ACIP Delays Hep B Vote, Reverses on VFC Coverage

The Advisory Committee on Immunization Practices (ACIP) voted today to postpone a vote on whether to change its recommendation that all children should get vaccinated against hepatitis B at birth. The vote was 11-1, with Martin Kulldorff, Ph.D., chair of the committee, the only dissenter.

The committee also revisited yesterday’s vote on whether the combined measles, mumps, rubella and varicella (MMRV) vaccine should be covered under the Vaccines for Children (VFC) program, which provides free or low-cost vaccine coverage for approximately half of children who are uninsured or on Medicaid. Today, the committee recommendation voted 9-3, with three abstentions, not to have it covered. This is a reversal of yesterday’s vote in favor of VFC coverage.

Members were supposed to vote on the hepatitis B recommendation yesterday but ran out of time after a lengthy debate on the issue.

Today’s discussion began with a unanimous vote for the recommendation that all pregnant women be tested for hepatitis B, but a debate ensued when it came to deciding if and when the hepatitis B vaccine should be given to newborns.

Vicky Pebsworth, OP, Ph.D., RN research director at the National Vaccine Information Center, a nonprofit organization that questions the safety of vaccination, urged the committee to “err on the side of caution” and cited information presented at yesterday’s session that showed that in 26 countries, the hepatitis B vaccine is given to infants at two or three months of age, instead of at one month.

“Up to 5% [of infants] were reported to have fever, 32% were drowsy and sleeping and 3% were categorized as having severe irritability,” Pebsworth said during her statement.

Cody Meissner, M.D., professor of pediatrics at Dartmouth Geisel School of Medicine, who was appointed to ACIP in June 2025, responded with, “I think the experience that we have accrued over administration of a dose of the vaccine in the first 12 to 24 hours is overwhelming, and the issues that were raised regarding irritability or restlessness that those are certainly not objective parameters that should be used to assess safety.”

“It is really important, as Dr. Meisner stated, to recognize that no intervention, not even Tylenol, not even amoxicillin, clearly not chemotherapy drugs, there's always some risk,” Amy Middleman, M.D., M.P.H., representing the Society for Adolescent Health and Medicine, echoed. “It is very easy to get distracted by one study that says this or one study that does or does not say that.” Middleman is not an ACIP member.

Kulldorff spoke in favor of VFC coverage.

“What all this means is that every child, including every child in the Vaccines For Children program, will have access to vaccines against measles, they will have access to be vaccinated against mumps, they will have access to be vaccinated against rubella, which is German measles and they will have access to be vaccinated against varicella, which is chicken pox,” Kulldorff said.

Kulldorff said that the reason for today’s revote was because of confusion in the interpretation of the vote yesterday.

The meeting is currently being streamed on the Centers for Disease Control and Prevention’s YouTube channel.

The panel’s votes require final approval from Jim O'Neill, the acting CDC director.