With the federal government now back open after the recent shutdown, one critical vehicle for formulating public health policy is immediately plunging back into chaos. The Advisory Committee on Immunization Practices (ACIP)—the expert body at the US Centers for Disease Control and Prevention (CDC) that for decades has, inter alia, guided the nation’s vaccination schedule—has been radically remade by Health and Human Services Secretary Robert F. Kennedy Jr. And now, Kennedy’s ACIP, repopulated with cranks and misfits, is racing ahead with dismantling the nation’s hugely successful childhood vaccine schedule.

A meeting originally planned for October but then paused has been abruptly rescheduled for December 4–5, according to a terse notice in the Federal Register. The agenda is somewhat vague, but it is clear that a vote on hepatitis B vaccine recommendations is expected. Given this committee’s recent pronouncements, many paediatricians and public-health officials expect another attempt to weaken or delay standard childhood immunisations.

Pre-Kennedy, the ACIP was one of the federal government’s most respected scientific advisory bodies. Its members included infectious-disease specialists, epidemiologists, paediatricians, virologists, and public-health researchers who spent years accumulating expertise, then underwent extensive vetting before being appointed. For decades, the committee earned bipartisan trust by grounding its vaccine recommendations on meticulous, transparent deliberations. But this is no ordinary moment. And this is no ordinary ACIP.

In June, Kennedy abruptly fired all seventeen existing ACIP members and replaced them with twelve new appointees, almost all of whom lack relevant expertise and are on record expressing anti-vaccine views. One member is a naturopathic doctor known for opposing infant vaccination. Another is a psychiatrist whose public work involves fringe nutritional theories rather than immunisation science. Another has repeatedly promoted scientifically debunked claims about childhood vaccines on social media.

This was not a subtle reshaping by Kennedy, it was a purge, the consequences of which became painfully obvious during the panel’s September meeting. The committee attempted its first major action: revising the recommendation for the administration of hepatitis B vaccine immediately after birth, a cornerstone of modern paediatric medicine.

Hepatitis B is a highly infectious virus that attacks the liver. When acquired in infancy or early childhood, it becomes chronic more than ninety percent of the time, leading to cirrhosis and liver cancer—often decades later but with devastating consequences. Because mothers and caregivers can be infected without knowing it, the birth dose of the hepatitis B vaccine—the first of three—is universally recommended in the US and around the world. The second is given at one to two months, and the third between six and eighteen months. The science is unambiguous: Vaccinating at birth closes a dangerous window of vulnerability. Today, about 2.4 million Americans live with chronic hepatitis B infection, and roughly half do not know they have it—a striking reminder of why early protection matters.

At the September meeting, Adam Langer, acting principal deputy director of the CDC’s National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention, presented extensive data confirming the vaccine’s safety, especially the birth dose. Decades of real-world evidence and post-market surveillance have not detected safety problems. No new research has suggested any reason to change the schedule.

Yet Kennedy’s ACIP arrived poised to do exactly that. A proposed recommendation drafted ahead of the meeting would have eliminated the birth dose for most newborns, pushing the first shot back to one month of age unless parents specifically requested earlier vaccination through “individual-based decision-making.” In other words: Don’t vaccinate at birth unless families somehow know to ask for it.

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When the committee began discussing the proposal, it quickly became clear that the panel did not understand the scientific basis for the change—because there wasn’t one. Joseph Hibbeln, one of Kennedy’s appointees and one of the few committee members with medical training (though not in immunisation or infectious disease), asked a basic question: Had anyone presented data comparing outcomes when the dose is given at birth versus one month? They had not. He then asked if there was any evidence of increased risk for adverse events in infants vaccinated early? There was none.

As more members began to question the logic of the proposal, the discussion unraveled. Some of them had clearly not read the briefing materials; others appeared to be unaware of long-established facts about hepatitis B transmission and infant vulnerability. Eventually, the panel voted 11–1 to table the recommendation, effectively admitting that the change was unsupported by evidence. But the December meeting leaves open the possibility that the idea—or some variation of it—will return.

The backlash from the medical and public-health community has been swift and forceful. The American Academy of Pediatrics (AAP) has condemned Kennedy’s ACIP and reaffirmed the existing, evidence-based childhood vaccine schedule. “The current schedule remains the best protection against serious health problems like liver disease and cancer,” the organisation told Ars Technica. In court filings and public statements, the AAP and other medical groups argue that Kennedy’s appointees “lack the credentials and experience required for their role” and that all decisions made by the reconstituted ACIP should be declared “null and void.” 

In a revised federal lawsuit, they argue that the committee has violated both the spirit and the letter of the law governing federal advisory bodies—laws designed to prevent exactly this kind of politicised takeover of scientific decision-making. AAP president Susan Kressly has warned that paediatricians are already witnessing the fallout: “fear, decreased vaccine confidence, and barriers for families to access vaccines.” In other words, the damage is not hypothetical. It is unfolding now, in paediatric waiting rooms, emergency departments, and communities already grappling with outbreaks of measles, whooping cough, and other preventable diseases. “The nation’s children are already paying the price in avoidable illnesses and hospitalizations,” Kressly said. “We urge federal leaders to restore the science-based deliberative process that has made the United States a global leader in public health. Urgent action is needed.”

It is a preview of what happens when scientific institutions are corrupted by people who reject the scientific method itself.

It might be tempting to dismiss this episode as an embarrassing but isolated blunder. It is not. It is a preview of what happens when scientific institutions are corrupted by people who reject the scientific method itself. The dismantling of the ACIP matters because its recommendations shape so many aspects of childhood vaccination in the US, including the shots required for school entry, insurance coverage, the training of paediatricians and nurses, and the offerings at local public-health clinics. Undermining the ACIP is not merely bureaucratic mischief; it is the deliberate, insidious weakening of the nation’s immunisation infrastructure.

The stakes are enormous. The US once routinely saw children die or suffer permanent disability from diseases like Hemophilus influenza meningitis, polio, and diphtheria—illnesses that are now rare precisely because of decades of evidence-based vaccine policy. When those policies are undermined, consequences soon follow. Following pockets of declining vaccine uptake, measles outbreaks surged in the US in 2019, and this year, there are already over forty percent more cases than in 2019. Whooping cough likewise hospitalises thousands of infants each year when vaccination rates decline. The hepatitis B vaccine proposal, with its mixture of scientific incoherence and ideological hostility to preventive medicine, is a case study in the dangers of replacing expertise with ignorance.

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Paediatricians and infectious-disease experts did not seek a political battle with the federal government. They are fighting it because the health of children depends on it. Every day, clinicians confront the consequences of misinformation—parents afraid to vaccinate, infants hospitalised with preventable infections and experiencing permanent sequelae, communities confused by contradictory messages from federal officials, and even local or state bans on vaccine mandates. This is the real-world cost of appointing anti-vaccine ideologues to scientific roles.

The December meeting will offer another glimpse into Secretary Kennedy’s vision for public health. Will the committee revive its effort to weaken the hepatitis B vaccine schedule? Will it next target other childhood vaccines? Or will public scrutiny and institutional pushback constrain the panel’s ambitions? And, more broadly, will members of Congress at last awaken from their coma and remember that they have oversight over departments and agencies in the Executive Branch?

What is already clear is that a century of progress in preventing infectious disease is now being tested—not by emerging pathogens, but by political choices. Restoring the credibility of the nation’s vaccine-advisory system will require more than tabling one misguided vote. It will require reestablishing the principle that critical public-health decisions belong in the hands of people who understand public health. The country cannot afford to treat its scientific institutions as ideological battlegrounds. The consequences, measured in sick children, have already begun to accumulate.