In an 8-3 decision, the US Centers for Disease Control and Prevention Advisory Committee on Immunization Practices, or ACIP, voted to abandon the universal hepatitis B birth dose recommendation for newborns, ending a decades-old advisement for infants to receive their first dose within 24 hours of birth. The decision cements a longtime goal of the anti-vax movement.

They voted instead for “individual-based decision-making, in consultation with a health care provider, for parents deciding when or if to give the HBV vaccine.” For pregnant people who test positive or have an unknown status for the virus, the CDC maintains that their infants should be vaccinated at birth.

The ACIP panel—appointed by HHS Secretary Robert F. Kennedy Jr.—landed on this new recommendation after a confusing, contentious, and thrice-delayed vote.

“This has a great potential to cause harm, and I simply hope that the committee will accept its responsibility when this harm is caused,” ACIP member Joseph Hibbeln said after voting against changing the guidance.

Hepatitis B is extremely infectious, transmitted by blood, semen, and other bodily fluids. It is especially dangerous for infants and children: When an infant develops a hepatitis B infection, they have a 90 percent chance of developing chronic hepatitis B, potentially predisposing them to things like chronic liver disease, cirrhosis, and liver cancer.

According to a December report from The Vaccine Integrity Project, an independent research group, there is “no benefit related to vaccine safety or protection of a delayed first dose compared with vaccination at birth.” But the group “identified critical risks of changing current US recommendations.” Vaccinating infants at birth also protects them once they’re taken home, to a daycare, or to meet with friends and family, as many people don’t even realize they’re infected. Per the Project’s report, an estimated 50% of people in the US living with HBV infection are unaware of their status.

The high-stakes meeting, which could have profound implications for the future of childhood immunizations in the United States, has been widely condemned as the latest example of Kennedy’s war on vaccines through mass firings, promotion of dangerous, unscientific claims on official government websites, and staff upheaval. It’s the committee’s third meeting since Kennedy fired all 17 members of ACIP and installed allies more likely to support anti-vaccine changes at the agency. The CDC’s acting director, Jim O’Neill, a Silicon Valley investor who has critiqued public health measures and has propped up unproven alternative treatments, is poised to support and further Kennedy’s vision for the agency.

So why change the immunization schedule? Proponents of delaying hepatitis B vaccinations argue that testing pregnant people for the virus before they give birth will effectively prevent infants from catching the virus. Kennedy himself has claimed that testing the mother will protect infants from hepatitis B infections, saying on Tucker Carlson’s podcast in June that, “every mother that goes to the hospital in this country is tested for it.”

However, as CNN reporting based on the CDC’s own scientists notes, “an estimated 12-16 percent of pregnant women are not screened for hepatitis B during pregnancy, and fewer than half of infants born to mothers infected with hepatitis B are identified through prenatal screening.”

Kennedy has also falsely claimed that vaccinations against hepatitis increase the risk of autism.

It’s unclear how ACIP’s decision will play out across the nation, though the CDC’s recommendation is not expected to affect insurance policies.

But experts say that the fact that the meeting happened at all is dangerous enough, as it validates unproven claims about childhood vaccinations. Dr. Richard Besser, who was the acting director of the CDC during former President Barack Obama’s administration, called the meeting’s agenda “concerning.” This administration, he continued, “seems hellbent on undermining people’s trust in vaccination.”

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