The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) is convening in Atlanta on December 4 and 5, 2025, for what many are calling the most consequential meeting on childhood vaccinations in decades. At stake: the future of the hepatitis B vaccine birth dose and the broader childhood immunization schedule that has shaped American public health for generations.
This is no routine gathering. Since Health and Human Services Secretary Robert F. Kennedy Jr. took office, he has replaced all 17 members of the ACIP with his own hand-picked appointees, many known for their vaccine-skeptic views. This shakeup has drawn sharp criticism from public health experts across the country, who worry that the new panel could upend long-standing, evidence-based vaccine policies. The December meeting marks the third such session under Kennedy’s tenure and the first since Martin Kulldorff, a former Harvard Medical School professor and outspoken critic of vaccine mandates, accepted a permanent role at HHS. Dr. Kirk Milhoan, a pediatric cardiologist and fellow with the Independent Medical Alliance—a group that has advocated for unproven COVID-19 treatments—will chair the committee for the first time.
The meeting’s agenda, posted publicly in advance, signals a potentially seismic shift. The committee will discuss and vote on recommendations around the hepatitis B vaccine on the first day, followed by a review of the entire childhood vaccine schedule on the second. The ACIP’s recommendations are not mere suggestions; they determine which vaccines are covered by insurance, who receives them, and even how states set their own immunization policies.
Central to the current debate is the hepatitis B vaccine, a three-dose series that begins with a shot administered to newborns within 24 hours of birth. This policy, in place since 1991, has been credited with a dramatic 99% reduction in serious hepatitis B infections among U.S. children between 1990 and 2019, according to the Georgia Recorder. The CDC’s current guidelines recommend this universal birth dose, which doctors say has virtually eliminated the disease among American babies.
Yet, speculation abounds that the new ACIP may vote to delay or even remove this birth dose recommendation. Earlier this year, Kulldorff questioned whether it was "wise" to administer shots "to every newborn before leaving the hospital," while Kennedy has falsely linked the hepatitis B vaccine to autism. If the committee acts, new guidelines could recommend that pediatricians delay the first hepatitis B vaccine dose until at least 30 days after birth for babies whose mothers test negative for the virus.
Experts are sounding alarms. Dr. Fiona Havers, a former CDC official who led the agency’s vaccine policy work, told ABC News, "Any hepatitis B infections that occur because a child wasn't vaccinated at birth are an avoidable tragedy. We will start seeing more children living with a lifelong incurable infection that can lead to death from cirrhosis or liver cancer." She explained that babies can be infected not only by their mothers but also by caregivers or others in the community who may unknowingly carry hepatitis B. Havers warned that returning to a "high-risk" vaccination policy—where only babies born to mothers who test positive are vaccinated—would likely result in an increase in hepatitis B infections among infants and children.
Chari Cohen, president of the Hepatitis B Foundation, echoed these concerns, telling the Georgia Recorder, "There’s no scientific argument that one could really make to get rid of the vaccine. There’s been no new data published, no scientific, rigorous data that would change anyone’s mind." Cohen also noted that while private insurers may continue to cover the hepatitis B vaccine, access for children enrolled in Medicaid or the Vaccines for Children program could be jeopardized if federal recommendations change.
The potential impact is already prompting divergent responses at the state level. Massachusetts and Rhode Island have pledged to maintain universal newborn hepatitis B vaccination regardless of what the CDC decides, while Georgia’s Department of Public Health is taking a wait-and-see approach, stating it "will monitor updates and federal guidance on administering the hepatitis B vaccine and assess how these changes may affect the health of Georgia’s newborns."
The debate over the hepatitis B vaccine is unfolding against a backdrop of broader skepticism about vaccines in some political circles. Former President Donald Trump has questioned the need for giving the hepatitis B vaccine at birth, arguing, "Hepatitis B is sexually transmitted. There’s no reason to give a baby that’s just born Hepatitis B." However, public health officials stress that hepatitis B can be transmitted in other ways—including from caregivers or through household contact—and that the birth dose is essential to prevent these rare but serious infections.
Senator Bill Cassidy, a physician and Louisiana Republican who played a key role in confirming Kennedy as health secretary, defended the current policy, saying, "We’ve decreased chronic hepatitis B by 20,000 people over two decades with this recommendation… the vaccine is safe. This is policy by people who don’t understand the epidemiology of hepatitis B." Cassidy’s support comes despite his own political party’s recent efforts to question vaccine mandates and promote parental choice over public health requirements.
The ACIP’s second day will focus on the entire childhood immunization schedule, which includes more than 30 recommended vaccine doses for diseases such as polio, diphtheria, tetanus, and RSV. The committee will also examine vaccine adjuvants and contaminants—a nod to claims made by Kennedy and others that ingredients like aluminum are neurotoxins. The CDC, however, maintains that adjuvants have been safely used in vaccines for over 70 years.
Earlier this year, the ACIP established two new work groups: one to review the cumulative effects of all recommended vaccines on children and adolescents, and another to revisit vaccines that haven’t been re-examined in over seven years. Some see these moves as an attempt to cast doubt on the safety of the schedule itself. Dr. Richard Besser, former acting director of the CDC, told ABC News, "There had not been concerns raised around the immunization schedule and forming a group that is going to look at [the schedule] wholesale when the going-in presumption is that it's not safe really, really worries me."
Meanwhile, the national debate is heating up. In Florida, state leaders are pushing to eliminate all childhood vaccine mandates, arguing that parents should decide whether their children are vaccinated. Health officials like Jacksonville’s Chief Health Officer Dr. Sunil Joshi counter that "freedom to choose not to get the vaccine is potentially hurting the rest of that classroom as well," warning that such moves could increase outbreaks of preventable diseases like measles, mumps, and whooping cough.
As the ACIP prepares to vote, the stakes could hardly be higher. The committee’s decisions will shape the health of millions of American children for years to come, influence state policies, and likely fuel ongoing debates about science, trust, and personal freedom in public health. All eyes are on Atlanta, and the outcome will reverberate far beyond the CDC’s walls.
