NEW YORK — Robert F. Kennedy Jr.’s vaccine advisers will vote this week on whether to delay hepatitis B shots for most American children, the new chair of the committee said, a move that would be the most consequential change since the health secretary began remaking vaccine policy.

Delaying the decades-old practice of administering the hepatitis B vaccine to newborns is an idea that has been pushed by long-time anti-vaccine activist Mr. Kennedy.

The committee has not settled on exactly how long to recommend pushing them back, the new committee head said in an interview. Some 3.5 million American children a year are recommended to get the shot on the day of their birth.

“We try to avoid giving things to the most vulnerable,” Dr. Kirk Milhoan, a pediatric cardiologist named to run the CDC’s Advisory Committee on Immunization Practices, said on Monday. “We want to test these things incredibly thoroughly before we give it to them, especially in a neonatal period or in a pregnant mother. So these are things that we have a very high suspicion of.”

A review of more than 400 studies and reports by independent vaccine experts released on Tuesday found that the US policy of giving the hepatitis B vaccine to newborns cut infections in children by more than 95%.

NO CONVERSATIONS WITH VACCINE MAKERS
The vaccine advisory committee to the US Centers for Disease Control and Prevention has not spoken directly to vaccine makers about potential supply concerns they have raised that could result from delaying the shots, Mr. Milhoan said.

“We’re not really dealing with that issue right now,” he said. “We haven’t had those discussions, and that might not be really appropriate for the (committee) to have those discussions outside of the meeting.”

Even small changes to the vaccination schedule could disrupt the supply of hepatitis B vaccine or others given in combination with that inoculation, such as the polio vaccine, for a year or longer, several vaccine makers and experts told Reuters.

The committee is scheduled to meet on Thursday and Friday.

Sources at vaccine makers, who spoke on the condition of anonymity, told Reuters the committee has not asked for specific data or details on how any changes to the hepatitis B vaccination schedule could impact vaccine supply in the US.

That is a departure from how it proceeded previously when the CDC would communicate directly with industry ahead of ACIP meetings, said John Grabenstein, a consultant and former Merck vaccine executive. Merck is one of the manufacturers that makes a hepatitis B shot used in the US.

He described the new committee as being far less predictable, saying that “uncertainty is not good in industry.”

A spokesperson for the US Department of Health and Human Services did not respond to a request for comment.

Mr. Kennedy cleared the way for CDC policy changes by ousting Director Susan Monarez over vaccine policy disagreements, as well as firing all 17 independent expert members of the Advisory Committee on Immunization Practices and replacing them with his own nominees.

Under his watch, the agency rewrote its website to say that evidence does not back the claim that vaccines do not cause autism, contrary to established science. The CDC has also dropped recommendations for COVID shots for pregnant women and children, drawing criticism from major US medical groups, and split up the combined measles-mumps-rubella-varicella vaccine for children younger than age 4.

SIGNIFICANT SUPPLY DISRUPTION POTENTIAL
Hepatitis B is a viral infection that causes liver inflammation. It primarily spreads through blood, semen or certain other body fluids, but can also be spread through more casual contact.

In addition to Merck, GSK makes a hepatitis B vaccine and Sanofi makes a combination shot with Merck that includes six different vaccines.

The hepatitis B vaccine is currently recommended for all American children in a series of three shots. The first shot is given in hospitals soon after a child is born with the final two generally administered as part of combination shots. The multi-dose shot includes vaccines against other illnesses like diphtheria, tetanus, pertussis, polio, and Haemophilus influenzae type b.

The combination shots could become useless if the recommendations on timing for the vaccines no longer align, Mr. Grabenstein said.

“This is what I call the tyranny of just-in-time inventory,” Mr. Grabenstein said. “To maximize efficiency, they will have minimized their stockpile, and if there’s an abrupt change, it could lead to shortages.”

Sanofi at the last ACIP meeting said any delay could “cause significant supply disruptions for a year or longer as production of vaccines is adjusted given the long lead time required.”

Merck has said that changes to the established schedule could lead to a resurgence of preventable disease.— Reuters

MOSCOW — Russian President Vladimir Putin spent around five hours negotiating with Donald Trump’s most trusted envoys until well after midnight in Moscow about the possible outlines of a peace settlement to end the war in Ukraine.

Mr. Trump has repeatedly complained that ending Europe’s deadliest conflict since World War Two has been one of the elusive foreign policy aims of his presidency and has at times scolded both Mr. Putin and Ukrainian President Volodymyr Zelenskiy.

“Our people are over in Russia right now to see if we can get it settled. Not an easy situation, let me tell you. What a mess,” Mr. Trump said on Tuesday in Washington, adding that there were casualties of 25,000 to 30,000 per month in the war.

Special envoy Steve Witkoff, a billionaire US real estate developer who has known Mr. Trump since the 1980s, and Jared Kushner, the husband of Mr. Trump’s daughter Ivanka, began talks in the Kremlin at around 1630 GMT on Tuesday.

They talked with Mr. Putin, his foreign policy aide Yuri Ushakov and Putin envoy Kirill Dmitriev, via interpreters, until well past midnight Moscow time, with the Kremlin announcing talks concluded only at about 2130 GMT.

There was no immediate word on the results – if any – of the meeting, though Mr. Dmitriev posted on X that the meeting was “productive” beside an emoji of a dove.

Mr. Witkoff was shown on Russian media arriving at the US embassy in Moscow.

So far peace talks have snagged over Russia’s territorial demands to the whole of Donbas, which its forces do not fully control. Other sticking points are Russia’s demands for a formal pledge that the US-led NATO alliance will not admit Ukraine and for limits on the Ukrainian army.

A leaked set of 28 US draft peace proposals emerged last week, alarming Ukrainian and European officials who said it bowed to Moscow’s main demands.

European powers then came up with a counter-proposal, and at talks in Geneva, the United States and Ukraine said they had created an “updated and refined peace framework” to end the war.

Mr. Zelenskiy, speaking in Dublin, said everything would depend on the talks in Moscow but that he was afraid the United States could lose interest in the peace process.

“There will be no easy solutions … It is important that everything is fair and open, so that there are no games behind Ukraine’s back,” he said. — Reuters

LONDON — The financial system risks undermining global trade if it fails to adapt to the economy’s needs, with developing countries likely to suffer the most, the UN Trade and Development Agency said on Tuesday.

Shifts in financial markets now drive global trade almost as much as real economic activity, with financial conditions increasingly determining global trade flows and shaping development prospects worldwide, the UNCTAD report, which was presented in London, said.

“Trade is not just a chain of suppliers. It is also a chain of credit lines, payment systems, currency markets and capital flows,” UNCTAD’s secretary-general, Rebeca Grynspan, said in a statement.

Ms. Grynspan told Reuters in an interview that the financial and trade systems are so closely synchronized that any rise in market volatility or uncertainty will have a significant impact on global trade.

UNCTAD said global growth was expected to slow from 2.9% in 2024 to 2.6% in 2025 due to rising financial volatility and geopolitical tensions.

More than 90% of global trade relies on bank financing, with dollar liquidity and cross-border payment systems remaining essential to international commerce.

“This deep reliance on financial channels makes trade closely linked to global financial and monetary conditions,” the report said. “A shift in interest rates or investor sentiment in a major financial center can affect trade volumes worldwide.”

The report said although developing economies are expected to grow faster than advanced ones, they face higher financing costs, volatile capital flows, and rising climate-related risks, factors that constrain the fiscal and investment space needed to sustain growth.

The dollar remains central to global finance. That offers stability in uncertain times, but it also ties developing economies to financial cycles they have little power to influence, the agency said.

“We need to find ways in which the instruments of the payment system, of the insurance, of the capacity of these countries to lend or do things in their own currency will be part of the resilience of the system for the future,” Ms. Grynspan said.

UNCTAD called for reforms to align trade and finance and ensure long-term stability, including modernizing trade rules, reforming the international monetary system to limit damaging currency and capital-flow volatility, and strengthening capital markets to expand affordable long-term finance.

“What does genuine resilience require? Integrated policy frameworks that recognize links between trade, finance and sustainability,” Ms. Grynspan said. “Fundamentally, we cannot understand trade isolated from finance.” — Reuters