A newborn’s first hours in a US hospital used to carry a quiet set of guarantees. A vitamin K injection against catastrophic bleeding. A hepatitis B vaccination. The assumption that whatever a family could afford, the country had already decided this child was worth protecting. I have spent more than 40 years in pulmonary and critical care medicine. I have seen children harmed by disease, poverty, by bad luck. I had not, until now, seen them harmed so methodically by their own government.

Read the headlines one at a time and the pattern disappears. A vaccine rule one week, a food program the next, the reorganization of an agency most people could not name. Each change arrives wrapped in a reasonable rationale: fiscal discipline, local control, parental choice. But arrange them in the order a child actually grows, and the rationales stop mattering. What you see instead is a sequence.

It starts at birth. Under the health secretary, Robert F Kennedy Jr, the routine childhood immunization schedule has been narrowed from 17 diseases to 11, and the hepatitis B birth dose is among the casualties.

Let me translate that from policy back into medicine. A hepatitis B infection caught in infancy turns chronic in roughly nine of 10 cases; in adults it is closer to one in 20.

Chronic infection is what produces cirrhosis and liver cancer three and four decades later. The harm hides for most of a lifetime,........

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