Pediatricians on the South Fork were harshly critical of the federal Advisory Committee on Immunization Practices’ vote on Friday to recommend that pregnant women who test negative for hepatitis B should decide when or if their child will be vaccinated against the virus at birth.
The 8-to-3 vote changes the federal Centers for Disease Control and Prevention’s recommendation, since 1991, that the first of three doses of the vaccine be given right after birth. From the 1991 universal-vaccination recommendation to the 2020s, infections among children and adolescents fell by an estimated 99 percent. The change announced on Friday, the pediatric infectious disease division chief at Stony Brook Children’s Hospital said flatly, means that “children will now die” from preventable diseases.
Hepatitis B is a highly infectious virus that attacks the liver, causing acute or chronic illness. It can be transmitted from an infected mother to her baby at birth as well as by unprotected sex, intravenous drug use, and even sharing items like razors.
In his tenure as secretary of the federal Department of Health and Human Services, Robert F. Kennedy Jr., a vaccine skeptic who has made many false statements about their safety, has overturned a long-accepted understanding both of vaccines’ safety and efficacy.
The Advisory Committee on Immunization Practices, or A.C.I.P., comprises independent public health and medical experts that advise the C.D.C. on vaccine policy, including the recommended childhood immunization schedule. Months after Mr. Kennedy’s January confirmation hearings, during which he testified that he was not anti-vaccine but rather believes vaccines “have saved millions of lives and play a critical role in health care,” he fired all 17 members of the A.C.I.P. and replaced them with members he personally selected, several of whom have ties to Children’s Health Defense, a source of vaccine misinformation that Mr. Kennedy chaired from 2015 until his 2023 campaign for president.
A.C.I.P., said Sharon Nachman, the pediatric division chief at Stony Brook Children’s Hospital, is “changing the future of our children. They are putting in a ticking time bomb that won’t explode for the next 20 years, when they’re not around to see and it’s going to be someone else’s problem.”
“It’s very worrisome,” said Gail Schonfeld of East End Pediatrics in East Hampton. “We’re all very concerned about the outcome and the trend to make decisions that affect the health and well-being of children without any scientific evidence or medical knowledge and input.”
“Patient welfare demands we routinely revisit vaccine recommendations,” Edwin Keeshan, medical director of the Meeting House Lane Medical Practice in Montauk, said. “In this case, the latest studies continue to confirm the safety and effectiveness of the [hepatitis B virus] vaccination at birth and its role in reducing infection among infants and children.”
Unlike a respiratory virus, Dr. Nachman said, “once infected, it can hang around for the rest of your life. Adolescents and adults may clear their infection,” she said, but some will “go on to have cirrhosis, liver failure, and liver cancers.” But infants who are infected from mothers with hepatitis B “are always infected and they always get cirrhosis, liver failure, liver cancers. It’s a lifelong infection that never clears. The only way to prevent it is to vaccinate. By vaccinating at birth and administering immune globulin,” which helps fight infection, “we can prevent those babies’ dying of liver failure.”
In the past, she said, “we only vaccinated those babies whose mothers we identified as having active hepatitis B. Guess what, we missed a huge amount of babies. That was the reason we changed what we do in pediatrics. Instead of always assuming we knew the answer, we said we must protect those infants, therefore everybody would get vaccinated before they left the hospital.”
“I am old enough to have been already seeing patients before the hepatitis B vaccine was routine for newborns,” Dr. Nachman said. “We saw babies with chronic active hepatitis B, and teenagers acquiring it. We even saw those babies infected dying as teenagers from cirrhosis.”
Putting children at risk — at least — for future liver ailments will have a far-reaching impact, Dr. Nachman predicted. “Those patients that need transplants aren’t getting them now,” she said. “You can only imagine how worse it will be when more patients need one and we don’t have any.”
Like other physicians, she lamented the politicization of vaccine policy. Hepatitis B, she said, “doesn’t care what political party you belong to. It’s an infection, and people catch it from one another.”
Even more concerning to these medical professionals is the possibility that the new recommendation for hepatitis B vaccination is only the first action in a sweeping overturning of policy for reasons divorced from public health. “I think we’re more worried about the plan that they have to make more significant changes over time,” Dr. Schonfeld said of the A.C.I.P. “I think vaccines are extremely important in preventing infection, and if we lose the ability to vaccinate our children, then there will be significant consequences in illness and death in children that would be otherwise preventable. This is what we see coming, and I don’t think everybody realizes all the consequences that may come about.”
In 2021, the Center for Countering Digital Hate identified Mr. Kennedy, who has no medical credentials, as one of 12 individuals who collectively produced nearly two-thirds of anti-vaccine misinformation on social media. Long an anti-vaccine activist, he has promoted the discredited belief that vaccines are linked to autism, and during the Covid-19 pandemic he shared conspiracy theories linking 5G cellular networks to the coronavirus.
Children’s Health Defense has sued many government agencies and media organizations, to date without success. “He has a personal agenda that he’s protected throughout all his interviews” with Congress, Dr. Schonfeld said of Mr. Kennedy. “Personal financial gain is definitely playing a role, but the people I fear the most have convinced themselves that they are right in what they think. There is a financial bias and I do think it drives their convictions, but they are convinced in those convictions, and they will fight to do what they think is right. They just are wrong.”
Also worrisome to the physicians who spoke with The Star is the prospect of a wave of lawsuits against vaccine manufacturers, which could result in their leaving the American market. “It’s certainly possible,” Dr. Nachman said. “Our colleagues in Europe and other countries are still looking for and want those vaccines. Possibly, manufacturers will not sell them in the U.S. but continue to make them, or . . . insurance companies will not pay for it. This will make two different Americas: those that can and can’t afford vaccines. The ones who can’t, will die.”
Use a trusted source in making medical decisions, Dr. Nachman urged parents. “A trusted source means somebody who went to medical school, spent years in a residency, is actively seeing children just like yours every day.”
“All of this was predictable,” Dr. Schonfeld said of A.C.I.P.’s vote on Friday, “and it is very clear what is coming next. Those of us who can see the logical outcomes of this can see that children are going to die. It pains us horribly, to not be able to stop what is happening.”
