of even if you want to document it. No one’s asking if you are hepatitis B positive or negative,” Griffin said. “I hope those programs are better now.”

In an earlier presentation, Dr. Cynthia Nevison, a climate researcher who is now a contractor to the CDC, suggested more targeted screening of immigrants might be a measure to reduce hepatitis B infections, rather than vaccinating all infants.

Nevison dismissed evidence of transmission of hepatitis B in immigrant Asian families to their US-born babies, saying the results were not likely to apply to the “average American child.”

One question hanging over the vaccine advisory committee meeting is why it decided to take a new look at the recommendation that babies get a dose of the hepatitis B vaccine at birth.

Typically, ACIP would only consider a policy change if there was new evidence of benefit or harm to consider. There’s no such evidence in this case.

“Why is there pressure today to change something that has been working?” said Dr. Grant Paulsen, who is participating in the meeting as a representative of the Pediatric Infectious Diseases Society.

Committee member Dr. Vicky Pebsworth, who led the working group that studied hepatitis B vaccination, said that ACIP has a responsibility to periodically review its policies.

“Plus we were aware that there was pressure coming from stakeholder groups wanting the policy to be revisited,” added Pebsworth, who has been on the board of the National Vaccine Information Center, a group that casts doubt on the safety of vaccines while downplaying their benefits.

Committee member Dr. Joseph Hibbeln, a psychiatrist, pointed out the that near elimination of hepatitis B infections in kids was considered one of the 10 greatest accomplishments in science and medicine in the United States,“so we have a high burden of proof to change this system or change our recommendations.”

“If there are any documents or documentation of rates of risks and rates of harm, I have not heard any,” Hibbeln said.

In her presentation, Pebsworth cited two surveys of parents, one of Oregon parents in 2014, and a 2025 survey conducted by the Kaiser Family Foundation and the Washington Post. In both surveys, a minority of parents reported delaying or refusing the hepatitis B vaccine. Among those who did, many said they were concerned about vaccine safety or that they felt the baby was too young to receive the shot.

Members of the CDC Advisory Committee on Immunization Practices meet in Atlanta on Thursday.

Vaccine advisers to the CDC delayed until Friday morning a vote that could lead to dramatic changes to hepatitis B vaccination practice in the United States.

The advisers, who were handpicked by US Department of Health and Human Services Secretary Robert F. Kennedy Jr. earlier this year, had expressed confusion about what they were voting on after the language changed a number of times, and said they wanted more time to consider it.

The committee had been scheduled to vote at 2:30 p.m. ET Thursday.

The committee had previously been expected to vote on hepatitis B vaccination changes at its meeting in September. That vote was postponed because the evidence fell short of what was needed to make a “confident evidence-based recommendation,” said Dr. Robert Malone, the committee vice chair who is leading this week’s meeting.

Malone noted that the new committee chair, Dr. Kirk Milhoan, “is about to jump on a plane to go to Asia” and will not be available to vote Friday morning.

ACIP’s recommendations are not final, although CDC generally aligns its recommendations with the committee’s decision. The recommendations shape doctors’ guidance to patients as well as state vaccine policy, insurance coverage and the Vaccines for Children program.

“This is the third version of the questions that most of the [ACIP] received in 72 hours,” Dr. Joseph Hibbeln, a member of the committee, said Thursday as the group headed toward a potentially seismic vote to remove a universal recommendation that newborns receive the hepatitis B vaccine. “We’re trying to evaluate a moving target.”

It was a sign of some of the confusion that pervaded previous meetings of the committee, which is composed of members handpicked by Health Secretary Robert F. Kennedy Jr. after he fired all previous sitting advisers in June.

Dr. Robert Malone, the ACIP vice chair running Thursday’s meeting, called it an “audio/visual harmonization” problem as new voting language couldn’t immediately be put up on slides, before calling for a short break to sort things out.

“We really need to know what we’re voting on,” a voice over the livestream said as the committee, some of whom were joining remotely, took a pause.

Attorney Aaron Siri speaks during a Senate hearing on September 9 in Washington, DC.

In response to a social media post from Republican Sen. Bill Cassidy that criticized his scheduled participation in ACIP presentations on the childhood vaccine schedule, lawyer Aaron Siri challenged the Louisiana doctor and lawmaker to a debate about vaccines.

“Bring your evidence and let’s have a long form public debate where we each get 10 minutes to go back and forth on each major vaccine topic,” Siri posted on X.

Siri disputed Cassidy’s claim that he “makes his living suing vaccine manufacturers,” saying that he “cannot virtually ever sue vaccine companies for vaccine deaths and harms because of the National Childhood Vaccine Injury Act of 1986.”

That law created the National Vaccine Injury Compensation Program, or VICP, after lawsuits against vaccine makers threatened to drive them from the market and cause vaccine shortages. The VICP provides a way for people who have rare but serious side effects from vaccinations to receive compensation from pharmaceutical companies without those manufacturers being found negligent.

It has been a target of US Department of Health and Human Services Secretary Robert F. Kennedy Jr., who pledged in July to “fix” it, a move Dorit Reiss, a professor of law at UC Law San Francisco who focuses on vaccine issues, said “serves a broader anti-vaccine agenda.”

Siri, an attorney with ties to Kennedy, is scheduled to make a presentation to the ACIP Friday morning about the childhood and adolescent immunization schedule.

With reporting by CNN’s Sarah Owermohle

A map created by the CDC shows the hepatitis B vaccine birth dose policy by country in 2025.

Some members of the vaccine advisory committee have repeated that the United States is one of only a few wealthy nations that have adopted the hepatitis B birth dose for all infants.

“It’s really important to keep in mind that the US is an outlier in recommending a universal birth dose of the hepatitis B vaccine compared to other high-income nations,” said Dr. Tracy Beth Hoeg, who was recently appointed acting director of the US Food and Drug Administration‘s Center for Drug Evaluation and Research and attended the ACIP meeting as an ex officio member.

“There are only a couple of other Western nations that still employ birth dose for hepatitis B,” Dr. Robert Malone, vice chair of ACIP said in a video created by the nonprofit MAHA Action and shared on social media. “The rest of them delay it.”

The United States was a pioneer in the recommending that all infants receive a dose of the hepatitis B vaccine as early as the day of birth. Universal vaccination of infants has been recommended in the US since 1991.

In 2009 and 2017, the World Health Organization recommended a universal birth dose of the hepatitis B vaccine for infants, and of its 194 member states, 116 have adopted the policy, according to a recent CDC analysis performed at the request of the committee.

Among a subset of 37 wealthier nations, including Canada, countries in the European Union, the UK, Japan, Switzerland, Australia and South Korea, the US is 1 of 8 to recommend a dose of hepatitis B vaccine to all infants at birth, according to the CDC review.

Most of these countries recommend vaccination soon after birth for infants born to mothers who test positive for hepatitis B.

For babies born to mothers who test negative for hepatitis B, most wealthy countries reviewed by the CDC still recommend vaccination during infancy. Eighteen recommend that babies get their first dose of vaccine by 2 months of age.

However, experts say countries that have delayed the birth dose for babies born to moms who screen negative have key differences with the US — including universal health care for their citizens — that have informed their policies. Changing US policy to align with countries that have different demographics and needs would be shortsighted and risks eroding decades of progress in eliminating a serious infection that can cause cancer and death, they say.

“Countries with at-risk recommendations typically have much smaller populations, often a fraction of the US population, and have health care systems that support constant screening, testing and care coordination,” Dr. Michelle Goveia, who is a former epidemic intelligence service officer at the CDC who is now executive director of global medical and scientific affairs at Merck, said in a comment at the meeting.

“In contrast, US health systems face significant challenges in identifying people living with hepatitis B, making the diagnosis of maternal infection and subsequent vaccination of newborn systematically more difficult and likely to lead to congenital infections.”

According to the CDC analysis, no other country in the world that has had a universal birth dose has ever reverted from a universal to selective recommendation. The United States would be the first.

The presentations Thursday on hepatitis B vaccination “are not following science,” Dr. Jason Goldman, a liaison to the ACIP for the American College of Physicians, told CNN.

Studies casting doubt on the need for hepatitis B vaccination and its safety were quoted out of context, and the proposed language for voting on vaccine recommendations “is inappropriate,” Goldman added.

The first vote scheduled for Thursday is whether to remove the universal recommendation that newborns receive a hepatitis B vaccine that’s been in place in the US since 1991. Instead, for babies whose mothers haven’t tested positive for the virus, the recommendation would move to “individual-based decision-making.” If parents forgo a birth dose, the vote would recommend babies receive the vaccine no earlier than two months of age.

But, Goldman pointed out, “all decisions are individual-based. Nothing is a mandate.”

He compared the nature of the recommendation that all babies receive a dose at birth with one he might make as a physician for other health decisions, such as whether patients should get a colonoscopy to screen for colorectal cancer.

“I recommend a colonoscopy to a patient. They still have a choice to do it. The evidence shows colonoscopy reduces incidence of cancer,” Goldman told CNN. “Same analogy. I recommend the hepatitis B vaccine. [The] patient can refuse. The evidence shows benefit of [the] vaccine in reducing disease.”

Speaking during the meeting, Goldman said the meeting should be ended now, before a vote.

“You are wasting taxpayer dollars by not having scientific rigorous discussion on issues that truly matter,” he said. “The best thing you can do is adjourn the meeting and discuss vaccine issues that actually need to be taken up.”

Dr. Cynthia Nevison and Dr. Mark Blaxill give presentations at the CDC's Advisory Committee On Immunization Practices meeting in Atlanta on Thursday.

In another departure from past practices, the CDC vaccine committee heard a presentation from Dr. Cynthia Nevison, a research associate at the University of Colorado at Boulder, where she is an atmospheric scientist.

One of her research studies, called “Autism Tsunami,” was written with the next ACIP presenter — Dr. Mark Blaxill, who introduced himself as a critic of the CDC who is now working at the agency — was retracted by the journal that published it.

The editors of the journal said the authors misrepresented and selectively cited. or cherrypicked, data and that there were no valid justifications for the mechanisms the authors proposed for prevention.

“This is someone with no hepatitis B expertise and a well documented anti-vaccine bias. They could not find an expert to present on this?” wrote Dr. Dorit Reiss, a law professor at the University of California at San Francisco and a vaccine policy expert who was posting about the meeting on social media.

In her presentation, Nevison, who introduced herself as a contractor to the CDC, suggested that hepatitis B infections had never been a real threat to infants.

Nevison’s presentation sought to cast doubt on the importance of the hepatitis B vaccine and on recent modeling evidence that indicated doing away with the birth dose would increase the number of preventable hepatitis B cases and deaths in kids.

“There’s very little evidence that horizontal transmission has ever been a significant threat to the average American child, and the risk probably has been overstated,” Nevison said.

Nevison noted that the greatest declines in hepatitis B cases had been among younger adults, ages 20 to 39 — exactly the age group born after the universal birth dose was first recommended in 1991.

Instead, she said the decline in cases in this age group “had to be [due to] other measures.” She said other measures that may have been driving down hepatitis B infections, including better screening of blood products used for transfusion, safer dialysis and the adoption of safer sex practices due to the AIDS epidemic.

In reality, the adoption of screening and recommendations to lower the risk of transmission to infants has been stepwise.

In 1984, the CDC first recommended vaccination of infants born to mothers who tested positive for hepatitis B. Four years later, in 1988, the CDC first recommended hepatitis B screening for all pregnant women. In 1991, the CDC recommended universal hepatitis B vaccination for infants, then, in 2005, the CDC updated the recommendation to specify that babies should get a shot before they leave their birth hospital. In 2018, the recommendation was revised to specify that all infants should get the shot within 24 hours of birth. Nevison failed mention this history in her presentation.

Dr. Cody Meissner, a professor of pediatrics at Dartmouth and the only current member of ACIP who has experience on the committee, said he took “strong positions against each of the three presentations.”

“This disease has gone down in the United States thanks to the effectiveness of our current immunization program,” Meissner said.

“The way I look at a neonatal birth dose is that it is a safety net.”

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At 16 he learned he had hepatitis B. Now, a CDC proposal to delay vaccination worries him

02:31 • Source: CNN

At 16 he learned he had hepatitis B. Now, a CDC proposal to delay vaccination worries him

02:31

Hepatitis B is a liver infection caused by a virus.

After an acute hepatitis B infection, many adults clear the virus. But acute infection can lead to chronic hepatitis B, which is linked to increased risk of liver cancer, organ failure and cirrhosis, or scarring over the liver. People with chronic hepatitis B are 70 to 85% more likely to die early.

Infants and children who are infected with hepatitis B are more likely to develop chronic disease, including about 90% of infants and 30% of children ages 1 to 5.

How is hepatitis B spread?

The hepatitis B virus is extremely infectious. It is transmitted when blood, semen, or another body fluid from a person infected with the virus enters the body of someone who’s not infected.

Certain medical conditions, behaviors and other factors increase an individual’s risk of acquiring hepatitis B — including injecting drugs and sexual activity — but anyone can get it. The hepatitis B virus can also be passed easily during childbirth from a pregnant woman to child during either a vaginal delivery or C-section.

How common is hepatitis B?

Many people with hepatitis B do not have symptoms, and more than half may not be aware of their infection.

The latest data from the CDC shows that there were about 2,200 newly reported cases of acute hepatitis B in 2023, but estimates suggest that the actual number of cases was more than six times higher — closer to 14,400.

The CDC also estimates that about 640,000 adults in the US have chronic hepatitis B.

Globally, the World Health Organization estimates that WHO estimates that 254 million people were living with chronic hepatitis B infection, with about 1.2 million new infections each year.

Can hepatitis B be treated?

There is no treatment for acute hepatitis B, but there are some medications that can be used to treat chronic cases. There is no cure but treatment for chronic hepatitis B can be lifelong.

How can hepatitis B be prevented?

The best way to prevent hepatitis B infection is vaccination.

Most people who have hepatitis B were infected as infants or young children when their immune systems were not fully developed. Currently, it is recommended that all infants get vaccinated shortly after birth.

Universal vaccination against hepatitis B was first recommended for infants in 1991, and the strategy has been credited with cutting the number of hepatitis B infections in kids from about 18,000 cases a year to an estimated 20 cases a year now.

The hepatitis B birth dose is given to infants within 24 hours of birth, before they leave the hospital. Anti-vaccine activists, including HHS Secretary Robert F. Kennedy Jr., have long questioned the necessity and safety of this vaccine, despite decades of evidence supporting it. The virus spreads through bodily fluids — drug use and sex can increase risk.

However, many people do not know they are infected. Everyday activities can also spread the virus, and it’s especially easy to transmit to babies during birth.

On Tucker Carlson’s podcast in June, Kennedy incorrectly claimed that the birth dose of the hepatitis B vaccine was linked to higher risk for autism and suggested that the recommendation was made to drive profits for pharmaceutical companies.

“They recommended the hepatitis B vaccines for babies when they’re an hour old, the first day of life, they get that. And you know, hepatitis B, if your mother’s got it, you should get it. And you can pass through maternal transmission, but every mother that goes to the hospital in this country is tested for it. So we know which ones are vulnerable, which aren’t,” Kennedy said

But testing doesn’t catch every case.

At the committee’s September meeting, CDC scientists reviewed recent studies showing that an estimated 12-16% of pregnant women are not screened for hepatitis B during pregnancy, and fewer than half of infants born to mothers infected with hepatitis B are identified through prenatal screening.

Women are typically tested during their first three months of pregnancy. t’s possible to miss maternal infections if a woman catches the virus after she’s tested for it. Maternal testing also doesn’t protect babies from being exposed to other positive family members or caregivers.

Infectious disease experts say vaccinating every baby provides a critical safety net to catch those at risk when maternal screening misses.

Sen. Bill Casssidy speaks during a Senate Finance Committee on September 4, in Washington, DC.

Senator Bill Cassidy, the Republican doctor who chairs the Senate Health, Education, Labor and Pensions Committee, posted on X Thursday morning that “the ACIP is totally discredited. They are not protecting children.”

Cassidy, who struggled openly with his pivotal vote to confirm Robert F. Kennedy Jr. as health secretary, linked to the meeting’s agenda and specifically cited a Friday presentation by Aaron Siri, an attorney Cassidy said “makes his living suing vaccine manufacturers. He is presenting as if an expert on childhood vaccines.”

Siri, who’s worked closely with Kennedy and served as his personal lawyer during Kennedy’s presidential campaign, has handled a number of vaccine-related cases, particularly challenging vaccine requirements. In 2022, he filed a petition on behalf of the Informed Consent Action Network, or ICAN, a nonprofit that challenges the safety of vaccines and vaccine mandates, for the US Food and Drug Administration to revoke approval of the polio vaccine used in the US.

A managing partner at the law firm Siri & Glimstad LLP, Siri is scheduled to open Friday’s ACIP meeting with a presentation about the childhood and adolescent vaccine schedule.

With reporting by CNN Health’s Brenda Goodman

In an opening statement at today’s meeting, ACIP Vice Chair Dr. Robert Malone said that a vote about the hepatitis B vaccination schedule was postponed at the last meeting because there were gaps in the data that was presented to the committee, and the evidence fell short of what was needed to make a “confident evidence-based recommendation.”

“That decision was not about hesitation or reluctance. It was about standards,” he said. “I want to emphasize this is exactly how the scientific process is supposed to function.”

Since then, a dedicated working group was formed to examine those issues in greater depth. Malone said that he was “not able to disclose the nuance of that work group, but it is quite diverse in membership and represents a full spectrum of opinion regarding hepatitis B vaccination.”

He underscored that the primary mission of ACIP is to provide independent advice to the CDC director, and said that his hope was that the committee approach today’s meeting “with seriousness, clarity and a willingness to challenge our own prior assumptions as its credibility depends on our commitment to a deliberative, transparent, evidence-based process.”

Deputy Health and Human Services Secretary Jim O’Neill is serving as acting director of the CDC. He assumed the role after HHS Secretary Robert F. Kennedy Jr. fired Director Dr. Susan Monarez earlier this year.

Health and Human Services Secretary Robert F. Kennedy Jr. attends a signing ceremony at the White House on November 13.

This is the third meeting of the Advisory Committee on Immunization Practices since HHS Secretary Robert F. Kennedy, Jr. — who has long questioned the safety of vaccines while downplaying their benefits — abruptly dismissed all 17 of its sitting members in June.

Kennedy immediately replaced them with eight of his own picks One of his choices, Dr. Michael Ross, dropped out during a mandatory review of each member’s financial holdings, leaving seven members on the panel.

In September, Kennedy announced five additional members bringing the committee’s roster to 12 voting members.

This week, the reconstituted committee lost its chair, Dr. Martin Kulldorff, who was appointed to a new role within HHS: chief science officer for the Assistant Secretary for Planning and Evaluation, or ASPE. During the last meeting, Kulldorff broke an important tie vote when the committee deadlocked 6-6 over a proposed recommendation that people should get a prescription from their doctor before they could get a Covid-19 vaccine, a shift that would have made it more complicated for people who wanted the shots to get them.

That brings the total number of voting members to 11. The new chair is Dr. Kirk Milhoan, who is trained as a pediatric cardiologist. Because Milhoan was joining the meeting remotely on Thursday, the committee’s vice chair, Dr. Robert Malone, was facilitating the meeting.

Malone was an early researcher of mRNA technology and has suggested that Covid-19 vaccines cause cancer — something regulatory agencies say is not the case. Malone also served as a paid expert witness in an antitrust lawsuit over Merck’s measles, mumps and rubella vaccine, testifying that plaintiffs compensated him at a rate of $350 per hour.

For decades, infants born in the United States have been universally recommended to get the first dose of the hepatitis B vaccine as early as the day they’re born.

CDC vaccine advisers selected by US Health and Human Services Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist, will vote Thursday on whether to change that recommendation, although the strategy nearly eradicated hepatitis B cases among children.

Anticipated votes posted online late Wednesday suggest “individual-based decision-making, in consultation with a health care provider” for a “birth dose” of the hepatitis B vaccine when parents have tested negative for the virus or whose status is unknown. For babies not receiving the birth dose, “it is suggested that the initial dose is administered no earlier than 2 months of age,” it says.

A second vote considers whether parents of a child who has already received a dose of the hepatitis B vaccine should work with a doctor to test the level of protection ahead of additional doses.

Here’s the voting language:

VOTE 1: ACIP recommends a birth dose of Hepatitis B virus (HBV) vaccine and Hepatitis B Immunoglobulin for infants born to women who test HBsAg-positive. ACIP recommends individual-based decision-making, in consultation with a health care provider, for parents deciding whether to give the HBV vaccine birth dose to infants born to women who are HBsAg-negative or whose HBsAg status is unknown. Parents should consult with health care providers and decide when or if their child will begin the HBV vaccine series. Parents and health care providers should consider vaccine benefits, vaccine risks, and infection risks. For those not receiving the HBV birth dose, it is suggested that the initial dose is administered no earlier than 2 months of age. Y/N

Footnote: Parents and health care providers should also consider whether there are risks, for example, such as a household member is HBsAg-positive or when there is frequent contact with persons who have emigrated from areas where Hepatitis B is common.

VOTE 2: When evaluating the need for subsequent HBV vaccine dose in children, parents should consult with health care providers to determine if a post-vaccination anti-HBs serology testing should be offered prior to subsequent HBV vaccine dose administration. Serology results should determine whether the established protective anti-HBs titer threshold of ≥10 mIU/mL has been achieved. The cost of this testing should be covered by insurance. Y/N

The first dose of the hepatitis B vaccine is routinely given to newborns shortly after birth, before they leave the hospital.

Vaccine advisers to the US Centers for Disease Control and Prevention are expected to vote today whether to make a major change to the childhood vaccine schedule.

The members of the Advisory Committee on Immunization Practices were handpicked by US Health and Human Services Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist, after he abruptly fired the 17 sitting members earlier this year.

The agenda for the Advisory Committee on Immunization Practices meeting — which runs today and tomorrow — includes a vote about hepatitis B vaccines for newborns, and more discussion on ingredients and timing for vaccines on the childhood schedule.