WASHINGTON — The future of access to critical childhood vaccines, including the hepatitis B shot, became a flashpoint in a Senate health committee hearing Wednesday, just a day before an influential vaccine panel is set to meet.
At the Senate Committee on Health, Education, Labor and Pensions hearing, Susan Monarez, former director of the Centers for Disease Control and Prevention, said the final meeting with Health Secretary Robert F. Kennedy Jr. that led to her being fired in August was tense.
Monarez said she refused two demands by Kennedy: fire career agency officials and sign off vaccine recommendations without seeing any data.
“He said if I was unwilling to do both, I should resign,” she said. “I responded that I could not pre-approve recommendations without reviewing the evidence, and I had no basis to fire scientific experts.”
Senators questioned Monarez for roughly three hours about her interactions with Kennedy, who said at a Senate Finance Committee hearing on Sept. 4 that Monarez was ousted because she wasn’t trustworthy.
A major concern voiced mostly by Democratic senators, who had voted against Monarez during her confirmation hearing in July, was that fewer vaccines for kids could lead to more deaths from preventable diseases — especially if any new recommendations weren’t based on scientific data.
“The concern is Robert F Kennedy [Jr.] is going to make America sicker again,” said Sen. Ed Markey, D-Mass. “They’re going to send us towards more disease, more death and more despair in our nation.”
Sen. Bill Cassidy, R-La., the committee’s chair, asked Monarez if Kennedy had told her he was going to change the childhood vaccination schedule.
“He said that the childhood vaccine schedule would be changing starting in September, and I needed to be on board with it,” Monarez said.
Monarez added that she and Kennedy “got into an exchange,” where she expressed willingness to change the childhood vaccine schedule if there were science or evidence supporting such a change.
The Advisory Committee on Immunization Practices (ACIP) is meeting Thursday and Friday, when 12 members appointed by Kennedy are expected to review and vote on shots for measles, Covid and hepatitis B.
The group will decide whether to change recommendations for hepatitis B, as well as the combination measles-mumps-rubella and chickenpox vaccine. Another vote on this fall’s Covid shot is scheduled for Friday.
Dr. Debra Houry, the CDC’s former chief medical officer, who testified alongside Monarez, said she expected the committee will recommend delaying the hepatitis B shot in children until the age of 4.
“There is going to likely be a discussion about hepatitis B vaccine, very specifically trying to dislodge the birth dose of hepatitis B vaccine and to push it later in life,” Houry told senators.
The hepatitis B shot is given to infants as three-dose series. Typically, children are recommended to get the first dose within 24 hours of birth, the second dose at one month, and the third between six to 18 months of age.
Houry said that prior to her departure from the CDC, she hadn’t seen any data to support changing the recommendation.
“I’m concerned about the future of CDC and public health in our country,” she said. ”If we continue down this path, we are not prepared, not just for pandemics, but for preventing chronic health disease, and we’re going to see kids dying of vaccine preventable diseases.”
Why change timing for hepatitis B vaccines?
The CDC doesn’t mandate vaccination. It recommends a schedule for children to get shot for communicable diseases. The vaccine advisory group regularly reviews data and updates the schedule based on guidance by doctors or scientists with expertise in the subject matter, said Dorit Reiss, a vaccine policy expert at the University of California, San Francisco.
Kennedy’s push to change when children are immunized and which vaccines are available to them comes amid dwindling confidence in the agency by the public.
An August poll from KFF, a health policy research group, found that more than half of adults in the U.S. say they trust health agencies and the CDC. But the percentage has dropped from 63% in September 2023 to 57% in July 2025, months after Kennedy took over.
For more than 30 years, the CDC’s ACIP has recommended children get the first of three shots at birth. (The recommendations are important as they influence what insurers are willing to cover at no cost.)
Sen. Cassidy, a gastroenterologist who specialized in liver disease, ended the hearing by speaking out in favor of the hepatitis B shot for infants.
“Before 1991, as many as 20,000 babies —babies! — were infected with hepatitis B in the United States of America, and that changed when the hepatitis B vaccine was approved for newborns,” Cassidy said. “Now, fewer than 20 babies per year get hepatitis B from their mother. That is an accomplishment to make America healthy again, and we should stand up and salute the people that made that decision, because there’s people who would otherwise be dead if those mothers were not given that option to have their child vaccinated.”
Capturing children and infants, particularly while they are young, with hepatitis B vaccine is critical, said Michaela Jackson, program director of prevention policy at the Hepatitis B Foundation.
It’s also important in ”preventing cirrhosis, preventing liver damage, liver cancer — all the consequences of living with a lifelong virus,” he said.
“There’s a direct correlation between the age of which you are infected and your chances of getting a chronic infection,” Jackson said. “A baby who is born with hepatitis B has a 90% chance of developing chronic hepatitis B. They’re going to take that with them throughout their entire life,” Jackson said.
During her testimony, Houry said many moms don’t know they have hepatitis B and can unintentionally transmit to their baby.
The change could put Kennedy — who has previously been critical of the CDC and its past policy decision — under more scrutiny.
Monarez said at the hearing that Kennedy made a number of “disparaging” remarks about the agency.
“He said that CDC employees were killing children, and they don’t care,” Monarez said. “He said that CDC employees were bought by the pharmaceutical industry. He said CDC forced people to wear masks and social distance like a dictatorship.”
In an emailed statement, Andrew Nixon, a spokesperson for HHS, said Monarez was “grossly distorting Secretary Kennedy’s concern about the CDC’s failure to respond to the COVID-19 pandemic.”
“The American people know the CDC failed its mission, and that failure put children in harm’s way,” he said.
Reiss, the vaccine policy expert, said revising that recommendation will directly put babies at risk.
“Revising it without ACIP’s usual thorough examination is irresponsible.”
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