Here's Your Local Epidemiologist Dr Katelyn Jetelina with a review of the ACIP meeting:
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ACIP key takeaways: What really happened and what it means for you.
"The two-day meeting of ACIP—the committee that once guided evidence-based U.S. vaccine policy before being upended under RFK Jr.—just wrapped. And… it was something else. Disgraceful. Unprepared. Dysfunctional. Incompetent. Terrifying. Embarrassing. Opaque.
"Our children deserve better. Period.
"In the end, the committee voted to move America back to pre-1991 by removing the universal vaccination recommendation for the Hepatitis B infant dose despite no new evidence of harm and ignoring clear benefits. They also recommended that parents ask clinicians for an antibody blood test to determine the need for subsequent doses, even though there’s no evidence that this works. This ultimately shifts the burden to clinicians and parents and abdicates the responsibility of the recommending body.
"While not the most catastrophic outcome, this change is going to have real consequences— with babies and families paying the price.
"Where this goes from here depends on what happens next. If confusion dominates headlines and clinical practice and falsehoods fill the void, the consequences will be serious. But if we respond the way we saw many do today—pushing back with clarity, authority, evidence, coordination, and grassroots strength—the harm can be contained and minimized.
What actually happened and what it means to you
"I’ll spare you the presentations. Over the past two days, The Evidence Collective (TEC) counted more than 60 (we lost count after this) falsehoods, distortions, and outright lies being megaphoned from one of the nation's highest committees. The potential damage from that alone is staggering. (The TEC debunk report is HERE; it was truly a herculean effort.)
"However, there were also decisions made on your behalf. Two recommendations passed:
Vote 1 (translation): If the mother is Hep B-positive, get the birth dose. If Hep B status is unknown, get the birth dose. If Hep B-negative, shared clinical decision-making about the birth dose. If the patient chooses to delay, delay for at least 2 months.
Interpretation: This changes the universal birth dose recommendation to a risk-based one, reverting us to pre-1991. This decision was not evidence-based. Hep B vaccine has one of the most well-established safety records of any vaccine. During the meeting, decades of favorable risk/benefit priorities were replaced by pseudoscience, baseless skepticism, and by non-experts.
Implications: We can expect to see hundreds of babies in the next decade who would otherwise not have contracted deadly chronic liver disease because of this change.
Importantly: If you do want a vaccine at birth, even if you don’t test positive, you still can (and should) get it and will be covered by insurance.
Vote 2 (translation): Parents can ask their clinicians whether to get an antibody blood test before Hep B vaccine doses 2 and/or 3.
Interpretation: As written, the recommendation is deeply confusing. The biggest issue: scientists do not know what antibody level guarantees long-term protection for babies, especially after just one dose. So the test can’t reliably tell families whether their child is actually protected.
Implications: Using a blood test to decide on Hep B vaccination means another infant blood draw, another appointment, and added costs for the health system and potentially for families. And while the recommendation suggests insurers should cover this testing, ACIP has no authority over anything beyond immunization policy. There’s also a practical concern: skipping Hep B doses 2 and 3 could disrupt how other routine infant vaccines are given, since many are bundled together (like DTaP and Hib). Under-immunized babies are at higher risk for preventable chronic liver disease.
Importantly: You can choose the standard 3-dose Hep B infant series and be confident that your baby is protected, without any extra blood draws.
"A lot of us are exhausted and, unfortunately, our work is not done. There will be increasing confusion about evidence-based vaccination options for parents, clinicians, hospital systems, and schools. This will decrease vaccination coverage, leading to more disease and unnecessary suffering. Use your networks and voices to make sure new parents and clinicians are empowered to make evidence-informed decisions.
Why this didn’t become catastrophic — and what gives me hope
"As a nation, we should strive for excellence, but the votes could have been even worse. The committee seriously considered removing the Hep B vaccine altogether or delaying it until the teen years. That didn’t happen—not because of this panel or its so-called “gold-standard evidence”—but because people, both inside and outside the room, refused to let ideology steamroll infants’ health. Their clarity, persistence, expertise, and coordination made a real difference.
"A nationwide, grassroots effort leading up to this meeting helped protect science and parental choice:
Hep B working-group experts pushed back hard against proposals like removing the Hep B vaccine altogether, keeping discussions grounded in Americans’ freedom to access vaccines.
Pre-bunking teams and communication networks prepared the public and providers for falsehoods, educating them on the playbook and what to expect and to anticipate questions, concerns, and confusion.
Professional organizations put hours and hours and hours of work into reviewing the evidence in a balanced way, studying the impact of votes, outlining the implications of different votes, and coordinating across disciplines.
"At the meeting, pushback was also on display:
Individuals spoke up within ACIP: There were two ACIP members—Meissner and Hibbeln—who pushed back hard on the unbalanced presentation of science, the unseriousness of the presentations, and the ridiculousness of the votes. “There were so many statements that I disagree with, it’s hard to be succinct,” Meissner said. I’m thankful they were there.
CDC scientists, working under impossible conditions, weren’t allowed in the room to present evidence, yet coordinated behind the scenes to protect the science. They also spoke up during the meeting. For example:
Adam Langer—CDC’s lead on Hep B—did a truly heroic job. He was exactly what this country needed in that moment. He stood up, clearly laid out what evidence we do and don’t have, and reminded everyone that the U.S. is not Denmark. He acknowledged ACIP’s arguments, leveled with them, and then steered the discussion back to why we were there in the first place. It was a masterclass in redirecting and keeping the meeting on track. Someone please send this man some cookies.
Clinicians, professional societies, and trusted messengers were ready in real time to counter misleading narratives and explain the real risks and benefits to patients.
People like Jason Goldman at the American College of Physicians and other liaisons took every opportunity to deliver concise information when they were called upon.
"Amid the dysfunction, a broad, determined coalition refuses to let ideology win. The courage, teamwork, and clear voices proved that the scientific community and the public are not powerless. They can still protect children’s health when institutions fail.
"The people have far more power than we sometimes think.
Bottom line
"The United States took a step backward in vaccine policy today, which will have implications ranging from confusion to preventable liver disease and deaths.
"But another important thing was on display: a huge grassroots effort refusing to let ideology override science. Do not come between public health, clinicians, and children’s health. We are fiercely devoted to them.
"Love, YLE"
Your Local Epidemiologist (YLE) is founded and operated by Dr. Katelyn Jetelina, MPH PhD—an epidemiologist, wife, and mom of two little girls. YLE is a public health newsletter that reaches over 435,000 people in more than 132 countries, with one goal: to translate the ever-evolving public health science so that people are well-equipped to make evidence-based decisions. This newsletter is free to everyone, thanks to the generous support of fellow YLE community members.
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