WATCH LIVE: RFK Jr.’s CDC panel. Discusses whether newborns should get the life-saving hepatitis B vaccine

NEW YORK (AP) — A federal vaccine advisory committee is expected to discuss this week whether newborns should get the hepatitis B vaccine — the first dose discovered to prevent cancer.

The Advisory Committee on Immunization Practices will hold a hearing on Thursday, December 4 at 8 a.m. EST. Watch the live stream in our video player above.

Federal health recommendations now suggest that all children be vaccinated against liver infections on the first day of life, but a panel by US Health Secretary Robert Kennedy Jr. on Thursday is expected to change that — going against previous public health advice.

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It’s not clear exactly what the committee is considering, but the American Academy of Pediatrics will still urge the birth dose, said Dr. Sean O’Leary of the organization.

“We will continue to recommend it because it saves lives,” he said.

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Here’s a look at the disease, the vaccine, and the debate about changing recommendations.

Liver disease can cause lifelong health problems

Hepatitis B is a serious liver infection that lasts in most people for less than six months. But for some — especially infants and children — it can become a long-term problem that can lead to liver failure, liver cancer, and scarring called cirrhosis.

In adults, the virus is spread through sex or through sharing needles while injecting drugs.

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But it can also be transmitted from an infected mother to the child. Up to 90% of children who get hepatitis B develop chronic infection, which means their immune systems never completely get rid of the virus.

It is estimated that up to 2.4 million people in the United States are infected with hepatitis B, and up to half of them do not realize they are infected, according to information from the Centers for Disease Control and Prevention.

Dr. Baruch Blomberg, a federal scientist, identified the virus causing the infection in 1965. He received a Nobel Prize for his discovery that led to tests and vaccines. The first hepatitis B vaccine was licensed in the United States in 1981.

The injection has been recommended for newborns for years

For decades, the country’s vaccine guidelines have been influenced by a government-appointed panel of experts, the Advisory Committee on Immunization Practices. Its recommendations are usually adopted as national guidance and are widely observed by doctors.

In 1991, the committee recommended that a first dose of hepatitis B vaccine be given at birth. The guidelines have been modified slightly over the years, and currently suggest a dose within 24 hours of birth for all medically stable infants who weigh at least 4.4 pounds (2 kg), as well as follow-up doses that should be given at approximately 1 month and 6 months.

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Why dose at birth? Health officials used to rely on screening pregnant mothers to find babies who may have been exposed to the virus. But experts say many cases were missed because some women were not tested or the test results were incorrect. The virus can also live on surfaces for more than seven days at room temperature, so unvaccinated children who live with someone with a chronic infection can become infected.

Hepatitis B vaccinations for newborns are a public health success story. Over about 30 years, cases among children fell from about 18,000 cases per year to about 2,200.

The Vaccine Safety Project, a collaboration of public health researchers, this week released its analysis of more than 400 studies and reports spanning 40 years. The group concluded that the birth dose is safe and is an important reason for the low rates of hepatitis C in children in the United States.

The committee reconsiders the recommendation for newborns

Kennedy, a prominent anti-vaccine activist before becoming the nation’s top health official, expelled all 17 members of ACIP earlier this year and replaced them with a group that included many anti-vaccine voices.

The committee raised concerns about giving a child a vaccine too early in life.

“Are we asking our children to solve an adult’s problem?” asked committee member Dr. Evelyn Griffin at the September meeting.

“The signal urging this is not a safety signal. It’s a trust signal. … It’s a parent who’s not comfortable doing this medical procedure at birth in a fairly unilateral way without significant informed consent,” said panel member Dr. Robert Malone, who was peppered with questions about why the change was necessary.

The committee tabled the vote at the September meeting, but action on it is scheduled to take place during Thursday’s meeting, according to the agenda. Federal officials did not answer questions about exactly how much delay is being proposed, or disclose the research being used as the basis for such a decision.

What happens if the shots are delayed?

Not knowing what the committee is thinking makes it difficult to guess the potential impact. But some tried.

Public health researchers collaborating with hepatitis advocacy organizations this week released a report estimating that delaying birth dose by two months could lead to at least 1,400 hepatitis B infections among children and 480 deaths. The report – which has not yet been peer-reviewed or published in a medical journal – estimated that the death toll would be higher if the first dose was administered later.

But O’Leary said ACIP’s change to the recommendation may have limited impact.

The committee’s most direct authority comes over what is covered by the government’s Vaccines for Children program, which pays for doses for uninsured children from low-income families. Hepatitis B shots are often included in the hospital’s final bill for the delivery. The new ACIP recommendation likely will not pose an economic barrier to continuing the current practice in many hospitals, he said.

He added that any change would confuse and frighten parents.

“If it’s scary, he shares” on social media, O’Leary said.

Several medical and public health organizations — and even some state government officials — said before the meeting that changing the recommendation was a terrible idea. Among them is a recently formed coalition of government leaders from several Northeast states, which this week issued a statement saying they will continue to urge families to get their birth shot within 24 hours of giving birth.

U.S. Sen. Patty Murray, a Democrat from Washington, this week called on Congress to force Kennedy to appear at a hearing and explain ACIP’s actions.

“Ending the decades-long recommendation to vaccinate children born in the United States against hepatitis B is a heartless choice to allow children to die,” Murray said in a statement.