Members of a key CDC advisory committee, known as the Advisory Committee on Immunization Practices, met in Atlanta on Dec. 4. Maya Homan/Georgia Recorder

ATLANTA — A Centers for Disease Control and Prevention committee voted to eliminate a recommendation that all newborn babies receive a vaccine against hepatitis B, ending a policy that has been in place since 1991 to protect Americans against an incurable liver disease that can lead to cirrhosis, cancer and liver failure. 

The current three-dose series for hepatitis B includes one vaccine administered to infants within 24 hours of birth, and subsequent booster shots given one month and six months after the initial dose. The universal vaccination policy is credited with a 99% drop in serious infections among American children between 1990 and 2019.

In its updated guidelines, the agency will continue to recommend that babies born to mothers who test positive for hepatitis B receive a vaccine at birth. However, in all other cases, the decision will be left to “individual-based decision-making,” a change that experts say will lead to an increase in chronic hepatitis B infections. The new recommendation also suggests that parents delay the first dose of the vaccine until at least two months after birth.

Friday’s decision comes after an 8-3 vote from a key CDC advisory committee, known as the Advisory Committee on Immunization Practices, which is charged with setting national guidelines around which people should be vaccinated against a wide range of preventable diseases and when those vaccines should be administered. The recommendations play a key role in determining which vaccines insurance companies are willing to cover and how accessible those immunizations are to the public.

The two-day meeting included several presentations from prominent anti-vaccine activists, including Aaron Siri, a vaccine injury lawyer who has previously represented U.S. Health Secretary Robert F. Kennedy Jr. and reportedly helped him vet health officials for President Donald Trump’s administration. At least two of them — Cynthia Nevison, a climate researcher who has ties to anti-vaccine groups, and Mark Blaxill, a former consultant and author — were recently hired by the CDC.

Retsef Levi, an ACIP member and professor of operations management at the Massachusetts Institute of Technology, called the updated recommendation a “very positive change in policy,” arguing that blanket vaccine recommendations force newborns to serve as “a safety net for adults’ mistakes.”

But Dr. Cody Meissner, another member of the committee who also serves as a professor of pediatrics and medicine at Dartmouth College, argued that the vaccines play a crucial role in protecting infants from the disease, and said there was no valid scientific evidence to support the changes implemented by the panel.

“Thoughtful inquiry is always commendable,” he told the committee. “But that inquiry should not be confused with baseless skepticism, which is what I think we’re encountering here.”

Sandra Fryhofer, a doctor and liaison for the American Medical Association, also criticized the move, arguing that implementing guidelines based on the mother’s hepatitis status will leave babies vulnerable to developing the disease from other sources, such as infected relatives. According to CDC data, roughly half of people with hepatitis B do not know they are infected.

“Are we going to test every patient that has access to or touches that baby?” she asked the committee Thursday. “I mean, that’s not something that’s really doable.”

The updated recommendation for the hepatitis B vaccine mirrors COVID-19 vaccine guidelines passed by the same panel in September, which place new emphasis on the risks of immunizations, though the CDC’s own data shows that the vaccines are safe and effective for most people. 

A second vote, which passed 6-4, encourages parents to discuss using serology testing, a type of blood test that measures antibodies to gauge how well a patient’s immune system has responded to a disease, before allowing their children to receive additional doses of the hepatitis B vaccine.

The changed recommendations will not prevent doctors from administering hepatitis B vaccines to newborns, but critics say they could create additional hurdles for families and healthcare providers.

“Adding excessive or ambiguous language around shared decision-making for routine vaccines muddies the waters, creates a false sense of scientific uncertainty and places unnecessary burden on clinicians and families,” said Dr. Natasha Bagdasarian, who was representing the Association of State and Territorial Health Officials.

Children enrolled in Medicaid or the Vaccines for Children program, which provides free immunizations to children who are uninsured or underinsured, will continue to be eligible for hepatitis B vaccines at birth under the new recommendations, according to program liaisons.

Federal fallout

As with the new COVID-19 vaccine recommendations, the updated hepatitis B guidelines will not take effect until being officially signed off by the acting CDC Director, Jim O’Neill.

But amid shifting federal guidance on public health policies, a growing number of state and federal officials are developing their own policies rather than relying on the agency’s guidelines. In a Dec. 3 letter sent ahead of ACIP’s meeting, more than 30 members of Congress urged O’Neill to maintain the existing recommendations, regardless of what the advisory committee decided.

“There is no data to support delaying the first immunization to one-month, four years, or 12 years of age,” the letter states.

U.S. Sen. Bill Cassidy, a Louisiana Republican who heads the Senate Health, Education, Labor and Pensions Committee, also called for O’Neill to forgo signing the updated recommendations.

“As a liver doctor who has treated patients with hepatitis B for decades, this change to the vaccine schedule is a mistake,” he wrote in a social media post after the vote. “The hepatitis B vaccine is safe and effective. The birth dose is a recommendation, NOT a mandate.”

Cassidy, a doctor, cast the deciding vote to confirm Kennedy as health secretary on the condition that Kennedy “maintain the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices without changes.” Kennedy later backtracked on that promise, firing all 17 previous members of the committee and replacing them with a slate of hand-picked appointees, many of whom are seen as vaccine skeptics.

In a Thursday social media post, Cassidy criticized the committee for its plans to hear testimony from Siri, the vaccine injury lawyer.

“The ACIP is totally discredited,” he added. “They are not protecting children.”

Health and Human Services Secretary Robert F. Kennedy Jr., joined by President Donald Trump, delivers an announcement on “significant medical and scientific findings for America’s children” in the Roosevelt Room of the White House on Sept. 22, 2025 in Washington, D.C. Federal health officials suggested a link between the use of acetaminophen during pregnancy as a risk for autism, although many health agencies have noted inconclusive results in the research. (Photo by Andrew Harnik/Getty Images)

WASHINGTON — A majority of Americans disapprove of Health and Human Services Secretary Robert F. Kennedy Jr.’s job performance and the federal government’s evolving vaccine policy, according to a poll released Thursday by the nonpartisan health organization KFF.

In addition, the vast majority of those surveyed have heard the unproven claims made by President Donald Trump, Kennedy and others in late September that taking acetaminophen, also known as Tylenol, during pregnancy could be one possible environmental factor in a child later being diagnosed with autism.

A total of 77% of the people KFF polled said they knew of the statements, though whether people believe the claims, which have yet to be established by the medical community, varied.

Only 4% of those surveyed said it is “definitely true” that taking Tylenol during pregnancy increases the risk of the child developing autism, and 35% said the claim is “definitely false.” Thirty percent said it is “probably true” and 30% said it is “probably false.”

Combined, 65% said it’s either probably or definitely false to say that taking acetaminophen during pregnancy increases the chance of a child developing autism, a complex disorder that experts believe is the result of both genetic and environmental factors.

When broken down by political party, 86% of Democrats, 67% of independents and 43% of Republicans said the claims were either probably or definitely false.

The survey shows 59% somewhat or strongly disapprove of how Kennedy is handling his new role at the top of the country’s public health infrastructure.

The level of support changes considerably depending on political party affiliation, with 86% of Democrats, 64% of independents and 26% of Republicans disapproving.

A slightly higher number, 62%, either somewhat or strongly disapprove of the United States’ vaccine policy.A similar trend emerged when those polled were broken up by political parties. Eighty-eight percent of Democrats, 67% of independents and 31% of Republicans somewhat or strongly disapproved of vaccine policy.

The survey shows a declining share of Americans have faith in the Centers for Disease Control and Prevention to provide trusted information about vaccines, compared with previous KFF polls in September 2023 and earlier this year.

A total of 63% of respondents two years ago trusted the CDC on vaccines, but that has declined to 50%.

Democrats’ faith in the CDC’s vaccine recommendations has dropped from 88% two years ago to 64%, independents have gone from 61% to 47% and Republicans have remained relatively steady, only going from 40% to 39%.

Across political parties, a person’s own doctor as well as the American Academy of Pediatrics and the American Medical Association remain broadly trusted for vaccine information.Eighty-three percent said they trust their doctor or health care provider, 69% believed information from the American Academy of Pediatrics and 64% had faith in the AMA.

The poll of 1,334 adults took place from Sept. 23 to Sept. 29 and had a margin of error of plus or minus 3 percentage points for the full survey. Questions broken down by a person’s political ideology had a margin of error of plus or minus 6 percentage points.

The CDC says people age 65 and older should talk to their doctor about COVID 19 vaccines. (Photo by George Frey/Getty Images)

The Centers for Disease Control and Prevention on Monday updated its adult and child immunization schedules to to recommend COVID-19 shots for people 65 and older after they consult with their health care providers.

The CDC also is recommending in its updated immunization schedules that toddlers receive the chickenpox vaccines as a standalone immunization rather than in combination with measles, mumps, and rubella (MMR) shot.

The CDC announced what it called the return to “individual-based decision-making to COVID-19 vaccinations” in a press release on its website Monday morning.

The immunization schedules adopt recent recommendations by the Advisory Committee on Immunization Practices (ACIP), which has been overhauled by Health Secretary Robert F. Kennedy Jr., who fired  all 17 former members of the vaccine panel earlier this year and replaced them with his own appointees.

RFK Jr. fired everyone on a key vaccine panel. Here’s who he replaced them with.

“Informed consent is back,” said Acting Director of the CDC and Deputy Secretary of Health and Human Services Jim O’Neill. “CDC’s 2022 blanket recommendation for perpetual COVID-19 boosters deterred health care providers from talking about the risks and benefits of vaccination for the individual patient or parent. That changes today,” he continued.

“I commend the doctors and public health experts of ACIP for educating Americans about important vaccine safety signals. I also thank President Trump for his leadership in making sure we protect children from unintended side effects during routine immunization.”

According to the CDC press release, individual-based decision-making “means that the clinical decision to vaccinate should be based on patient characteristics that, unlike age, are difficult to incorporate in recommendations, including risk factors for the underlying disease as well as characteristics of the vaccine itself and the best available evidence of who might benefit from vaccination.

“Individual-based-decision-making,” the release continues,” allows for immunization coverage through all payment mechanisms including entitlement programs such as the Medicare, Medicaid, Children’s Health Insurance Program, and the Vaccines for Children Program, as well as insurance plans regulated by the Affordable Care Act.”

Vaccines greatly reduce rates of death and disease around the world. The American Academy of Pediatrics, American Academy of Family Practitioners, American College of Obstetricians and Gynecologists, American Medical Association, American Nurses Association, American Pharmacists Association, National Academy of Medicine, and World Health Organization endorse the use of vaccines.

The health insurance trade group AHIP issued a statement last month saying health plans would continue to cover all ACIP-recommended vaccinations, including updated formulations of the COVID-19 and influenza vaccines, with no cost-sharing for patients through the end of 2026.

Health insurance group says vaccines in Florida still a covered benefit

The Florida Board of Pharmacy met briefly last month to affirm that Florida patients don’t need a prescription from their physician before receiving a vaccine. That’s because Florida law authorizes certain pharmacists who work in collaboration with physicians to administer vaccines.

Chickenpox

Meanwhile, the “new recommendation of standalone chickenpox vaccination for toddlers through age three follows evidence presented to ACIP by the CDC Immunization Safety Office’s that healthy 12–23 months old toddlers have increased risk of febrile seizure” from the combined chickenpox-MMR vaccine compared to those given immunization for chickenpox separately.

“The combination vaccine doubles the risk of febrile seizures without conferring additional protection from varicella compared to standalone vaccination,” the CDC statement says. Febrile seizures are brought on by high fevers.

A U.S. Department of Education employee leaves the building with their belongings on March 20, 2025 in Washington, D.C., amid mass layoffs.  (Photo by Win McNamee/Getty Images)

WASHINGTON — The Trump administration began posting plans over the weekend that detail how hundreds of thousands of federal workers will be furloughed during a government shutdown, while others will keep working without being paid. 

The updated guidance gives the clearest picture yet into how President Donald Trump and White House budget director Russ Vought hope to reduce the size and scope of government when given increased authority over the federal workforce during a funding lapse. 

A shutdown will begin Wednesday unless Republicans and Democrats in Congress reach agreement on a stopgap spending bill. Congressional leaders were set to meet Monday afternoon with Trump, but it was unclear if any agreement would result that would avert a shutdown.

The Defense Department’s plan shows it would keep about 406,500 of its 741,500 civilian employees working without pay during the shutdown, with the remaining going on furlough. 

The nearly 2.1 million military personnel housed within the department would continue to work throughout a shutdown but would not be paid until after it ends. 

The plan says the Defense Department believes operations to secure the U.S. southern border, Middle East operations, Golden Dome for America defense system, depot maintenance, shipbuilding and critical munitions are the “highest priorities” in the event of a shutdown. 

Medical and dental services, including private sector care under the TRICARE health care program, would largely continue at the Defense Department, though “(e)lective surgery and other routine/elective procedures in DoW medical and dental facilities are generally not excepted activities, unless the deferral or delay of such procedures would impact personnel readiness or deployability.”

Thousands of workers to be sent home from HHS

The Health and Human Services Department plans to furlough about 32,500 of its nearly 80,000 employees during a shutdown. 

The various components of HHS — including the Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services, Food and Drug Administration, and National Institutes of Health — have individual plans for a shutdown. 

The Centers for Medicare and Medicaid Services plans to retain 3,311, or 53%, of its employees during a shutdown and “will maintain the staff necessary to make payments to eligible states for the Children’s Health Insurance Program (CHIP).”

The CDC plans to have 4,891, or 35.88%, of its employees as well as those at the Agency for Toxic Substances and Disease Registry keep working. 

The contingency plans says that “(r)esponses to urgent disease outbreaks and continuing efforts to support the President’s Emergency Plan for AIDS Relief (PEPFAR), World Trade Center (WTC) Health Program, the Energy Employees Occupational Illness Compensation Program Act (EEOICPA), and the Vaccines for Children (VFC) program” would continue during a shutdown. 

The CDC would not be able to undertake several other activities, including providing “guidance to state and local health departments implementing programs to protect the public’s health (e.g., opioid overdose prevention, HIV prevention, diabetes prevention).”

Departments with plans

Here is a list of the departments that have posted updated contingency plans in September:

• Defense Department contingency plan
• Education Department contingency plan
• Health and Human Services contingency plan
• Homeland Security Department contingency plan
• Labor Department contingency plan
• Justice Department contingency plan
• Social Security Administration contingency plan
• Treasury Department contingency plan

Here is a list of the departments that hadn’t posted updated contingency plans as of Monday afternoon:

• Agriculture Department contingency plan
• Commerce Department contingency plan
• Energy Department contingency plan
• Housing and Urban Development contingency plan
• Interior Department contingency plan
• State Department contingency plan
• Transportation Department contingency plan
• Veterans Affairs Department contingency plan

States Newsroom’s Washington, D.C. Bureau reached out to the  departments that didn’t have contingency plans posted to ask when those might become public.

A spokesperson for the USDA wrote in an email the department “is prepared for all contingencies regarding Department operations, including critical services and supports.” 

A State Department spokesperson said leadership “is undergoing all necessary planning efforts to sustain critical missions.”

Federal employees who work  without pay will be paid after the shutdown concludes. 

According to the Office of Personnel Management — the executive branch’s chief human resources agency — “after the lapse in appropriations has ended, employees who were furloughed as the result of the lapse will receive retroactive pay for those furlough periods.” 

The Government Employee Fair Treatment Act of 2019 requires furloughed government employees to receive back pay as a result of a government shutdown. 

That law does not apply to federal contractors, who face uncertainty in getting paid during a shutdown. 

Ashley Murray, Ariana Figueroa, Shauneen Miranda and Jacob Fischler contributed to this report.