‘We Are Doing Harm’: RFK Jr.’s ACIP Guts Universal Hep B Vaccination at Birth

The steady destruction of the country’s public health pillars continues apace. This week, the reshuffled Advisory Committee on Immunization Practices (ACIP) voted to overturn a vaccine policy in place for over three decades—a change that will almost certainly be carried out by Robert F. Kennedy Jr., the current secretary of Health and Human Services.

On Friday morning, the ACIP voted 8-3 to remove its previous recommendation that all children in the U.S. be vaccinated against hepatitis B starting at birth. In its place, the panel is endorsing “individual-based decision-making†for determining when most children should get their first hepatitis B shot. Many outside groups and experts have sharply criticized the ACIP’s about-face, noting that scant credible data was presented to justify such a dramatic reversal.

“If that recommendation goes forward, it will be without evidence and will ignore over 30 years of existing evidence and gambles with the safety of children,†James Campbell, vice chair of the Committee on Infectious Diseases at the American Academy of Pediatrics, told Gizmodo.

The vaccine-skeptical ACIP

Ordinarily, the ACIP is a panel of relevant experts organized by the Centers for Disease Control and Prevention to help guide vaccine policy in the U.S. But in June 2025, RFK Jr. abruptly and unilaterally dismissed all 17 members of the previous ACIP without any notice. Later that month, without any public review, he installed a new batch of ACIP members; he added more members in September.

Like Kennedy himself, many of the new ACIP members have a track record of misrepresenting vaccine safety or have directly profited from testifying against vaccine manufacturers. The newest chair of the ACIP, Kirk Milhoan, wrongly stated in October that covid-19 vaccines have caused spikes in cancer cases and miscarriages, for instance.

Since taking over the ACIP, RFK Jr.’s lackeys have slowly but surely undermined vaccines. In their first two meetings, they voted to restrict the use of certain flu vaccines and the combined measles, mumps, rubella, and varicella vaccine—votes that many health experts and groups bashed as unscientific. But this latest move to remove universal at-birth dosing for the hepatitis B vaccine is the ACIP’s largest change yet, and one that could have plenty of harmful ramifications.

Why universal at-birth vaccination is important and safe

Hepatitis B is transmitted through direct contact with infected bodily fluids and can be spread from mother to child during childbirth. The ACIP and CDC recommended universal hepatitis B vaccination for infants starting in 1991, eventually endorsing at-birth dosing for the first shot (of three).

Since its enactment, this recommendation has helped dramatically lower rates of hepatitis B in the country, particularly among newborns. Preventing these earliest cases is especially important, since 90% of infections in children will become chronic; about a quarter of these children will later develop life-threatening conditions like cirrhosis and liver cancer.

At no point did the ACIP workgroup make a compelling case for the removal of this policy.

The members speculated about possible health risks of the hepatitis B vaccine, like multiple sclerosis, without mentioning that the vast majority of studies have ruled out such a connection. The vaccine is widely accepted to be safe, with potential serious risks like anaphylaxis being exceptionally rare (perhaps one in a million) and treatable. The ACIP also presented no evidence that delaying the dose from birth to one to two months of age would provide any added safety benefits.

Members also claimed that some countries do not endorse universal at-birth dosing. Critics have rightly noted that many more countries (115 in total) do recommend this dose, while countries that rely on a more selective screening approach often have advantages the U.S. doesn’t, such as a universal health care system.

Notably, a substantial portion of pregnant women in the U.S. (up to 18%) do not currently receive testing for the virus. And even today, around 17,000 American children are born annually to mothers positive for hepatitis B. So delaying the first dose could leave children more vulnerable to a missed maternal infection or to later exposure from other family members.

Unsurprisingly, many experts weren’t on board with the ACIP’s expected change even prior to the vote.

“This review found no benefit related to vaccine safety or protection of a delayed first dose compared with vaccination at birth, but identified critical risks of changing current U.S. recommendations,†concluded a report from the Vaccine Integrity Project, published just prior to the ACIP meeting.

The ACIP meeting was also besieged by disorganization and chaos. For the second meeting in a row, the ACIP agreed to postpone the vote on hepatitis B (at the end of the September meeting, they postponed the vote entirely), after several members expressed confusion about what exactly they were voting on. The committee changed the exact language of the votes several times in the lead-up to the meeting and during the meeting itself.

What happens to hepatitis B vaccination now?

The ACIP held three specific votes related to the hepatitis B vaccine.

For children born to mothers who test negative for antibodies to hepatitis B, the ACIP is now pushing for an individualized approach, one where “parents should consult with health care providers and decide when or if their child will begin the HBV vaccine series.†And for families who choose not to start vaccination at birth, the ACIP recommended that vaccination not start any earlier than two months (the ACIP offered no clear rationale or evidence for this specific cut-off).

“We are doing harm,†Cody Meissner, one of the few members who voted no, immediately stated following the vote.

In the second vote, ACIP stated that parents should consult with their doctors to decide whether the full series of vaccinations is needed for their children, based on antibody results. This vote was more marred by contentious debate, as some ACIP members rightly pointed out that no evidence supports whether a shorter vaccine series would be as effective for lifelong immunity.

In the third vote, the ACIP voted to incorporate their new recommendations into the Vaccines for Children federal program.

The ACIP recommendations are just that, and the CDC is not obligated to endorse them. But a refusal seems unlikely given the current state of the agency. Earlier this summer, RFK Jr. fired former CDC director Susan Monarez, allegedly for refusing to rubber-stamp decisions issued by ACIP without review. By contrast, the current acting CDC director, Jason O’Neill, is a strong supporter of Kennedy and has voiced his support for certain goals of the anti-vaccination movement, such as breaking up the MMR vaccine.

Many groups like the AAP still endorse at-birth dosing for hepatitis B vaccination. And some states have already signaled that they will not abide by the ACIP’s hijacking of vaccine policy. Late last month, for instance, the New York City Department of Health and the Northeast Public Health Collaborative—a coalition of states’ public health agencies formed this September—issued an advisory continuing to support vaccination within the first 24 hours of birth.

“If ACIP chooses to ignore evidence, when it comes to vaccines, parents and clinicians must ignore ACIP and look to those who continue to offer data-based guidance, especially our medical societies,†Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, told Gizmodo.

It’s certainly possible that many doctors and families will still agree to vaccinate their children as early as possible for hepatitis B. But it’s also likely that some children will slip through the loosened safety net and contract this dangerous viral infection. A recent modeling study, released as a preprint paper late last month, estimated that even a two-month delay in vaccination could result in an extra 90 acute infections, 75 chronic infections, and 29 child deaths every year, along with $16.4 million in added costs.

These latest votes are also a sign that the anti-vaccination movement’s grip on public health is tightening. Following the hepatitis B vote on Friday, the ACIP also held a discussion of the entire childhood vaccine schedule. And while the group will not issue votes on the schedule at this time, it’s almost certain that the ACIP’s deliberation will set the stage for more sweeping changes moving forward.

RFK Jr. and his allies have begun their resculpting of the country’s vaccine policy, and there’s no indication that they’re finished yet.