December 03, 2025
6 min read
Key takeaways:
- The CDC’s Advisory Committee on Immunization Practices will meet on Thursday and Friday this week.
- A vote on the hepatitis B birth dose is on the agenda, as is a broader discussion of childhood vaccines.
The CDC’s vaccine advisors, led by a newly named chair, will discuss making more changes to the childhood vaccine schedule during a 2-day meeting that starts on Thursday.
The meeting was scheduled to take place in October but was postponed because of the government shutdown. It is the third meeting of the Advisory Committee on Immunization Practices (ACIP) since HHS Secretary Robert F. Kennedy Jr. removed the existing 17 members of the panel in June and replaced them with his own picks, currently totaling 11 voting members.
The CDC’s vaccine advisors are reviewing existing childhood immunization recommendations. Image: Adobe Stock
There is only one vote on the agenda this week, which is expected to be a vote Thursday on whether to delay the hepatitis B vaccine dose currently recommended for all infants at birth. The ACIP debated making this change during its last meeting in September but ultimately tabled the vote after members disagreed about the timing of the shot.
This week’s meeting could have implications for the childhood vaccine schedule beyond HBV vaccination. Here’s what you can expect — and not expect — to happen:
A broader discussion of the child vaccine schedule
In June, then-chair Martin Kulldorff, PhD, announced during his opening remarks at the first meeting of Kennedy’s remade ACIP that the committee would be reviewing existing vaccine recommendations and assessing whether people receive too many shots, which raised concern among experts.
The committee has already voted to overturn a longstanding recommendation that allowed young children to get a shot that combines protection against measles, mumps, rubella and varicella — the MMRV vaccine — and to remove thimerosal-containing influenza vaccines from the market for all ages, a longtime goal of anti-vaccine activists, including Kennedy.
As of Wednesday morning, the draft agenda posted online for this week’s meeting still lacked the basic details normally provided before ACIP meetings, including what time each discussion would take place. The cursory document was an “unusual” sight, Yvonne “Bonnie” Maldonado, MD, a Stanford professor and physician who was one of the ACIP members dismissed by Kennedy in June, told Healio.
“Usually, the agenda would have which working groups are presenting, the topics and speakers. The slides for the presentations would be uploaded a day or two before the actual meeting, sometimes the day of the meeting,” Kevin A. Ault, MD, another former ACIP member and chair of the department of obstetrics and gynecology at Western Michigan University Homer Stryker MD School of Medicine, told Healio.
Although the agenda is short on details, it is apparent that Friday’s discussions will focus on possible changes to the childhood and adolescent immunization schedule, based on public comments made by the newly named ACIP chair and the list of topics, which includes:
- CDC vaccine risk monitoring evaluation;
- vaccine schedule history;
- childhood/adolescent immunization schedule;
- vaccine schedule considerations; and
- adjuvants and contaminants.
Kirk Milhoan, MD, PhD, a pediatric cardiologist from Hawaii who was named ACIP chair after Kulldorff was appointed this week to a senior role at HHS, told The Washington Post that, in addition to the vote on delaying the HBV birth dose, the committee will assess the timing of the vaccines on the childhood schedule and their ingredients and whether the shots are responsible for a rise in allergies and autoimmune disorders.
Kennedy has long espoused anti-science views about vaccines, including that they are to blame for the rise in autism diagnoses and that they contain ingredients that are dangerous to children’s health. This past summer, he criticized a large Danish study that found no link between aluminum in vaccines and the development of autoimmune, allergic or neurodevelopmental disorders, arguing that its design was “flawed” and unsuccessfully calling for its retraction.
But vaccines included on the child and adolescent immunization schedule are safe and timed to provide the optimal protection, said Sean T. O’Leary, MD, MPH, who chairs the American Academy of Pediatrics’ infectious diseases committee.
“Every vaccine on that schedule and the recommended timing of it exists for a reason,” O’Leary, a professor of pediatrics at the University of Colorado School of Medicine, said during an AAP press briefing this week.
Additionally, each vaccine ingredient serves a purpose, he said. For example, aluminum salts, which the CDC notes have been used safely in vaccines for more than 7 decades, help boost a person’s immune response.
“Plenty of research has found no evidence that aluminum in vaccines causes any of the conditions that they say it does, including autoimmune conditions, neurodevelopmental disorders or other serious adverse events,” O’Leary said. “Removing aluminum, or really any ingredient, from these vaccines could impact their effectiveness and reduce childrens immune systems’ abilities to protect against disease.”
Because the current vaccine schedule is based on science, any changes made by the ACIP would be based on ideology, not evidence, O’Leary said.
He noted that the AAP makes its own vaccine recommendations, which have been mostly harmonized with CDC for the past 30 years. (The AAP split with the CDC recently on COVID-19 vaccination, publishing more inclusive recommendations.)
“Any changes they do make could be devastating to children’s health and public health as a whole,” O’Leary said. “We’re going to continue producing our own childhood vaccine schedule, and we’ll be pointing parents and families in that direction to help protect the health and safety of their kids.”
A vote on HBV birth dose
The CDC currently recommends that all newborns receive the first dose of HBV vaccine within 24 hours of birth to prevent perinatal transmission of the highly infectious virus, which can become a life-long chronic infection, especially among people infected as infants. The second dose is recommended between ages 1 and 2 months, and the third dose should be administered between ages 6 and 18 months, according to the CDC vaccine schedule.
The HBV vaccine “birth dose” has been credited with reducing HBV transmission among babies and children in the U.S. by around 95% and preventing an estimated 90,000 deaths since it was first recommended by the CDC in 1991.
The vote that was tabled by the ACIP in September could have removed the recommendation for a birth dose and replaced it with a recommendation that the first dose not be given until an infant is aged at least 1 month if the mother tests negative for hepatitis B surface antigen. Another vote could have given parents the option to have their newborn vaccinated regardless of testing based on shared clinical decision-making.
There was debate among voting members about the timing of the first dose, with some supporting its administration at birth and others suggesting that it be delayed until age 2 or 3 months. Milhoan told the Post that the panel will again discuss delaying the first dose of HBV vaccine.
The scientific evidence that HBV vaccines are safe is overwhelming, the CDC notes. A recent review of more than 400 studies undertaken by the Vaccine Integrity Project — an initiative launched earlier this year by the University of Minnesota’s Center for Infectious Disease Research and Policy — found that there was “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.”
“The review found no short-term or long-term safety benefit to delaying the first dose, so [it appears] there are no new data that would cause safety concerns that would lead to a change in the current recommendation,” Hepatitis B Foundation President Chari A. Cohen, DrPH, MPH, who was not involved in the review, told Healio.
In a public comment submitted for the ACIP meeting, the Vaccine Integrity Project said delaying the first dose of HBV vaccine “would reduce protection for infants and increase the risk of avoidable HBV infections, undermining decades of progress in hepatitis B prevention and U.S. efforts to eliminate viral hepatitis as a public health threat.”
“The hepatitis B vaccine has one of the most well-established safety records of any vaccine,” O’Leary said, “and it’s one of our best.”
For more information:
Chari A. Cohen, DrPH, MPH, can be reached at edward.tate@hepb.org.
Kevin A. Ault, MD, Sean T. O’Leary, MD, MPH, and Yvonne “Bonnie” Maldonado, MD, can be reached at infectiousdisease@healio.com.
Sources/Disclosures
Source:
References:
- CDC. ACIP meeting information. https://www.cdc.gov/acip/meetings/index.html. Updated Nov. 25, 2025. Accessed Dec. 3, 2025.
- CDC. Adjuvants and vaccines. https://www.cdc.gov/vaccine-safety/about/adjuvants.html. Updated Dec. 20, 2024. Accessed Dec. 3, 2025.
- CDC. Child and adolescent immunization schedule by age (addendum updated August 7, 2025). https://www.cdc.gov/vaccines/hcp/imz-schedules/child-adolescent-age.html. Updated Oct. 7, 2025. Accessed Dec. 3, 2025.
- CDC. Hepatitis B perinatal vaccine information. https://www.cdc.gov/hepatitis-b/hcp/perinatal-provider-overview/vaccine-administration.html. Updated Aug. 27, 2025. Accessed Dec. 3, 2025.
- Sun L. RFK Jr.’s vaccine advisors plan biggest change yet to childhood schedule. The Washington Post. Dec. 2, 2025. https://www.washingtonpost.com/health/2025/12/02/acip-hepatitis-b-childhood-immunization-schedule/. Accessed Dec. 2, 2025.
- Vaccine Integrity Project – Hepatitis B. https://www.cidrap.umn.edu/vaccine-integrity-project/hepatitis-b. Accessed Dec. 3, 2025.
Disclosures:
Ault and Maldonado report no relevant financial disclosures. Cohen reports that the Hepatitis B Foundation received research and outreach grants from Dynavax Technologies, Gilead Sciences, Roche, and Vir Biotechnology; that she is a member of advisory boards for Gilead and GSK, with renumeration going to the Hepatitis B Foundation; is co-chair of Hep B United; has volunteered for the International Coalition to Eliminate of HBV governing board; is a member of steering committees for the HBV Forum, hepbcommunity.org, and HepVu; and has completed unpaid work as a member of the board of directors for the Hepatitis B Foundation and Baruch S. Blumberg Institute. Healio could not confirm relevant financial disclosures for O’Leary at the time of publication.
Ask a clinical question and tap into Healio AI’s knowledge base.
- PubMed, enrolling/recruiting trials, guidelines
- Clinical Guidance, Healio CME, FDA news
- Healio’s exclusive daily news coverage of clinical data
