There has been some good news about the vaccine in recent weeks, with studies showing that it is possible to get a flu shot. reduces heart diseaseShingles vaccine may prevent or slow dementia and single human papillomavirus shot protection A girl who suffered from cervical cancer all her life.
But in the upside-down world of Health and Human Services Secretary Robert F. Kennedy Jr., vaccines are in jeopardy. The vaccine committee, dominated by the skeptics he selected for the panel, voted 8 to 3 Friday to end a 34-year recommendation to inoculate newborns with the hepatitis B virus. This practice helped reduce viral infections by 99%, from about 16,000 cases in 1991 to just 7 cases in 2023.
As the committee deliberated, the dangers of giving up on the vaccine were clear. Measles, a completely vaccine-preventable disease, is having its worst year in the U.S. since 1992, with continued resurgences in Utah, Arizona and South Carolina. A two-year outbreak of whooping cough, which can be detected by a vaccine, has resulted in nearly 60,000 reported cases, including at least six infant deaths.
But members of the Advisory Committee on Immunization did not discuss these diseases on the first day of their meeting. The panel’s official purpose is to determine vaccination policies to counter those risks, but under Kennedy the emphasis was on countering the doubts of vaccine skeptics and opponents.
Like previous meetings of the committee, which was hand-picked by Kennedy after firing the panel’s 17 current experts in June, this one clashed confusingly with past practices at the Centers for Disease Control and Prevention. Kennedy described the agency as a “den of corruption.”
The committee’s chairman, epidemiologist Martin Kulldorff, left his position three days before the meeting to take a senior position at HHS. His successor, pediatric cardiologist Kirk Milhoan, claimed The claim that the mRNA technology used to make Covid vaccines is the “biggest threat to humanity” was made on planes or in Asia for most of the meeting, with Deputy Speaker Robert Malone taking the reins. Malone opposes vaccine mandates and has become a darling of the anti-vaccine movement, telling podcast host Joe Rogan in 2021 that Americans are “basically hypnotized” into getting the COVID-19 vaccine.
Typically, slides and data from panel meetings are posted on the CDC website a few days in advance. This time it wasn’t posted at all.
The committee’s working group that studied the hepatitis B vaccine did not include accredited hepatitis experts. When some panel members expressed doubts during the ACIP meeting, CDC hepatitis specialist Adam Langer stepped in to answer questions. He frowned at the proposed changes.
Amazing choices from experts
At 8 a.m. on December 4, the CDC finally listed the names of the conference speakers. Aaron Siri, one of Kennedy’s former lawyers and a legal foe of immunizations, was scheduled to headline a debate on childhood vaccination schedules on Friday.
Senator Bill Cassidy, a Louisiana Republican and physician who cast the deciding vote to give Kennedy his position, said on the social platform
In the replies to his post, some people wanted to know what Cassidy plans to do about this. Although he publicly criticized some of Kennedy’s moves on vaccines, the senator made no notable efforts to overturn them.
As the meeting began, Malone noted that Vicky Pepsworth, senior director of the National Vaccine Information Center, a cornerstone of vaccine skepticism for 40 years, is chairing the committee reviewing the entire childhood vaccine schedule. This is a repository of ACIP recommendations that protect American children from measles, whooping cough, influenza, tetanus, chickenpox, meningitis, and many other diseases.
Typically, seasoned CDC and FDA experts on vaccines and infectious diseases present data on diseases and prevention options before ACIP votes on policy. Instead, Pebsworth, a vaccine-skeptic climate scientist, Cynthia NevisonMark Blaxill, a businessman who helped lead another anti-vaccine group, published a negative case for the hepatitis B vaccine on December 4.
Tracy Beth Høeg, a sports medicine physician who worked for a year with Vinay Prasad, a University of California-San Francisco epidemiologist and now the FDA’s vaccine chief, often agreed. Nevison and Blaxill were co-authors of a 2021 autism study that was retracted due to data misrepresentation and other issues.
Not surprisingly, the picture they painted on December 4 suggested that birth doses of hepatitis B were not necessary and, despite years of scientific consensus, could be dangerous.
The presentation surprised Cody Meissner, an infectious disease expert and one of the only vaccinologists on the CDC panel. “There are so many statements I disagree with that it’s hard to be concise,” he said.
Yvonne Maldonado, an infectious disease expert at Stanford University and one of the former ACIP members expelled in June, said it was horrifying to see unverified presentations from non-expert, non-doctors.
“Almost every statement this committee has made has been misinformation, disinformation or outright lies,” she said. “They’re cherry-picking data, pulling out marginal newspapers, and misunderstanding good newspapers. They’re not the right people to make decisions.”
Pebsworth said the committee was addressing the birth dose issue, perhaps because of “pressure from stakeholder groups,” including Kennedy and his allies. She incorrectly said the United States was an “outlier” in the universal recommendations.
In fact, the birth dose of hepatitis B vaccine is available in 115 countries and is recommended by the World Health Organization (WHO). However, many Western European countries limit birth doses to target groups.
Arguments for birth dose
Targeted measures to stop the virus in the 1980s, including encouraging safe sex, increasing blood testing and vaccinating mothers’ babies with hepatitis B, have achieved most of the decline in cases since then, Nevison said. But most experts say birth dose played a role. And the virus remains a threat. Approximately 640,000 carriers in the usa
The birth dose is a “safety net,” Meissner said. “This is for chronically infected mothers who cannot get tested for this reason.”
“Where is the evidence that it is harmful?” asked another panelist, psychiatrist Joseph Hibbeln.
In the years since birth doses of hepatitis B vaccine were recommended, few major side effects have been identified.
Blaxill, who 25 years ago helped develop the disproven theory that traces of mercury in vaccines cause autism, said the hepatitis B vaccine was poorly studied. He pointed to studies showing high fevers in some children after the shots, which he said suggests brain inflammation.
Maldonado said that was wrong. “I saw thousands of children with fever,” she said. “It’s different from encephalitis.”
Nevison said a handful of vaccine court rulings have established at least some harm from hepatitis B vaccinations. Reed Grimes, director of the Health Resources and Services Administration’s Injury Compensation Program Division, explained that compensation does not necessarily mean proof of injury and that the government has decided not to contest the claims.
Speculation blossomed. Panelist Evelyn Griffin, an obstetrician-gynecologist, hypothesized that the increased cases of inflammatory bowel disease may be linked to the medium (brewer’s yeast) used to produce the hepatitis B vaccine. She did not cite the source of the idea.
Babies born with hepatitis B have a 90% chance of developing chronic hepatitis later in life, and 25% of babies with chronic infection die prematurely from chronic liver disease.
Members of the panel pushing to end the universal birth dose argued that pregnant women’s blood tests should reveal who should get the shot. However, only 35% of women who test positive receive all recommended follow-up care, and the virus can easily spread through casual contact such as toothbrushes or bath towels. A recent study found that stopping the birth dose could result in nearly 500 deaths per year.
Prior to the meeting, a large-scale briefing was held for reporters and reporters. “Free bunking” thesis There are three recent comments from established medical experts who see the new ACIP as a sounding board for anti-vaccine views, saying it “inflates speculative risks while downplaying well-established vaccine benefits.” CDC officials wrote:.
They noted that the birth dose for hepatitis B is already optional, although it is strongly recommended by doctors. But recommending shared decision-making based on individual choice, as ACIP voted to do on Dec. 5, could add paperwork for doctors and create doubt in parents’ minds.
ACIP recommendations are not binding, but have been used by health insurers in the past to make coverage decisions. Andrew Johnson, who represented the Centers for Medicare and Medicaid Services at the meeting, said federal agencies and private insurers will continue to pay for hepatitis B vaccinations in most cases if parents choose to do so. But studies have shown that vague advice leads to lower vaccination rates, said Katherine Edwards, a vaccinologist at Vanderbilt University.
Anti-vaccine activists have long targeted the hepatitis B birth dose. At one point, they made the unsubstantiated claim that it caused sudden infant death syndrome.
However, within 10 years of universal dose implementation, SIDS rates fell by almost half. This was thanks to the HHS-American Academy of Pediatrics’ ‘Back to Sleep’ campaign. The campaign urged parents to avoid the risk of suffocation by ensuring their babies do not sleep face down.
