Once upon a time, the group that advises the government on vaccine policy followed a set formula for making a new recommendation: it methodically studied cost analyses, reviewed data on the benefits and risks, and, critically, analyzed how the proposed policy would play out in doctors’ offices, birthing hospitals, and other locations where vaccines are administered.

No more, it seems. When it voted last week during a two-day meeting to jettison a 30-plus year recommendation that all babies get vaccinated at birth against hepatitis B, the Advisory Committee on Immunization Practices appeared to give little, if any, consideration to the knock-on effects their votes could have.

For some families, the ramifications could be considerable. Because subsequent doses of the hepatitis B vaccine

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