Say Hello to Hepatitis B, Baby

Anti-vax ACIP are bumbling their way to higher rates of pediatric liver cancer...and worse

ACIP vs Recombivax: Judge Hepatitis Bob virus presiding

At their last meeting, the Advisory Committee on Immunization Practices (ACIP) was unable to effectively end the hepatitis B virus (HBV) vaccine birth dose because they did not develop recommendations they could vote on. I predicted they would rectify this. I was wrong.

This is a lesson to never underestimate ACIP’s incompetence. They were completely unprepared for a meeting that was delayed by two months due to the government shutdown. Most of the panel had not seen the draft voting recommendations, which were not posted on the ACIP website until minutes before the meeting. These were changed on the fly and not circulated to ACIP members. The panelists were unable to even understand motions that were on the table. Eventually, they delayed the vote.

Personnel movements have led to a wild week in governmental vaccination policy as is, both in terms of movement within agencies and across the Department of Health and Human Services (HHS). When former ACIP Chair Martin Kulldorff moved to a newly created HHS “in-house think tank” as the Chief Science Officer on Tuesday, ivermectin pastor and cardiologist Kirk Milhoan was promoted to ACIP Chair. Self-proclaimed mRNA vaccine inventor Robert Malone was appointed to Vice Chair and ran this particular meeting, which today was geared toward eliminating the hepatitis B virus (HBV) vaccine birth dose. Multiple arguments broke out. It turns out that running meetings efficiently and letting any comment go unremarked upon are not his greatest talents. ACIP didn’t accomplish much in the way of voting on day 1. But they made up for it on day 2.

ACIP voted to recommend delaying the birth dose to up to 2 months in babies born to mothers who test negative for HBV infection, but allowing people to get it if they want it. They also voted to recommend that booster doses be contingent on antibody levels. Together, these will reduce the number of babies who get the HBV vaccine within 24 hours of birth. That means serious health consequences:

• more babies will be infected with HBV

• more babies will develop chronic HBV infection

• more children will develop severe liver disease

• more children will develop liver cancer

• more children will die from a preventable disease

These effects won’t be measurable for years because HBV pathogenesis occurs slowly. Because of the birth dose, HBV prevalence is extremely low in the US. HBV will creep back over time, but it may not be recognized. HBV often doesn’t cause observable clinical disease, so people may not know if they or their babies are infected, especially if they don’t have access to testing. Chronic HBV infection causes liver cancer, but it takes years to develop. The consequences to even a small policy change like this are significant, but it will take decades for their impact to be felt.

Unfortunately, even when ACIP is at its most incompetent, they can still inflict serious damage. It’s a relief that ACIP did not take on the measles-mumps-rubella (MMR) vaccine. It’s a relief that they weren’t capable of doing much besides pass a recommendation that discourages the HBV birth dose and boosters. But they still limited it. They continued to chip away at the long-standing practice of using a scientific, transparent, evidence-based approach to make national recommendations about vaccination. They spread more disinformation and further normalized pseudoscientific, ideological practices. ACIP’s actions today pave the way for worse things to come for everyone except the preventable diseases that will return.

Why are we even talking about this?

The HBV discussion got off to a discouraging start. Anti-vax nurse and ACIP member Vicki Pebsworth kicked things off addressing the policy question at hand: “address the current recommended schedule” including the birth dose. Feel free to read through her very text-heavy slides. The gist of it is that ACIP is taking this on for three reasons: loss of stakeholder trust, lack of alignment with other rich countries, and the fact that it’s been awhile. Like, since the last meeting in September when they tried and failed to find anything bad to say. It really is an excellent, low-risk, high-benefit vaccine and the data shows that the birth dose brought the US to the brink of eliminating HBV infection.

At this meeting, the issue discussed was whether the birth dose is necessary for babies of mothers who are not chronically infected with HBV. However, the purpose here is to erode access to vaccines, so there needs to be at least the pretense of a scientific case for restricting vaccine access. Thus ACIP’s presenters attempted to support the idea that if mothers are tested and found not to be chronically infected, then their babies are not at risk of infection. This assumes that vertical transmission (mother to baby during birth) is the only mechanism of transmission to infants.

That is not true. Horizontal transmission (to babies from other adults and kids) also occurs, so unvaccinated babies remain at risk after birth. Delaying the birth dose by two months or longer puts children at risk of an incurable chronic infection that causes liver failure and cancer. Data clearly shows that implementing the birth dose reduced chronic HBV prevalence to near-elimination of new cases. The birth dose demonstrates a clear benefit for every child born in America.

From “Universal Hepatitis B Vaccination at Birth: Safety, Effectiveness, and Public Health Impact”, Vaccine Integrity Project, 2025

The modern recombinant HBV vaccine has an excellent safety record and adverse events are rare, with decades of supporting data. At the last ACIP meeting, CDC experts presented these data. It was sufficiently persuasive that the panel was unable to formulate a recommendation. They didn’t make that mistake this time around.

This time, ACIP brought its own hand-picked “experts” to make the scientific case, which is hard to do, because there is no evidence that there is any reason to reevaluate the birth dose. Atmospheric scientist Cynthia Nevinson and anti-vaccine propagandist Mark Blaxill, the authors of a retracted review entitled “Autism Tsunami: the Impact of Rising Prevalence on the Societal Cost of Autism in the United States,” (guess what they think causes autism?) joined a new Childhood Vaccination Schedule ACIP workgroup in which secret experts will convene to secretly analyze secret data. Both Nevinson and Blaxill gave presentations that were notable only for the extent to which their data was cherry-picked, exaggerated, manipulated, or fabricated.

L: Tracy Beth Høeg, R: Mark Blaxill. Are two quacks sufficient to make a flock?

It’s unclear what qualified either Nevinson or Blaxill to discuss this, since their sole experience with vaccinology is making things up about vaccination. Their lack of meaningful expertise did not stop either of them from being hired at CDC to manufacture evidence.

Virtually every member of the majority anti-vax coalition on ACIP popped in to normalize various unsupported claims to justify their opposition to the birth dose:

• Only randomized placebo-controlled trials can detect safety signals (not true)

• Aluminum salt adjuvants are dangerous in multiple ways (not true)

• The US should be more like “peer countries” (AKA Denmark, which FDA’s newly appointed Center for Drug Evaluation and Research Director Tracy Beth Høeg cites constantly) with no birth dose (the US is not comparable to Denmark in any way)

• We should have more humility because COVID vaccines decreased trust (only because current ACIP members lied about them)

• Parents can’t provide and are often not given the opportunity to provide “informed consent” (not true)

ACIP members Joseph Hibbeln and Cody Meissner asked in vain for evidence and application of established frameworks for evidence-based policymaking over the course of the meeting. Hibbeln grew more visibly furious at Malone’s lack of regard for these processes as the meeting progressed. Justifiably so, in my opinion, as Malone began to openly mock him for failing to unmute himself rather than respond to Hibbeln’s persistent, correct, and unanswered insistence on relying on evidence.

ACIP expert liaisons (professional organizations who participate as non-voting members) also demanded that the panel use the CDC frameworks for policy development. Amy Middleman of the Society for Adolescent Health and Medicine and Jason Goldman of the American College of Physicians in particular held Malone to account for deviating from any kind of objective or scientifically justifiable decision-making processes.

The vote

After increasingly contentious discussions on day 2, mostly between Malone, Levi, and Høeg versus Meissner, Hibbeln, and the expert liaisons, the ACIP finally voted.

Vote 1 is for the recommendation that mothers who test negative for HBV infection should decide whether to use the birth dose or not. If they decide not to get the birth dose, the ACIP recommends they wait at least two months. This vote passed 8-3.

Vote 2 is for the recommendation that parents ask their kids’ pediatricians about whether their kids should get boosters based on their antibody titers. This recommendation is a bit pointless, since it exceeds ACIP’s scope, which is limited to immunization. It also doesn’t supersede the existing recommendation, which is for three doses. The full three-dose regimen confers lifelong protection, regardless of antibody levels. This vote passed 6-4, with one abstention.

As is typical of this ACIP, these “recommendations” are clumsily worded and ultimately will fail to administratively end the HBV birth dose. However, the fact that this ACIP meeting did not live up to my worst fears is not reassuring. Despite their ineptitude, they still managed to score a critical hit by further entrenching subjective, politically-motivated public health policy in place of scientifically rigorous standardized frameworks.

The various ACIP members and presenters spent a lot of time discussing trust. Malone, Levi, and Høeg blamed everything from Biden to COVID vaccines to the fact that the US is not Denmark, but never addressed what MAHA adherent would call a “root cause” of this distrust: their own lies about vaccine safety and effectiveness. They voted on recommendations they developed based on anti-vaccine ideology rather than evidence. They conceal their actions. They dismiss criticism, ignore evidence that negates their claims, and lie repeatedly until people start to believe them.

Ringmaster of the Advisory Circus on Immunization Practices

Typical Malonian scholarship. I assume this podcast is autobiographical.

A big part of the problem was how the meeting was managed by the ACIP Vice Chair. Malone is a physician, entrepreneur, conspiracy theorist, and gentleman horse farmer from Virginia who claims to have invented mRNA vaccines because he did an important but ultimately incremental study decades ago. He used a lipid (fat)-based method to transfect nucleic acid vaccines in vivo (deliver DNA or mRNA inside animal muscle cells in a living animal). Although this was an important step in developing the technology that would eventually become mRNA vaccines, it wasn’t essential and it wasn’t an achievement that only Malone’s unique genius could have accomplished.

Malone’s current career depends on his being professionally aggrieved against any scientist, clinician, or public health professional who points out that he’s overstating the significance of his ancient work. Malone has been spending the current phase of his career working on an entirely different field of study: trafficking in paranoid anti-government conspiracy theories and profiting handsomely from it.

Milhoan was too busy preaching the gospels of both Jesus Christ and ivermectin in Asia to join his colleagues in Atlanta, so he handed the gavel to Malone. He boasts hundreds of thousands of Substack subscribers, a book on how public health and evidence-based vaccination policy is mass psychosis induced by shadowy globalist puppet masters trying to mind-control us all, and a financial windfall from monetizing his ideas about vaccine-mediated psychological warfare. He nurtures a deep and eternal grudge against vaccinology as a field since he feels perpetually butthurt that his scientific genius hasn’t been adequately appreciated.

For someone who regularly complains about the loss of trust, Malone hasn’t done much to earn any. He commented on virtually everything, despite being permanently behind schedule and rarely having anything meaningful to contribute besides his frequent urgency to urinate. He claimed expertise in virtually every topic area: viral hepatitis, pediatrics, adjuvants, clinical trial design, pregnancy, childbirth, statistics, and public trust. At one point he declared himself the “representative” of immunology on the panel. There is no topic that Malone cannot epistemically claim by virtue of unbridled smugness and comical overconfidence.

Malone’s pompous yet unhinged outbursts are legendary. He would cut people off by claiming it was now “the witching hour.” He brought up “the elephant in the room,” which was the cumulative risk of the entire vaccine schedule. That is the idea that vaccines with negligible risks, such as HBV and aluminum salt adjuvants, are combined and this creates an additive risk. He praised friendly commenters for their “comity. C-O-M-I-T-Y” at least twice. He also regaled the panel with regular updates on what sounds like symptoms of benign prostate hyperplasia.

Those of us in science and public health who retain a tenuous grasp on the reality that our life’s work is being decimated by the MAHA machine have developed coping mechanisms. At least we can laugh about the people advocating for the preventable illness and death of millions of American children are cartoonishly stupid and unworthy of the evil they endorse. Malone epitomizes this incompetent malice against our health. Former CDC National Center for Immunization and Respiratory Disease Director Demetre Daskalakis told me, “One day I want to tell him that I enjoy reading his posts about mainstream media that he refers to as MSM. I replace it with men who have sex with men when I read it and it brightens my day.”

Thanks for fixing that idea immediately in my head for all eternity

Malone once picked a fight with Daskalakis about vaccine policy on the hellsite, in what Gateway Pundit described as a “fiery clash” with “Biden’s Pro-Gay Orgy Czar” (due to his expertise in queer health, HIV, mpox vaccination efforts, and the fact that he looks great in a leather harness). Malone also has equated trans people with pedophiles, shared memes exalting gun violence against scientists after the CDC was attacked by a domestic terrorist who killed a police officer in August, and threatened to sue Senator Richard Blumenthal for calling for Malone’s firing. Malone claimed this was not only libelous, but illegal. Call me conservative and old-fashioned in my patriotism, but I’d prefer to spend my time with an orgy czar than a bigoted, thin-skinned supporter of terrorist attacks on federal employees.

Personally, I agree with Blumenthal that promoting lethal violence against federal public health workers for promoting vaccination is disqualifying for inclusion on a panel that determines whether or not Americans can access vaccines. Malone disagreed and responded that nobody can take a joke anymore, especially people who were in lockdown for hours watching bullets shatter windows in multiple federal buildings as a radicalized extremist who believed they suffered a vaccine injury attempted to kill them.

Now that he got to be in charge like the Very Important Expert in Everything that he is, he seemed to be in a much better mood. Malone seems as happy and content as he does when talking about men who have sex with men on Twitter. Unfortunately, his cheerfulness appears to come from chipping away at public confidence in vaccines, putting millions of babies at risk of liver cancer and chronic, progressive liver disease.

Disease promotion through malevolent ineptitude

Although one might be tempted to think that with leadership like Malone’s and incremental or unenforceable recommendations like today’s, the ACIP is limited in terms of the harms it can inflict on public health. This is only partially true.

I doubt that the current ACIP is competent enough to develop recommendations without a framework to guide their decisions. They are generally unfamiliar with the rules and the charter governing ACIP’s processes and scope. They struggle with parliamentary procedure. The majority of ACIP are outrageously unqualified to evaluate data about vaccines or translate evidence into effective immunization recommendations.

However, like most kakistocrats, they can still do damage simply by being incompetent. By lacking expertise, their unflinching loyalty to MAHA directives, and failing to develop effective recommendations as an independent advisory panel, they undermine one of our central mechanisms for vaccine regulation. They cultivate doubt and distrust in public health and science with their spectacularly terrible performances as much as with their convoluted recommendations. Because ACIP is nominally an expert panel, their deliberations and claims provide a pretext for other bad actors elsewhere in government, such as HHS Secretary Robert F. Kennedy, Jr., to present pseudoscience endorsed by the panel as if it were an acceptable alternative view. They have greased their wheels for making more immediately impactful recommendations in the future. And they will not be stopped unless there is a substantial enough public outcry.

The current ACIP must be dismantled. Panelists like Malone, Milhoan, Levi, and Griffin and ex officio members like Høeg are unqualified to deliberate on vaccines they are hostile to and lack expertise in. This will only happen with public demands to remove them. So, for the sake of yourselves, your kids, and your communities…start making demands. Now. Before they can do more.