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SUNDAY SCIENCE: THE VACCINE GUARDRAILS ARE GONE  
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Tom Bartlett
December 5, 2025
The Atlantic
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_ RFK Jr.’s allies are in full control of U.S. immunization policy.
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Robert Malone, Elijah Nouvelage / Getty

 

In case there was any doubt before, it’s now undeniable that Robert
F. Kennedy Jr.’s allies are in charge of the country’s vaccine
policy. The latest evidence: His handpicked vaccine advisory committee
voted today to scrap the decades-old guidance that all babies receive
the hepatitis-B vaccine shortly after birth. Now the panel recommends
that only children born to mothers who test positive for the infection
or have unknown status automatically receive a shot at birth. Everyone
else has the option of a shot at birth or—as the committee
recommends—waiting until at least two months after birth.

Those who favor the change argue that other countries, such as Denmark
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and Finland, vaccinate only newborns of mothers who test positive, and
that rates of infection are relatively low in the United States. All
of this is true. But in the U.S., many expectant mothers don’t get
tested for hepatitis B, and even if they do, those tests sometimes
fail to pick up the virus. The rationale for giving the vaccine right
away is to wipe out an infection that will afflict the majority of
people who contract it as babies for the rest of their life (and, for
as many as a quarter of those chronically infected, result in their
death from cirrhosis or liver cancer). The World Health Organization
and the American Academy of Pediatrics both endorse the universal
birth dose. “When you remove that foundation, you essentially cause
the whole prevention process to collapse,” Noele Nelson, a former
CDC researcher who has published multiple papers on hepatitis B, told
me.

The meeting, which began yesterday, was also proof that Kennedy, and
those he’s empowered, no longer feel bound by previous norms. In
June, Kennedy fired every outside adviser on the committee, alleging
unspecified conflicts of interests (even though members are required
to disclose those conflicts and recuse themselves when necessary). He
has since stacked the board with members who share his doubts about
vaccine safety. During the previous meeting, in September, those new
members seemed at times unaware of basic facts about vaccines and
often unsure about what they were voting on. In the end, their
recommendations were fairly modest, advising that children younger
than 4 receive two separate shots for MMR and chickenpox.

This week’s meeting was, if anything, more chaotic. Days before it
started, Martin Kulldorff, a former Harvard Medical School professor
who had been chair of the advisory board, left the committee for a
position at the Department of Health and Human Services. The new chair
is Kirk Milhoan, a pediatric cardiologist who is a member of the
Independent Medical Alliance, a group that has promoted the use of
ivermectin to treat COVID-19 despite clinical trials showing that the
drug isn’t effective against the virus. But Milhoan didn’t show up
in person for the meeting, leaving the moderating duties to Vice Chair
Robert Malone, the author of the conspiracy-theory-driven book
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_PsyWar_ and a hero to people who oppose COVID vaccination; Malone has
called [[link removed]] Anthony
Fauci “an accomplice to mass murder.” (HHS did not respond to a
request for comment, nor did Malone or Milhoan.) In the days leading
up to the decision on the hepatitis-B shot, committee members received
four different versions of the question they’d be voting on, and the
final language is still difficult to decipher.

Read: The most extreme voice on RFK Jr.’s new vaccine committee
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The meeting was dominated by presentations not from career CDC staff,
as it was even in September, but from fringe figures who are closely
aligned with Kennedy. Mark Blaxill—a longtime Kennedy ally in the
anti-vaccine cause who now works for the CDC—gave a presentation
about hepatitis-B-vaccine safety. He noted that he’d been “a
critic of the CDC for many years, so it’s been an honor and a
privilege to work on the inside and to address some of these
issues.” Another presenter, Cynthia Nevison, is a research associate
at the University of Colorado at Boulder’s Institute of Arctic and
Alpine Research. She is also one of Blaxill’s co-authors on a 2021
paper on rising autism rates that was retracted after the journal’s
editors and publisher concluded that they had made a host of errors,
including misrepresenting data. (Blaxill told me that the paper was
later published with “modest additions” in another journal.)

Just as the meeting was more chaotic than earlier iterations, the
pushback was even sharper. Cody Meissner, a pediatrician and committee
member who’d also served on the board during the Obama
administration, noted, accurately, that rates of hepatitis B have
declined in the United States “thanks to the effectiveness of our
current immunization program.” Malone interjected—as he did at
several points in the meeting—that this was merely Meissner’s
opinion. “These are facts, Robert,” Meissner responded. Joseph
Hibbeln, a fellow committee member, shouted that there hadn’t been
“any information or science presented” about whether delaying the
hepatitis-B dose by two months made sense. Amy Middleman, a
pediatrician and representative of the Society for Adolescent Health
and Medicine, urged the committee “to go back to our true experts”
at the CDC. Adam Langer, a longtime CDC expert who is the acting
principal deputy director of the center that oversees hepatitis
prevention, at one point cautioned the committee not to use countries
such as Denmark, which has a much smaller population and more
comprehensive prenatal care, as a basis for comparison. Most panelists
seem not to have cared.

In the end, the concerns of the committee’s few dissenters—along
with the chorus of objections from representatives of medical
organizations—were disregarded. The committee voted overwhelmingly
(8–3) to change the recommendation. “This has a great potential to
cause harm, and I simply hope that the committee will accept its
responsibility when this harm is caused,” Hibbeln said afterward.
The board also voted that parents should have the option of testing
their children’s antibody titers against hepatitis B before they
receive subsequent doses of the vaccine—a move for which, several
meeting participants pointed out, there is little scientific support.
A senior CDC scientist wrote to me that it was the “least
science-based, most illogical public health recommendation in U.S.
history.” The committee’s decisions are not final yet: The CDC
director still needs to sign off on them. Because Kennedy pushed out
Susan Monarez
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less than a month after she was confirmed as director, the decision
will rest with the acting director, Jim O’Neill, whom Kennedy
selected as deputy HHS secretary and who has no background in
medicine.

Read: ‘It feels like the CDC is over’
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The new normal for the vaccine advisory committee appears to be the
appearance of vigorous scientific debate in which the experts are
either not consulted or simply disregarded. That doesn’t bode well,
because the committee apparently plans to reconsider the rest of the
childhood-immunization schedule—something Kennedy promised Senator
Bill Cassidy, who chairs the Senate health committee, that he would
not do. Earlier today, the committee heard a presentation from Aaron
Siri, a lawyer who worked for Kennedy’s presidential campaign and
has represented clients who believe that their children were injured
by vaccines. He used his time to spell out his doubts about the
childhood-vaccine schedule.

According to Malone, the committee had asked Paul Offit and Peter
Hotez, both widely respected vaccine experts, to appear as well. In an
email, Hotez told me he declined because the board “appears to have
shifted away from science and evidence-based medicine.” Offit told
me in an email that he didn’t remember being asked to attend but
that he would have declined because the committee “is now an
illegitimate process run by anti-vaccine activists.” Even Cassidy,
who has mostly stopped short of directly criticizing Kennedy’s
actions in office, slammed Siri’s appearance in front of the
committee, posting on X earlier this week that the committee was now
“totally discredited.” (When I asked Siri for comment, he pointed
me to an X post in which he’d challenged Cassidy to a public debate
on vaccines. A spokesperson for Cassidy’s office did not respond to
a request for comment.)

At the end of today’s meeting, the board gave a preview of its next
target: aluminum salts, which are used in a number of childhood
inoculations to boost immune response. (A presentation on the topic by
Kulldorff was originally scheduled for today, but was removed from the
agenda last night.) A recent study of more than 1 million Danish
children found no evidence that aluminum salts are associated with
neurodevelopmental disorders such as autism. Yet Milhoan, the new
chair, said concerns had “reached a threshold where it needs to be
considered.” Another member, Retsef Levi, speculated about how new
safety trials might be conducted. If the committee decides at its next
meeting, in February, that a common ingredient, used in vaccines for
decades, is unsafe, it could upend childhood immunization in the
United States. Which is, of course, exactly what many of Kennedy’s
longtime allies have wanted all along.

_Tom Bartlett_ [[link removed]]_ is
a staff writer at The Atlantic._

_When the founders of The Atlantic gathered in Boston in the spring of
1857, they wanted to create a magazine that would be indispensable for
the kind of reader who was deeply engaged with the most consequential
issues of the day. The men and women who created this magazine had an
overarching, prophetic vision—they were fierce opponents of
slavery—but they were also moved to overcome what they saw as the
limits of partisanship, believing that the free exchange of ideas
across ideological lines was crucial to the great American experiment.
Their goal was to publish the most urgent essays, the most vital
literature; they wanted to pursue truth and disrupt consensus without
regard for party or clique.  _

_Subscribe to the Atlantic_
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