The panel of experts that advises the Centers for Disease Control and Prevention on vaccines voted on Dec. 4 to delay a vote on whether to change recommendations for hepatitis B vaccination, the first vaccine that many children receive in the United States.

Advisory Committee on Immunization Practices (ACIP) members voted 6–3 to defer votes to Friday.

Dr. Kirk Milhoan, the panel’s new chairman, was not present during the vote and will not be available tomorrow because he is traveling to Asia, Dr. Robert Malone, ACIP’s vice chair, said.

Some members said they wanted to delay the votes over concerns about a last-minute change to the voting language.

The language for the votes had initially said the committee was set to advise the CDC to only recommend birth doses of the hepatitis B vaccine to infants born to mothers who tested positive for hepatitis B. That was changed to continue also recommending the early dose for infants born to mothers who had an unknown hepatitis B status.

ACIP offers nonbinding advice to the CDC. The agency’s director typically adopts ACIP’s advice without alteration.

Officials have since 1991 recommended that all infants receive a hepatitis B vaccine shortly after birth. Additional doses are advised at 1 to 2 months and 6 to 18 months of age.

Hepatitis B cases have dropped significantly since a peak in the 1980s.

CDC contractor Cynthia Nevison presented data she said indicated there were other sources for the decline, including better screening for hepatitis B infections.

Mark Blaxill, a recent CDC hire who authored the book “The Age of Autism: Mercury, Medicine and a Man-Made Epidemic,” presented data he said suggested the vaccine needs better safety testing.

CDC officials said that universal hepatitis B vaccination has worked well in reducing transmission of the virus, which can lead to severe liver disease.

“This disease has gone down in the United States thanks to the effectiveness of our current immunization program,” Dr. Cody Meissner, an ACIP member who voted to defer the vote and expressed opposition to changing the regimen, said during the meeting.

Supporters of changing the schedule pointed to how pre-licensure clinical trials did not include any control groups and how, in many other countries, officials only recommend hepatitis B vaccination for infants whose mothers tested positive for the virus.

“The current policy is misaligned relative to existing recommendations in most other developed countries,” Vicky Pebsworth, an ACIP member who chaired the panel’s workgroup on hepatitis B vaccines, told colleagues.

Representatives of hepatitis B manufacturers told the panel that the companies oppose changing the schedule.