The vote on whether to continue the universal newborn hepatitis B vaccination policy was postponed, but the discussion at ACIP exposed how, for decades, the blanket directive to vaccinate infants immediately after birth rested on assumptions, theoretical models, and partial data rather than on a solid scientific foundation.
“As a father and a scientist, I do not understand how we have the courage to ask parents to vaccinate a healthy newborn at birth when the child’s risk is so low and the evidence so thin. I honestly do not know where that courage comes from.”
This statement by Prof. Retsef Levi during yesterday’s ACIP meeting captured, with his characteristic clarity and directness, the core theme that emerged from the entire session: significant scientific gaps in a universal vaccination policy that has been in place for more than three decades in the United States.
The committee had been scheduled to vote on what seemed like technical questions: whether to eliminate universal newborn vaccination and administer the hepatitis B shot only to infants whose mothers test positive, and whether to replace the current policy, which does not allow for full informed consent, with a shared decision-making model between parents and physicians regarding vaccination later in infancy.
What surfaced during the session may have been even more important than the vote itself: for the first time, the ACIP’s scientific staff presented, openly and systematically, the profound gap between the institutional narrative and the evidence base, or rather the lack of one, that underpinned an expansive policy for 30 years. They detailed how a major, far-reaching public health directive had been constructed on assumptions, theoretical frameworks, and partial datasets, absent rigorous foundational research.
Hellbound and Down 