Tangle Podcast Episode Summary

Episode: The new hepatitis B vaccine recommendations
Host: Isaac Saul
Date: December 8, 2025

Overview

In this episode, host Isaac Saul examines the recent controversial vote by the CDC's Advisory Committee on Immunization Practices (ACIP) to roll back the long-standing universal recommendation for hepatitis B vaccination at birth. Isaac provides a neutral, in-depth look at arguments from across the political spectrum, reactions from medical experts, and shares his own personal perspective as a new parent. The discussion highlights the intersection of science, public health, and political ideology, and the implications for parents, clinicians, and the country at large.

Key Topics & Insights

1. Background and Policy Change

[06:17 – 09:46]

• On Friday, ACIP voted 8-3 to eliminate the universal recommendation for all newborns to receive a first dose of the hepatitis B (HepB) vaccine soon after birth.
• The new guidance suggests mothers who test negative for hepatitis B should decide with their doctor if and when to vaccinate their newborn, potentially delaying the first dose until at least 2 months.
• The committee heard from several vaccine critics; notably, no CDC subject matter experts presented.
• Health Secretary Robert F. Kennedy Jr. recently fired all previous ACIP members, appointing new ones, many with a track record of vaccine skepticism.
• Critics warn this change could increase hepatitis B cases, reversing decades of progress.

2. What the Left is Saying

[11:59 – 16:05]

• The left broadly denounces the decision as medically unfounded and ideologically motivated.
• Dr. Leana S. Wen (Washington Post):
  • Praises that high-risk babies are still covered but calls the new approach a solution in search of a problem.
  • Highlights that HepB spreads within households, not just mother-to-child, justifying universal newborn vaccination.
  • Memorable Quote:

    “There is no evidence that the birth dose is unsafe, and no evidence that waiting until two months offers any advantage to safety or efficacy.”
    (Dr. Leana S. Wen, 12:57)

• Dorit Rice (STAT News):
  • Criticizes committee incompetence, citing lack of expertise and confusing voting procedures.
  • Points out that several presenters were anti-vaccine activists without hepatitis B subject matter experience.
• Jonathan Cohen (The Bulwark):
  • Says RFK Jr.’s appointees have largely opposed vaccines, shaping committee outcomes.
  • Warns that CDC guidelines heavily influence public trust and clinical practice.

3. What the Right is Saying

[16:05 – 19:59]

• Some on the right support the change, seeing it as aligning U.S. health policy with other countries and reflecting legitimate parental concerns about vaccine volume.
• Emily Kopp (Daily Caller):
  • Argues U.S. policy now matches other high-income nations recommending later HepB vaccination.
  • Notes universal early vaccination was based on trials with limited data.
  • Memorable Quote:

    “All of the committee members agreed that the committee lacks key data on the risks and benefits.”
    (Emily Kopp, 16:52)

• Streiff (RedState):
  • Suggests prior universal vaccination was unnecessary given low risk to most newborns.
  • Argues parents and critics raising concerns are unfairly painted as anti-vaccine extremists.
• Jeffrey Singer (Cato):
  • Views the episode as evidence against centralized federal health guidance, urging more reliance on independent clinical expertise.

4. Views from Medical Professionals

[19:59 – 22:39]

• Medical groups are nearly unanimous in their criticism:
  • American Association of Immunologists:
    “Delaying the vaccine would mark a dangerous departure from decades of achievement in preventing hepatitis B infection and its complications.”
  • Highlight the vaccine's robust safety record and dramatic reduction of pediatric hepatitis B since 1991.
• Caitlin Jettalina (Your Local Epidemiologist):
  • Emphasizes the lack of new evidence against the vaccine and warns the change will cause confusion and decrease vaccination rates.
  • Memorable Quote:

    “This ultimately shifts the burden to clinicians and parents and abdicates the responsibility of the recommending body.”
    (Caitlin Jettalina, 21:18)

5. Host's Perspective: Isaac Saul’s Take

[22:39 – 30:01]

• Isaac shares his candid experience as a new parent navigating vaccine decisions amid confusion and misinformation:
  • Acknowledges parents' fears and the emotional challenge of making health decisions for infants.
  • Describes relying on trusted external sources (like Emily Oster) and medical professionals to cut through the noise.
  • Notes that he and his wife followed traditional advice and got their child the HepB vaccine.
  • Expresses concern that the ACIP decision adds confusion and erodes confidence for parents, especially with the panel’s biased selection.
  • Critiques the lack of CDC expert input and inclusion of known vaccine opponents at the meeting, saying: Memorable Quote:

    “This is decidedly not scientific debate. It's working towards a preordained outcome.”
    (Isaac Saul, 28:45)

  • Highlights that U.S. population diversity and healthcare differences undermine comparisons with other nations’ vaccine schedules.
  • Calls ACIP’s process a worrying departure from open scientific debate and warns of real consequences for children’s health.

Notable Quotes & Memorable Moments

• “Universal newborn vaccination has helped drive childhood hepatitis B infections down from 18,000 cases in 1991 to just about 20. Why change a policy that has been so effective?”
  — Dr. Leana S. Wen, [13:45]
• “The current ACIP is biased, incompetent and makes decisions that will harm children and adults. We deserve better.”
  — Dorit Rice, [15:51]
• “There is a growing concern about the effects of these successive assaults on the child's very immature immune system and the downstream effects.”
  — Streiff (RedState), [17:35]
• “Now is not the time to undermine confidence in one of the most successful vaccine-based public health interventions in modern history.”
  — American Association of Immunologists, [20:33]
• “The actions of the department [RFK Jr. leads] actually shut down genuine scientific exchange of ideas, which to me is the most frightening aspect of ACIP's decision.”
  — Isaac Saul, [29:38]

Timestamps for Key Segments

• [04:46] – Start of Main Topic / News Recap
• [06:17] – Overview of ACIP’s New HepB Recommendation
• [11:59] – What the Left is Saying
• [16:05] – What the Right is Saying
• [19:59] – What Medical Professionals are Saying
• [22:39] – Isaac’s Personal Take
• [30:01] – End of Main Discussion

Tone and Language

Isaac Saul maintains his trademark candid, empathetic, and analytical tone throughout, expressing concern for public trust and the burden on parents. For quoted writers from both left and right, the language is sharper and more critical, particularly about the political maneuvering behind the ACIP decision.

Summary

The episode provides a clear, balanced exploration of the ACIP’s move to roll back universal newborn hepatitis B vaccination—a decision decried by public health experts but supported by some conservatives and vaccine skeptics. The discussion underscores the risk that ideological policymaking poses for public trust and children’s health. Isaac closes with the voice of a concerned parent and journalist, arguing that scientific debate should be open, informed by experts, and shielded from political manipulation.

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