| Doctors, public health officials and even patients are closely watching this week’s meeting of an influential panel at the US Centers for Disease Control and Prevention and wondering how vaccine recommendations will change under the Trump administration. Health reporters Robert Langreth and Jessica Nix explain how its decision-making over at least one shot got messy. Plus: What happened when Trump gutted one of the best deals the federal government has to offer, and a former teen member of a notorious cybercriminal group talks about his role. If this email was forwarded to you, click here to sign up. Health and Human Services Secretary Robert F. Kennedy Jr. has long been critical of the safety of many vaccines. In June he fired all 17 members of the Advisory Committee on Immunization Practices, a key panel that makes vaccine recommendations, and later replaced them with a handpicked group, several of whom previously had been critical of Covid-19 shots or other vaccines. One target of Kennedy’s ire has been the hepatitis B vaccine, a series of shots that’s recommended starting at birth to prevent a liver disease that’s particularly devastating when acquired during childbirth or as an infant. In June he went on the Tucker Carlson Show and questioned whether it was necessary to give the birth vaccine for a disease that’s sexually transmitted in adults, pointing to a debunked theory that giving the vaccine early could cause autism. That made yesterday and today’s meeting of the newly reconstituted ACIP a key test of how aggressive the Trump administration would be in dialing back child vaccine recommendations. The panel had been scheduled to vote on whether to recommend delaying the first dose of the hepatitis B shot until one month or later in infants whose mothers had tested negative for the virus while pregnant. It could’ve been the first step in a broader rollback of vaccine recommendations. But instead, the ACIP meeting descended into chaos, with the panel members unable to agree on much about the hepatitis B shot, partially because members didn’t fully understand the implications of their votes. In one exchange during Thursday’s meeting, panelist and Louisiana OB-GYN Evelyn Griffin criticized the birth shot and claimed it wasn’t safe for newborns. “Are you asking babies to solve an adult problem?” she asked.  Griffin at the ACIP meeting on Thursday in Chamblee, Georgia. Photographer: Elijah Nouvelage/Getty Images Other panel members supported the shot, noting that there was little good evidence presented at the meeting that the birth shot was either unsafe or ineffective. “No vaccine is 100% safe and no vaccine is 100% effective,” said Cody Meissner, a professor of pediatrics from the Geisel School of Medicine at Dartmouth College. In terms of the newborn hepatitis vaccine, the benefit “far outweighs” any adverse side effects, he said. The hepatitis B shot is a preventative vaccine; after completion of the three-dose series, children are protected for life against the disease. Children are particularly vulnerable to contracting the hepatitis B virus, the effects of which can include liver cancer or liver failure later in life. That’s why the World Health Organization recommends the first dose be given to all kids at birth, something the majority of countries do. In the US, the birth dose has been recommended for more than three decades. In another vote, the panel said that Merck & Co.’s combination vaccine for measles and three other viruses shouldn’t be given as one shot to children under 4 because it increases the rare risk of seizures. Instead, the youngest children should get two separate shots to prevent the infections, the panel said, in what amounted to a relatively small tweak to the existing schedule. On the hepatitis B shot, some panel members appeared to demand that vaccine safety researchers prove a negative. “The absence of data that statistically proves lack of safety does not mean that the product is safe,” said panel member Robert Malone, a scientist who has studied mRNA and is a vaccine skeptic who wrongly claimed that Covid shots cause a form of AIDS. Ultimately, the panel postponed Thursday’s vote on the hepatitis B shot and then on Friday shelved it indefinitely for further study. That could mean more fireworks in meetings down the road. The panel did agree that all expectant mothers should be tested for the virus. One downside of delaying the birth shot: The test isn’t perfect and produces some false negatives, says Paul Offit, a vaccine researcher at Children’s Hospital of Philadelphia who’s clashed with RFK Jr. But the biggest downside of changing the recommendations without a strong reason to do so is that the move could further erode the public’s confidence in vaccines, Offit says. He adds: “We have virtually eliminated hepatitis B in children because of the birth dose, and we’ve done it safely.” Sign up for the Prognosis newsletter to get the latest in health, medicine and science—and what it means for you. | 
