Federal vaccine advisers appointed by Robert F. Kennedy Jr. are preparing to vote on what would be the biggest change in decades to the routine childhood immunization schedule in the United States. The proposal would end the long-standing practice of giving all newborns a dose of the Hepatitis B vaccine within 24 hours of birth at least for babies whose mothers test negative for the virus.
The plan is being led by the Advisory Committee on Immunization Practices (ACIP) under its new chair, Kirk Milhoan, a pediatric cardiologist and known critic of coronavirus vaccination. Milhoan said the panel will vote on the change Thursday and is also reviewing whether vaccines given throughout childhood may contribute to rising rates of allergies, asthma, eczema, and autoimmune disorders.
For more than 30 years, the birth dose of the hepatitis B vaccine has been widely credited with nearly eliminating infant and childhood cases of the disease. Universal vaccination starting in 1991 helped drive a roughly 99 percent drop in infections among children, teens, and young adults.
Supporters of the proposed change argue that, when a mother has already tested negative for hepatitis B, the chance of transmission is negligible, making the birth dose unnecessary in many cases. They contend that a delayed schedule may be safe and could ease concerns about possible long-term effects of early-life vaccination. Milhoan said the panel is still finalizing exactly when the first dose would be given if the change passes.
Public-health experts warn that the move could reverse decades of progress against hepatitis B. Babies sometimes slip through the cracks: maternal infection status can be missed if mothers are not screened or are infected later in pregnancy. For those infants, the birth dose serves as a vital safety net.
Critics also express concern that the broader review of the childhood immunization schedule may be driven more by doubts and skepticism than by new scientific evidence. Several major medical organizations have already expressed concern that the reconstituted ACIP may be departing from widely accepted, data-driven public-health practices.
Once ACIP votes, the final decision will rest with the director of the Centers for Disease Control and Prevention (CDC). The recommendation carries great weight: historically, CDC directors almost always adopt ACIP’s proposals, meaning the change could quickly become standard practice nationwide.
As the vote approaches, many pediatricians and public-health advocates are watching closely, warning that changing or delaying the hepatitis B birth dose could leave vulnerable infants unprotected and potentially open the door to preventable disease outbreaks. Others call for careful review, but only based on strong scientific evidence.
