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Tick bites are rising. What to know about Lyme disease and alpha-gal syndrome.

2026-05-06T11:00:00+00:00

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Hello and welcome to Healthbeat’s weekly report on stories shaping public health in the United States.

This week, I’m highlighting the news that tick season has begun, with cases rising three-fold in the past month. We have good news about one of the most feared infections transmitted by ticks, Lyme disease, and not so good news about a non-infectious disease caused by ticks, alpha-gal syndrome.

I am Dr. Jay K. Varma, a physician, epidemiologist, and public health expert currently serving as chief medical officer at Fedcap, a global nonprofit focused on economic mobility and well-being for vulnerable communities. Views expressed here are my own.

Tick season has arrived early and aggressively

The Centers for Disease Control and Prevention reported last week that emergency department visits for tick bites have risen roughly three-fold since March, from 34 per 100,000 visits to 96 per 100,000. That is the highest rate for this point in the year since 2017. The Northeast and Midwest have the highest rates of tick bites, with the Northeast already at nearly 50 tick-bite ER visits per 100,000.

What we call “tick season” in the United States is the stretch from roughly April through September, when warming weather draws ticks out of leaf litter and into the grassy, brushy edges of yards, parks, hiking trails, and gardens.

Ticks are often present at the tips of grass blades and low shrubs, then grab onto deer, dogs, or humans as they brush past. Tick bites and diseases transmitted by them are rising because of climate change. Warmer temperatures are allowing tick populations to survive further north and to extend their activity for longer periods of the year.

The two ticks of greatest public health concern in the United States right now are the blacklegged tick (also known as the deer tick) and the lone star tick. The blacklegged tick transmits Borrelia burgdorferi, the bacteria that cause Lyme disease, as well as less common infections such as babesiosis and anaplasmosis.

Another type, the lone star tick, is driving the rapid rise of alpha-gal syndrome, a delayed allergy to red meat. The lone star tick is identifiable by the white spot on the back of adult females and is notable for actively crawling toward people, rather than simply lying in wait to bite.

Lyme disease is, by far, the most common tick-borne illness in the country, with about 476,000 people diagnosed and treated each year. Alpha-gal is rarer, but causes substantial difficulty for patients and may be increasing. Both conditions are the focus of important news in the past month, so let’s take them in turn.

Will we soon have a vaccine for Lyme disease?

A vaccine for Lyme disease is important, because many initial infections are missed. Untreated Lyme can cause arthritis, heart problems, and neurologic complications, and, even when infection is caught early and treated, some patients report long-lasting fatigue and pain. A vaccine could potentially prevent or reduce these conditions.

What’s less well known is that we had a Lyme vaccine in the 1990s. In 1998, the Food and Drug Administration approved LYMErix, a vaccine that was about 76% effective in preventing infection. Although the scientific data for the vaccine was strong, demand for it plummeted after people began reporting arthritis-like symptoms after receiving the vaccine.

Researchers warn of threats – to humans and native plants – from little-known ant

It turns out that the rate of arthritis-like symptoms was similar in the general population and that symptoms did not correlate with the second or third dose, as a true immune-driven side effect should. Nevertheless, a class-action lawsuit was filed, and GlaxoSmithKline pulled the vaccine from the market in 2002.

Now, more than two decades later, Pfizer and Valneva have announced phase 3 results for a new Lyme vaccine candidate, PF-07307405. The vaccine works through an unusual and elegant mechanism: It generates antibodies in your bloodstream that the tick ingests when it bites you. Those antibodies disable the bacteria inside the tick before they can be transmitted into your body.

In the VALOR trial, Vaccine Against Lyme for Outdoor Recreationists, the vaccine was 73% effective at preventing confirmed Lyme disease 28 days after a fourth dose and about 75% effective one day after the fourth dose.

Although these numbers are promising and Pfizer says it will submit for regulatory approval, there are some important concerns.

First, fewer Lyme cases occurred during the trial than expected, so the primary statistical endpoint was not technically met, even though the secondary analysis was.
Second, this is a four-dose vaccine (three shots in the first year, then a booster before the next tick season). In my experience as both a physician and leader for large-scale vaccine programs, it is extremely difficult to get adults to complete a four-dose vaccine series.
Finally, in the current anti-vaccine environment, I worry whether the FDA will consider this vaccine, whether the CDC would promote it even if FDA approves it, and whether the public will actually accept it. It would be deeply unfortunate if we relived the LYMErix story a second time.

Alpha-gal is rising, but is it more widespread than we realize?

If you have not heard of alpha-gal syndrome yet, it’s likely you will in the near future. It is a delayed allergic reaction to red meat (e.g., beef, pork, lamb, sometimes dairy and gelatin) caused by a sugar molecule called galactose-alpha-1,3-galactose, abbreviated as “alpha-gal.”

The lone star tick carries this molecule in its saliva. When the tick bites you, it can trigger your immune system to make antibodies against alpha-gal. After that, eating a hamburger may cause hives, vomiting, stomach cramps, or, in some cases, life-threatening anaphylaxis several hours later. It has been called “the midnight allergy,” because patients often eat dinner, fall asleep, and wake in the night to a full-body reaction.

The foundation of any public health response to a disease is to count it. You cannot prevent what you cannot see. Yet alpha-gal surveillance in this country is patchwork, as described in a recent article.

Arkansas became the first state to make alpha-gal a reportable condition in 2023, and more than 15 states track cases to some degree. New York, which is home to one of the country’s most concentrated hot spots in Suffolk County, does not track cases statewide. New York City does — and has documented 280 suspected cases since 2024 — even though the lone star tick is not common in the five boroughs.

The CDC has documented more than 110,000 suspected cases since 2009 and estimates the true number could be three to four times higher.

Without comprehensive surveillance, public health agencies cannot warn their communities about how common it is and who is likely to get it. Clinicians are less likely to consider it, and patients spend time bouncing between specialists before they are diagnosed.

Where to look for advice on tick bite prevention

Although changes to its website have been problematic, the CDC does remain an excellent resource for information on how to prevent tick bites. The single best protection is a combination of applying Environmental Protection Agency-registered repellents on your skin, treating shoes and clothes in permethrin, walking the center of trails, and conducting full-body tick checks within two hours of coming inside.

If you are bitten, consider using the CDC’s Tick Bite Bot that walks you through what to do.

Until next week,

Jay

Dr. Jay K. Varma, who is recognized globally for his leadership in the prevention and control of infectious disease, writes about public health for Healthbeat. He has guided epidemic responses, developed policies, and implemented programs that have saved lives across Asia, Africa, and the United States. He is based in New York. Contact Jay at jvarma@healthbeat.org.

New York City Council passes plan to step up education on vaccines

2026-04-30T21:36:51+00:00

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The New York City Council on Thursday passed a package of bills seeking to do more to educate parents about the safety and effectiveness of vaccines as immunization rates show signs of starting to dip.

The five bills aim to make it easier for schools to disseminate accurate information about vaccines to parents, as well as to require the Department of Health and Mental Hygiene to develop a plan by year’s end that will educate New Yorkers about the importance of childhood and adolescent vaccinations.

The package will be sent to Mayor Zohran Mamdani, who has 30 days to sign, veto, or let the bills lapse into law.

The action comes as the federal government led by Health and Human Services Secretary Robert F. Kennedy Jr. and followers of his Make America Healthy Again movement are working to sow doubt and confusion about vaccines, which are scientifically proven to be safe and effective. As a result, state and local governments are taking a greater role in educating the public.

New York state has long had some of the highest vaccination rates in the country, but that record may be faltering.

In New York City, new data suggest parents are delaying routine vaccinations for their children. In March, the city reported that about 1 in 3 2-year-olds had not received all doses of seven vaccines – DTap (diptheria, tetanus, and acellular pertussis); polio; measles, mumps, and rubella; hib; hepatitis B; varicella (chickenpox); and pcv (pneumococcus).

S.C. measles outbreak declared over after 997 cases

This prompted city health officials to launch a $1 million campaign over four weeks encouraging parents to vaccinate their children. Officials say the campaign ran in multiple languages and on TV, radio, print news, kiosks, and transportation hubs in neighborhoods with low vaccination rates.

“The new life that Kennedy is giving to the movement has clearly given new life to the diseases themselves,” City Council Speaker Julie Menin said at the council meeting, before the bills were introduced. “The erosion of public trust in science doesn’t just increase health risks for his own band of followers, it also puts our wider community in jeopardy. As lawmakers and as leaders, we cannot sit back and let that happen.”

The United States has seen more measles cases over the past year than it has in decades. An outbreak in South Carolina reached nearly 1,000 cases. Most of those infected were unvaccinated.

James Alwine, a virologist, professor emeritus at the University of Pennsylvania, and visiting professor at the University of Arizona, is a member of Defend Public Health, a nationwide network of public health leaders and advocates. He applauded the legislation and offered this advice for the health department on vaccine messaging: Keep it simple and straightforward while highlighting the harm that these preventable diseases can inflict on children.

“Stay out of the real science and data — that just doesn’t work,” Alwine told Healthbeat. “You can’t fight against what they’re saying by trying to tell people, ‘Well, here’s the science, here’s the data, here’s the study.’ It just falls on deaf ears, mainly because it’s hard to explain in lay terms.”

Here is a rundown of the bills:

Educating parents: Sponsored by Council Member Shekar Krishnan, Introduction 260-A requires the health department, in collaboration with the Department of Education, to develop informational material about vaccines. DOE is also required to distribute the materials to parents of all New York City public school students, including those enrolled in early childhood programs such as 3-K and Pre-K. The material must include general information on how vaccines work, their public health benefits, their safety, and where to access vaccines required for school attendance.
Educating the public: Sponsored by Council Member Eric Dinowitz, Introduction 693-A requires the health department, in collaboration with relevant agencies, to develop and implement a plan by no later than Jan. 1, 2027, to educate the public about the benefits and importance of childhood and adolescent vaccinations. In developing the plan, the health department is required to consider recommendations adopted by major medical organizations, including the American Academy of Pediatrics.
Authorizing dentists to immunize: Sponsored by Council Member and Health Committee Chair Lynn Schulman, Resolution 273 calls on the New York State Legislature to pass, and the governor to sign legislation authorizing dentists to administer flu shots, Covid vaccines, human papillomavirus vaccines, or a vaccine related to a public health emergency.
Recommending vaccines: Also sponsored by Schulman, Resolution 425 calls on the legislature to pass, and for the governor to sign state legislation requiring vaccines to be regulated, recommended, administered, and insured based on the recommendations of various nationally and internationally recognized health care organizations.
Reimbursing costs for providers: Also sponsored by Schulman, a preconsidered resolution calls on the legislature to pass, and the governor to sign a bill requiring insurance to reimburse the total direct and indirect expenses for providers administering vaccines.

In a written statement attributed to city Health Commissioner Dr. Alister Martin, the health department said it looks “forward to continuing our partnership with Chair Schulman and City Council on this issue.”

Trenton Daniel is a reporter covering public health in New York for Healthbeat. Contact Trenton at tdaniel@healthbeat.org or on the messaging app Signal at trentondaniel.88.

South Carolina’s measles outbreak is over: 7 things to know about largest U.S. outbreak in decades

2026-04-27T23:49:47+00:00

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Officials at the South Carolina Department of Public Health declared their record-breaking measles outbreak to be over on Monday after no new cases emerged during the past 42 days.

“Though we reached nearly 1,000 cases, we are grateful that, by and large, it remained confined to one county and did not spread statewide, as was always our concern and fear,” Dr. Brannon Traxler, the department’s deputy director and chief medical officer, said at a news conference.

Here are seven things to know about the largest U.S. measles outbreak in more than 35 years:

Most people who got infected weren’t vaccinated

Of the 997 measles cases documented in the outbreak, 932 patients were unvaccinated, 19 had an unknown vaccination status, and 20 were only partially vaccinated with only one dose of the two-dose MMR (measles-mumps-rubella) vaccine, according to the department’s data.

Just 26 people were fully vaccinated with two doses of MMR vaccine. Two doses of the vaccine is about 97% effective in providing protection against measles infections; one dose is about 93% effective, according to the Centers for Disease Control and Prevention.

Infections, increased vaccination credited in stopping outbreak

Traxler said there are three main reasons state health officials think the outbreak has ended: the large number of people infected, widespread community cooperation with quarantine and isolation, and increased vaccination against measles in recent months.

The 997 people sickened with measles developed immunity to the disease, Traxler said. “Though that carried with it, of course, the risk of severe illness, a weakened immune system and the potential for devastating complications even years from now,” she said.

Another important factor in stopping the spread of the virus, she said, was that the “vast majority” of people who were infected or exposed followed public health instructions to stay home and avoid infecting others.

Lastly, thousands of people got vaccinated. In Spartanburg County, she said, an additional 3,788 doses of MMR vaccine were administered during the six months of the outbreak compared with the previous year.

“In particular, January and February were record months for MMR vaccination in the state,” she said.

Risks for future measles outbreaks continue in South Carolina

This outbreak may be over, but outbreak risks remain in Spartanburg County and across the state. Traxler noted that pockets of people who are not protected against measles remain in many communities.

“We’re going to continue to see sporadic cases that are going to be travel-associated most likely,” Traxler said, noting the goal is to keep one of these travel cases from sparking a larger outbreak.

“If we don’t continue to see increases in vaccination, I’m worried that we could see another large – maybe not this large, but hopefully not – but another large outbreak in a community where it gets introduced from someone who had traveled.”

State’s $2.1 million cost is only part of the outbreak’s bill

The department estimates that the outbreak response cost the state of South Carolina $2.1 million. But that was just the costs the department could calculate for staff time, vaccination costs, and other direct expenses.

It doesn’t include all of the costs to the health care system, schools, businesses, and beyond, she said. “What were the economic impacts to the state of parents who had to miss work?” she asked. It’s not part of that number.

Outbreak began with 5 cases, centered in Spartanburg County

The outbreak was first identified in early October, with just five cases. For weeks the virus seemed to spread slowly – then the holiday season began.

On the Tuesday before Thanksgiving, the state had logged 55 measles cases. By Dec. 12, there were 126 cases – and more than 300 people in quarantine, Healthbeat’s timeline of the outbreak shows.

By mid January – after the December holidays and multiple public exposures at schools and churches – the outbreak surged, with more than 100 new measles cases being identified every few days. By Jan. 20, the department had documented 646 cases. Cases slowed during February and March.

The last time the state announced a new case in the outbreak was on March 17, the day the case total reached 997.

Before the measles outbreak could be declared over, there needed to be two incubation cycles – or 42 days – without any new cases.

Winter break school closures delayed investigations, quarantines

During the critical December holiday period – before the outbreak surged – South Carolina health officials were hampered in their efforts to control measles exposures because of winter break school closures, Healthbeat reported earlier this year.

Internal department records, obtained by Healthbeat, revealed how outbreak investigators were delayed in their efforts to quickly quarantine schoolchildren exposed to measles right before the two-week winter break period began. Because schools were closed, outbreak investigators couldn’t reach anyone at multiple Spartanburg schools to get contact information for classmates, staff, and others who had been exposed to infected people.

To prevent similar communications gaps during the recent spring break period, the department contacted schools across the state’s 11-county Upstate region to identify a person who would be available to provide attendance and contact information during the spring break closures of schools and administrative offices.

Department’s response, lessons learned to be evaluated

“The outbreak is over, but our work to understand and prevent measles and future outbreaks is not,” Traxler said. “A thorough after-action review and analysis is being started. We believe our outbreak response team did a tremendous job under really unprecedented conditions. But there are always things that we can learn from and improve on in our future with future responses, and we are committed to doing so.”

One of the things the department did well, she said, was urging members of the health care community to be pro-active in immediately reporting any suspected measles case – even before any test results come back. That early heads-up, she said, allowed the department to immediately start educating the patient about the need to isolate and begin earlier contact tracing.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48.

NY health update: Declining MMR vaccinations, high Black maternal death rates, fish safety, and spring health alerts

2026-04-24T15:55:34+00:00

This article originally appeared at Your Local Epidemiologist New York. Sign up for the YLE NY newsletter here. Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

Before I jump into this week’s newsletter, I have to give a shoutout to my mom, who just ran the Boston Marathon. Watching her train so hard, get up at the crack of dawn, and then run 26.2 miles with 30,000 other runners was incredible. I’m so proud of her.

And congratulations to everyone else who left it all on the course last weekend. The videos of runners helping other runners over the finish line, people giving everything they had, and the volunteers, medics, and coordinators making sure everyone stayed safe and cared for — wow. Man, I love runners.

Okay, back to this week’s New York Dose. I’m covering new data on childhood MMR vaccination, what New York is doing to reduce Black maternal mortality, an environmental win for people fishing the Lower Hudson, and a few spring health updates, including what I’m doing to get ready for warm weather.

NYC childhood MMR coverage is down

New York has long had some of the highest vaccination rates in the country. But even here, cracks in that strong foundation are starting to show. In New York City, new data suggest routine childhood vaccination is being delayed. In March, the city reported that about one in three 2-year-olds had not received all doses of the seven recommended vaccines, prompting officials to launch a new campaign in response.

This is the kind of shift that can seem small on paper, but it’s exactly how vulnerability builds quietly over time.

One of the clearest warning signs is measles, mumps, rubella coverage. In 2024, 93% of New York City children ages 24 to 35 months had received at least one MMR dose by their second birthday. In 2025, that dropped to 89%.

Percent of New York City children ages 24-35 months who received at least one measles, mumps, rubella vaccine by their second birthday.

That matters, especially right now. As of this month, New York state has confirmed eight measles cases this year. Nationally, we’ve seen how quickly measles can spread in communities with lower vaccination rates (YLE national has covered that here). And in 2019, New York City experienced a major outbreak, with 649 cases in a largely unvaccinated community in Williamsburg.

Even small percentage-point drops matter. In a city as large as New York, they translate to thousands more children vulnerable to measles if the virus is introduced.

This is one of those issues that can feel abstract until it isn’t. Delayed vaccination leaves young children vulnerable during the exact years when some vaccine-preventable diseases can hit hardest. Measles is extraordinarily contagious, and community protection depends on keeping coverage high.

Black mothers in New York state die from pregnancy-related causes at 4x the rate of white mothers

Black Maternal Health Week (April 11–17) just wrapped up across the state, and unfortunately the numbers underlying it are striking. The week exists in part to address some of the most persistent and devastating disparities in American medicine: Black women are substantially more likely to die from pregnancy than mothers of other races. State data estimate that Black women died of pregnancy-associated causes about four times more often than white women in New York. In New York City, it’s about five times higher.

That gap is shocking, and frankly, unacceptable. But New York is taking steps to reduce Black maternal mortality by putting several policies in place to help.

Here are some programs in New York aimed at reducing maternal deaths:

Postpartum coverage now lasts a full year. New York Medicaid and Child Health Plus extended postpartum coverage from 60 days to 12 months, helping more families stay connected to care during a period when serious complications can still happen.
Doula care is covered by Medicaid. New York Medicaid covers doula services during pregnancy and up to 12 months postpartum, including prenatal visits, labor and delivery support, and postpartum care. Eligible New Yorkers can find participating doulas in the Medicaid program here.
New York became the first state in the country to offer paid prenatal leave. Since Jan. 1, 2025, New York has required private-sector employers to provide pregnant workers with 20 additional hours of paid prenatal leave for pregnancy-related medical care. This is the first law of its kind in the country, and it is separate from other leave options.

The paid prenatal leave policy is especially important. It gives workers paid time off for things like OB visits, testing, monitoring, and other pregnancy-related appointments. And that matters, because barriers to prenatal care are often not about willingness, but can be about whether someone can afford to miss work. It may mean choosing between a clinic visit and food for dinner, a co-pay and prenatal vitamins, an ultrasound, and keeping the air conditioning on. Policies that reduce the financial cost of getting care are one of the clearest ways to reduce barriers to care.

What you can do to access benefits:

If you’re pregnant or recently postpartum and on Medicaid, confirm that your coverage extends for a full year after pregnancy.
If you want labor or postpartum support, check whether you’re eligible for a state-covered doula through New York’s Medicaid doula directory.
And if you work in the private sector, ask your HR department about your paid prenatal leave rights.

For the first time in 50 years, you can eat striped bass you catch from the lower Hudson River

New York state recently updated its fish consumption advice and says you can now eat some fish from the Lower Hudson River for the first time in 50 years. The updated advisory reflects decades of cleanup on the Hudson to lower polychlorinated biphenyls (PCBs — a toxic synthetic chemical) contamination enough to meet health guidelines.

The biggest update is for striped bass: Pregnant women and children under 15 can now eat one meal per month, and the general population can eat up to four meals per month from the Lower Hudson. But some fish, including carp and small-mouth bass, are still off-limits because of PCBs, so it’s still important to check the specific guidance before eating what’s caught.

For example, there are new advisories on forever chemicals known as PFOS, which apply to Lake Ontario, Lake Erie, Lake George, Lake Champlain’s Cumberland Bay, Seneca Lake, and others. So, if you fish or your family fishes, check the local updated guidance before eating your catch.

New York fish advisory regions.

This change is a good reminder that public health wins can be slow, and often unglamorous (no offense to the fish). But the fact that we have cleaner water, better environmental regulation, and long-term monitoring for these chemicals — and can see our progress firsthand — is worth celebrating.

Pollen and tick updates

Some quick notes on spring health.

Tree pollen is ramping up, with some parts of the state now experiencing high levels. For those with asthma or more intense allergies, it’s a good idea to speak with a health care practitioner about controlling symptoms before pollen makes it worse.

Reducing pollen exposure comes down to a couple key behaviors:

Avoid pollen outside. Check local pollen counts (like on pollen.com) and limit outdoor activity during early morning and on high-wind, dry days. The best time to go outside is after it rains, which helps clear pollen from the air.
Avoid pollen inside. Remove shoes before entering your home, wipe down pets, change after being outside, shower especially before bed to rinse off pollen, keep windows and doors closed, and run a HEPA filter.

For a deeper dive, check out my recent post on pollen.

We’re also in the thick of tick season. From now until about October, ticks will be active across New York, including in New York City. If you’re heading to parks, wooded areas, or anywhere with brush and tall grass, use repellent, and do tick checks on yourself, kids, and pets.

Emergency department visits for tick bites in the Northeast so far this year (green) compared to last year.

Last quick segment. I know the weather has been all over the place, from gorgeous 88-degree afternoons, back to the icy rain we have this week, but I wanted to get a couple things on your radar as we get closer to more warm days.

First, the program that provides free air conditioners is now accepting applications across New York state. This is important because extreme heat is New York’s most deadly weather.

To see if you qualify to get a free air conditioner through the Essential Plan Cooling Program, check out the qualifying conditions and application here.

Second, now is a good time to check the expiration date of your sunscreen. The active ingredients that block UV rays in sunscreen degrade over time, reducing effectiveness, increasing sunburn risk, and potentially causing skin irritation or rashes. It’s a good idea to make sure what you have on hand isn’t expired, and replace it if needed.

Bottom line

You’re all caught up on New York public health news. Have a great weekend, and I’ll see you next week!

Love,

Your NY Epi

Dr. Marisa Donnelly, PhD, is an epidemiologist, science communicator, and public health advocate. She specializes in infectious diseases, outbreak response, and emerging health threats. She has led multiple outbreak investigations at the California Department of Public Health and served as an Epidemic Intelligence Service Officer at the Centers for Disease Control and Prevention. Donnelly is also an epidemiologist at Biobot Analytics, where she works at the forefront of wastewater-based disease surveillance.

PEPFAR snapshot after funding cuts: Less HIV testing means more cases

2026-04-23T11:00:00+00:00

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Hello from Nairobi.

This week we’re heavy on the Africa news. We’ll cover two important HIV stories, one about new U.S. data, and one on South Africa. Together, they offer a clearer read on the global HIV response and, I hate to say it, they undo some of the cautious optimism I’d started to feel. We’ve also got a hopeful malaria story from Eswatini, and a broad snapshot of vaccination across the continent.

My name is William Herkewitz, and I’m a journalist based in Nairobi, Kenya. This is the Global Health Checkup, where I highlight some of the week’s most important stories on outbreaks, medicine, science, and survival from around the world.

With that, as we say in Swahili: karibu katika habari — welcome to the news.

New data: a stalling fight against HIV

The U.S. State Department finally released new data Friday on PEPFAR, the two-decade-old U.S. President’s Emergency Plan for AIDS Relief at the center of the global fight against HIV/AIDS.

As Reuters reports, this was the first public update in 16 months, and the only official snapshot of the program after the widespread disruptions in 2025 and a roughly 30% drop in funding. (Worth noting: The data are also incomplete. The update only covers the final quarter of 2025.)

What’s the topline?

The Trump administration is pointing to a single figure: that 20.6 million people are still on HIV treatment. Taken alone, that’d be fine news, because it’s nearly level with the figures from both 2024 and 2023.

But, as Reuters notes, that treatment figure relies on some funky accounting. It includes about “3 million people whose care was provided by their own governments.” And even setting that aside, advocates are worried for a simpler reason: Treatments may be steady, but the data indicate significantly more new HIV infections are slipping through.

The data paint a clear picture.

From 2024 to 2025, 4.7 million fewer people were tested for HIV (a drop of about 22%). About 78,000 fewer people were diagnosed with HIV (20%). And 2 million fewer people were taking preventive treatment (10%).

It’s a fairly shocking downturn, and portends a future of more HIV, not less.

As Charles Kenny, a senior fellow at the Center for Global Development who has been tracking the data, told Reuters: “If people aren’t tested, they can’t know if they’re positive. If we don’t know they’re positive, they cannot be put on drugs … We’re building up problems for the future."

Or, as Kenny told the New York Times, “the long-term trajectory could be back to as depressing as I thought it was going to be last year.”

Inside South Africa’s HIV slowdown

Ok, so that new PEPFAR data give a global view.

But this week Physicians for Human Rights, a U.S.-based non-profit, also zeroed in on what these changes look like with a report from one country: South Africa, home to the largest HIV epidemic in the world.

South Africa is a fascinating case to focus on, because there are several reasons you could expect it would be better positioned to absorb the shock of the HIV funding cuts than many other countries.

Why? For one, it’s an upper-middle-income country that spends a hefty 16.8% of its budget on health. And in recent years, the United States covered just 17% of its overall HIV response, with the majority managed domestically. (That’s far less than in countries like Uganda, Tanzania, or Lesotho, where international funding has historically paid for the vast majority of those programs.)

But in the report, the interviews with health workers, researchers, and patients across South Africa tell a different story: a system where “a future surge in otherwise preventable new HIV infections [is] all but inevitable,” and where “catastrophic” cuts to HIV research are already having global effects.

I reached out to the co-authors of the report: Karen Naimer, the director of programs at Physicians for Human Rights, and Emily Bass, an author and HIV/AIDS expert, to understand what’s actually breaking here.

First, we talked about the hit to laboratories.

As Naimer explained, for years South Africa has been a global center for HIV research, with both a large number of cases and the advanced, scientific infrastructure to study them. That’s one reason why before 2025, South Africa was the largest foreign recipient of funding from the U.S. National Institutes of Health — America’s federal medical research agency. Roughly $400 million went into studies that shaped how HIV is treated worldwide.

But, as she explained, much of that work has been cut off.

Alongside a pullback in dollars, a new NIH rule has blocked U.S. funding from reaching overseas research partners, leaving “terminated studies, the loss of clinical trial capacity, and the attrition of skilled personnel,” she said. And this isn’t just a South Africa problem, “that dismantling of the clinical research infrastructure in South Africa will have global implications.”

What about on the ground – how is everyday HIV prevention and care in South Africa faring?

The report really paints the picture of why testing is falling and fewer HIV cases are being found.

As Bass explained, while the United States funded a minority of South Africa’s overall HIV response, it covered a majority share of the front-line prevention work, especially the more intensive and expensive programs like community testing and outreach. “And virtually all of that investment ended overnight in South Africa,” she said, adding that much of it still hasn’t been replaced.

Ultimately, HIV prevention depends on reaching people who feel fine and aren’t thinking about HIV. They’re not seeking medical care, so the system has to go to them. (Think mobile testing vans or having social media influencers chat about HIV prevention).

Take that away, and you’re left with clinics. And if that’s the whole strategy, it’s no wonder it’s falling short. As Bass put it, “people are not going to regularly elect to go to a clinic and wait hours to get a test, just to find out if they are HIV negative.”

One final note: These cuts to preventive care are hitting just as lenacapavir (the breakthrough HIV prevention drug we’ve been covering extensively) was about to be rolled out.

So, instead of hitting the ground with speed, Bass tells me, the very systems meant to deliver this new drug have been dismantled. “We destroyed that platform, and it really is destruction,” she said.

Holding the line on malaria

The Guardian has an interesting story out of Eswatini (the small, landlocked country between South Africa and Mozambique) that is seemingly close to eliminating malaria altogether.

How close? Well, in 2024, the country of 1.2 million recorded only “362 confirmed malaria cases.” A feat all the more impressive given that “cases have risen globally for six consecutive years,” even in neighboring countries.

As the story shows, part of what’s made the malaria response so effective is the tight disease surveillance system in Eswatini, where individual infections are treated with immediate house-to-house testing and spraying.

There is some peculiarity here worth mentioning. The last mile is often the hardest and most expensive in disease control (polio is a classic example). But malaria is a little different because the symptoms are so visible, and the disease spreads very locally.

What this means is that once malaria cases get very low, a country can concentrate resources on each infection with remarkable efficiency. (This is the very dynamic that allowed the United States to pull off malaria elimination in 1951.)

Unfortunately, Eswatini’s progress nevertheless sits right up against a very different reality in neighboring Mozambique, where there are more than 11 million cases a year. It’s an ever present challenge that, well, mosquitoes don’t care much for borders.

And there are other looming challenges, too. As Mark Edington, the head of grant management at the Global Fund, told the Guardian:

“If you look at the combination of decreased malaria funding, from us and probably from the U.S.; you look at increased resistance towards both drugs and insecticide; you look at population growth; you look at extreme weather events, which are increasing; and you put that all in a mixing bowl, the result is not good … It is worrying.”

What’s the takeaway?

Certainly Eswatini deserves kudos for this heroic effort. But the real question is whether it can hold the line. With 11 million cases just across the border, a lasting elimination of the disease is just not possible, and keeping numbers this low will require the same constant, expensive vigilance year after year.

Immunization across Africa

The World Health Organization has released a new snapshot on the state of vaccinations across the African continent. As the AP reports, it’s both the “first-ever comprehensive analysis” of its type and a mixed bag of news.

Let’s start with the positive, which is the long view. The data in the report make a strong case that vaccination efforts on the continent have been one of the most consequential humanitarian achievements in modern history.

Think I’m overselling it?

Consider that over the last 50 years, vaccination efforts have “saved more than 50 million lives.” Even just since 2000, routine programs have reached “more than 500 million children,” preventing more than “4 million deaths each year.”

Zooming in a bit, there have been some very specific successes, too. Wild polio has been eliminated from the continent (the last case was in 2016). And tetanus infections during childbirth, once a major killer, have also been largely eliminated as a public health threat.

What’s the worse news?

The report outlines that most vaccine-preventable diseases have been mired in stalled vaccination coverage, and in many cases for more than a decade.

For example, only half of children on the continent are receiving two doses of the measles shot, which is the only sure-fire preventative for the disease. HPV vaccination sits at just 28%. And the hepatitis B shot, which is given at birth, reaches only 17%.

The WHO’s target for all these vaccines is 90%. We’re not even close.

And, unfortunately, we’re on track to see things worsen.

The funding behind these programs is shrinking, with the AP noting that “the U.S. withdrawal from WHO in January resulted in the loss of about 40% of the agency’s overseas development funding,” and the Gavi Vaccine Alliance is also “experiencing a financial crunch.”

What’s the takeaway? I have mixed feelings. It’s worth appreciating the extraordinary amount of human suffering we’ve reduced through vaccination. But it’s not enough, and it’s frustrating to realize we may be stuck at an arbitrary high-water mark well short of what we’re capable of.

I’ll see you next week.

William

William Herkewitz is a reporter covering global public health for Healthbeat. He is based in Nairobi. Contact William at wherkewitz@healthbeat.org.

Most Americans believe vaccines are safe and effective

2026-04-22T11:00:00+00:00

Public health, explained: Sign up to receive Dr. Jay K. Varma’s reports in your inbox a day early.

Hello and welcome to Healthbeat’s weekly report on stories shaping public health in the United States.

This week, a headline about vaccine skepticism made me gasp – that is, until I read the actual data. Then I turned my attention to another important federal health program that is at risk of being gutted the same way Centers for Disease Control and Prevention vaccine policy was. And a surprise comment from President Donald Trump has upended what had been promising bipartisan momentum on child care, a service that is critical to health.

Do Americans trust that vaccines are safe and effective?

I gasped this past week when I read a headline that said that “more Americans doubt vaccine safety than trust it.” With measles and pertussis resurging, this headline suggested that vaccine skeptics are winning and made me worry that even more fearsome vaccine-preventable infections, such as polio and diphtheria, might soon return as well.

The headline came from a Politico poll of 3,851 U.S. adults, conducted in March by Public First. The poll found that nearly half of respondents said the facts on vaccines are “still up for debate” and that it is “damaging to enforce their uptake.” A plurality also said they support reducing the number of vaccines Americans receive. Politico reported that the findings suggest “RFK Jr.’s views are commonplace across the land.”

As an epidemiologist, I knew I needed to set aside time to review the actual data in more detail. Thankfully, other experts I trust had already done that.

Pediatrician and public health physician David Higgins analyzed the poll’s methodology and identified a fundamental flaw. The core question was what survey researchers call a “double-barreled” question, except, as Higgins pointed out, it actually had four barrels.

Respondents were asked to choose between two statements: one saying the science is clear and it is “damaging to question it,” and another saying the facts are “up for debate” and it is “damaging to enforce” vaccine uptake. Those are four distinct and independent beliefs fused into a single complicated and odd choice.

For example, a pediatrician who thinks the science is clear but believes vigorous debate is essential to good science has no good answer. Neither does a parent who trusts vaccines, has chosen to vaccinate their children, and also opposes government mandates. Because this question was so poorly worded, it was wrong for Politico to report the sweeping conclusion that half the country now shares Health and Human Services Secretary Robert F. Kennedy Jr.’s worldview.

NYC launched a $1M campaign to promote vaccination. Here’s what it gets right, and where it misses.

Other data from the same poll are reassuring and were downplayed. Only 10% of respondents chose the most skeptical position that vaccine risks are significant and enforcing vaccines is dangerous. And only 34% said they see reducing vaccines as a core principle of the Make America Healthy Again movement, the ideological home of anti-vaccine politics.

The idea that vaccine skepticism is now the default is itself a public health threat. People who see misleading headlines may begin to wonder why they are the outlier in trusting vaccines. Public health advocates need to both loudly oppose the anti-vaccine movement and widely celebrate the fact that most Americans still believe that vaccines are safe and effective.

Eager for some good news about vaccine uptake in the United States, I was also pleased to see a famous athlete endorsing vaccines this week. Basketball star Tyrese Haliburton — who led the Indiana Pacers to the cusp of the NBA championship last year before tearing his Achilles tendon in the final game — was recently diagnosed with shingles.

In an interview about his experience, he had this message to the audience: “I would tell anybody over 50 years old to get the [shingles vaccine]. This has sucked.” I strongly agree with that recommendation, as I have written about previously.

What is the future of the U.S. preventive services task force?

A federal program tasked with guiding doctors and health insurance companies on disease prevention has effectively been shuttered, but testimony from Kennedy last week suggests that he might do to it what he did to CDC’s vaccine program.

The U.S. Preventive Services Task Force is one of the most valuable, though least known, programs in American health policy. Established in 1984, it is an independent, volunteer panel of physicians and health professionals that reviews scientific evidence on preventive services and grades them on a scale from A to D. Think about mammograms, colonoscopies, depression screening, cholesterol tests, and HIV pre-exposure prophylaxis. Under the Affordable Care Act, insurance companies are required to fully cover services rated A or B at no cost to patients.

Since he took over, Kennedy has cancelled all of the task force’s scheduled meetings and refused to name replacements for five of its 16 members whose terms expired in December. As a result, there have been no new recommendations on important issues, and the task force was unable to publish a legally mandated annual report to Congress. Nineteen senators sent Kennedy a letter last month demanding he stop blocking the panel’s work.

Leadership disruptions at the CDC endanger American health

Then, in testimony before Congress last week, Kennedy went further. He called the task force “lackadaisical and negligent for 20 years” and said he would appoint new members with “a clear mission.” What’s Kennedy’s version of a clear mission? I worry that he wants the U.S. government to do what he did to the CDC’s Advisory Committee on Immunization Practices and stock it with people ideologically aligned to him. This could mean that the task force starts recommending interventions that have no basis in evidence but that Kennedy endorses, such as peptide injections and raw milk.

Why does this matter so much?

As public health expert Tom Farley argues, the U.S. health care system needs an independent, conflict-free body to evaluate evidence. Otherwise, the guidance that flows to physicians and patients gets distorted by financial interests. Medical specialty societies often publish their own guidelines, but many of their members have financial ties to the companies that stand to benefit from the tests and treatments being recommended.

The task force’s credibility to me and other practicing physicians has always rested on the fact that its members have no such conflicts and consider the totality of evidence, including the costs of testing or treating too much.

The importance of health and safety in child care

Trump recently upended the national conversation about child care saying that he does not believe the federal government should be in the business of paying for it. Until recently, child care had been a rare issue in which there is genuine bipartisan consensus in Washington. Lawmakers from both parties have been advocating for more federal investment, arguing that child care is important infrastructure for adults to be able to work and to grow the U.S. economy.

At an Easter lunch on April 1, Trump said, “We can’t take care of day care. We’re a big country, we have 50 states. We have all these other people, we’re fighting wars. We can’t take care of day care.”

Millions of American families have no child care options available to them, and, even among those that do, the cost is exorbitant, often exceeding the cost of college tuition. Many states are looking for local resources to fund child care expansion. In my home city of New York, the new mayor ran on a promise of universal child care for children from 2 to 4 years old.

If states do find their own resources to expand the number of child care seats, I am hoping that they also allocate sufficient funding for health and safety. In a report I recently authored, I argue that expanding the number of child care seats without ensuring health could make the system even more fragile with facilities closed because of outbreaks or staff shortages.

States need to budget for protecting children’s health, supporting child care workers’ health, and designing and maintaining facilities safely. These are important issues that parents can also try to assess when deciding where to enroll their children.

Until next week,

Jay

Pollen and ticks on the rise, changes to the Essential Plan, and NY bills to protect vaccines

2026-04-03T17:26:55+00:00

There’s a ton going on in the world of New York health, so let’s jump right into it.

Pollen is here. Ugh.

Is anyone else starting to notice the little tree buds and green sprouts starting to pop up? And despite the confusing false spring/second winter chaos weather we’ve been experiencing in New York, daily temperatures have been warming. That means we can expect local pollen counts and allergies to increase over the next several weeks, along with those cute little sprouts.

Most U.S. communities see three pollen waves — trees, grass, weeds. New York is currently in the tree pollen season. This is relevant because individual allergy sensitivity can vary by pollen type.

If you feel like allergies have been starting earlier or lasting longer, you aren’t imagining it. Over the past few decades, allergy seasons in New York have gotten worse, partly due to climate change and warming temperatures. Earlier this month, the 80-degree day we had in New York City was record breaking — the earliest 80-degree day we’ve had on record.

The length of the average allergy season has now grown by over three weeks since 1970, with higher pollen counts.

Longer and more intense pollen seasons can exacerbate allergies and respiratory conditions for New Yorkers. While simply annoying for many of us, seasonal allergies can actually be dangerous for many with asthma — every spring, emergency department visits for asthma spike.

For those with asthma or more intense allergies, it’s a good idea to speak with a health care practitioner about controlling symptoms before pollen season really takes off. There are also many actions we can take to reduce pollen exposure and prevent it from entering your home:

Check local pollen counts.
Leave shoes at the door and change clothes after outdoor activities.
Wipe off furry animals after they’ve been outside.
Shower before bed.
Keep windows closed during peak pollen times (midday).
Run air conditioning or HEPA filters.
Dust and vacuum regularly.

Dr. Zach Rubin, an allergy doctor, joined YLE on the America Dissected podcast last year and gave great tips on managing allergies:

To relieve sinus symptoms, it can help to rinse your nose with saline water (like with a neti pot), but only using distilled or sterilized water. I’ve found neti pots to really help.
For medications, second-generation antihistamines like cetirizine (Zyrtec) tend to have fewer side effects than diphenhydramine (Benadryl). As always, talk with your doctor or pharmacist for more information on medications.

Alpha-gal, aka meat allergy, from ticks is increasing in NY

Alpha-gal syndrome, the red meat allergy caused by lone star tick bites, is rising in New York, and Long Island is a hot spot. The Centers for Disease Control and Prevention estimates that 96,000 to 450,000 people in the United States may have been affected since 2010, and cases have been increasing. Suffolk County stands out: CDC data suggest it accounts for about 4% of suspected cases nationwide.

Symptoms can include:

Hives
Stomach pain
Vomiting or diarrhea
In more severe cases, anaphylaxis, which is life-threatening

Reactions can begin 2–6 hours after eating red meat or other mammal-derived products, which can make it harder to link consuming meat with the reaction.

It used to be that alpha-gal syndrome was mostly found in people who spent a lot of time outdoors or in the woods (like hikers, hunters, farmers, and outdoor workers). But now, many communities are reporting it to be more common, even in people who don’t spend much time in rural outdoor spaces.

So how does a tick bite turn into a meat allergy? After feeding on mammal blood, the lone star tick carries a sugar molecule called alpha-gal in its gut. When it bites a person, trace amounts of that sugar slip into the body through its saliva. Because humans don’t naturally carry alpha-gal, our immune system may treat it as foreign and start making antibodies against it (i.e., have an immune response to the sugar molecule). Later, when that same person eats red meat or other mammal products, the immune system recognizes alpha-gal again — and can trigger an allergic reaction, often several hours after a meal.

What else to know:

How long does it last? It’s considered a chronic disease, persisting indefinitely. For some, sensitivity fades after 1–5 years without new tick bites.
Is there a blood test? Yes. A specific blood test can measure IgE antibodies to alpha-gal. It’s the most reliable diagnostic tool available today.
Why is it hard to track? Cases are not nationally notifiable, so public health officials don’t get complete real-time data.

The best protection against alpha-gal syndrome is the same as with Lyme disease: Prevent tick bites in the first place.

Health policy updates

Changes to the Essential Plan and what it means for insurance coverage

But first, where are my “Pitt” fans at?

Remember how earlier this season there was a construction worker (Orlando) who came in with diabetic ketoacidosis after rationing his insulin because he couldn’t afford it? While the acid built up in his blood was life-threatening, he was terrified of what the hospital bill would be. He worked multiple part-time jobs, none of which provided insurance, and he made just above Medicaid’s income cutoff. He was fully employed, but still couldn’t afford health insurance.

This story hit close to home for New York.

New York’s Essential Plan was built for people in this exact situation: those who don’t get insurance through work but earn just over the limit to qualify for Medicaid. It now covers 1.7 million New Yorkers, up from 380,000 when it launched in 2016.

But the program is now shrinking. After budget cuts from the “Big Beautiful Bill Act” (HR 1), New York asked the Center for Medicare and Medicaid Services for permission to switch the current Essential Plan to an older structure. (I wrote about it last month.) CMS just approved that request last week (which to be honest, was a pleasant surprise). This means that income-based eligibility for the Essential Plan will now drop from 250% of the federal poverty level, to 200% on July 1, 2026. This change preserves Essential Plan coverage for about 1.3 million New Yorkers statewide, but about 500,000 are expected to lose it.

For single adults, this means that the income cutoff falls from ~$40,000/year to ~$32,000/year. For a family of four, that threshold drops from ~$83,000 to ~$66,000. People making just above the new thresholds will now likely be pushed to the marketplace to pay for insurance, where coverage can cost far more ($10,000-$12,000 per year out of pocket) with higher deductibles that many families simply can’t afford.

While this is bad news, it could have been a whole lot worse. If CMS didn’t approve New York’s workaround, the entire Essential Plan could have shut down. This move doesn’t save everyone’s coverage, but it did prevent a total collapse.

Here’s what to do:

Check your pay stubs: If your income is between $32,000 and $40,000 as a single adult or ~$66,000 to 83,000 for a family of four, watch your mail closely.
New York has started notifying affected New Yorkers, and coverage changes will begin July 1.
Visit NY State of Health to explore your options, or call the helpline at 1-855-355-5777.

Something to watch: New vaccine bills in NY

Gov. Kathy Hochul and New York lawmakers are moving forward with two bills that would further protect vaccines in New York, as federal vaccine policy has become unstable.

The first bill focuses on insurance coverage for vaccines. It would require state-regulated insurers to fully cover the costs of vaccines recommended by the Advisory Committee on Immunization Practices or recommended by the state’s health commissioner. The goal is to make sure that insurance coverage continues even if federal ACIP recommendations change.

This bill would require private insurers and state-sponsored insurance to cover the cost of these vaccines. So far, it does not make any changes to vaccines covered by Medicaid or the Vaccines for Children program, both of which are still linked only to ACIP recommendations.

The second bill is about broader immunization guidance. It would remove references to ACIP in multiple state laws, like school immunization requirements, the recommended schedule for newborns, and pharmacist vaccine administration rules. Like the first bill, it shifts guidance toward the New York state health commissioner. This could be good, but it could also be risky in the future — politics change, and there’s no guarantee that future commissioners will be as evidence-forward as ours is right now.

The proposed bills build on the executive order Hochul put forward in the fall to preserve vaccine access, and would put those actions into state law. It’s a good step. These bills are also an example of how vaccine access is increasingly becoming a hyperlocal issue. But the bills still need to pass through the state legislature, so they aren’t set in stone yet.

Bottom line

You’re all caught up on New York public health news! Enjoy this weather, and consider stocking up on tissues and bug repellent. :)

Love,

Your NY Epi

How the Iran war is disrupting the world’s medicine supplies

2026-03-26T11:00:00+00:00

Public health, explained: Sign up to receive Healthbeat’s Global Checkup in your inbox a day early.

Hello from Nairobi.

This week we start with a reminder that the world’s conflicts rarely stay confined to the map. The Iran war is scrambling medical supply chains globally, because the Persian Gulf is not just an energy chokepoint but a critical transit hub for pharmaceuticals.

That said … we’re feeling the energy squeeze, too! Rumors of fuel rationing started circulating in Nairobi early this week, which was enough to send me out late at night to fill up my tank just in case.

With that, as we say in Swahili: karibu katika habari — welcome to the news.

The Iran war is a drug shipping fiasco

The starkest warning yet of how the Iran war could scramble global health comes from this must-read analysis in Think Global Health. The short version: The war is choking the movement of medicines around the world.

To be clear, it’s not that the Persian Gulf countries (like Saudi Arabia, Qatar, and the United Arab Emirates) are major drug producers. They’re not. It’s that these countries form “a critical pharmaceutical transit hub,” where drugs and their basic ingredients from India, Europe, and China routinely pass before heading to Africa, Asia, and the United States.

For reference, this is a region whose “pharmaceutical industry is worth $23.7 billion,” but where roughly 80% of that trade depends on medicines or pharmaceutical ingredients passing through.

And right now both ways these medicines largely transit, the sea shipping lane in the Strait of Hormuz and the Persian Gulf’s giant cargo airports, are badly disrupted. Shipping has dropped “90% below pre-war levels,” while air cargo capacity has fallen by “79% in the Gulf region.”

Where will the shocks be felt first?

I reached out to one of the authors, Prashant Yadav at the Council on Foreign Relations, who is a leading expert on global health care supply chains to ask.

Right now the biggest risk is cold-chain medicines, which he writes are “vaccines, insulin, biologics, and cancer therapies” with “short shelf lives” that have to move quickly and stay within a tight temperature range; largely “between 2°C and 8°C,” 35-46°F.

Most cold-chain medicines move by air cargo, Yadav told me, and airlines cannot simply add new capacity overnight if those routes stay disrupted. Even over the medium term, “I don’t think European airlines, or the two major African ones that have stepped in, will enhance their cargo carrying capacity by buying new planes just because this may continue for a few more months,” he said.

When shipments of these drugs are held up, those medicines can spoil. And even when they don’t, delays multiply. As the article notes, cargo carriers “need a week and a half to catch up for every week that air shipments are suspended.”

Also at risk is helium supplies, a gas that is “an essential input for cooling the magnetic resonance imaging (MRI) machines used worldwide for [over 95 million] medical scans,” each year. Qatar alone produces a third of the world’s helium. And the threat is not just constraints from the transit fiasco, but physical damage to the industry, including Iran’s March 18 attack on a major helium production site in Qatar.

Yadav believes we will ultimately see some “supply impact for MRI helium,” but exactly how severe it may become is too hard to untangle right now. Much will depend on how long Qatar’s production remains offline and how exactly limited supplies are allocated between industries, like semiconductor manufacturing (which is an enormous use for the gas).

Perhaps unexpectedly, the war has also put medical research under threat. Yadav’s article describes how the Gulf region was in the middle of a clinical trial boom, driven by “the area’s high chronic-disease prevalence and its lenient regulations allowing for fast-tracked trials,” and that supply chain chaos could interrupt ongoing trials.

The good news is that, for now, "short-term risks of drug shortages are low in most countries,” Yadav writes. But that’s because of “inventory buffers” that governments and pharmaceutical companies keep around the world. But those cushions are temporary. If shipping and air freight disruptions drag on, shortages will eventually work their way through the system.

I also asked Yadav whether the war could trigger a price squeeze for medicines made with petroleum products, which is more than you might think. “Most of our medicines have some kind of a chemical precursor, and a very significant portion of those chemical precursors are petrochemical derivatives,” he said. (For example, acetaminophen and ibuprofen are made using an oil-based chemical called propylene.)

But Yadav says, for now, that’s not a major concern. The petrochemical ingredients in something like a pill of ibuprofen only make up only around 5% of the cost, with the rest tied up in processing and manufacturing.

But other cost implications are coming fast. A combination of rerouted flights, rising air-cargo rates, and surging insurance premiums for ships mean that moving medicines are more expensive everywhere. And at least one supply chain logistics firm says that, “consumers could see drug costs affected within four to six weeks.”

Yadav’s article ends with a clear policy warning. Governments may need to temporarily loosen certain import regulations so medicines can move through alternate routes. Longer term, he says the world needs something bigger: a standing G20 coordination system that tracks where medicines are stuck and helps countries respond before shortages hit.

A rare campus outbreak

The UK is facing an outbreak of meningococcal disease among university students in Kent, which is in England’s southeast. It has already killed two people, the BBC reports. The outbreak has drawn serious attention in British media, because while the disease is rare, it strikes with a fairly shocking speed and quickly becomes deadly.

Disease breakdown: Meningococcal disease is an illness caused by a bacteria called Neisseria meningitidis. It spreads through respiratory droplets, similar to Covid, and often starts with flu-like symptoms, followed by patients developing a distinct red and purple rash. It is largely preventable through vaccination, and can be treated with antibiotics, although it can leave survivors with permanent disabilities. Confusingly, outbreaks are sometimes referred to more broadly as “meningitis” in mass media, which is a condition that refers to the often-deadly inflammation of the tissues surrounding the brain and spinal cord.

A Scientific American report on the situation framed the outbreak as a reminder of why vaccination programs matter. William Schaffner, an infectious disease physician at Vanderbilt University Medical Center, told Scientific American that “this outbreak is a very unusual event,” and underscored “how routine, comprehensive vaccination has had a profound effect on really dramatically reducing the occurrence of what was once an extreme, ordinarily feared infection.”

Reading that, my immediate question was if the UK outbreak might portend something broader: like a smaller equivalent of the measles resurgence, where slipping vaccination coverage is allowing outbreaks to return?

Ultimately, that seems unlikely. The Kent outbreak was caused by a rarer strain of meningococcal disease known as strain B. While many children are routinely vaccinated against it, vaccine boosters for strain B are often offered only selectively in places like the UK and United States because cases are so uncommon. That means the gap that appears on college campuses is usually not missed shots but fading protection as immunity wanes over time.

I also reached out to Schaffner directly, who told me that “the outbreak in Kent does not portend similar outbreaks elsewhere.” He emphasized that the disease holds “very little risk to the general public for two reasons,” he said. First, because it needs close, repeated contact to spread. The illness spreads “most readily amongst semi-confined populations such as university students” who share classrooms, dorms, and nightlife, he said. (The epicenter of this spread is believed to have been a bar).

Second, containment is relatively straightforward. In Kent, “the public health response has been brisk and comprehensive,” he said, with health officials quickly giving antibiotics to people who may have been exposed.

Vaccine side effects (... good ones!)

A senior infectious disease reporter I follow, Helen Branswell, just published an interesting article in STAT News that sits somewhere between op-ed and straight news. She walks readers through vaccine by vaccine to explain a simple but often overlooked point: Immunization programs rarely benefit just one person against one pathogen.

Pure speculation on my part, but I’m imagining this story originated as a sort of professional self-care for a veteran health reporter. After watching the maddening vaccine debate circle the bowl of conspiracy-land too many times, maybe you just need to reset the conversation. Anyhow, I’m here for it!

I won’t walk through the whole list here, but three examples really jumped out to me:

Rubella vaccination in kids has essentially eliminated a once-devastating birth defect in mothers that left many babies “deaf, blind, or with developmental delays.”

The meningitis vaccine has helped decimate gonorrhea infections, with surprising studies suggesting the shot offers about a “30% to 40%” spillover protection against the sexually transmitted infection.

And Human Papillomavirus vaccination has turned into what one expert called “one of the most elegant herd immunity stories that we have” in public health, reducing several cancer rates broadly… even in men who were never the original targets of the vaccine program.

Argentina, out of the WHO

Argentina has finally made good on its year-old promise to withdraw from the World Health Organization, Al Jazeera reports. It is the second country to ever do so, after the United States. It may sound symbolic, but the move cuts off Argentina from the United Nations agency which (as we’ve covered extensively) “monitors health trends, tracks disease, promotes health care access, and trains medical providers.”

So why’d they do it?

Argentina’s President Javier Milei has framed the move as a matter of national “sovereignty,” criticizing the WHO’s “health advice during the Covid-19 pandemic,” and saying Argentina will pursue “international cooperation in health through bilateral agreements” instead.

Do those arguments sound familiar? They should, as both the criticisms and the shift toward bilateral deals echo the exact complaints and policies we’ve heard from the Trump administration. So, it’s clearly Argentina’s model.

Not to quibble, but it’s worth noting one key point: The WHO does not control countries’ health policies, and its Covid-19 recommendations were never strong-armed on Argentina. It is an advisory body. (Just ask Sweden, or Argentina’s neighbor Uruguay).

My takeaway? Ultimately, unless this move somehow triggers further exits, I’m not seeing it as a dramatic new fracture in global health cooperation. It’s another aftershock of far-right domestic politics that have been spilling into health policy since 2025.

Secret jungle medical school

Let’s finish this week with a remarkable story from The Guardian, which followed a group of nursing students in Myanmar who just graduated from a “secret jungle school” of medicine built during the country’s civil war.

The background: After the military coup in 2021 destroyed large parts of the public health system, an underground network of clinics emerged. This “parallel secret health system” surfaced to treat injured pro-democracy fighters and “those who cannot risk government-controlled hospitals or who live in the vast areas of the country which are outside the regime’s control.”

Eventually, the effort expanded beyond treating patients to training the next generation of nurses. One nursing teacher “contacted colleagues in the U.K., and together nurses in Myanmar and Britain arranged video masterclasses,” for a full curriculum.

All told, “dozens of international academics recorded lectures for the 58 modules needed to cover Myanmar’s curriculum, and “the Phoenix Bachelor of Nursing Science” degree was born.

The article describes how lectures were “smuggled on memory sticks across the country,” and how the students completed their training under extraordinary conditions: like studying in remote classrooms while dodging drone surveillance and airstrikes. As one organizer put it, “safety is never guaranteed.” Another described bombs landing “right next to the classroom.”

It’s a powerful read, and the new graduates say the program represents something larger than medical training. “The name Phoenix itself is powerful for us. It symbolizes rising from the ashes of the destruction the coup has caused … We are the living proof that education and hope cannot be extinguished by violence.”

I’ll see you next week!

William

William Herkewitz is a reporter covering global public health for Healthbeat. He is based in Nairobi. Contact William at wherkewitz@healthbeat.org.

NYC launched a $1M campaign to promote vaccination. Here’s what it gets right, and where it misses.

2026-03-19T14:45:00+00:00

There’s a lot going on this week in New York health news, including a city campaign trying to encourage conversations about vaccines, a win for vaccine access at the federal level, and a new program for PFAS testing in private wells. Let’s jump in.

NYC launched a new vaccine campaign. Here’s what it gets right, and where it misses.

The NYC Health Department has launched a new $1 million, four-week vaccine campaign: “Ask Questions, Get Answers, Vaccinate.”

When a friend first shared it with me, I was genuinely stoked. A campaign trying to create a feedback loop between institutions and local communities?! Yes, please! That’s exactly what we need right now —more health departments meeting people where they are, addressing real confusion, and empowering New Yorkers to make evidence-based decisions. Something that closes the distance between officials and the communities they serve.

But after looking into it further, and seeing the price tag, I was honestly pretty bummed.

The campaign will run across TV, radio, print, LinkNYC kiosks, and on transportation hubs, with a focus on neighborhoods with lower vaccination rates. Medical practitioners participating in the Vaccines for Children program will also receive posters and handouts to share with families. The city also launched a webpage that answers common vaccine questions and links to additional resources (which are pretty good FAQs).

The intent was there. And, it’s really important to acknowledge that people have questions about vaccines. That is a good thing.

How to win the war of narratives in global public health

But if you dig deeper, the campaign falls short in a couple of important areas:

The cost. A four-week ad campaign is not the same as long-term trust-building, and it’s expensive ($1M!), especially for its length, at a time when public health departments are scraping for pennies.
Telling people to “talk to your doctor” assumes they have a doctor they trust and can access. One in three Americans don’t have a primary care physician. It also assumes that clinicians themselves feel equipped and empowered to respond to these questions in a short 12-minute visit. What we’re hearing at YLE is that many clinicians need more support in this area.
This also doesn’t move us toward the affordability that the new health commissioner is prioritizing. Telling someone to see a doctor is, for many people, telling them to take time off work, find child care, and potentially take on debt.
There doesn’t appear to be much of a feedback loop. Good communication is not just sharing information; it also means listening and asking for feedback.
It misses some of the places where many families are actually getting health information now, especially social media.

If I had $1 million to spend, it wouldn’t be on a short-term advertising campaign. What is needed is something far more structural: direct public access to the health department and supporting trusted community messengers with the tools, staff, knowledge, and partnerships to reach families where they’re at, sustainably. I would also like to see greater investment in open communication channels for families to share their questions, concerns, and experiences back to the health department, instead of information flowing only top-down.

This could look like:

Hosting listening session in neighborhoods with lower vaccination rates.
Partnerships with community-based organizations, schools, and faith leaders.
Regular surveys and summaries of questions and concerns from New Yorkers.
Clinician training and tools for talking about hot-button topics.
Online and social media monitoring to know what is circulating in real time.

Being trustworthy happens over time, through a set of actions taken over and over and over again. Some of those actions include repeated conversations in communities, schools, clinics, and neighborhood spaces, through relationships.

What this means for you: If you have questions about vaccines, drop them in the comments here, and we will get back to you! And maybe we can send them to the health department as well.

New York is offering free PFAS testing and money to fix contaminated wells

If you own or rent a home with a private well in Westchester, Suffolk, Dutchess, Putnam, Orange, or Ulster County, this is for you.

New York state launched a new program on March 9 that offers free private well testing for PFAS, often called “forever chemicals.” If contamination is found above the state threshold, the state will also help pay to address it.

PFAS (per- and polyfluoroalkyl substances) are a group of manmade chemicals that persist in the environment and in the body. They’ve been used for decades in products like nonstick cookware, firefighting foam, and food packaging. They’re also linked to some health issues, including kidney and testicular cancer, thyroid disease, immune suppression, and pregnancy complications.

This matters especially for people with private wells because private well water does not get the same routine oversight as public drinking water systems. Private household wells are not regulated under the federal Safe Drinking Water Act, and government agencies usually do not monitor or treat private well water—that’s the responsibility of the owner. Sources of PFAS in well water can come from runoff from manufacturing, landfills, wastewater, contaminated soils, or fertilizers.

Here are the details for the new program:

Testing is free for eligible households in six counties.
If PFOA or PFOS (specific types of PFAS) levels are at or above 10 parts per trillion, New York’s drinking water standard, residents may qualify for financial help.
Eligible households can receive up to $5,000 for a PFAS treatment system, or up to $10,000 to connect to public water.
Renters are eligible too, not just homeowners.
Funding is first-come, first-served, with $1.5 million available per county.

Dutchess and Putnam County applications are open now. Orange, Suffolk, Ulster, and Westchester are expected to open in the coming months.

What this means for you: If you live in one of these counties and use a private well, this is a concrete opportunity to check for contamination and get financial help if a problem is found. Apply or learn more here.

A judge blocked RFK Jr.’s ACIP overhaul —what it means for New York

A judge blocked Health and Human Services Secretary Robert F. Kennedy Jr.’s overhaul of the Advisory Committee for Immunization Practices and the related changes to the childhood vaccine schedule. While this is a win for Americans, it likely doesn’t change much day to day for New Yorkers. That’s because New York had already moved to preserve prior vaccine recommendations, protect access, and require insurance coverage, creating a buffer against much of the federal disruption. (I’ve covered this previously.)

In practical terms, the ruling mostly restores nationally what New York had already protected locally.

The bigger issue here is continued confusion: Back-and-forth changes to vaccine guidance are hard for families, clinicians, and schools to follow, even when access is protected. For a deeper dive into the ruling and what it means nationally, read Katelyn Jetelina’s YLE National piece from Tuesday.

Bottom line

The bottom line this week is that the city’s new campaign to improve communications around vaccines has a lot of room for improvement, the state PFAS well-testing program is a clear example of environmental health in action, and the court decision on ACIP was a win for federal vaccine policy but doesn’t practically affect New Yorkers. You’re all caught up — see you next week!

Love,

Your NY Epi

Doctors warn of a deadly complication from measles outbreaks

2026-03-13T15:57:15+00:00

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The first sign came when Deepanwita Dasgupta was 5 and started stumbling more while playing at her home in Bangalore in southern India. The girl was always up to something, so her parents figured extra bumps and bruises were just symptoms of an active childhood. Maybe, they thought, it was ill-fitting shoes.

Relatives described the unicorn-loving child as smart, affectionate, and occasionally rascally. Before she learned the alphabet, she had figured out how to find her favorite show, “Blippi,” on a phone. She was known to sneak butter from the fridge to enjoy a few finger licks.

But then her limbs started jerking. A spinal tap revealed measles in her cerebrospinal fluid. The virus she probably had as an infant had secretly made its way to her brain. Now 8 years old, Deepanwita is paralyzed, unable to talk.

Measles causes complications — ranging from diarrhea to death — in 3 in 10 infected people, according to the Infectious Diseases Society of America. Some are immediate, while others take weeks or months to appear. The one Deepanwita is experiencing, subacute sclerosing panencephalitis, or SSPE, typically takes years to rear its head.

“People think, ‘Oh, you know, if we get measles, then we’ll be fine, because I know my neighbor had it and they’re fine,’” said Yasmin Khakoo, who leads the national Child Neurology Society but spoke to KFF Health News in her capacity as a New York City doctor with expertise in neurologic conditions.

South Carolina wants to avoid a spring break measles outbreak surge, enlists school help during closures

Measles, though, can be dangerous: A 7-year-old in South Carolina will have to relearn how to walk after enduring one of the more immediate complications, brain swelling. And every so often, the virus plants a ticking time bomb in the nervous system. A person can recover from measles and continue life as usual, no longer contagious and without any identifiable symptoms — sometimes for a decade or more — before problems appear. While some patients end up severely disabled for a while, Khakoo said, the condition is almost always fatal.

Before the advent of widespread and effective vaccines, the complication occurred enough in the United States that in the 1960s a doctor created a national registry of SSPE patients. Researchers now estimate about 1 in 10,000 people who get measles will develop SSPE, but the risk is significantly higher for those who contract measles before age 5. Populous nations where the virus is endemic, including India, see cases routinely.

Now, doctors and researchers fear that as vaccination rates drop and measles spreads in the United States, cases of this debilitating complication will also rise here. Since the start of 2025, the Centers for Disease Control and Prevention has recorded over 3,500 measles cases — more than in the entire preceding decade — mostly people who were unvaccinated. Many were children. Last year, Connecticut doctors diagnosed a 6-year-old with SSPE, and in California, a school-age child who’d had measles as an infant died of it.

“We are likely to see SSPE cases going forward, especially if we don’t get this under control,” said Adam Ratner, a member of the American Academy of Pediatrics’ Committee on Infectious Diseases and author of the book "Booster Shots."

Concern about SSPE was great enough that in January, the Child Neurology Society published a video to educate U.S. clinicians about the condition, and doctors who have seen such cases are warning their peers.

“We don’t have a way of knowing who’s going to get it, and we don’t have a way of very effectively treating it,” said Aaron Nelson, a professor of neurology with the New York University Grossman School of Medicine. “The one best thing that we can do, ideally, is to prevent children from having to go through it in the first place.”

The recommended two-dose measles vaccine slashes an exposed person’s risk of getting the contagious virus from 90% to 3% — and thus reduces the chance of SSPE. The vaccines carry small risks of febrile seizure and a bleeding condition, but measles itself has a higher risk of causing both.

Researchers find some missed SSPE cases

A 2017 study of California children who developed SSPE after a measles outbreak there years ago determined that 1 case is diagnosed for about every 1,400 known cases of measles in children under age 5, and 1 for every 600 infected babies.

The researchers also found that, over the years, doctors had missed some cases among patients who had died with undiagnosed neurologic illness.

The possibility that future cases could go undiagnosed spurred Nava Yeganeh and her colleagues to publish a news release in September when a Los Angeles County child died of SSPE.

Deepanwita Dasgupta and her mother, Anindita Dasgupta, celebrate the child’s fifth birthday in 2022.

“We’ve had very few cases of measles in the last 25 years in this country,” said Yeganeh, who is the medical director with the Vaccine Preventable Disease Control Program at the Los Angeles County public health department and has had two patients with SSPE. “Unfortunately, that’s changing, and so we wanted to make sure that everyone was aware of this long-term complication.”

The California child who died had gotten measles as an infant, Yeganeh said, before the child could receive the vaccine. Measles is highly contagious, so at least 95% of the population must be immune to it to protect vulnerable people — including babies too young to vaccinate and people who are immunocompromised — from infection.

“This is an example of someone who did everything right, wanted to protect their child against this infection, and unfortunately ended up losing their child because we didn’t have herd immunity for them,” Yeganeh said.

Shortly after Yeganeh’s group published the news release in California, Nelson was working to get the word out, too.

He had recently seen a 5-year-old whose family had traveled to the United States for medical care after the child started stumbling, jerking, hallucinating about bugs and animals, and having seizures. The child had contracted measles as an infant and had been too young to be vaccinated. Nelson diagnosed the child with SSPE.

“Imagine that: Having a child who is healthy and happy, moving to talking less and less, eventually not able to walk,” Nelson said. “It’s a very sad thing.”

He thought he would encounter the condition only in medical school textbooks, as a relic of the past. Instead, in October he found himself presenting the case at the Child Neurology Society’s national conference and participating in the society’s video about the condition. “I’ve now seen something I shouldn’t have ideally seen ever in my career,” he said.

Warning signs come from India

Globally, the number of measles outbreaks has increased in recent years, and physicians in places including the U.K. and Italy have recently seen clusters of SSPE.

The high human cost of measles’ spread is especially evident in India. While total cases aren’t tracked, about 200 families caring for people with SSPE, including Deepanwita’s, are in a single chat group in the Bangalore area.

In New Delhi, Sheffali Gulati studies SSPE and sees about 10 new patients a year with the condition, what she calls the “delayed echo” of measles outbreaks. The youngest she has seen was 3 years old.

“The ages are coming down, and a death or a vegetative state can develop as soon as in six months to five years of onset,” said Gulati, who leads the pediatric neurology program at the All India Institute of Medical Sciences and until recently led India’s Association of Child Neurology.

Gulati hasn’t found any treatments that reverse SSPE’s course, only some that slow its progress. She’s found herself counseling parents: It’s catastrophic, it’s not their fault, and they can do nothing but accept it.

Deepanwita’s relatives try to find joy where they can. They think they noticed the girl smiling when her favorite cousin called recently. Anindita Dasgupta, her mother, said Deepanwita moves her hands and feet on her own and sometimes turns her head, especially when her father enters the room. The girl communicates with her parents through her eyes and a few sounds.

But it’s far from where she was in 2022: At a cousin’s birthday, a few months before noticeable symptoms started, Deepanwita started the birthday song and sang the loudest.

At her own 8th-birthday gathering last year, Deepanwita, wearing a pink eyelet dress and a nasal tube, could only blink and move her eyes as she sat propped up before two cakes that she would not be able to eat. She can no longer swallow, so her mom dabbed a bit of icing on her tongue.

‘The problem could be solved with vaccination’

Roberto Cattaneo, a molecular biologist at the Mayo Clinic in Rochester, Minnesota, has been studying SSPE for years. He recently used postmortem brain tissue to map how the measles virus can spread from the frontal cortex to colonize the entire brain. Still, he said it’s a “black box” what exactly measles is doing in those dormant years between the initial infection and when the symptoms of neurologic damage crop up.

It’s possible the virus replicates in the brain that whole time, undetected, killing off neurons. But with so many neurons in the human brain — 10 times as many as people living on the planet — the brain may find a way to adjust, Cattaneo said, until finally it can’t anymore.

He’s applying for funding to continue research on the disease and possible treatments, though ultimately, he wishes he didn’t have to. The tools to obliterate the condition already exist.

“The problem could be solved with vaccination,” Cattaneo said. The United States should have no cases of SSPE, he said. “It’s just painful.”

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

South Carolina wants to avoid a spring break measles outbreak surge, enlists school help during closures

2026-03-12T21:28:16+00:00

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Amid concerns that spring break could reignite South Carolina’s measles outbreak, state health officials are trying to avoid a repeat of the communication gaps that delayed measles exposure investigations when schools were closed for winter break.

Healthbeat revealed last month that the South Carolina Department of Public Health was hamstrung in late December in its efforts to quickly warn and quarantine students and staff who had been exposed to measles. The problem: Schools were closed over winter break and they had nobody available to provide contact information to outbreak investigators.

The result was that people who were unaware they were infectious continued to interact with others in the community during the busy winter holiday season. In the weeks that followed, cases of measles surged dramatically and the South Carolina outbreak became one of the largest in decades.

“We are concerned that we may see another surge in cases,” Dr. Linda Bell, South Carolina’s state epidemiologist said. “So we have actually been in contact with schools to work with them more closely, to make sure that we have points of contact.”

Bell said Thursday that the department has sent letters to schools in South Carolina’s 11-county Upstate region asking them to identify a person who will be available during the spring break vacation period – when schools and administrative offices are closed – who can provide school attendance and contact information if it is needed for measles exposure investigations.

Here's how the S.C. measles outbreak grew after the holidays

“We’ve been receiving steady responses from the schools for those points of contact,” she said.

The health department said late Thursday that the letters, which requested contact information by March 10, were sent to all public school superintendents in the Upstate region. Only 11 of the 23 superintendents had supplied contacts as of Thursday. “DPH has previously established contacts at private and charter schools that have been impacted by the outbreak,” the department said.

Of the 993 measles cases recorded since the outbreak was identified in October, 936 have been in Spartanburg County and most of the others in nearby Upstate counties, according to state data. Almost all of those who have been infected were unvaccinated and most have been school-age children and teens.

In recent weeks, the number of new measles cases being reported to the department has slowed to a trickle. On Monday, the health department said just two new cases had been identified since Friday.

In Spartanburg County, spring break is scheduled for April 6-10 for many schools, but dates vary throughout the state.

“We’re very encouraged by the decline in cases, but we won’t be able to declare this outbreak over until we’re certain that measles transmission has ended,” Bell said. School holiday break periods pose an increased risk for the spread of measles because they often involve people traveling and socializing more.

The winter holiday break was a time of significant spreading of measles in the Spartanburg area.

Between early October – when the outbreak began – and Dec. 22, when Spartanburg County schools closed for winter break, there had been a total of 144 measles cases during the nearly three-month period. Then, in just the three weeks after schools reopened in January, there were more than 500 new cases of measles, state data show.

When Healthbeat asked South Carolina’s health department last month why it hadn’t reached out to schools to have contacts in place before winter break, the department said: “DPH cannot direct school employees to come to work to assist with outbreak investigations.”

Bell on Thursday said the new outreach to schools is an example of the department incorporating lessons learned into its outbreak response. “DPH has made the ability to communicate with school officials who have access to the information needed for case investigation a priority ahead of the upcoming spring break,” she said.

Measles is highly contagious and spreads through the air when an infected person breathes, coughs, or sneezes. The virus can linger in a room for up to two hours after an infectious person has left. Because a person is infectious for four days before the telltale measles rash appears, and initial symptoms may seem like a cold, many people spread the disease before they know they have it.

While two doses of the measles-mumps-rubella vaccine is 97% effective in preventing measles, those who are unvaccinated are at high risk of infection if they are exposed.

Christian school refused to share student information

Based on internal health department records, Healthbeat reported last month that during winter break there were delays quarantining people who had been exposed to measles – just prior to the holiday recess – at three public schools and one private Christian school.

In most cases, the schools were closed and didn’t have anyone available to provide information.

But when outbreak investigators reached Westgate Christian School in Spartanburg, the principal refused to provide information required to ensure those at risk of spreading the disease knew of the need to stay in quarantine, according to a health department warning letter to the school that Healthbeat recently obtained under South Carolina’s public records law.

According to the Jan. 9 letter, Westgate Christian School Principal Gail Grab responded to requests for information about exposed students by sending an email on Dec. 30 that said in part: “We will not provide personal details and immunization status information for the students in our school.”

Then when Grab sent outbreak investigators a list of exposed students on Dec. 31, the only names on it were the siblings of the person who had measles.

The department’s “final warning” letter on Jan. 9 gave the school until 1 p.m. the next day to provide the required information about all students who were had contact with the person with measles or the department would issue a public health order, under which the school could face fines of $1,000 per day for each exposed student’s name left off the list.

“Your continued failure to comply with this lawful demand has significantly impeded DPH’s ability to conduct mandatory case investigation, contact tracing, and quarantine monitoring,” the letter said. “This lack of cooperation places quarantined students, school staff, and the families of your students at increased and unnecessary risk of measles exposure, a highly contagious and serious disease.”

The school did comply before the deadline, Bell said.

Grab did not respond to requests for an interview on Wednesday. Pastor James Wooten, Westgate Christian’s president, replied Wednesday to emailed questions about the letter by saying he was traveling. He previously told Healthbeat that the school thought it had provided all necessary information on Dec. 31. He did not previously disclose that the school’s principal had sent an email refusing to provide required information.

Plans unclear at schools with past delayed measles investigations

Officials at the other three schools where state investigations of measles exposure incidents were delayed during winter break did not answer Healthbeat’s questions Wednesday and Thursday about any changes they have made for the upcoming spring break period.

Mark Robertson, principal at Global Academy of South Carolina, a public charter school where state records show only 21% of students are up-to-date with school immunizations, said he had no comment.

A vaccination rate of 95% is needed in communities to stop the spread of measles.

South Carolina has spent $1.6 million to combat its huge measles outbreak – and it’s not over yet

Cynthia Robinson, a spokesperson for Spartanburg County School District 6, did not respond to emails and calls on Wednesday and Thursday. Delays investigating measles cases over winter break occurred at the district’s Jesse S. Bobo Elementary School, where state data show 94% of students are up-to-date on vaccines.

Other schools that had delayed measles exposure investigations over winter break were in Spartanburg County School District 2: Sugar Ridge Elementary, where state data show 78% of students are up-to-date on vaccines, and Boiling Springs Elementary, where 80% of students are up-to-date on vaccines, also had delays investigating measles exposures during winter break, Healthbeat previously reported.

Adrian Acosta, a District 2 spokesperson, did not answer Healthbeat’s questions about what the district will do differently during spring break to avoid the winter break problems providing health officials with measles contact tracing information.

Acosta first sent a statement saying a district nurse supervisor is available 24/7. Then when asked if this person will be available during the spring break vacation period, Acosta emailed another statement saying school administrators are “always on the job.” Acosta added: “If an administrator knows they will be out of touch or unreachable, then it is expected that they have a communication plan in place.”

But Acosta did not respond to questions about what the district will do differently during spring break to prevent a recurrence of the delays.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

Controversial federal vaccine advisory committee: Deadline is Thursday to comment on March ACIP meeting

2026-03-09T15:51:20+00:00

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A controversial federal vaccine advisory committee, which is scheduled to meet next week to discuss Covid-19 vaccine injuries and Long Covid has set a Thursday deadline for the public to submit comments.

The Advisory Committee on Immunization Practices has disclosed few details about its agenda for the meetings on March 18-19 at the Centers for Disease Control and Prevention in Atlanta. The committee was supposed to meet last month, but cancelled its sessions amid an ongoing lawsuit and after failing to post agenda information, as required.

The formal notice for the March meeting published in the Federal Register says the committee’s agenda will include updates on the committee work groups and “discussions on COVID-19 vaccine injuries and Long-COVID and ACIP recommendation methodology. Recommendation votes may be scheduled for COVID-19 vaccine injuries and Long-COVID and ACIP recommendation methodology.”

No additional details were provided about these topics and the notice also says that the group’s agenda items “are subject to change as priorities dictate.” The ACIP meeting webpage also did not provide any additional details as of Monday morning.

The public can submit written comments online through the Federal Register meeting notice. Comments must be received by Thursday, the notice says.

The committee will also provide time for members of the public to make oral comments. The notice says: “Oral public comment will occur before any scheduled votes, including all votes relevant to the ACIP’s Affordable Care Act and Vaccines for Children Program roles.” Priority will be given those who file a request to speak at the meeting by Thursday. Details on how to make a request to speak at the meeting are found on the ACIP meeting webpage.

The committee, which meets three times a year, had all of its members replaced last summer by Health and Human Services Secretary Robert F. Kennedy Jr. and has come under fire from major medical professional associations that have said the reconstituted committee has been making changes to vaccine recommendations that lack scientific merit.

An ongoing lawsuit brought by American Academy of Pediatrics and other medical groups over the Trump administration’s vaccine changes has sought to stop ACIP’s next meeting because of concerns the committee will take a vote that will result in removing funding for certain vaccines for children from low-income families or who lack adequate insurance. Several state attorneys general are also suing HHS over recent changes to the childhood and adolescent vaccine schedule.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48.

Anti-vaccine polices may be slowing, but the damage could be lasting

2026-03-04T12:00:00+00:00

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Hello and welcome to Healthbeat’s weekly report on stories shaping public health in the United States.

I am Dr. Jay K. Varma, a physician, epidemiologist, and public health expert currently serving as chief medical officer at Fedcap, a national nonprofit focused on economic mobility and well-being for vulnerable communities. Views expressed here are my own.

This week, I have been watching signs that the federal government’s rollback of vaccines may be slowing, although the detrimental impact on public health may be long-lasting.

Is the rollback of U.S. vaccines ending?

In the 12 months after Robert F. Kennedy Jr. was confirmed as secretary of the U.S. Department of Health and Human Services, the federal government took dramatic steps to stop the development and delivery of vaccines that protect children and adults against infectious diseases. Is it possible these efforts are slowing or even stopping?

Media outlets have recently reported that RFK’s anti-vaccine actions represent a big political risk for the GOP heading into the midterm elections and that he has been instructed to delay or stop anti-vaccine activities — at least for now. According to Politico, President Donald Trump’s own pollster, Tony Fabrizio, found that Kennedy’s moves to downsize the childhood vaccine schedule are broadly unpopular. A White House official summarized the administration’s new posture with striking bluntness: “I think we’re largely done with vaccines.”

Indeed, despite the increasing prominence of the anti-vaccine movement on social media and in politics, polls conducted in the past few months show that the American public still thinks highly of vaccines, favors mandatory vaccination for school attendance, fears the return of vaccine-preventable infections, and believes recent vaccine policy changes will harm children’s health.

How experts and institutions have pushed back

Prominent experts and professional organizations in public health and clinical medicine — including pediatrics, general adult medicine, obstetrics and gynecology, and infectious diseases — have taken strong public stances opposing the administration. Notably, the American Academy of Pediatrics, a longstanding partner and adviser to the Centers for Disease Control and Prevention on childhood vaccines, just published its own independent pediatric vaccine schedule for 2026. At the bottom of the webpage is a pointed note that the CDC has a different vaccine schedule that “is not currently endorsed by the AAP.”

While the pharmaceutical and biotechnology industry has been largely muted in its public statements, one notable exception is Pfizer CEO Albert Bourla. Speaking at the World Economic Forum in Davos in January, Bourla called Kennedy’s rhetoric and policies on vaccines “anti-science” and described his opposition to vaccines as being “almost like a religion.”

The strongest institutional pushback is coming from states. Fifteen states just filed suit against HHS to reverse the administration’s decision to reduce the number of diseases children are routinely immunized against from 17 to 11. The lawsuit also challenges the “unlawful replacement” of members of the Advisory Committee on Immunization Practices and asks the courts to nullify Kennedy’s January revision to the childhood vaccine schedule.

As researchers at Georgetown University’s Commonwealth Fund document, states are working to delink their vaccine and preventive care standards from federal entities that they no longer trust. States are joining together in regional scientific bodies to independently review vaccine evidence and publish their own recommendations. An umbrella organization, the Governors Public Health Alliance, has been created to coordinate across the different regional state coalitions.

Are there positive signs in vaccine policy?

I have some hope that the pushback from experts, professional societies, industry, and states is working. Here are a few important signs from the past month.

On Feb. 11, the Food and Drug Administration surprised the pharmaceutical and biotechnology world with an unprecedented “refusal to file” response to Moderna’s application for an mRNA flu vaccine. Then, a few days later, the FDA suddenly reversed that decision. The FDA’s reversal on Moderna’s vaccine has been widely attributed to White House pressure on the FDA, suggesting that even within an administration that is skeptical of vaccines, they are still reluctant to block vaccine companies from even having their products reviewed by FDA.

The CDC’s ACIP meeting originally scheduled for February has been postponed to March 18, and the agenda is, to say the least, unusual. Rather than proposing revisions to the vaccine schedule, reviewing the efficacy of existing vaccines, or reviewing new vaccines, the ACIP meeting will focus instead on the methodology of how ACIP makes recommendations, on Long Covid, and on vaccine injuries. That is a meaningful retreat from where this panel was six months ago.

The administration also suffered a loss in its effort to find data to support its opposition to the hepatitis B vaccine. A few months ago, the administration directed the CDC to fund a randomized controlled trial of birth-dose hepatitis B vaccine in Guinea-Bissau conducted by the University of Southern Denmark. The protocol proposes to withhold the vaccine from half of 14,000 newborns in Guinea-Bissau, where nearly 20% of people already carry chronic hepatitis B infection and where up to 90% of babies exposed to the virus at birth will go on to develop chronic infection.

The World Health Organization called withholding the vaccine from newborns in Guinea-Bissau “serious and potentially irreversible harm” and raised significant concerns about the study’s scientific justification and ethical safeguards. The government of Guinea-Bissau announced last week that it would not permit the trial to go forward. “It’s not going to happen, period,” the country’s foreign minister told Reuters.

And, perhaps most remarkably, the CDC’s recently appointed principal deputy director, Dr. Ralph Abraham, abruptly resigned after less than two months on the job. Abraham is a prominent skeptic of vaccines and his appointment seemed to signal that the agency was going to completely realign itself in opposition to vaccines. After assuming his position, Abraham shocked the public health community by saying that the ongoing measles outbreaks, including child deaths, and the loss of the United States’ measles elimination status was, in his words, the “cost of doing business.”

Abraham’s departure leaves the CDC without a permanent director or deputy director. (The administration has taken the unusual position of appointing NIH Director Jay Bhattacharya also to be the acting director of the CDC, a move that Yale public health professor and activist Greg Gonsalves says means he can now “do two jobs terribly.”)

U.S. immunization programs face death by a thousand cuts

While I am optimistic that the vaccine rollback is slowing, I am fearful of the damage that’s already been done. Even if HHS slows down or halts future anti-vaccine efforts, the administration has already pursued a “death by a thousand cuts” strategy: defunding basic vaccine science and clinical trials, raising the regulatory bar for FDA approval, stocking advisory committees with self-described anti-vaxxers, and cutting resources for public education and outbreak response.

The damage from 2025 will not be undone by a midterm-driven political pivot. While many states are doing heroic work to preserve vaccine access, some states are moving in the opposite direction, adopting their own anti-vaccine statutes that could outlast any particular administration.

In 2026 and beyond, we are likely to be left with fewer vaccines in development, uneven standards from state to state, confused providers and patients, and the slow erosion of the unified national infrastructure that once made the U.S. childhood immunization program the envy of the world.

Wishing you a healthy week,

Jay

How milder winters are luring mosquitoes – and the diseases they carry – beyond the ‘tropics’

2026-02-26T12:00:00+00:00

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Hello from Nairobi.

This week’s news is heavy on drug trials and some groundbreaking scientific research – two subjects I try to cover cautiously, because scientists, research institutions, and others have incentives to hype early findings. Anyhow, in global health terms, it is a good issue to be grappling with. It means there wasn’t some new outbreak I had to research.

With that, as we say in Swahili: karibu katika habari — welcome to the news.

Mainland Europe: a mosquito’s tropical getaway?

There’s a whole rogues gallery of tropical, mosquito-borne diseases that have long been relegated to the warmer and poorer parts of the world. For example: malaria, dengue, Zika, and chikungunya virus.

But global warming and roving mosquitos are rapidly blowing up the traditional boundaries of what counts as “tropical.” A new study in the journal Royal Society Interface finds that many of these diseases can now be transmitted by mosquitoes across most of southern and central Europe, The Guardian reports.

To be clear, the study isn’t just a speculative forecast. For some of these diseases, the shift has already happened.

Take chikungunya. “Up until last year, France had recorded 30-odd cases of chikungunya over the last 10 years or so. [In 2025], they had over 800,” said Steven White, one of the scientists at the UK Centre for Ecology and Hydrology that was behind the new study.

Disease breakdown: Chikungunya (a particular focus of the new study) is a virus first identified in Tanzania in the 1950s. Its name means “that which bends up,” a nod to the symptomatic contortions caused by terrible joint pain and fever. Although there’s no cure, death is rare, with fewer than 1 in 1,000 perishing from the illness. The real cost is in long-term pain: chronic arthritis that can last for months or years.

One of the study’s most unsettling findings for chikungunya was that the virus can incubate inside the increasingly invasive Asian tiger mosquito at much lower temperatures than previously believed. Specifically, “the study found the cut-off temperature for transmission is 13 degrees C - 14 degrees C,” or about 55 to 57 degrees F.

That dramatically expands the map of where outbreaks are possible, “meaning infections can occur for more than six months of the year in Spain, Portugal, Italy, and Greece, and for three to five months of the year in Belgium, France, Germany, Switzerland, and a dozen other European countries.”

What’s the takeaway?

First, it’s increasingly hard to see the northern spread of these tropical diseases (across North America, too) as anything but inevitable. As winters grow milder and warm seasons stretch longer, the conditions that allow these viruses to circulate are expanding … and exponentially!

I reached out to Flavia Riccardo, an independent infectious diseases researcher at the Italian National Institute of Health. She shared a recent study she co-authored that adds an important nuance. For now, the main risk is not these viruses becoming permanently established in Europe. It is infected travelers bringing them in during mosquito season, and triggering local outbreaks that can flare out of control.

My second takeaway is this: If there’s a morbid upside, it may be that once these diseases begin affecting wealthier countries, they could finally attract the sustained research funding and political urgency they need.

Guinea-Bissau stomps out a controversial vaccine trial

Last week, I mentioned in passing that World Health Organization Director-General Tedros Ghebreyesus publicly condemned a controversial U.S.-funded vaccine study on infants in the West African nation of Guinea-Bissau. Now, the country has shut it down, Reuters reports.

Guinea-Bissau’s foreign minister ultimately said, “It’s not going to happen, period,” after scientists, health bodies, and U.S. lawmakers raised alarms.

The trial, backed by the U.S. Centers for Disease Control and Prevention, would have tested the timing of the hepatitis B vaccine in newborns. Some “critics had said it was being used to test theories linking vaccines to autism,” and others (including the WHO chief) decried it as unethical because only half of infants would receive the life-saving shot at birth.

The threat here is clear: “90% of babies exposed to hepatitis B at birth or in their first year of life develop a chronic infection, and 15% to 25% of these die early of related liver failure or cancer as a result.”

To be perfectly fair to the researchers, “under the [proposed] trial, half the infants would receive [the vaccine] at birth,” and “the remainder at 6 weeks,” which is when infants normally receive the vaccine in the formal health care system in Guinea-Bissau. So the researchers hadn’t planned on taking anything away from vulnerable infants. The African nation “plans to introduce the dose at birth only in 2028.”

Still, at 6 weeks, “many infants whose mothers have hepatitis B are already infected,” and as I wrote last week: It is just hard to imagine a similar trial within the United States surviving legal/ethical challenges.

Magic mushrooms go mainstream

Magic mushrooms are having a bit of a clinical moment.

Compass Pathways, a British pharmaceutical company, announced that its synthetic psilocybin (which is the psychoactive chemical found in magic mushrooms) treatment hit its “major goals” in a large, late-stage trial for hard-to-treat depression, Reuters reports.

The report says that the company now plans to meet with the U.S. Food and Drug Administration and could seek approval for the treatment as early as 2027. (Keep in mind, this would be the first approved psychedelic therapy cleared in the United States.)

What’s my takeaway? Before we all start penciling psychedelics into the next generation of antidepressants, I’d strongly recommend reading this thoughtful essay published in STAT last week.

Erica Rex, a writer who participated in an early magic mushroom trial, warns that the rush to commercialize psychedelics is stripping away the therapy, community, and careful supervision that made those early studies feel safe and transformative. She argues that the drug alone is not the treatment. And profit incentives may directly clash with the slow, human elements that made psychedelic therapy work for her.

A ‘clock’ for Alzheimer’s symptoms

A new study published in the research journal Nature Medicine suggests we may soon be able to do something Alzheimer’s researchers have long dreamed of: Detect Alzheimer’s disease early and estimate when symptoms will begin, the Washington Post reports.

The study describes how to use blood draws to “build a ‘clock’ for Alzheimer’s disease that could roughly predict when symptoms will develop.” The core of the work revolves around tracking the levels of “one specific protein, called p-tau217,” in the blood.

This protein is important, because it is a hallmark sign that Alzheimer’s has started. More specifically, it shows that “clumps of misfolded proteins called amyloid plaques [have] begun to build up in the brain.”

Now just measuring that protein in blood draws isn’t enough on its own.

The bloodwork data has to be fed into a computer model that contains information about the patient, such as their age, which is then used to “forecast symptom onset within a margin of three to four years.”

So, yeah… it’s a wide error range. And practically speaking, this kind of prediction isn’t precise enough yet to guide individual treatment decisions.

But (and here’s the important part!) it could matter enormously for the potential, future use of novel drugs. That’s because two big Alzheimer’s studies underway are testing if newly developed “anti-amyloid” drugs can slow or prevent the disease if they’re given early enough.

If those drugs truly work best early, then knowing when “early” begins would be incredibly important.

The quest for a universal vaccine

I want to tread very, very carefully here. This next story is genuinely fascinating, but I’ve covered enough “breakthroughs” to know how easy it is to get carried away. The bigger the claim, the more skepticism we should hold.

The journal Science has just published a paper describing a provocative new approach to developing a “universal vaccine,” the BBC reports. That is, a vaccine that doesn’t just target one virus, but puts the entire immune system on high alert against many.

The paper is not theoretical. Stanford University scientists developed a nasal spray vaccine that they tested on mice against infections that attack the lungs. The end result was a “three-month effect” in which the mice’s immune systems were in a “heightened state of readiness” that “led to a 100- to -1,000-fold reduction in viruses getting through the lungs and into the body.”

This included effective immunity against a medley of cold and flu viruses, among other would-be invaders.

That is big news! So what’s the actual science here? To understand it, it helps to step back and look at what traditional vaccines are actually designed to do.

Traditional vaccines all use different strategies to teach the immune system to recognize a specific virus or bacteria. This is done by either by exposing the body to a weakened, dead, or fragmented germ … or by delivering instructions for the body to make a harmless piece of it (this last one is the new mRNA method, developed during the Covid-19 pandemic.)

This even newer approach is totally different. Instead of teaching the immune system to identify attackers, the vaccine artificially mimics the signals “immune cells [use to] communicate with each other” in the midst of an infection. Normally, when an infection begins, immune cells send out chemical signals that trigger a system-wide defensive response. And when on high alert, immune cells become more active and better able to contain invading viruses or bacteria.

This vaccine recreated that early alarm. It did this by introducing a molecule that flips the sensors inside some immune cells, pushing them into that heightened state of readiness.

Yes, it absolutely does sound like an incredible breakthrough. So … let’s move on to my beloved caveats.

First: This has not been tested in humans. It worked on mice, which is not nothing, but many, many fascinating mouse studies have failed to translate into people.

Second: The researchers now have to run the clinical trial gauntlet. That starts with Phase 1 trial to test safety, Phase 2 to figure out dosing and immune response, and Phase 3 to see whether it actually works in large numbers of people. Historically, only about 10% of drugs that start these trials end as an approved drug. Most are found to be unsafe or ineffective. Even at Phase 3, roughly half still fail.

Still, it’s promising.

I’ll see you next week!

William

William Herkewitz is a reporter covering global public health for Healthbeat. He is based in Nairobi. Contact William at wherkewitz@healthbeat.org.

Huge S.C. measles outbreak slows, fueling cautious optimism it may end earlier than predicted

2026-02-25T21:56:44+00:00

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South Carolina’s huge measles outbreak has slowed significantly in recent weeks, raising hopes among health officials that the disease’s spread might end sooner than expected, the state’s epidemiologist said Wednesday.

Since Feb. 17, the South Carolina Department of Public Health has documented 17 new measles cases. That’s far fewer than the 100 or more new cases being identified every few days during mid-January, when the outbreak spiked following the winter holidays.

“We’re encouraged with the downward trend, particularly in the last two weeks,” said Dr. Linda Bell, who has been leading the state’s response since the outbreak was identified in October with an initial five cases.

Since then, 979 people – mostly school-age children – have been sickened with measles. All but 52 of the cases have been in Spartanburg County; about 95% have been among people who were not vaccinated.

“No one should underestimate the hard work and long hours that front-line, often entry level epidemiologists have put into this response, and [who] are largely responsible for this downward trend that is actually occurring a bit earlier than previously projected,” Bell said.

Earlier in the outbreak, Bell said that modeling had suggested the outbreak might last for as long as six months.

“The case counts per week now are really down to the level that we were seeing at the beginning of December,” she said. “We are now 22 weeks into this and we hope, with that continued downward trend, in parallel to the hope that vaccination coverage will increase, will help us end this sooner than was originally projected.”

Bell said the department has asked the Centers for Disease Control and Prevention to assist the department in the coming weeks to do studies to help learn from the outbreak, including studies that examine chains of transmission and the costs associated with the public health response to the outbreak, as well as health care costs.

Officials remain concerned, however, that the outbreak has the potential to spike yet again. “This is not over yet. It’s not nearly over yet,” Bell said. “It is these pockets of under-vaccinated people who remain susceptible. That ongoing susceptibility in our population may continue to fuel ongoing spread.”

To stop measles outbreaks from spreading in localized communities, at least 95% of people need to be vaccinated. But in Spartanburg County, state health officials have said measles vaccination rates for school children across the county are just 90% – and they are even lower within some individual schools and communities.

“Many of the schools in Spartanburg County have some of the lowest vaccination coverage rates in the state,” Bell said. “So all of those are contributing to the reason that the outbreak has been focused in Spartanburg County, because of higher risk there, because of lower coverage.”

This is also a likely contributing factor for why measles cases identified recently in a few other South Carolina counties haven’t spread widely in those locations, Bell said. Of the 979 cases in the South Carolina outbreak, 927 involve people in Spartanburg County.

“Even if we are only seeing a dozen or so cases per week, the risk we can surge remains,” Bell said.

Bell noted that schools will be going on spring break in the coming weeks, bringing with it the risk of people who have been exposed to measles becoming infectious and spreading the disease to others at tourist attractions and while traveling. “This is a great concern,” she said.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

Chaotic federal vaccine committee meeting: It’s off, now it’s on again. But still no word on agenda.

2026-02-24T20:53:32+00:00

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The federal Advisory Committee on Immunization Practices now plans to meet March 18 and 19, according to updated information posted on the committee’s website at the Centers for Disease Control and Prevention.

No information had been posted Tuesday about what topics or votes will be on the meeting’s agenda, how the public can comment on agenda items, or even what time the meetings will start and end.

The committee, which meets three times a year, had long planned to meet this Wednesday through Friday in Atlanta. But as the meeting date approached, the committee failed to make public – as required – its planned agenda, jeopardizing its ability to meet legally, Healthbeat reported last week.

The cancellation also followed efforts in a lawsuit filed by the American Academy of Pediatrics and other medical groups that have sought to stop the group’s next meeting because of concerns that ACIP will take a vote that will result in removing funding for certain vaccines for children from low-income families or who lack adequate insurance.

Officials at the CDC and the U.S. Department of Health and Human Services did not immediately respond to questions about the rescheduled meeting.

Federal advisory committees are required to give the public advance notices about their meeting agendas and other basic information about how the public can attend or watch the meetings. Historically committees were required to give at least 15 calendar days notice before a meeting, but in December the Trump administration reduced that to seven calendar days.

On Tuesday, the American Academy of Obstetricians & Gynecologists announced that it was withdrawing as a liaison member of the vaccine advisory committee, citing an array of concerns, including what it said was ACIP’s cherry-picking of data and unilateral changes to childhood and adolescent vaccination schedules without expert input.

“The recent reconstitution of the committee; the removal of ACOG experts from ACIP workgroups; and HHS’ unilateral changes to vaccine recommendations, which bypassed established scientific and clinical processes, represent a fundamental departure from the scientific rigor and impartiality that have been the hallmark of this committee for 60 years,” said ACOG President Dr. Steven J. Fleischman.

The committee had all of its scientific advisers replaced last summer by HHS Secretary Robert F. Kennedy Jr.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

CDC vaccine advisory committee ‘in violation’ of public meeting rule cancels next week’s sessions

2026-02-20T00:21:24+00:00

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A controversial federal vaccine advisory committee has canceled a planned meeting next week, a spokesperson for the U.S. Department of Health and Human Services said Thursday.

The cancellation of the meeting of the Advisory Committee on Immunization Practices came after the committee failed to make public – as required – the details of its planned agenda for next week’s sessions, which raised questions about whether the meeting could legally occur, Healthbeat reported Wednesday.

It also follows efforts by the American Academy of Pediatrics and other medical groups to have a federal court in Massachusetts stop the ACIP meeting, court records show. The medical groups, which are suing HHS over changes made in January to the childhood vaccination schedule, told the court it feared the group would take a vote at the meeting that would remove funding for certain vaccines for children who are from low-income families or lack adequate insurance.

HHS spokesperson Andrew Nixon would not elaborate on why next week’s meeting was canceled. “We will not hold the ACIP meeting later this month,” Nixon said in a brief statement Thursday. “Further information will be shared as available.”

The American Academy of Pediatrics and other medical groups, in court filings this week, said that they anticipated the ACIP would be voting at its February meeting to downgrade from “routine” to “non-routine” several vaccines that are no longer routinely recommended under the contested January vaccine schedule. Such a vote, the groups said, would cut off access to hepatitis A, hepatitis B, rotavirus, influenza, and meningococcal vaccines to children who rely on the federal Vaccines for Children program to pay for their immunizations.

The medical groups noted to the court that although no agenda had been posted for the ACIP meeting, the committee Vice Chair Robert Malone had publicly written on his Substack about how “the ACIP will need to vote during their next meeting to approve language aligning the Congressionally mandated Vaccines for Children Program [VFC] with the new schedule.”

Lawyers for HHS on Wednesday countered that concerns the vaccines would be removed from the Vaccines for Children program were “purely speculative.” On Thursday they filed a notice with the court saying that the ACIP meeting, which had been scheduled for Feb. 25-27, had been “postponed” and that the committee would not be meeting in February.

The committee – which in its last meeting made significant changes to the childhood vaccine schedule – had not made public its agenda or other key details for the meeting next week at the Centers for Disease Control and Prevention, despite federal requirements.

“Legally, I believe that HHS is in violation of federal law,” Lawrence Gostin, Founding O’Neill Chair in Global Health Law at Georgetown University, told Healthbeat on Wednesday. “But Secretary Kennedy has long been flouting federal law, especially when it comes to good governance, transparency and administrative practice.”

Officials from HHS and the CDC did not answer questions about why no meeting notice and agenda information had been posted in the Federal Register or on the ACIP’s website before Wednesday.

The committee – which last summer had all of its scientific advisers replaced by HHS Secretary Robert F. Kennedy Jr. – has become a front line in the political, cultural, and scientific war over vaccines. During its last meeting, in December, Republican U.S. Sen. Bill Cassidy, a Louisiana physician, called the committee “totally discredited” for seeking a briefing from a lawyer and vaccine critic with ties to Kennedy.

The late cancellation of the upcoming ACIP meeting is just the latest controversy for the group.

Federal advisory committees historically have been required to let the public know about their meeting agendas and other basic information at least 15 calendar days in advance of the meeting. In December, the Trump administration reduced the advance notice to at least seven calendar days before a meeting. Wednesday was seven days before the ACIP meeting date listed on the CDC website.

Federal rules require that the public be told – through a posting in the Federal Register – details such as the time and location of the meeting, how to attend electronically, and whether registration is required for attendance. The rules also called for the committee to post a summary of the agenda, topics to be discussed, and instructions for how to access meeting materials, as well as how the public can comment in writing or in person.

The only way a committee can give less than seven days of notice, the rules say, is “if the President determines this is necessary for reasons of national security, or if the head of an agency determines this is necessary due to exceptional circumstances,” with the reasons being included in the Federal Register meeting notice.

“These meetings are one of the few opportunities for the public to make their voices heard,” said Michaela Jackson, program director for prevention policy at the Hepatitis B Foundation. “When notice comes too late, people lose the chance to share their experiences and help shape policies that directly affect their health, their families, and their communities.”

Jackson said it takes significant research for stakeholders to prepare for ACIP meetings. “Contributors want to present the strongest evidence available to support our positions, but it is extremely difficult to craft meaningful or relevant comments when no agenda or list of topics is provided in advance.”

Gostin said the lack of required public notice for the ACIP meeting ran afoul of both the Federal Advisory Committee Act and the Administrative Procedure Act. He said the public should care because it’s important to have thoughtful public input into government decisions – such as vaccine policy – that will impact people’s lives.

“Advance notice and comment are the hallmarks of transparency, good government, and democracy,” Gostin said. “Without advanced notice and an opportunity to comment, major stakeholders cannot weigh in and feel as though they are left in the dark, which they are.”

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48.

S.C. measles cases surged after holiday school closures delayed outbreak investigations

2026-02-17T10:00:00+00:00

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South Carolina’s state health department faced a significant problem in the critical weeks before the state’s measles outbreak surged in January.

As schoolchildren continued to fall ill with measles in late December, outbreak investigators needed help from schools to get contact information for the classmates, staff, and others who had been exposed. They needed to be warned quickly so they wouldn’t spread the virus to others if they were infected.

But schools were closed for their two-week winter break. Nobody was available at most schools to provide the information health officials needed, according to South Carolina’s state epidemiologist and records obtained by Healthbeat.

This communication gap between the South Carolina Department of Public Health and schools in Spartanburg County – the outbreak’s epicenter – resulted in delays quarantining people who were at risk of unknowingly spreading the highly contagious disease. An infected person is contagious beginning four days before the tell-tale measles rash appears.

At the same time, the state health department was grappling with its own holiday staffing challenges, according to the internal DPH outbreak reports that Healthbeat obtained under South Carolina’s public records law.

While the number of measles cases grew in December, the number of DPH staff assigned to combat the outbreak dropped. The internal DPH reports repeatedly note concerns about holiday staffing, workloads, burnout, the availability of backup staffing, and “limited support due to workforce reduction in April 2025.”

Only after New Year’s Eve did outbreak staffing begin to increase significantly, records show.

Dr. Linda Bell, the state epidemiologist who is leading South Carolina’s outbreak response, said that despite challenges, public health staff “worked diligently throughout the holidays.”

“DPH made many efforts to reach impacted schools over the holidays with limited success because the schools were closed,” Bell said in written responses to Healthbeat’s questions.

By early January, the South Carolina measles outbreak surged to become one of the largest in the United States in decades.

“It’s impossible to know exactly what impact school closures and the resulting delays had on the spike in cases,” Bell told Healthbeat.

However, the delays hampered one of the department’s key strategies for slowing the virus’ spread: Rapid identification and home quarantine of exposed children and adults who were at risk of developing and further spreading the disease because they aren’t vaccinated.

“Our inability to get contact information for potentially exposed students and notify those families resulted in some people being out and about in the community without knowing that they were infectious,” Bell said. “The consequences being new cases due to additional exposures from people who would have otherwise been in quarantine had we been able to make contact.”

This occurred during a time of increased socializing over the holidays, she noted.

It usually takes a week to 12 days, and sometimes as long as three weeks, for people infected with measles to start showing symptoms. The virus spreads through the air when a contagious person breathes, sneezes, or coughs.

Before Spartanburg County schools closed for winter break on Dec. 22, the state health department had logged 144 measles cases since the outbreak began in early October, state data show. In the three weeks after schools reopened during the week of Jan. 5, outbreak investigators were chasing after more than 500 new cases of measles.

The outbreak continues to grow, reaching 950 confirmed cases in South Carolina as of last week, a tally that doesn’t include cases sparked in other states.

School officials with Spartanburg County’s District 2 and District 6, whose elementary schools were among those with delayed exposure investigations during winter break, have declined repeated requests from Healthbeat for interviews or information about their procedures for providing time-sensitive public health information during extended school break closures.

Both districts have had multiple measles exposure incidents in their schools since the outbreak began last fall, requiring dozens of students to be excluded from class due to quarantines.

What happened in South Carolina is a cautionary tale for health departments and schools across the United States – especially as measles makes a resurgence amid declining vaccination rates. So far this year, at least 24 states have reported measles cases to the Centers for Disease Control and Prevention.

In the coming weeks, schools across the country will be closing again for spring break.

“I just want to emphasize how normal Spartanburg is,” said Scott Thorpe, executive director of the nonprofit Southern Alliance for Public Health Leadership, noting that the pockets of low vaccination rates that have fueled the South Carolina measles outbreak are also common in other communities. “I hope that everybody is really preparing for this, because I don’t think it’s going anywhere anytime soon.”

With some communities having multiple school districts plus numerous private schools, Thorpe said that strengthening lines of communication between public health and schools takes time. “To try to figure out how to interact successfully in all these circumstances, in a crisis situation, is really hard,” he said.

School nurses, staff often not paid to work over breaks

Pat Endsley, president-elect of the National Association of School Nurses, said school breaks can pose a special challenge for health departments doing infectious disease contact tracing because school nurses and other staff often aren’t being paid to work during those periods – and they may even be traveling out of town.

With every state operating differently, Endsley said she’s not aware of any national best practice for addressing school contact tracing for measles during extended school break periods. A lot of the best practices were written specifically to address the emergence of the Covid-19 pandemic, she said.

“The gold standard would be to have some kind of person who is at the school, who’s not going anywhere, who could have access to information,” said Endsley, who served as a school nurse in Maine for 23 years and now teaches full time.

“Maybe that’s something that would come out of South Carolina, or Texas, or these other places with measles,” she said. “Based on this information, we could develop some exemplars of communication.”

How the South Carolina measles outbreak grew from 5 to over 900 cases

In at least some communities, health departments have found ways to ensure measles exposure investigations aren’t thwarted by school breaks.

Health officials battling another large measles outbreak along the Utah-Arizona border said they had no difficulties reaching impacted schools over the recent winter break.

“Our epidemiologists report that contact tracing and other issues involving students ran uninterrupted over the winter holidays, mainly due to frequent communication with an established point of contact with our largest school district,” said David Heaton, a spokesperson for the Southwest Utah Public Health Department. The school contact was available to help over the holidays, Heaton said.

Dani Lagana, a spokesperson for the Mohave County Department of Public Health in Arizona, said the department’s measles response activities are not dependent on school calendars.

“Effective contact tracing in school-associated cases relies on established communication protocols and coordination between public health and education partners,” Lagana said by email. “Health departments routinely plan for coverage during holidays and breaks to ensure appropriate notification and follow-up when needed.”

It’s unclear why – before winter break closures began – similar arrangements weren’t put in place between the South Carolina DPH and schools in Spartanburg County.

“DPH cannot direct school employees to come to work to assist with outbreak investigations,” the South Carolina department said in an emailed statement to Healthbeat.

The department said it has contact lists for school administrators, but these administrators may not have access to the detailed information outbreak investigators need when schools are closed.

“Comparisons of response activities from one jurisdiction to the next should be made with caution,” the state health department said. “Each jurisdiction has unique circumstances including differences between centralized vs. autonomous county public health agencies.”

Winter break delays in investigations of measles exposures occurred at Boiling Springs Elementary, where 80% of students are up-to-date on vaccines.

In South Carolina, public health activities are centralized and provided by state DPH employees at offices across the state. Arizona and Utah, have multiple local health departments covering a single county or multi-county region, in addition to state health departments.

Healthbeat asked each of Spartanburg County’s seven public school districts whether they had any policies or procedures that would specifically enable rapid sharing of student contact information during holiday breaks with public health officials who are trying to control infectious disease outbreaks. None of the districts provided answers to these questions.

Schools play an important role in helping public health investigators quickly determine which students, teachers, staff, and visitors may have been exposed to the infected individual. Not only does measles spread through the air, the virus can linger in a room for two hours after the contagious person has left.

School staff can provide health investigators detailed information about the movements of an infected student – and who was around them while they were contagious – by going through class schedules and rosters of those participating in extracurricular activities and riding on school buses. They also know which students lack immunity to measles because school records show which ones have exemptions from vaccine requirements for medical or religious reasons.

Rapid notification of at-risk individuals is critical, health officials say, so they know to quarantine at home and watch for early signs of measles that might otherwise be mistaken for a cold or the flu. In the four days before measles’ hallmark rash appears – and the person is already contagious – their earliest symptoms are typically a fever, cough, runny nose, and red, watery eyes.

“I definitely can see the issue that DPH had during winter break with schools closed two to three weeks, and no way to do that school notification, contact trace, get information from nurses,” said Dawn MacAdams, president of the South Carolina Association of School Nurses. “But then you run into: nurses don’t get paid during that time.”

MacAdams said that during Covid, school nurses faced overwhelming workloads and long hours helping with contact tracing without being paid for the extra work. “Nurses were working Christmas Eve, Christmas Day, New Year’s because the numbers were exploding and the guidance was changing,” she said.

MacAdams said she’s not sure what the solution is for ensuring timely contact tracing of school-associated measles exposures when schools are closed.

“That’s a really good question to think about with DPH on what are the things we can do,” she said. “Most spring breaks are somewhere the first or second week of April this year. So we’re going to be in another desert of the availability of school personnel to provide information.”

Records show quarantine delays at five Spartanburg schools

Internal South Carolina DPH reports show there were delays during winter break notifying and quarantining people who had been exposed to measles at three public schools, one public charter school, and one private Christian school.

For the exposure incidents at these schools, the department’s internal daily outbreak summary reports during winter break repeatedly listed that health officials were reaching out to the facilities or that the status of quarantine actions were still “TBD” – or to be determined.

It’s unclear how many exposed students and staff weren’t contacted quickly because these schools were closed. “Parsing out all those we were working to reach, whether students or others, during that time when cases were surging is not possible,” Bell said.

Measles investigation and quarantine delays occurred at Global Academy of South Carolina, a public charter school where only 21% of students are up-to-date on required school vaccines.

One of the schools where winter break investigation and quarantine delays occurred is Global Academy of South Carolina, a public charter school where only 21% of students are up-to-date on required school vaccines, including the measles, mumps and rubella shot. To prevent measles outbreaks, 95% coverage is needed.

It took Global Academy until Jan. 9 to provide outbreak investigators with a requested “line list” detailing the names and contact information for exposed students and staff, the DPH documents obtained by Healthbeat show. The school’s winter break was Dec. 22-Jan. 2.

“Global Academy finally provided a line list yesterday, and we are going through it,” a DPH official said in a Jan. 10 email updating the South Carolina governor’s office on the outbreak response.

The school’s principal, Mark Robertson, did not answer Healthbeat’s questions and told a reporter to contact DPH.

Global Academy was one of the first two schools to have confirmed measles cases when the outbreak began in early October. The school has had repeated rounds of students being quarantined and excluded from class.

Other schools that had delayed winter break investigations of measles exposure incidents included large public elementary schools in Spartanburg County School Districts 2 and 6, the records show. Throughout the outbreak, the district’s schools have had exposure incidents requiring students to quarantine, state records show.

In District 2, winter break delays occurred in investigations of exposures at Sugar Ridge Elementary, where state data show 78% of students are up-to-date on school vaccines, and at Boiling Springs Elementary, where 80% of students are up-to-date on vaccines.

In District 6, the delays also occurred at Jesse S. Bobo Elementary School, where state data show 94% of students are up-to-date on school vaccines.

Officials with both districts have declined repeated requests from Healthbeat since Jan. 9 for interviews or answers to specific questions about the outbreak’s impact on student health, as well as the circumstances surrounding the exposure investigation delays over the winter break.

Health officials’ efforts to get complete exposure contact information from one school were so protracted coming out of the winter break that they were preparing to issue a formal public health order to force compliance. The school says it promptly provided information.

Maternity unit, BMW plant among groups exposed in South Carolina measles outbreak, records reveal

In January, the state health department issued a “final notice letter” to Westgate Christian School in Spartanburg because of the school’s continued “noncompliance,” Healthbeat reported earlier this month. The school was closed for its Christmas break from the afternoon of Dec. 19 through Jan. 2.

Outbreak investigators had been asking for contact information for exposed students and staff since Dec. 29, Bell said. A list that the school provided on New Year’s Eve was deemed “insufficient.”

When Westgate Christian’s break was over and the requested information still hadn’t been provided, Bell said the department issued a “final notice” to the school on Jan. 9. The letter warned that if the information wasn’t received by 1 p.m. on Jan. 10, the department “would issue a Public Health Order pursuant to S.C. Code § 44-1-140 compelling compliance.”

The issue was resolved the next day when the school provided the requested information, Bell said.

Pastor James Wooten, Westgate Christian’s president, said that until the school’s administrator received the “final notice” email – at 5 p.m. on Friday, Jan. 9 – she thought the health department had been provided everything it needed on Dec. 31.

“Other than a thank you acknowledging receipt, she received no further correspondence or request for information until the final notice warning,” Wooten told Healthbeat last week. School officials wonder why, if outbreak investigators needed more information, “they didn’t simply reply to the email and request it,” Wooten said.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

A warning on the price of aid cuts: 9.4M preventable deaths

2026-02-12T12:00:00+00:00

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Hello from Nairobi.

It’s been an interesting week. On Tuesday I joined a panel hosted by the American Foreign Service Association to talk about why taxpayers across Western countries don’t see the benefits of aid, or really see its reduction or absence either. It was a great chat, and on a topic I can’t help but be annoyingly sincere about!

This week we have a few stories that feature philanthropies, which are a small but increasingly important part of global aid, especially as Western government funding continues to shrink.

My name is William Herkewitz, and I’m a journalist based in Nairobi, Kenya. This is the Global Health Checkup, where I highlight five of the week’s most important stories on outbreaks, medicine, science, and survival from around the world.

With that, as we say in Swahili: karibu katika habari — welcome to the news.

9.4 million: the death toll of aid cuts

The science journal The Lancet Global Health just published a rigorous analysis on how last year’s global aid cuts are translating to deaths, reports the (sadly beleaguered) Washington Post.

The topline? Staying the course, we should expect about 9.4 million additional preventable deaths through 2030.

If aid funding drops even further, the researchers say that deaths could easily rise to 22.6 million; roughly equal to the entire death toll from WWI. (To be clear, I’m internalizing this more severe scenario as a warning, rather than an earnest forecast.)

We’ve previously covered models that have pointed in this direction, but this new paper is the most comprehensive yet. It was also partially funded by a philanthropy, the Rockefeller Foundation, which I reached out to. After all, as aid contracts, the funding that hasn’t retreated is more important than ever.

Eric Pelofsky, the foundation’s vice president for global economic recovery, spoke with me about the findings and about how philanthropies like his see their role in this moment.

First off, “the takeaway here is that any sort of assertion that this aid reduction could be done without [a high] cost of human life is just not grounded in the facts,” Pelofsky told me. He also stressed the immediacy of the findings. “If you came away thinking this is a problem that we can deal with in four years, I think the answer is absolutely not. The urgency is too great,” he said. We are, after all, talking about over 9 million human lives.

Where do philanthropies like the Rockefeller Foundation fit in this moment?

First, at the big-picture level, it’s worth remembering that only about 5% of humanitarian and development aid comes from private philanthropy. So, after last year’s cuts, “even if we were all to drop everything and try to fill the holes, we couldn’t do it,” Pelofsky said.

Instead Pelofsky sees their advantage right now elsewhere: in taking risks governments won’t with taxpayer money, backing analysis (like this paper), and working at financial plumbing of global development, rather than just writing checks. This includes “incredibly boring and incredibly important,” work like what his foundation has done to help development banks restructure their balance sheets so they can get more money out the door where it’s needed.

Still, Pelofsky was clear: They’re facing the same hard tradeoffs as everyone else, weighing what needs desperate attention right now against “where our dollar can make the biggest impact.”

Can philanthropy save us?

On this very topic … the world’s biggest philanthropy is likewise signaling that it can not play savior. The Gates Foundation told the AP it will “not change course in the face of massive foreign aid cuts.” (Disclosure: The Gates Foundation funded the launch of Healthbeat).

Instead, the foundation’s CEO Mark Suzman said the foundation will focus at least 70% of its money toward preventing maternal and child deaths and fighting key infectious diseases, while trimming or winding down other lines of work. “Not only will we not be taking on new priorities, we’re actively narrowing our priorities,” he said.

Why? As we discussed with Pelofsky, the scale of aid cuts simply does not allow even the best funded foundation to replace vanished government aid, and this is the Gates Foundation’s acknowledgement of that reality.

Second, Suzman says they are choosing to concentrate where they think the life-and-death returns are clearest. This means winding down less-urgent programs like ones “that aimed to give more people in sub-Saharan Africa and South Asia access to digital financial services.”

My takeaway? The Gates Foundation is betting that we will not see a quick rebound in aid generosity. They are planning for a world where the active threat is … 9.4 million additional preventable deaths by 2030.

A resurgence of cholera … vaccines!

A little background here: About four years ago, cholera vaccine production shrank to just one producer in South Korea. With a vanishing supply, this effectively brought pre-emptive global vaccination to a halt. (Countries could use what little was left to react to outbreaks, rather than trying to prevent them.)

The vaccine shortfall helped fuel a resurgence of cholera in Africa, which as we reported in October, became the worst outbreak on the continent in about 25 years.

Disease breakdown: Cholera is a bacterial infection that infects up to 4 million people each year. Because it largely spreads through water contaminated with feces, it thrives in humanitarian disasters or anywhere else that basic sanitation has broken down. (Think conflict or flooding.) Cholera’s horror is its speed. It causes sudden, violent diarrhea that can empty the body so quickly that stools turn a pale, milky white. Without treatment, cholera can kill in a matter of hours.

But the World Health Organization just announced that the vaccine shortage is ending, France 24 reports. Since 2022, “global supply of oral cholera vaccines [has] doubled”, and now the WHO is doling out 20 million doses to Mozambique, Bangladesh, and the Democratic Republic of the Congo to get vaccination campaigns rolling again.

So what happened? The WHO and organizations like the Gates Foundation basically scrambled to help get the lone South Korean producer, EuBiologics, to ramp up supply. This included backing a simplified new vaccine that can be manufactured more quickly at a massive scale.

My takeaway: This shows exactly why the WHO matters. When pharma companies do not see a profitable market, it’s this global body that steps in to push lifesaving vaccines into production.

Taking ‘addictive’ snacks seriously

I’ve read a lot of scientific papers over the 15 years as an on-again, off-again science journalist. Let’s be real, even on fascinating subjects … they’re usually a bit of a slog. So trust me when I say it’s actually worth your time to read this paper on ultraprocessed foods in full, which was covered by The Guardian. It reads like part nonfiction book, part provocative essay.

The paper compares ultraprocessed foods and tobacco products to a somewhat shocking effect. The authors’ walk through how each is deliberately designed (from the dosing of ingredients and the engineering of sensory cues) to tap into reward pathways in the brain. For the foods, this is to deliver fast, reinforcing hits of refined carbs and fats.

For example, they describe how food engineers intentionally design snacks so the taste does not linger, which nudges you to take another bite. One put it bluntly in a TV interview: This is “so that you want more of it,” the engineer said, and when pressed on whether that is about addiction, he replied, “that’s a good word.”

Effectively, these foods and snacks are “engineered to encourage addiction,” just like cigarettes. And the takeaway is clear: If they’re made like cigarettes, perhaps they should be regulated like cigarettes.

I have long been wary of the impulse to ask governments to micromanage personal food choice. I think personal responsibility still matters, and that you should be able to have chips and a Coke without the state wagging its finger at you.

… but if you are like me (skeptical of soda taxes yet convinced that tobacco regulation has saved countless lives) it’s worth hearing the argument on how many of today’s ultraprocessed foods may have crossed a line in the design for addictive consumption.

As the lead author of the study, Ashley Gearhardt, told me over email: “We regulate thousands of tobacco and alcohol products differently based on risk. Most alcoholic beverages are mostly water, yet it’s clearly labeled because once it’s engineered to alter mood and seed cravings, it’s no longer about hydration. Ultra-processed foods operate similarly. They’re not about nourishment so much as craving and mood effects.”

Just enough WHO funding

Let me end on a bit of good news.

The WHO is now reporting that it “has mobilized about 85% of the resources” needed for this and next year’s core budget, thanks in part to countries agreeing to increase their mandatory contributions. That is not nothing!

“Eighty-five percent sounds good – and it is,” said WHO Director- General Tedros Ghebreyesus, with a “deeper crisis averted.” That said, he warns that the remaining 15% will be “hard to mobilize,” which I’m giving you permission to read as “absolutely not going to happen.”

What’s missing in that 15%? At least in part, it’s the WHO’s work on “emergency preparedness, antimicrobial resistance, and climate resilience.”

Still, this is a partial stabilization in a still fragile moment for global health.

I’ll see you next week!

William Herkewitz is a reporter covering global public health for Healthbeat. He is based in Nairobi. Contact William at wherkewitz@healthbeat.org.

When conspiracy theories dictate global vaccine policy

2026-02-05T12:00:00+00:00

Public health, explained: Sign up to receive Healthbeat’s Global Checkup in your inbox a day early.

Hello from Nairobi.

The realities of public health hit home for me this weekend. My daughter just started pre-K, a touching milestone I was repeatedly warned would bring more illness into our home. (I took this to mean perpetual sniffles.) Instead, after about a week, she shared a lovely bout of norovirus with me.

My name is William Herkewitz, and I’m a journalist based in Nairobi, Kenya. This is the Global Health Checkup, where I highlight five of the week’s most important stories on outbreaks, medicine, science, and survival from around the world.

With that, as we say in Swahili: karibu katika habari — welcome to the news.

Vaccine conspiracies as global health policy

Gavi, the global organization that finances and distributes vaccines in poorer countries, finds itself in a funding standoff with the United States, Reuters reports.

For reference, “the U.S. previously contributed around 13% of Gavi’s funding,” and still has outstanding funds owed to the organization from the Biden era.

The issue at hand?

You might assume this is tied to America’s broader reworking of the global health budget, but… it is not. Instead, the Trump administration has told the global vaccine group “to phase out shots containing thimerosal as a condition of providing the group with funding.”

If you (like me) have made it this far in your life without needing to know what thimerosal is, let me present you with the disappointing news: It is a benign preservative at the center of several vaccine/autism conspiracy theories.

I reached out to Peter Hotez, director of the Texas Children’s Hospital Center for Vaccine Development, and one of the world’s foremost experts on vaccine development and vaccine misinformation to get his take.

He cautioned against “sanewashing” conspiracy claims or even detailing them next to mainstream vaccine science, which creates a “false equivalency,” as if both sides deserve equal weight.

“The thimerosal/autism link was debunked many years ago through both large epidemiological studies and even nonhuman primate neurodevelopment studies,” Hotez said, with the overwhelming fatigue of somebody who has explained this several hundred times before. “Many of these false links were popularized by [U.S. Health and Human Services Secretary Robert F. Kennedy Jr.’s] discredited 2005 article published in Rolling Stone and Salon magazines, since retracted by the editors.” As for the ultimate impact on Gavi, it remains to be seen whether the administration follows through, or whether Gavi decides to cave to the anti-science demand.

But “it’s tragic for the world’s children that now their access to vaccines and immunizations could be imperiled by this kind of pseudoscience,” Hotez said.

We’re winning the worm war

Guinea worm disease is on the verge of eradication, with just 10 infections reported worldwide last year, the Washington Post reports.

Disease breakdown: Guinea worm (also known as Dracunculiasis) is a parasite that spreads through drinking contaminated water, or eating infected animals. I’ll spare you the gory details (because this one is a true stomach turner), but it forms a terrible worm-filled blister. Though not lethal, at its peak in the 1980s, it was endemic across 20 countries and infected about 3.5 million people per year. Four decades later, there is still no treatment beyond pain meds.

The global effort to eliminate the disease has been led by the Carter Center since the 1980s. Last year’s total caseload is a drop from 15 cases in 2024 and consists of “four human cases … reported in Chad, four in Ethiopia, and two in South Sudan.”

The organization reports that the global aid pullback “has not stopped the Guinea worm program at ground level.”

What’s particularly incredible about the ongoing elimination project is that there is no vaccine or cure for guinea worm. This global effort’s success is largely the byproduct of sustained, committed gruntwork, with decades of programs to “educate the public, train volunteers, and distribute water filters in affected areas.”

I have two takeaways: First, we are clearly winning this war against the worm. If Guinea worm cases reach zero, it would be only the second human disease ever eradicated, after smallpox. (That said, I’m still hopeful we’ll first eliminate polio before the decade is out.)

Second, the last mile will be the hardest. Unlike polio or smallpox, Guinea worm also has animal hosts. Officials say the grunt work must continue, even after zero human cases. The disease can bounce back unless animal transmission (including dogs, domestic cats, and freshwater fish) is stopped, too.

Still, if Guinea worm fades into history, the credit belongs to the community health workers and volunteers who kept at the slow, quiet work for decades, moving village by village.

ChatDNA

Last week I was admittedly a bit flippant about a story on artificial intelligence helping pharma companies speed up the “unsexy” side of drug trials. Well, this week brings a more humbling piece on AI’s promise in driving real medical advancement.

Smithsonian magazine reports that researchers at Google DeepMind have unveiled a new artificial intelligence tool called AlphaGenome.

The tool leverages what AI does best (processing and learning from enormous datasets) to crunch the full book of our DNA. Essentially, it’s meant to help scientists predict how the parts of DNA we still cannot fully explain help tell our cells what to make, and when and how to make it.

The piece has a world-class explainer on the fundamental science:

“DNA is made of four different units called nucleotides: adenine (A), cytosine (C), guanine (G), and thymine (T). These letters pair up and act as an instruction manual for cells, yet only 2% of human DNA tells our cells how to build proteins, the building blocks of life. The remaining genetic code was long dismissed as “junk DNA,” but now, scientists know it plays an important role in regulating gene activation. Certain variants and mutations in the genome can lead to disease — and AlphaGenome’s goal is to predict what those changes are.”

So what’s the promise? The designers of the AlphaGenome believe the tool “can help experts develop new genetic therapies and ways to diagnose rare diseases.” Especially by pointing human researchers toward complex genetic links that are hard to spot on their own. Best of all: “The new resource is freely available to other researchers, who can modify the program based on their own needs.”

The tool has limitations, of course, including issues predicting the impact of DNA regions that influence each other at a great distance (meaning the segments are several hundred thousand letters away).

Still, I will be looping back in the coming months. As Pushmeet Kohli, vice president of science at Google DeepMind, put it: “I think we are at the start of a new era of scientific progress, and AI is going to enable a number of different breakthroughs.”

I have to admit … I believe it.

We. Declare. ‘Water bankruptcy!’

The United Nations says the world has entered a new kind of water crisis, one it calls “global water bankruptcy,” Health Policy Watch reports. That means rivers, lakes, and underground sources that once bounced back after droughts or heavy use are being drained faster than they can recover.

Perhaps the starkest example is the Aral sea in central Asia. In the late ’80s it was still the world’s fourth-largest lake. Today it barely exists.

Not to lay it on thick, but the report hits you with some staggering facts:

“More than half of the world’s large lakes have lost water since the early 1990s, over 30% of glacier mass since 1970 has disappeared in certain regions, while about 410 million hectares of natural wetlands — a land mass nearly equal to that of the European Union — have been destroyed over the past five decades.”

And the human impact?

Today about “4 billion people — nearly two-thirds of the global population — face severe water scarcity for at least one month every year.” The report particularly points to farmers in dry regions who pump groundwater for irrigation year after year, a practice that physically cannot continue indefinitely.

What’s my takeaway?

I find these reports largely overwhelming, because the solutions are not mysterious. National governments across the world need to act to protect water sources, manage them better, and plan for scarcity. Will they? Not anytime soon.

Tangent here, but I’m reading What We Can Know by Ian McEwan, which is set in a future Britain after a climate collapse. In the book, historians look back on our current era as a period they call “The Derangement,” when people had clear knowledge of climate change but failed to act at the needed scale.

With this report it is, uh … uncomfortably on the nose.

Mosquitoes keep moving

I’m leaving you this week on a story with a somewhat fascinating twist.

Chile is on high alert after finding an Aedes aegypti mosquito in the capital of Santiago, reports El Mercurio, the country’s largest newspaper.

Why is this such bad news? The mosquito, which is still absent from large parts of the country, is known as a major vector for a host of highly transmissible diseases including dengue, chikungunya, Zika, and yellow fever. Enough so that it’s commonly called the “dengue mosquito” or “yellow fever mosquito.” It also particularly thrives in cities, breeding in locations like flower vases, plastic bottles, gutters, and even old tires.

As we reported in October, this is an insect that sticks around. “Once Aedes aegypti mosquitoes establish themselves in an area warm enough for them to survive the winter, it becomes extremely difficult to eliminate them,” Dr. Marietjie Venter, an animal-borne virus expert, told me last year.

Granted, this is not the first time the mosquito has appeared in Chile. But as climate change makes the country increasingly habitable for it, health officials are worried sightings this year could signal the mosquito establishing a foothold … and introducing a perpetual risk of terrible tropical diseases. It would not take much. After all, as Chile’s head of health emergencies, Ester Alywin, warned on Friday, “a single female mosquito can lay up to 1,500 eggs in her lifetime.”

What’s the twist?

The singular mosquito was identified by eye by an airport staff member at a warehouse in Santiago International, then caught and then sent for analysis at a public laboratory.

Readers, I’ve searched for more detail on how staff could possibly be trained well enough to recognize and capture a single, specific mosquito (!) rather than just swatting it … but I’ve come up empty. Apparently, someone took their annual public health briefings seriously.

Anyhow, you’re my hero of the week, anonymous Chilean airport warehouse worker.

I’ll see you next week.

William Herkewitz is a reporter covering global public health for Healthbeat. He is based in Nairobi. Contact William at wherkewitz@healthbeat.org.

How New York’s state health chief is navigating the ‘Great Desensitivation’

2026-01-30T19:15:45+00:00

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Dr. James McDonald is leading the New York State Department of Health at a tumultuous time for public health in America.

Disruptions to federal health funding, vaccine recommendations, and operations at the Centers for Disease Control and Prevention are creating new challenges for state public health systems.

As head of one of the nation’s largest state health departments, McDonald is tasked with leading the response to those challenges – keeping New Yorkers insured at the top of the list.

McDonald, 62, a pediatrician, joined the state health department in July 2022 and became commissioner on June 9, 2023. He has also served at the Rhode Island Department of Health and the Indian Health Service in the Navajo Nation in Chinle, Arizona.

This week, he sat down with Healthbeat for a conversation in his office at the Erastus Corning Tower in Albany, sharing his perspective on issues like looming cuts to Medicaid, a new public health alliance in the Northeast, how global health affects New York, and how the CDC is “forever changed” in this era he calls the “Great Desensitivation.”

Here’s the interview, which has been edited for clarity and brevity.

What are the top three public health health challenges facing New York this year? What keeps you up at night?

The biggest threat is the change in how the current [federal] administration is looking at insuring New Yorkers. I have worried a little bit about Medicaid coverage. Starting in 2027, when you look at the work requirement that’s part of H.R. 1, what they’re trying to do is get people off Medicaid. It’s based on a concept that people don’t need Medicaid. The reality of it is a lot of people on Medicaid already are working. They don’t make much money, and they need Medicaid because that’s their health insurance. That’s one of my biggest concerns for this year and next.

Although the federal health policy is they want to make America healthy again, the actions look more toward just promoting suffering. This should bother more people than it does on a national level.
Dr. James McDonald, New York state health commissioner

One of my other big concerns is what’s happened to the Affordable Care Act. We’re addressing it as best we can. In 2024 we expanded our coverage to people up to 250% of the federal poverty level. Just to make that real, that’s like an individual making up to $39,000 a year. Those are working New Yorkers, and that’s changed. Now we have to change that to accommodate where the federal government is going.

The third concern I have is that as a country we are in a period that I’m going to call the Great Desensitization. We’re tolerating things that we never would have tolerated before. That encompasses things like hearing misinformation about vaccines, and people are confused by this. I was concerned about how the shutdown was handled. The government was comfortable with people losing food benefits, and the state of New York stepped in to protect our New Yorkers. What I see with people becoming uninsured is an overarching theme, and one of my concerns is, although the federal health policy is they want to make America healthy again, the actions look more toward just promoting suffering. This should bother more people than it does on a national level.

Let’s go back to one of the things you’ve just said: H.R.1.

What I’m concerned about is people who need health insurance won’t get health insurance. The challenge for any state is going to be, how do you apply the exceptions for people who can’t work, so you can actually keep them insured. One of the challenges states are going to have is we don’t have the rules and regulations yet that the federal government is going to use to enforce this. Those come into being by June 30. So that gives us till Dec. 31 — six months – to implement a very substantive change. We are doing our best to get ready for that, but without seeing the regulations, there’s only so much we can do.

What I’m concerned about is that you’re going to end up with people who aren’t going to get health care. Most of us would agree, generally, if you find cancer early, you get better outcomes, whether it’s breast cancer or colon cancer. But if you don’t have health insurance, you’re not going to have a mammogram, because you’re going to say, I’m not going to pay for that. That’s not something you go to the emergency department for. But if you don’t have health insurance, you’re not going to have a colonoscopy. If you don’t have a mammogram, we’re not going to find your breast cancer before it turns into cancer or the early stages. As annoying as a colonoscopy is, they’re really important to have. If you don’t have a colonoscopy, we’re not going to find that polyp that was precancerous and remove it.

We all learned growing up, an ounce of prevention is worth a pound of cure. I see the federal health policy being this smorgasbord of chaos and confusion.

Could the new CDC guidelines that seem to emphasize “choice” deter New Yorkers from getting vaccinated, and what is New York state doing to push back on this messaging and reach people who might need to hear these guidelines?

It’s important to know there was no new science presented; there was really no new information presented. This was implementing something that was really politically motivated.

No vaccine in New York or any state is given without informed consent. I’ve been a pediatrician for over 35 years. I’ve given over 100,000 vaccines easily in my career, and every single one of them has had informed consent. No one gets vaccines without consent, and shared clinical decision making is simply a risk-benefit conversation with your health care provider. That already happens.

What happened to the CDC schedule is it went from something that was easily understandable to something exceptionally confusing. I don’t think the impact in New York is going to be significant. New York’s vaccine requirements, which are mandated by New York state law, haven’t changed. I don’t think they’re going to change.

How might you be able to reach people who are skeptical of vaccines?

There’s no one way to solve that issue. We put forward honest, objective information. We go to different communities. We work with local leaders, we work with local health departments, we work with community-based organizations. What a lot of people want to do is they want to hear the truth from people they know.

We are not going to convince everyone of everything about every vaccine and people still have informed consent. Having said that, there’s still the vaccine requirements. If they want to enter school, they’re going to have to adhere to the vaccine requirements. The thing I worry about, as a physician and as a pediatrician, is I’ve seen adverse health consequences and vaccine-preventable diseases.

One of the first children I took care of in medical school, before the Hib [Haemophilus influenzae type b] vaccine came out, was a little 3-year-old who had amputations below her knees because of Haemophilus influenzae type b meningitis. There was no vaccine then. That was terrible. It’s someone who had to live a whole lifetime with health consequences.

The CDC sidelined these childhood vaccines. Here’s what they prevent.

I’ve seen less than a handful of kids with Hib meningitis who weren’t immunized for whatever reason. But this is a disease that should really not be something we’re even worried about because it’s a vaccine that works so well. I worry about parents having to live with a preventable tragedy.

One of the things I’m concerned about the current vaccine direction with the federal government is this nonchalance about the seriousness of vaccine-preventable disease, almost as if being hospitalized for a child for a vaccine-preventable disease is no big deal. I can tell you, when a child is in the hospital, the child is very sick, the child is suffering, and the parents are suffering along with their child.

In light of the changes at the CDC and other federal health agencies, we’ve seen the Northeast Public Health Collaborative come to fruition and work as a regional outfit focused on public health. What role do you see the collaborative playing in the region?

The Northeast Public Health Collaborative is 17 jurisdictions from Maine to Maryland. It’s health departments collaborating with each other in an organized manner — it was something we used to do informally. But what’s different about this is that it’s health departments collaborating in an organized manner about matters of common interest, so we can coordinate efforts and learn together. We should have done it years ago, but it’s part of our forever future. It’s not a political response. One of the things I think about too is that sometimes one state might have experience with a problem, another state might not, but we can share the expertise. One of the things about the collaborative is there are tiny states and big states. New York is 20 million people, Rhode Island is 1 million.

You said that the collaborative is not meant to be a political response, but there could be some who view it that way and might see it as a rival to the CDC. What would you say to that?

The CDC is forever changed. There are still good people doing great work at the CDC, and we talk to them every day. What you’ve seen now is politics dictating change at CDC. When I really think about what health departments are collaborating on, it’s like, how do individual health departments work better together? If you think about public health, we all have similar missions. We might write them differently, but most health departments want to improve the health and well-being of the population.

There’s no political affiliation with the Health Department. We’re objective. We don’t want to deliver public health based on political party [affiliation]. That’s never part of the conversation. There is no politics built into the collaborative. It isn’t about that. Most people in public health aren’t interested in politics. They’re interested in public health. They’re very different things.

Let’s say there’s a disease outbreak here in New York state, or somewhere else in the Northeast. Would New York state or the collaborative reach out to the CDC? Would you all be in touch?

We do that routinely. Let’s take measles. When we have a case of measles, we talk to the CDC, but it’s usually informing them. It’s not getting their advice. Because most health departments know what to do when it comes to containing a disease — this is really fundamental public health. We don’t usually need CDC to help us with an outbreak. Where CDC helps with an outbreak is when you have something unusual going on in your state or in a very large number and then CDC will still send what’s called an Epi Aid Team, and that can still happen. There’s no reason that that will change in the future, and this is where CDC will still be a helper.

I don’t know that they’re going to be the national lead on things as much as they used to be, because what you’re seeing now is the political overlay. What you’ll see is we do work with CDC every day in New York state, and we still will, and they still work with us, but when it comes to health policy for states, states are going to rely less and less on CDC and more on their own state health department, and that is probably a better thing for everybody in the long run anyway, because your state health department and local health departments know your state better than any federal entity will.

One thing about the CDC is the CDC was trying to create recommendations for the entire United States, which is all the way from Maine to the Northern Mariana Islands — very different places. Regionalized and localized recommendations make more sense for everybody.

Last week, California Gov. Gavin Newsom said his state will join the World Health Organization’s Global Outbreak Alert and Response Network. Have there been conversations here in Albany related to that? Is this something that you all have considered doing?

We’re looking at it. One of the things the New York State Department of Health does is we created something called the Global Update. Every week we give a weekly report for anyone who wants looking at what are the global outbreaks going on. If you want to know what’s going on with chikungunya, we’ll tell you.

What the U.S. leaving the WHO means for health in America and the world

It’s important to underscore that the United States leaving the World Health Organization has a much larger impact, because what we’re not doing is we’re not financially supporting global immunization campaigns — overall, helping people be healthy. And one of the reasons why I’m concerned about it in New York state is we’re the gateway to a lot of America. But generally, if people are healthier overseas, that benefits New York state and the United States, because they don’t bring the disease here. The World Health Organization does a lot of things coordinating with CDC and others when there’s a viral hemorrhagic fever.

For example, no one talked about the Marburg outbreak in 2024 in Tanzania, in the United States, because it didn’t come here. The reason why viral hemorrhagic fever didn’t come here is because the World Health Organization worked with CDC to address it in Tanzania. We knew what was happening, and we were ready in case it came here, but it was contained. And one of my big concerns is by pulling out of the World Health Organization and by underfunding CDC, what risk are we inviting in the United States? Because people get in planes and travel, and you are literally 12 hours away from the biggest surprise ever. I don’t understand why we’re willing to live in this period of ignorance.

Trenton Daniel is a reporter covering public health in New York for Healthbeat. Contact Trenton at tdaniel@healthbeat.org or on the messaging app Signal at trentondaniel.88.

Trump policies at odds with emerging understanding of Covid’s long-term harm

2026-01-27T15:54:55+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

Possible risk of autism in children. Dormant cancer cells awakening. Accelerating aging of the brain.

Federal officials in May 2023 declared an end to the national Covid pandemic. But more than two years later, a growing body of research continues to reveal information about the virus and its ability to cause harm long after initial infections resolve, even in some cases when symptoms were mild.

The discoveries raise fresh concerns about the Trump administration’s Covid policies, researchers say. While some studies show Covid vaccines offer protective benefits against longer-term health effects, the Department of Health and Human Services has drastically limited recommendations about who should get the shot. The administration also halted Biden-era contracts aimed at developing more protective Covid vaccines.

The federal government is curtailing such efforts just as researchers call for more funding and, in some cases, long-term monitoring of people previously infected.

“People forget, but the legacy of Covid is going to be long, and we are going to be learning about the chronic effects of the virus for some time to come,” said Michael Osterholm, an epidemiologist who directs the University of Minnesota’s Center for Infectious Disease Research and Policy.

The Trump administration said that the Covid vaccine remains available and that individuals are encouraged to talk with their health providers about what is best for them. The Covid vaccine and others on the schedule of the Centers for Disease Control and Prevention remain covered by insurance so that individuals don’t need to pay out-of-pocket, officials said.

“Updating CDC guidance and expanding shared clinical decision-making restores informed consent, centers parents and clinicians, and discourages ‘one size fits all’ policies,” said HHS spokesperson Emily Hilliard.

Is Covid during pregnancy linked to autism? What a new study shows, and what it doesn’t

Although Covid has become less deadly, because of population immunization and mutations making the virus less severe, researchers say the politicization around the infection is obscuring what science is increasingly confirming: Covid’s potential to cause unexpected, possibly chronic health issues. That in turn, these scientists say, drives the need for more, rather than less, research, because over the long term, Covid could have significant economic and societal implications, such as higher health care costs and more demands on social programs and caregivers.

The annual average burden of the disease’s long-term health effects is estimated at $1 trillion globally and $9,000 per patient in the United States, according to a report published in November in the journal NPJ Primary Care Respiratory Medicine. In this country, the annual lost earnings are estimated to be about $170 billion.

One study estimates that the flu resulted in $16 billion in direct health costs and $13 billion in productivity losses in the 2023-24 season, according to a Dec. 30 report in medRxiv, an online platform that publishes work not yet certified by peer review.

Studies show Covid’s growing reach

Much has been learned about Covid since the virus emerged in 2019, unleashing a pandemic that the World Health Organization reports has killed more than 7 million people. By the spring of 2020, the term “long Covid” had been coined to describe chronic health problems that can persist post-infection.

More recent studies show that infection by the virus that causes Covid, SARS-CoV-2, can result in heightened health risks months to more than a year later.

For example, researchers following children born to mothers who contracted the virus while pregnant have discovered they may have an increased risk for autism, delayed speech and motor development, or other neurodevelopmental challenges.

Another study found babies exposed to Covid in utero experienced accelerated weight gain in their first year, a possible harbinger of metabolic issues that could later carry an increased risk for cardiovascular disease.

These studies suggest avoiding severe Covid in pregnancy may reduce risk not just during pregnancy but for future generations. That may be another good reason to get vaccinated when pregnant.

“There are other body symptoms apart from the developing fetal brain that also may be impacted,” said Andrea Edlow, an associate professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School who was involved in both studies. “We definitely need more research.”

Epidemiologists point to some specific, emerging challenges.

A U.K. study in the New England Journal of Medicine found people who fully recovered from mild Covid infections experienced a cognitive deficit equal to a three-point drop in IQ. Among the more than 100,000 participants, deficits were greater in people who had persistent symptoms and reached the equivalent of a nine-point IQ drop for individuals admitted to intensive care.

Ziyad Al-Aly, a clinical epidemiologist who has studied longer-term health effects from Covid, did the math. He estimated Covid may have increased the number of adults in the United States with an IQ of less than 70 from 4.7 million to 7.5 million — a jump of 2.8 million adults dealing with “a level of cognitive impairment that requires significant societal support,” he wrote.

“People get Covid-19, some people do fine and bounce back, but there are people who start experiencing problems with memory, cognition, and fuzzy brain,” he said. “Even people with mild symptoms. They might not even be aware.”

Diane Yormark, 67, of Boca Raton, Florida, can relate. She got Covid in 2022 and 2023. The second infection left her with brain fog and fatigue.

MRNA vaccines, once a Trump boast, now face attacks from some in GOP

“I felt like if you had a little bit too much wine the night before and you’re out of it,” said Yormark, a retired copywriter, who said the worst of her symptoms lasted for about three months after the infection. “Some of the fog has lifted. But do I feel like myself? Not like I was.”

Data from more than a dozen studies suggest Covid vaccines can help reduce risk of severe infection as well as longer-lasting health effects, although researchers say more study is needed.

But vaccination rates remain low in the United States, with only about 17% of the adult population reporting that they got the updated 2025-26 shot as of Jan. 16, based on CDC data.

Trump administration officials led by HHS Secretary Robert F. Kennedy Jr. have reduced access to Covid vaccines despite the lack of any new, substantiated evidence of harm. Though the shots were a hallmark achievement of the first Trump administration, which led the effort for their development, Kennedy has said without evidence that they are “the deadliest vaccine ever made.”

In May he said on X that the CDC would stop recommending Covid shots for healthy children and pregnant women, citing a lack of clinical data. The Food and Drug Administration has since issued new guidelines limiting the vaccine to people 65 or older and individuals 6 months or older with at least one risk factor, though many states continue to make them more widely available.

The Trump administration also halted almost $500 million in funding for mRNA-based vaccines. Administration officials and a number of Republicans question the safety of the Nobel Prize-winning technology — heralded for the potential to treat many diseases beyond Covid — even though clinical trials with tens of thousands of volunteers were performed before the Covid mRNA vaccines were made available to the public.

And numerous studies, including new research in 2025, show Covid vaccine benefits include a reduction in the severity of disease, although the protective effects wane over time.

How Covid may affect brain health

Researchers say more and broader support is important because much remains unknown about Covid and its impact on the body.

The growing awareness that, even in mild Covid cases, the possibility exists for longer-term, often undetected organ damage also warrants more examination, researchers say. A study published this month in eBioMedicine found people with neurocognitive issues such as changes in smell or headaches after infection had significant levels of a protein linked to Alzheimer’s in their blood plasma. EBioMedicine is a peer-reviewed, open-access journal published by The Lancet.

In the brain, the virus leads to an immune response that triggers inflammation, can damage brain cells, and can even shrink brain volume, according to research on imaging studies that was published in March 2022 in the journal Nature.

An Australian study of advanced brain images found significant alterations even among people who had already recovered from mild infections — a possible explanation for cognitive deficits that may persist for years. Lead study author Kiran Thapaliya said the research suggests the virus “may leave a silent, lasting effect on brain health.”

Al-Alay agreed.

“We don’t know what will happen to people 10 years down the road,” he said. “Inflammation of the brain is not a good thing. It’s absolutely not a good thing.”

That inflammatory response has also been linked to blood clots, arrhythmias, and higher risk of cardiovascular issues, even following a mild infection.

A University of Southern California study published in October 2024 in the journal Arteriosclerosis, Thrombosis, and Vascular Biology found the risk for a major cardiac event remains elevated nearly three years after Covid infection. The findings held even for people who were not hospitalized.

“We were surprised to see the effects that far out” regardless of individual heart disease history, said James R. Hilser, the study’s lead author and a postdoctoral fellow at the UCLA David Geffen School of Medicine.

Covid can also reactivate cancer cells and trigger a relapse, according to research published in July in the journal Nature. Researchers found that the chance of dying from cancer among cancer survivors was higher among people who’d had Covid, especially in the year after being infected. There was nearly a twofold increase in cancer mortality in those who tested positive compared with those who tested negative.

The potential of the Covid virus to affect future generations is yielding new findings as well. Australian researchers looked at male mice and found that those who had been infected with and then recovered from Covid experienced changes to their sperm that altered their offspring’s behavior, causing them to exhibit more anxiety.

Meanwhile, many people are now living — and struggling — with the virus’ after-effects.

Dee Farrand, 57, of Marana, Arizona, could once run five miles and was excelling at her job in sales. She recovered from a Covid infection in May 2021.

Two months later, her heart began to beat irregularly. Farrand underwent a battery of tests at a hospital. Ultimately, the condition became so severe she had to go on supplemental oxygen for two years.

Her cognitive abilities declined so severely she couldn’t read, because she’d forget the first sentence after reading the second. She also had to leave herself reminders that she is allergic to shrimp or that she likes avocados. She said she lost her job and returned to her previous occupation as a social worker.

“I was the person who is like the Energizer bunny and all of a sudden I’d get so tired getting dressed that I had to go back to bed,” Farrand said.

While she is better, Covid has left a mark. She said she’s not yet able to run the five miles she used to do without any problems.

This story originally published at KFF Health News, Healthbeat’s national reporting partner.

How Emory’s Vaccine Dinner Club helps scientists connect in tough times

2026-01-20T21:42:13+00:00

This story was part of Healthbeat’s live storytelling event, “Aha Moments in Public Health,” held Nov. 3 at Manuel’s Tavern in Atlanta. Watch the full show here. Sign up to receive Healthbeat’s free Atlanta newsletter here.

The downstream echo of my “aha” moment in public health is the reason I was late arriving for tonight’s program.

Here’s the background. In 1981, Dr. Jim Curran led the Centers for Disease Control and Prevention task force that investigated the very first cases of a new disease that we all later came to know as AIDS. I joined the field as an AIDS community and medical educator five years later, and 12 years after that, in 1998, I was recruited from the Emory School of Medicine to the Rollins School of Public Health by Curran, who was by then serving as the school’s dean, to help him start a National Institutes of Health-funded Center for AIDS Research at Emory.

At one of our first meetings with organizational shareholders from across campus, someone floated an idea that CFAR and the Emory Vaccine Center could collaborate on hosting an evening seminar series to raise our mutual profiles.

“That’s a great idea!,” I chirped up. “We could serve food too and call it the Vaccine Dinner Club!”

Instantly the room erupted with laughter, but as soon as Curran handed me the job of designing, organizing, and running the new initiative, that is exactly what I did.

Having been told that a seminar on HIV vaccines at Emory might draw as many as 30 or 40 scientists, I booked an appropriately sized room and sent out an email to a couple of colleagues asking for their help in advertising our first gathering. In that email, which I begged recipients to treat like a chain letter, I asked people to write me back directly if they wanted to attend the VDC’s first meeting, which would begin with networking over wine and cheese, followed by a science presentation given by Emory Vaccine Center Director Dr. Rafi Ahmed, and end with a casual buffet dinner.

Return emails began to trickle and then pour in. This shouldn’t have been all that surprising because this was during a period in history in which you weren’t allowed to even serve coffee at a federally funded meeting, and here I was offering free wine, cheese, and dinner. But I was still floored when, by the time the Vaccine Dinner Club met for the first time a month later, on Jan. 6, 1999, more than 300 people had registered to attend.

As you may know, the CDC is a separate nation-state located on the Emory campus and, to this day, I swear I felt the ground rumbling gently beneath my feet as wave after wave of CDC employees came thundering down Clifton Road on foot, apparently at a dead run, in the direction of food-and-drink-enabled science.

My gratification turned to panic, though, when it became clear to the milling crowd that somebody (OK, me) had forgotten that wine bottles must be opened before their contents can be consumed.

Fortunately, it turns out that the VDC membership has self-selected for resourcefulness from the very beginning and that a surprisingly large number of people carry corkscrews in their pockets and purses.

In almost no time at all, an impromptu bucket brigade of meeting attendees, led by biostatistics luminary Dr. Betz Halloran, formed to uncrate, open, pour, and distribute 300+ glasses of wine. The rest of the evening was fabulous as well, and I really think that that night set the stage for thinking of the VDC truly as a club, not a seminar series.

But, believe it or not, that wasn’t my “aha” moment.

And it still wasn’t my “aha” moment 21 years and almost 200 programs later when the pandemic happened and the VDC had to go online.

Taking dinner club to Zoom opened it to more people

I still vividly remember stepping up to the podium on March 4, 2020, to open what later turned out to be our last in-person meeting for four years. The talk was titled Covid-19: What We Know, What We Suspect, What We Fear and starred Dr. Jay Butler, deputy director for infectious diseases at the CDC.

In those days, the VDC’s average meeting attendance was around 200, but I have no idea how many people were there that night. Seriously, I don’t because to maintain plausible deniability with the fire marshal I stopped counting at 550. But let’s just say that we were in a two-level auditorium and it was standing room only.

When I stepped behind the podium and looked at that absolute sea of faces, I put down the meeting-opening cowbell I had been ringing and, without thinking, blurted out:

“Dr. Butler’s talk will include an analysis of Covid-19 super-spreader events. And speaking of super-spreader events ... would everyone in this extremely crowded, windowless room please behave responsibly and hold your breath for the next 60 minutes?”

Mike Luckovich, editorial cartoonist at The Atlanta Journal-Constitution, drew this sketch of Dr. Kimbi Hagen, the founding director of two international science-focused dinner clubs.

But my “aha, this is why I do it” moment didn’t even occur then. That came later, after the VDC had entered the Zoom era and my fear that the club would collapse in the absence of free wine proved to be unfounded. In fact, to my puzzlement, membership requests and registration attendance absolutely exploded in size during the pandemic to the point that I began opening each meeting with a slide showing the ever growing list of countries around the world from which any given month’s attendees were Zooming in.

And then one day it all made sense. I was reading registration form comments for the upcoming meeting and one said “thank you, Thank You, THANK YOU Kimbi for keeping the VDC going. My job is to increase Covid vaccine uptake in a part of the country that believes Covid is a hoax. I absolutely LIVE for these monthly opportunities to relax and spend time, even if only online, with my tribe, The People Who Get It. The VDC makes me feel less alone.”

That was my “aha” moment. That was when I realized that for some people, maybe many, attending VDC meetings was no longer simply about having access to cool science, it was now also, and perhaps more importantly, about having access to a safe space where — in a world that was increasingly making the trashing of public health and public health professionals into a full-time job — they could feel seen, heard, supported, and not so alone.

Now there are two: Vaccine Dinner Club IRL and online

I am a public health professional like most of you here, but it turns out that my public is you — the people who make public health happen. I do what I do, so that you can do what you do.

That insight was re-crystalized for me post-pandemic when, after pausing the VDC for the entirety of the 2024-25 season, I was absolutely inundated with hundreds of thank you messages when I restarted the club this past September.

As a result, when the VDC’s two major sponsors notified me that they want VDC meetings to scale back from monthly to quarterly and revert to in-person only, which would restrict meeting attendance to people in Atlanta, I became acutely aware of the sense of abandonment and exclusion that that might create among the membership.

My solution was to start a second club. With sponsorship from the Rollins School of Public Health, the new club only meets in the months that the Vaccine Dinner Club does not meet and addresses public health issues that are not vaccine specific.

Because I outsourced the naming of the club to the members and we are currently narrowing down possibilities for a final vote, the new org is currently officially known as the As-Yet-Unnamed Dinner Club, or UDC. Membership in the UDC, which didn’t even exist 2 months ago, is 6,711, which is almost 1,300 more members than the Vaccine Dinner Club took 27 years to accrue. That speaks very strongly about the continued need for an organization like this.

Our inaugural meeting of the As-Yet-Unnamed Dinner Club on Oct. 1 was titled Public Health Chaos: What It Means for America, and starred three long-time VDC members, Drs. Demetre Daskalakis, Deb Houry, and Dan Jernigan — aka “D3” — the three senior leaders who resigned from the CDC after Health and Human Services Secretary Robert F. Kennedy Jr. fired CDC Director Susan Monarez.

Almost 2,600 people attended that first meeting, including more than 100 who have retroactively registered after the meeting was over, just to receive a link to meeting recording.

The second meeting of the UDC, Science Under Siege: What You Can Do About It, took place this evening. It featured superstar author Dr. Peter Hotez and is why I was late getting here tonight. Because I couldn’t bear the thought of missing out on your stories, not to mention Healthbeat’s first birthday party, I hosted this month’s UDC meeting from my laptop here at Manuel’s Tavern. You can retroactively register for that meeting if you want to hear Hotez’s thoughts about how we can fight anti-science.

Why there’s hope for public health in America

Speaking of anti-science … before ending my story, I want to read a few sentences that I included in my email opening registration for this evening’s UDC meeting. They originally came from an email to one of the UDC members and spring from conversations I have been having with multiple VDC and UDC members who have reached out to talk about how distraught they are, as I am, as we all are, over the deliberate damage that is being done to public health in America right now. This is what I wrote:

“I keep reminding myself that perhaps the only advantage to being as old as I am is that I have lived a long time. Including growing up in the Jim Crow South. Which means that I have real-time memories of cross burnings, segregated schools, whites-only everything, and the Tuskegee study.

“Which also means that I know, from my own lived experience, that we as a country are fully capable of righting great wrongs that are inflicted on us by our government because we have done so before. There is precedent for it in my own lifetime.

“So I have to believe that we will get through this because we can get through this because we have gotten through even worse. And successfully come out on the other side.”

Thank you.

Dr. Kimbi Hagen is the founding director of two international science-focused dinner clubs. She has been a faculty member in the Department of Behavioral, Social, and Health Education Sciences at the Rollins School of Public Health at Emory since 1998.

Vaccines are helping older people more than we knew

2026-01-14T14:09:28+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

Let’s be clear: The primary reason to be vaccinated against shingles is that two shots provide at least 90% protection against a painful, blistering disease that a third of Americans will suffer in their lifetimes, one that can cause lingering nerve pain and other nasty long-term consequences.

The most important reason for older adults to be vaccinated against the respiratory infection RSV is that their risk of being hospitalized with it declines by almost 70% in the year they get the shot, and by nearly 60% over two years.

And the main reason to roll up a sleeve for an annual flu shot is that when people do get infected, it also reliably reduces the severity of illness, though its effectiveness varies by how well scientists have predicted which strain of influenza shows up.

But other reasons for older people to be vaccinated are emerging. They are known, in doctor-speak, as off-target benefits, meaning that the shots do good things beyond preventing the diseases they were designed to avert.

The list of off-target benefits is lengthening as “the research has accumulated and accelerated over the last 10 years,” said William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center in Nashville, Tennessee.

Some of these protections have been established by years of data; others are the subjects of more recent research, and the payoff is not yet as clear. The first RSV vaccines, for example, became available only in 2023.

Still, the findings “are really very consistent,” said Stefania Maggi, a geriatrician and senior fellow at the Institute of Neuroscience at the National Research Council in Padua, Italy.

The CDC sidelined these childhood vaccines. Here’s what they prevent.

She is the lead author of a recent meta-analysis, published in the British journal Age and Ageing, that found reduced risks of dementia after vaccination for an array of diseases. Given those “downstream effects,” she said, vaccines “are key tools to promote healthy aging and prevent physical and cognitive decline.”

Yet too many older adults, whose weakening immune systems and high rates of chronic illness put them at higher risk of infectious diseases, have not taken advantage of vaccination.

The Centers for Disease Control and Prevention reported last week that about 31% of older adults had not yet received a flu shot. Only about 41% of adults 75 and older had ever been vaccinated against RSV, or respiratory syncytial virus, and about a third of seniors had received the most recent Covid-19 vaccine.

The CDC recommends the one-and-done pneumococcal vaccine for adults 50 and older. An analysis in the American Journal of Preventive Medicine, however, estimated that from 2022, when new guidelines were issued, through 2024, only about 12% of those 67 to 74 received it, and about 8% of those 75 and older.

What we’re learning about flu and RSV shots

The strongest evidence for off-target benefits, dating back 25 years, shows reduced cardiovascular risk following flu shots.

Healthy older adults vaccinated against flu have substantially lower risks of hospitalization for heart failure, as well as for pneumonia and other respiratory infections. Vaccination against influenza has also been associated with lower risks of heart attack and stroke.

Moreover, many of these studies predate the more potent flu vaccines now recommended for older adults.

Could the RSV vaccine, protective against another respiratory illness, have similar cardiovascular effects? A recent large Danish study of older adults found a nearly 10% decline in cardiorespiratory hospitalizations — involving the heart and lungs — among the vaccinated versus a control group, a significant decrease.

Why flu season will likely be worse this year and how to prepare

Lowered rates of cardiovascular hospitalizations and stroke did not reach statistical significance, however. That may reflect a short follow-up period or inadequate diagnostic testing, cautioned Helen Chu, an infectious disease specialist at the University of Washington and co-author of an accompanying editorial in JAMA.

“I don’t think RSV behaves differently from flu,” Chu said. “It’s just too early to have the information for RSV, but I think it will show the same effect, maybe even more so.”

Vaccination against still another dangerous respiratory disease, Covid, has been linked to a lower risk of developing long Covid, with its damaging effects on physical and mental health.

What studies show about shingles vaccine and dementia

Probably the most provocative findings concern vaccination against shingles, aka herpes zoster. Researchers made headlines last year when they documented an association between shingles vaccination and lower rates of dementia — even with the less effective vaccine that has since been replaced by Shingrix, approved in 2017.

Nearly all studies of off-target benefits are observational, because scientists cannot ethically withhold a safe, effective vaccine from a control group whose members could then become infected with the disease.

That means such studies are subject to “healthy volunteer bias,” because vaccinated patients may also practice other healthy habits, differentiating them from those not vaccinated.

Although researchers try to control for a variety of potentially confounding differences, from age and sex to health and education, “we can only say there’s a strong association, not a cause and effect,” Maggi said.

But Stanford researchers seized on a natural experiment in Wales in 2013, when the first shingles vaccine, Zostavax, became available to older people who had not yet turned 80. Anyone who had was ineligible.

Over seven years, dementia rates in participants who had been eligible for vaccination declined by 20% — even though only half had actually received the vaccine — compared with those who narrowly missed the cutoff.

“There are no reasons people born one week before were different from those born a few days later,” Maggi said. Studies in Australia and the United States have also found reductions in the odds of dementia following shingles shots.

In fact, in the meta-analysis Maggi and her team published, several other childhood and adult vaccinations appeared to have such effects. “We now know that many infections are associated with the onset of dementia, both Alzheimer’s and vascular,” she said.

In 21 studies involving more than 104 million participants in Europe, Asia, and North America, vaccination against shingles was associated with a 24% reduction in the risk of developing dementia. Flu vaccination was linked to a 13% reduction. Those vaccinated against pneumococcal disease had a 36% reduction in Alzheimer’s risk.

Inside the FDA’s vaccine uproar: It’s not just about Covid shots

The Tdap vaccine against tetanus, diphtheria, and pertussis (whooping cough) is recommended for adults every 10 years, with vaccination among older adults often prompted by the birth of a grandchild, who cannot be fully vaccinated for months. It was associated with a one-third decline in dementia.

Other researchers are investigating the effects of shingles vaccination on heart attacks and stroke and of Covid vaccination on cancer survival.

Inflammation may play a role

What causes such vaccine bonuses? Most hypotheses focus on the inflammation that arises when the immune system mobilizes to fight off an infection. “You have damage to the surrounding environment” in the body, “and that takes time to calm down,” Chu said.

The effects of inflammation can far outlast the initial illness. It may allow other infections to take hold, or cause heart attacks and strokes when clots form in narrowed blood vessels. “If you prevent the infection, you prevent this other damage,” Chu said.

Hospitalization itself, during which older patients can become deconditioned or develop delirium, is a risk factor for dementia, among other health problems. Vaccines that reduce hospitalization might therefore delay or ward off cognitive decline.

Health officials in the Trump administration have assailed childhood vaccines more than adult ones, but their vocal opposition may be contributing to inadequate vaccination among older Americans, too.

Many will not only miss out on the emerging off-target benefits but will remain vulnerable to the diseases the vaccines prevent or diminish.

“The current national policy on vaccination is at best uncertain, and in instances appears anti-vaccine,” said Schaffner, a former member of the CDC’s Advisory Committee on Immunization Practices. “All of us in public health are very, very distressed.”

“The New Old Age” is produced through a partnership with The New York Times. This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

The CDC sidelined these childhood vaccines. Here’s what they prevent.

2026-01-06T23:46:20+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

The federal government has drastically scaled back the number of recommended childhood immunizations, sidelining six routine vaccines that have safeguarded millions from serious diseases, long-term disability, and death.

Just three of the six immunizations the Centers for Disease Control and Prevention says it will no longer routinely recommend — against hepatitis A, hepatitis B, and rotavirus — have prevented nearly 2 million hospitalizations and more than 90,000 deaths in the past 30 years, according to the CDC’s own publications.

Vaccines against the three diseases, as well as those against respiratory syncytial virus, meningococcal disease, flu, and Covid, are now recommended only for children at high risk of serious illness or after “shared clinical decision-making,” or consultation between doctors and parents.

The CDC maintained its recommendations for 11 childhood vaccines: measles, mumps, and rubella; whooping cough, tetanus, and diphtheria; the bacterial disease known as Hib; pneumonia; polio; chickenpox; and human papillomavirus, or HPV.

Federal and private insurance will still cover vaccines for the diseases the CDC no longer recommends universally, according to a Department of Health and Human Services fact sheet; parents who want to vaccinate their children against those diseases will not have to pay out-of-pocket.

Experts on childhood disease were baffled by the change in guidance. HHS said the changes followed “a scientific review of the underlying science” and were in line with vaccination programs in other developed nations.

HHS Secretary Robert F. Kennedy Jr., an anti-vaccine activist, pointed to Denmark as a model. But the schedules of most European countries are closer to the U.S. standard upended by the new guidance.

For example, Denmark, which does not vaccinate against rotavirus, registers around 1,200 infant and toddler rotavirus hospitalizations a year. That rate, in a country of 6 million, is about the same as it was in the United States before vaccination.

“They’re OK with having 1,200 or 1,300 hospitalized kids, which is the tip of the iceberg in terms of childhood suffering,” said Paul Offit, the director of the Vaccine Education Center at the Children’s Hospital of Philadelphia and a co-inventor of a licensed rotavirus vaccine. “We weren’t. They should be trying to emulate us, not the other way around.”

Public health officials say the new guidance puts the onus on parents to research and understand each childhood vaccine and why it is important.

Here’s a rundown of the diseases the sidelined vaccines prevent:

RSV. Respiratory syncytial virus is the most common cause of hospitalization for infants in the United States.

The respiratory virus usually spreads in fall and winter and produces cold-like symptoms, though it can be deadly for young children, causing tens of thousands of hospitalizations and hundreds of deaths a year. According to the National Foundation for Infectious Diseases, roughly 80% of children younger than 2 who are hospitalized with RSV have no identifiable risk factors. Long-awaited vaccines against the disease were introduced in 2023.

Hepatitis A. Hepatitis A vaccination, which was phased in beginning in the late 1990s and recommended for all toddlers starting in 2006, has led to a more than 90% drop in the disease since 1996. The foodborne virus, which causes a wretched illness, continues to plague adults, particularly people who are homeless or who abuse drugs or alcohol, with a total of 1,648 cases and 85 deaths reported in 2023.

Hepatitis B. The disease causes liver cancer, cirrhosis, and other serious illnesses and is particularly dangerous when contracted by babies and young children. The hepatitis B virus is transmitted through blood and other bodily fluids, even in microscopic amounts, and can survive on surfaces for a week. From 1990 to 2019, vaccination resulted in a 99% decline in reported cases of acute hepatitis B among children and teens. Liver cancer among American children has also plummeted as a result of universal childhood vaccination. But the hepatitis B virus is still around, with 2,000-3,000 acute cases reported annually among unvaccinated adults. More than 17,000 chronic hepatitis B diagnoses were reported in 2023. The CDC estimates about half of people infected don’t know they have it.

Rotavirus. Before routine administration of the current rotavirus vaccines began in 2006, about 70,000 young children were hospitalized and 50 died every year from the virus. It was known as “winter vomiting syndrome,” said Sean O’Leary, a pediatrician at the University of Colorado. “It was a miserable disease that we hardly see anymore.”

The virus is still common on surfaces that babies touch, however, and “if you lower immunization rates it will once again hospitalize children,” Offit said.

Meningococcal vaccines. These have been required mainly for teenagers and college students, who are notably vulnerable to critical illness caused by the bacteria. About 600 to 1,000 cases of meningococcal disease are reported in the United States each year, but it kills more than 10% of those it sickens, and 1 in 5 survivors have permanent disabilities.

Flu and Covid. The two respiratory viruses have each killed hundreds of children in recent years — though both tend to be much more severe in older adults. Flu is on the upswing in the United States, and last flu season the virus killed 289 children.

What is shared clinical decision-making?

Under the changes, decisions about vaccinating children against influenza, Covid, rotavirus, meningococcal disease, and hepatitis A and B will now rely on what officials call “shared clinical decision-making,” meaning families will have to consult with a health care provider to determine whether a vaccine is appropriate.

“It means a provider should have a conversation with the patient to lay out the risks and the benefits and make a decision for that individual person,” said Lori Handy, a pediatric infectious disease specialist at the Children’s Hospital of Philadelphia.

In the past, the CDC used that term only in reference to narrow circumstances, like whether a person in a monogamous relationship needed the HPV vaccine, which prevents a sexually transmitted infection and certain cancers.

The CDC’s new approach doesn’t line up with the science because of the proven protective benefit the vaccines have for the vast majority of the population, Handy said.

In their report justifying the changes, HHS officials Tracy Beth Høeg and Martin Kulldorff said the U.S. vaccination system requires more safety research and more parental choice. Eroding trust in public health caused in part by an overly large vaccine schedule had led more parents to shun vaccination against major threats like measles, they said.

Georgia parents show strong confidence in childhood vaccines as federal guidance shifts

The vaccines on the schedule that the CDC has altered were backed up by extensive safety research when they were evaluated and approved by the FDA.

“They’re held to a safety standard higher than any other medical intervention that we have,” Handy said. “The value of routine recommendations is that it really helps the public understand that this has been vetted upside down and backwards in every which way.”

Eric Ball, a pediatrician in Orange County, California, said the change in guidance will cause more confusion among parents who think it means a vaccine’s safety is in question.

“It is critical for public health that recommendations for vaccines are very clear and concise,” Ball said. “Anything to muddy the water is just going to lead to more children getting sick.”

Ball said that instead of focusing on a child’s individual health needs, he often has to spend limited clinic time reassuring parents that vaccines are safe. A “shared clinical decision-making” status for a vaccine has no relationship to safety concerns, but parents may think it does.

HHS’s changes do not affect state vaccination laws and therefore should allow prudent medical practitioners to carry on as before, said Richard Hughes IV, an attorney and a George Washington University lecturer who is leading litigation against Kennedy over vaccine changes.

“You could expect that any pediatrician is going to follow sound evidence and recommend that their patients be vaccinated,” he said. The law protects providers who follow professional care guidelines, he said, and “RSV, meningococcal, and hepatitis remain serious health threats for children in this country.”

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

South Carolina measles outbreak grows in wake of holiday season

2026-01-06T21:39:20+00:00

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The ongoing measles outbreak in South Carolina – one of the nation’s largest in recent months – continues to grow in the wake of the holiday season, with 26 new infections reported Tuesday.

This surge in new cases raises to 211 the total number of people infected in the outbreak, which began last fall and is centered in Spartanburg County, along the state’s northwestern border.

Nearly all of those infected have been children and teens, and nearly all have been unvaccinated, according to the South Carolina Department of Public Health. Four people, including children and adults, have been hospitalized for complications of the disease.

“The sharp increase in cases and the number of people currently in quarantine does not indicate the outbreak is waning,” said Dr. Linda Bell, the state epidemiologist who is leading the department’s measles response.

“The primary challenge to controlling measles spread is the lower than needed vaccination coverage to achieve herd immunity in the community,” she said.

Statewide, the percentage of students who are fully vaccinated with two doses of measles vaccine has fallen below the 95% needed to protect against outbreaks. At some individual schools, vaccination rates can be significantly lower.

South Carolina’s outbreak is among 49 U.S. outbreaks reported during 2025, according to the Centers for Disease Control and Prevention. Nationwide, these outbreaks were responsible for most of the 2,065 confirmed measles cases nationwide last year, according to CDC data that was most recently updated on Dec. 31.

While scientists race to study spread of measles in U.S., Kennedy unravels hard-won gains

It’s the first time in more than 30 years that the number of measles cases in the United States has exceeded 2,000. There were three deaths.

Arizona, which also is experiencing a recent outbreak of measles along the Arizona-Utah border, had identified 214 infections as of its update on Tuesday. In Utah, 156 people had been diagnosed with measles in that outbreak as of Dec. 30.

Texas, which announced the end to its significant measles outbreak in August, confirmed more than 760 cases, with 99 people hospitalized and two deaths of school-age children.

The United States was deemed to have eliminated measles in 2000. But the ongoing outbreaks that began last year have put the country at risk of losing its measles elimination status.

In South Carolina, state health officials on Tuesday said 144 people are in quarantine and seven more are in isolation. For those in quarantine, the latest end date is Jan. 28.

The outbreak shows no signs of being brought under control. The state health department said the newly identified cases potentially exposed others to measles in multiple public settings, including schools and churches.

It typically takes 7 to 12 days – but sometimes up to 21 days – after exposure for people to start showing initial symptoms, such as cough, runny nose, red eyes, and a fever, which are later followed by a rash. That means those who were exposed and became infected in late December will start showing symptoms now and in the coming days.

“This disease finds pockets of unvaccinated folks and just runs through those pockets like wildfire,” said Dr. Robert Oliverio, chief medical officer for ambulatory care and population health for Roper St. Francis Healthcare in Charleston. “It tends to hit hard. These couple of school systems in the Upstate now are really getting decimated.”

While the outbreak has so far been centered around Spartanburg County on the northern edge of the state, he said he wouldn’t be surprised to see cases in other parts of the state. “I can’t imagine that we’ll get through this season, particularly with schools getting back in and kids traveling around.”

A person who has measles is contagious starting four days before the disease’s hallmark rash appears and continues to be able to spread the virus through four days after symptoms appear. South Carolina health officials have emphasized that this means people can spread the disease before they know they are infected.

“It is very important for those with mild illness or who are in quarantine to stay home to protect others,” the state health department said Tuesday. “We encourage employers to support workers in following DPH recommendations to stay out of work while ill or in quarantine. which also protects businesses, other workers, and clients.”

Among the places where new public exposures to measles have occurred: Sugar Ridge Elementary and Boiling Springs Elementary on Dec. 18 and 19, prior to the schools’ winter break. Nine students of these schools are in quarantine, state health officials said.

Between Dec. 19 and Dec. 25, exposures occurred at four churches: Tabernacle of Salvation Church, Slavic Pentecostal Church of Spartanburg, Unitarian Universalist Church of Spartanburg, and Ark of Salvation Church.

Over the weekend, South Carolina health officials issued another public alert that a person infected with measles – who was unaware they were infectious – had made Christmas Eve visits in Greenville, S.C., to a Best Buy store and a downtown gastropub called the Nose Dive. Then on Dec. 27, the person attended a planetarium show at the Spartanburg Library.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

Flu is spreading across Georgia. Hospitals urge masking and vaccination.

2026-01-02T20:21:46+00:00

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As flu rates increase in Georgia, forcing families to replace trips to visit grandparents with trips to the doctor, local health systems are asking people to mask up and warning patients of longer wait times in the emergency room.

It’s hard to say exactly how many cases of flu there are in Atlanta, in part because of reporting delays due to the holidays. Many people now test for flu at home, said Dr. Andrew Thornton, a doctor who works in Wellstar urgent care clinics in Atlanta. That means official data sources are likely an undercount.

But health systems say they are being hit hard – and they expect the number of cases to increase in the coming weeks. Meanwhile, Georgia’s flu vaccination rates remain low, putting more people at risk of complications and even death.

Twenty-nine people died from flu in Georgia between the start of the season in October and Dec. 27, according to data from the Georgia Department of Public Health. That includes seven during Christmas week, Dec. 21-27. There were 1,580 hospitalizations for flu in an eight-county metro Atlanta area in the same period.

“We’re seeing a huge rise in flu these last couple of weeks,” Thornton said. And wastewater data from Wastewater Scan shows steady increases in flu in Atlanta over the course of December.

“It causes a major issue with volume, because not only does it fill our urgent cares, but it also can fill primary care practices and pediatric offices and also the emergency rooms and hospitals,” Thornton said.

Why flu season will likely be worse this year and how to prepare

Health care systems face an added strain when their workers get sick, he said. “Everyone gets affected by these spikes in flu cases.”

Georgia’s December surge is in line with national trends. Nationwide, the Centers for Disease Control and Prevention reported an increase of about 10,000 flu cases between Dec. 13 and 20.

There are several reasons for the increase, including a mismatch between the variant of flu covered by this season’s flu vaccine and the dominant type circulating (H3N2) relatively early in the season. That’s likely compounded by low vaccination rates.

Northeast Georgia Health System this week started requiring its staff to wear masks, and it strongly encourages patients to do so as well. On Friday, the system had 85 patients admitted for flu across its five hospitals, and 37.5% of the tests administered for flu came back positive for Influenza A this week, spokesperson Layne Saliba said. That’s about 10 percentage points higher than the same time last year.

“We are seeing an increase in very sick kids and teens this cold and flu season,” Children’s Healthcare of Atlanta’s website says, and the health system is requiring people over age 2 to wear masks in its facilities.

Emory Healthcare has created a dedicated 24/7 flu hotline where patients can speak to a nurse and be connected with the right kind of care. As of Tuesday, it is also asking people to wear masks while visiting its health care facilities.

‘I feel like I got hit by a train’

Thornton said telemedicine can be a good option for patients who want to stay home – and it can help relieve the pressure on local health systems. But people who are at higher risk for complications may want to see a doctor in person.

Rapid flu tests, whether self-administered at home or in a clinic, are about 70% accurate, Thornton said, but can sometimes result in false negatives. So health care providers also rely on other clues to diagnose and track flu.

Patients typically describe flu as having a very rapid onset of symptoms like body aches, fever, and respiratory ailments, which can help distinguish it from a cold or other illness, Thornton said.

“People tend to describe it very similarly. They say, ‘I feel like I got hit by a train’ or ‘I got hit by a bus’,” Thornton said. That telltale descriptor helps providers distinguish flu from a bad cold.

People at high risk for complications – such as the elderly, pregnant people, and those with certain chronic health conditions or who are immunocompromised – should check in with a medical provider, Thornton said. It’s also important to ensure that the flu does not progress to pneumonia or another complication.

Treatments like Tamiflu can reduce the severity of the flu if administered in time. Nationwide, the number of such prescriptions filled during December increased, another sign that flu cases are on the rise, according to data from GoodRx’s research team.

“We don’t want to see any deaths from the flu virus, and especially if we have a vaccine that can help protect people,” Thornton said.

Even though this year’s vaccine doesn’t perfectly match the current variant that is circulating widely (H3N2), it still provides good protection and reduces risk of serious complications and death from the disease.

Most Georgians have skipped the shot, with just 17.7% of adults and 12.6% of children age 6 months to 17 years vaccinated by the end of November, according to data from the CDC.

Cases could rise when metro school systems reopen next week, Thornton said.

“There’s a lot of factors involved. How many people picked up the virus over the holidays? How high are the vaccination rates in kids right now? We don’t quite have all that data yet, so it will remain to be seen,” Thornton said.

RSV, Covid are also on the rise

Thornton said he’s seen a “slight increase” in Covid cases over the past few weeks. He’s also noticed an uptick in RSV cases.

As of Dec. 20, CDC wastewater data showed Georgia with a moderate level of RSV and a very low level of Covid cases. The number of positive tests for RSV at selected clinical laboratories in Georgia increased during December as well, according to DPH data for the same period.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

5 From the Field: Q&A with Harris County Public Health official Ericka Brown

2025-12-24T12:00:00+00:00

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Dr. Ericka Brown, the local health authority at Harris County Public Health in metro Houston, began her career as a physician providing clinical care.

But Brown was always focused on helping underserved communities, she said, initially working in Harris County’s safety net health system and now serving as the county health department’s division director for community health and wellness.

We recently spoke with Brown to get her insights on five questions about her public health work in Texas’ largest county by population. This 5 From the Field interview has been edited for clarity and length.

What drew you to a career in public health? Is it something you planned? Did you stumble into it?

It’s a little bit of both. I am a family medicine physician by training, and when I trained, there was not much education or exposure to public health. It was strictly clinical practice. I always practiced with underserved communities. As a provider, that’s just my love.

Now I get to affect the lives of patients and vulnerable populations, not just one patient at a time, but really thinking about it from a more global perspective, and driving the health of the community forward.

What are the one or two most pressing public health issues that your department is working on right now?

Immunizations. It’s really a huge issue since Covid and the politicization of immunizations. There is a lot of misinformation, which leads people to make misinformed decisions. So providing factual, scientific, evidence-based information about immunizations is one of the key issues we’re working on.

The other issue is equity, specifically equity for marginalized, vulnerable populations. Not just around their medical care, but around all the social support drivers that make a community healthy.

Access is one of the biggest issues. Providing education to the community and support about what is out there and what is everyone eligible for, what’s available. Then working with those partners to make sure that there is direct access and that the barriers to that social support service or medical service are removed, whether it be a language barrier, transportation barrier, or financial barrier.

How has declining public trust impacted the work your department is doing in the community?

It makes it more difficult.

The role of the community health workers and our outreach teams is very important to make sure we are reaching into communities from a culturally responsible perspective. I can say for Harris County Public Health, that is something that we do very well.

We are still a trusted member of the community, and I think that that is something that was built over time, and it is withstanding what is happening now.

We have a huge network of community health workers, both internal to our department and with external partnerships. These are people who are trusted advisers in the community, who are of the communities and part of that culture.

This goes a very long way to be able to speak to different communities in a culturally competent way, so that they can hear and receive the message that we are trying to give, hear and receive information about resources, about prevention. And they can trust that the information is factual.

What public health accomplishments are you particularly proud of?

My division holds all of the clinical and some of the social support services for the county public health department.

The team has done a phenomenal job at standing up a maternal-child health program, a Healthy Start program, and one of the leading WIC programs. Harris County, unfortunately, has one of the highest Black maternal mortality rates in the country.

It is our role to not only provide a strategy on how to move the needle in improving those outcomes, but to bring the community together and then to also provide programming around that.

Our clinical services for those who are vulnerable, in marginalized populations, who may be uninsured or under-insured, provides a range of health services, such as dental services, preventive services, STI [sexually transmitted infection] testing and treatment. Our substance use department is doing a phenomenal job at educating the community about the substance misuse problems that we have in our county, what to do about them, how to destigmatize those who are suffering from that condition.

Those are just some of the things that I’m just extremely proud of that we’ve been able to make a difference in improving the health of the community.

It’s the holiday travel season. Do you have any personal best practices for staying healthy when you travel?

When I’m sick, or when my children or someone in my family is sick, I stay home. You may not have the flu, you may not have Covid, but you have something. Nine times out of 10 that something is contagious. So, I try to stay home and keep my germs to myself.

If I’m traveling on a plane, I am one of those people that has my own sani-wipes, and I wipe my space down.

Certainly when we’re traveling, hand washing with soap and water is really key because all of those things we’re touching, other people are touching. It’s a naturally occurring thing that germs are around.

I am a huge proponent of vaccinations for myself, for my children, for my family. I do think they keep the public and myself and my family safer. So getting vaccinations at least two weeks prior to travel, because immunity has to have time to build up.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

Inside the FDA’s vaccine uproar: It’s not just about Covid shots

2025-12-19T16:02:40+00:00

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Six days after a senior Food and Drug Administration official sent a sweeping internal email claiming that Covid vaccines had caused the deaths of “at least 10 children,” 12 former FDA commissioners released an extraordinary warning in the Dec. 3 issue of the New England Journal of Medicine.

They wrote that the claims and policy changes in the memo from Vinay Prasad, the head of the FDA’s Center for Biologics Evaluation and Research, pose “a threat to evidence-based vaccine policy and public health security” and break sharply from longstanding scientific norms.

What is unfolding inside the FDA is not a narrow dispute over Covid vaccines. It is an attempt, according to critics and vaccine scientists, to rewrite the rules governing the entire U.S. vaccine system — how risks are weighed, how benefits are proved, and how quickly lifesaving shots reach the public. Former agency leaders warn that if these changes take hold, the consequences could be lasting: fewer vaccines, slower updates, weakened public trust, and more preventable outbreaks.

Prasad made clear he sees the moment as corrective. “Never again will the U.S. FDA commissioner have to himself find deaths in children for staff to identify it,” he wrote, telling employees the agency’s mission, and its “worldview,” would change.

Prasad’s email reopened old arguments about Covid vaccines, using what is generally considered weak and misleading science in the peer-reviewed research community. He claimed that FDA staff had found “at least 10” deaths in children that happened “after and because of” Covid vaccination, using reports from the Vaccine Adverse Event Reporting System.

The VAERS system is notoriously crowdsourced, meaning anyone can contribute, and scientists say it serves only as a clearinghouse for reports. For example, a person could file a report saying that after getting a flu shot, their hair turned purple. Though that report would remain in the database until it was reviewed, it cannot prove the cause of medical events. But Prasad argued that the true number of deaths was likely higher because many cases go unreported.

On Substack, Inside Medicine reported Dec. 11 that Prasad used incomplete information and that a Dec. 5 internal FDA memo set the pediatric death toll from Covid shots somewhere between zero and seven. Department of Health and Human Services spokesperson Emily Hilliard wrote, “The FDA’s investigation into deaths caused by Covid vaccines is still ongoing and there’s no final count yet of those deaths.”

Prasad also accused the FDA and the Centers for Disease Control and Prevention of downplaying the risk of heart inflammation, called myocarditis, in young men; criticized the agency for approving shots for teenagers; and suggested that school and workplace vaccine mandates may have “harmed more children than we saved,” adding that “we do not know if we saved lives on balance.”

By comparison, more than 2,100 American children died of Covid itself since the pandemic began, the CDC reported.

Based on his erroneous and misleading claims about Covid vaccines, Prasad proposed a major overhaul of how vaccines are approved. He said the FDA should stop relying on immune markers to establish the efficacy of shots, such as antibody levels, and instead require large placebo-controlled randomized trials that track hospitalizations and deaths before approving most new vaccines.

Many immunologists and vaccine experts say it’s unethical to test vaccines known to be effective against disease with a control group that would receive a placebo, exposing them to infection.

“There is a rock-solid principle in bioethics that it is unethical to test any drug or vaccine against a placebo if it is known to be safe and effective. The reason is that such placebo-controlled trials would effectively deny patients access to a vaccine that could prevent a dangerous infectious disease,” said Lawrence Gostin, a professor of global health law at Georgetown University.

Prasad called the current flu vaccine system an “evidence-based catastrophe,” questioned the approval of vaccines for pregnant women based on immune response alone, and raised concerns about giving multiple vaccines at once. He told staff to rewrite FDA guidelines to match his new “worldview” and said anyone who disagreed with his “core principles” should resign.

The former FDA leaders expressed alarm in the NEJM article. They said Prasad is exploiting public frustration over the federal response to Covid to spark doubt about the entire childhood vaccine system, which could undo decades of success in protecting children from deadly diseases.

“This is really different. And it’s really dangerous. And people will be hurt, particularly by the vaccine decisions,” former FDA Commissioner Robert Califf said in an interview. He also warned that Prasad’s proposed policies — which he noted echo positions on vaccines held by Health and Human Services Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist — could shake the entire vaccine market.

“The goal of RFK seems to be to make it impossible for vaccines to be available in the U.S.,” he said. If the proposals advance, he added, “it won’t be a viable business.”

Hilliard pushed back sharply on those concerns, writing: “The American people deserve evidence-based science. Prasad’s email lays out a philosophical framework that points us toward that higher standard. We will soon release documents laying out that framework and data confirming how the Covid vaccine resulted in children’s deaths that previous leadership failed to properly investigate.”

For generations, the childhood vaccine program has depended on clear rules, strong safety systems, and public trust. Experts say Prasad’s ideas, based on claims they argue are not supported by real evidence, could make it much harder to test, approve, and deliver vaccines to families.

Prasad’s framework could fuel parental doubt

Prasad’s memo indicates he considers VAERS reports as proof that vaccines caused children’s deaths. The system, though, is designed to be only an “early warning system” for potential safety issues with vaccines that can be investigated further.

“VAERS signals should never be taken as proof of true vaccine risks without careful, confirmatory studies,” said Katherine Yih, an epidemiologist and longtime investigator with the Vaccine Safety Datalink, a CDC program.

Doing so, scientists say, directly feeds public fear at a time when many parents are already unsure whom to trust.

“Causation requires converging evidence, not just one report or coincidence,” said Robert Hopkins, medical director of the National Foundation for Infectious Diseases.

Prasad’s framework, however, treats uncertainty as a reason to halt development entirely.

Experts fear this doubt won’t stay limited to Covid vaccines. Once parents start to question the FDA’s honesty, they may begin doubting longstanding vaccines for measles, polio, or whooping cough — shots that have protected children for decades.

“Science must be transparent,” Gostin said. If families believe the FDA is misusing data or silencing experts, confidence in the entire vaccine system can collapse, he said. “There’s a public narrative that people have lost trust in science, but that’s not true. The vast majority want the FDA to make decisions based on the best scientific evidence. Once they believe that the agency is marginalizing scientists and cherry-picking evidence, their trust will plummet.”

Vaccine pipeline is delicate

Prasad’s new framework will likely make it far harder for companies to produce or update vaccines. The 12 former FDA commissioners warned that requiring clinical trials for all new or updated shots would slow vaccine improvements and leave people unprotected. His plan, they wrote, “would impede the ability to update vaccines in a timely fashion, especially for respiratory viruses.”

For fast-changing viruses like flu and Covid, this could be disastrous. There’s simply not enough time to run full clinical trials every time a virus mutates.

There are also major business effects. Vaccine development is costly, and companies may decide the United States is no longer worth the risk. If companies slow down or leave the market, families could face shortages, fewer innovations, and fewer protections for their kids.

Science depends on ‘checks and balances’

Science depends on open and public debate. Prasad’s memo warned his employees against it. In addition to demanding that FDA staff members who disagree with him resign, he said their disputes should stay private and called leaks “unethical” and “illegal.”

Susan Ellenberg, a former director of the FDA’s Office of Biostatistics and Epidemiology, warned that Prasad risks destroying the process that makes science credible. “If disagreement is treated as disloyalty, you lose the only mechanism that keeps science honest,” she said.

Without strong internal debate, safety reviews become weaker. “You lose the checks and balances that make vaccine safety science credible,” said Kathryn Edwards, a pediatric infectious disease specialist at Vanderbilt University Medical Center who served on the Clinical Immunization Safety Assessment Network during the Covid pandemic.

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

Hospitals mum on how they’ll handle new guidance on hepatitis B shots for newborns

2025-12-18T00:11:17+00:00

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Maternity hospitals across the country will now play a significant role in whether babies will universally be vaccinated against hepatitis B at birth as the federal government drops its long-held recommendation for the shot.

But many of the nation’s largest maternity hospitals wouldn’t answer questions over the past week about their current policies and how they will handle the changing guidance.

The guidance now only recommends a birth dose of the vaccine for a subset of babies whose mothers test positive for the hepatitis B virus or whose status is unknown. They further suggest that mothers who test negative for the virus but still want to vaccinate their babies delay the shots for at least two months after birth – a dramatic change that major medical societies say will cause a resurgence of liver disease.

Late Tuesday, the Centers for Disease Control and Prevention announced that its acting director, Jim O’Neill, had approved the vaccine recommendations made early this month by an advisory panel that had been reconstituted to only include members selected by Health and Human Services Secretary Robert F. Kennedy Jr., a vaccine critic.

Healthbeat asked 10 of the nation’s largest maternity hospitals and systems that deliver the most babies about their existing policies for hepatitis B birth doses and whether they are changing as a result of the new CDC Advisory Committee on Immunization Practices guidance. These 10 hospitals and systems delivered more than 227,000 babies in 2024, according to the American Hospital Association’s annual survey data.

All but two of these large maternity hospitals wouldn’t answer specific questions – in writing or in an interview – about their hepatitis B birth-dose policies, existing standing orders for newborns, or any impact of the new federal guidance.

“Unfortunately we will not be able to provide anyone to speak on this matter at this time,” said a spokesperson for Northside Hospital in Atlanta. The spokesperson didn’t respond to questions about why.

Vaccine panel’s hepatitis B vote signals further turbulence for immunization policy, public trust

At Orlando Health Orlando Regional Medical Center in Florida, a spokesperson responded similarly and without explanation: “We are unable to assist with this request.” Healthbeat received similar responses from several of the other large maternity hospitals.

HCA Healthcare, one of the nation’s largest hospital chains, equivocated without answering questions about individual hospital policies or how they may change. HCA helps operate St. David’s North Austin Medical Center in Texas, which is listed among the American Hospital Association’s largest maternity hospitals.

“As a health system, it is our practice to support our physicians by providing information and best practices, including the latest guidance from CDC as well as professional societies, so they can use their extensive training and experience to exercise their independent medical judgment to assess patients’ needs and determine appropriate care,” HCA said in a statement to Healthbeat.

Other hospitals and systems that didn’t answer Healthbeat’s questions included: NYU Langone Hospitals in New York City, Parkland Health in Dallas, AdventHealth Orlando in Florida, and Northwestern Memorial Hospital in Chicago.

A spokesperson for the American Hospital Association said the group had no comment on why so many of the nation’s largest maternity hospitals seemed reluctant to discuss how they are responding to the change in federal guidance.

Two large maternity hospitals told Healthbeat they plan to continue to offer and recommend universal hepatitis B vaccination for babies born at their facilities regardless of whether their mothers have tested positive, a practice that continues to be endorsed by the American Academy of Pediatrics, the American Academy of Family Physicians, and numerous other major medical societies.

At Memorial Hermann Greater Heights Hospital in Houston, the birth dose of hepatitis B vaccine will continue to be offered to all newborns, said Dr. Luis Ostrosky, chief epidemiology officer for the Memorial Hermann Health System.

“Following best evidence and guidance from major medical societies, Memorial Hermann will continue to offer and recommend neonatal hepatitis B vaccination, in line with the American Academy of Pediatrics immunization schedule,” Ostrosky said. “Parents will continue to have the choice – as has always been the case – to accept or decline the recommended guidance, in consultation with their health care provider.”

Babies born on the Inova Fairfax Medical Campus, located in Falls Church, Virginia, near the nation’s capital, also will continue to be universally offered a birth dose of the vaccine, which a spokesperson for the system said remains a part of its standard newborn nursery order to be given within 24 hours of birth with parental consent.

“Inova follows the American Academy of Pediatrics recommendation for universal Hepatitis B vaccination at birth due to the decades of clinical and scientific evidence demonstrating its safety and efficacy in preventing serious illness,” the health system said in an email to Healthbeat. “Decisions regarding vaccination are always made collaboratively between Inova patients and their care providers.”

It appears that New York-Presbyterian Hospitals in New York City also are continuing to provide universal birth doses. This system gave an obscure, one-sentence response to Healthbeat without providing details of its birth dose policies or standing orders. It said: “All our hospitals follow NYSDOH guidance and established best practices,” referring to the New York State Department of Health. The department’s website says it continues to recommend the universal birth dose.

The CDC had recommended universal vaccination of newborns since 1991. Since that time the annual number of reported cases among U.S. infants and children has dropped by 99%, from 16,000 to less than 20, according to the American Academy of Pediatrics.

The birth dose of the vaccine prevents the virus from being transmitted to babies during childbirth and protects them during childhood against infections that can be spread by family members and other caregivers who often are unaware they are infected.

The virus is highly contagious and spreads through contact with blood and body fluids. It can spread through sharing personal items such as razors, toothbrushes, and nail clippers, as well as through sexual contact and the use of unsterile needles.

RFK Jr. wants to delay the hepatitis B vaccine. Here’s what parents need to know.

“This is a vaccine that we have several decades of experience with. We know it’s safe, we know it’s effective, and we know that it’s important,” said Dr. Michael Warren, chief medical and health officer for the March of Dimes, who previously served as the associate administrator of the federal Health Resources and Services Administration’s maternal and child health bureau.

Warren said it’s unclear whether the changing federal guidance will create any barriers to families accessing birth doses for their infants when they deliver at hospitals across the country.

“Hospital policy absolutely does matter,” Warren said. “Almost all babies in this country are born in hospital settings, and so the hospital is really this important front door to a life of good health, and that starts with that routine newborn care, including that birth dose of hepatitis B vaccine.”

If hospital policies were to create barriers, it would contribute to a decrease in vaccination rates and an increase in cases of hepatitis B infections, which can cause cirrhosis, liver failure, and liver cancer, he said.

Warren said he can’t speculate why hospitals seemed reluctant to answer Healthbeat’s questions about their policies and response to the federal guidance. He said he’s heard anecdotally that some hospitals are planning to continue offering universal birth doses.

In Michigan, several health systems – Corewell Health, Henry Ford Health, McLaren Health Care, Munson Healthcare and the University of Michigan Health – have said they will continue to provide universal hepatitis B immunization of newborns, according to the Detroit Free Press.

Warren noted that several state health departments have issued recommendations encouraging parents to continue to have their babies universally vaccinated at birth. A few have issued standing orders or executive directives that authorize providers to administer the doses.

“I hope that their hospitals and those states will follow those recommendations,” Warren said.

Parents who want their babies to receive the birth dose or who have questions about the vaccine can talk with their obstetricians and pediatricians, he said.

“We hope that families are always asking questions about routine newborn care and why it’s important to have these recommended pieces of care done,” Warren said.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

Why flu season will likely be worse this year and how to prepare

2025-12-16T18:53:37+00:00

Dr. Jay K. Varma is a special contributor to Healthbeat. Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

In my clinic last week, I began to see the signs of what I have been fearing for months. Two patients came in on the same day with high fever, sore throat, and body aches. Both tested positive for influenza.

While there is nothing remarkable about people getting the flu in the winter, what worries me is the timing and spread. Across New York state, influenza activity is already far higher than it was at this point in recent years. During the week ending Dec. 6, there were more than 12,000 reported flu cases and nearly 1,400 hospitalizations. During the same week last year, there were fewer than 5,000 cases and about 300 hospitalizations. Two years ago, cases were similarly high, but hospitalizations were substantially lower.

This season, influenza is arriving earlier, spreading faster, and sending more people to the hospital. The United States is heading into a flu season that is likely to be worse than what we have experienced in recent winters.

Why this flu season is likely to be severe

Several factors are converging at the same time to increase the likelihood of a severe flu season.

The first factor is viral evolution. The dominant strain right now is influenza A H3N2, and it has accumulated mutations that allow it to partially evade prior immunity. This strain has already driven early and large flu surges in other parts of the northern hemisphere, including Japan, the United Kingdom, and parts of Europe. Some hospitals in those countries reported seeing January level flu activity as early as October.

The second factor is timing. Flu has arrived earlier than usual before health systems have fully prepared and before vaccination campaigns have reached their peak, so the pressure builds faster.

The third factor is behavioral. During the Covid pandemic, many people adopted habits that reduced flu transmission, including masking in crowded indoor spaces, staying home when sick, and improving indoor air quality and ventilation. Most of those practices have faded. At the same time, fewer Americans are getting their annual flu vaccine. Adult flu vaccination coverage has declined over the past several years, particularly among people under 65 who nonetheless have medical conditions that put them at higher risk of complications.

Finally, hospitals are entering this winter with little reserve. Emergency departments, inpatient wards, and intensive care units are operating close to capacity even before seasonal respiratory viruses peak. In that context, a severe flu season can make it much harder for people to get prompt and high-quality care in outpatient and inpatient facilities.

What we know about this year’s flu vaccine

Because of the way influenza viruses mutate and the waning of human immunity over time, the effectiveness of the seasonal flu vaccine varies each winter. Every spring, global experts analyze data and try to predict what influenza strains are likely to circulate in the coming winter. When circulating viruses mutate after those strains are selected, the match between vaccine and virus can be imperfect.

That is what has happened this year. Data from the United Kingdom show that the dominant H3N2 subclade circulating this winter is different from the strain used to produce the northern hemisphere vaccine. Laboratory studies confirm reduced reactivity between the vaccine strain and the circulating virus.

Early vaccine effectiveness data from the UK show that, despite this mismatch, vaccination does reduce severe illness, albeit not as much as we would like. The vaccine reduced emergency department visits and hospital admissions by 72%-75% among children and adolescents and 32%-39% among adults.

This aligns with how I have been counseling patients in my clinic. The flu vaccine does not guarantee that you will avoid infection. What it does is lower the odds that influenza turns into pneumonia, respiratory failure, or a hospital stay – turning a “wild” infection into a “mild” infection.

In a year when hospitals are stretched thin, that difference matters both for individuals and for the entire health system.

What public health agencies can do now

While the Centers for Disease Control and Prevention’s website still recommends annual seasonal flu vaccination for anyone ages 6 months or older, it is unlikely the CDC will be permitted to run advertising this year to promote that recommendation, as it has in years past. Last February, soon after taking office, the new Health and Human Services secretary cancelled the CDC’s 2024-25 flu vaccination campaign.

State and local health departments can fill that gap by promoting flu vaccine through all available channels and enlisting social media influencers to promote it as well. The priority is demographic groups and settings where flu spreads quickly and causes disproportionate harm. Nursing homes, assisted living facilities, long-term care facilities, shelters, jails, and prisons all require targeted vaccination efforts, rapid testing access, and clear infection control guidance.

Clinicians also need reminders about antiviral treatment. Medications like oseltamivir are only effective when started as soon as symptoms begin and primarily benefit populations at highest risk for severe complications, including young children, pregnant people, older adults, and those with chronic medical conditions. Too often, opportunities to reduce severity are missed because testing and treatment are delayed.

What health care facilities can do now

While flu season has begun, hospitals and clinics still have time to bolster their capacity to handle future surges. Bolstering capacity starts with ensuring their staff do not become severely ill from influenza.

Many patients arrive at a facility with one illness, but leave with influenza, because respiratory viruses spread easily inside health facilities. Facilities need to upgrade the completeness of screening patients for respiratory symptoms at initial intake, then isolating and testing patients for influenza and other respiratory viruses. Masking policies that include visitors, especially in patient care areas, remain a simple and effective tool during periods of high respiratory virus circulation. Assessing airflow, upgrading central air filtration, and using portable air purifiers in crowded spaces can reduce viral spread indoors. These improvements benefit patients and staff well beyond this flu season.

What employers can do now

Employers have more influence on flu spread in their offices and communities than they often realize. Providing paid time off for vaccination or offering on-site flu clinics removes a major barrier for many workers. Encouraging employees to stay home when sick and permitting remote work, rather than rewarding them for showing up despite illness, reduces outbreaks in the workplace.

Making high-quality masks available to employees that want to use them, improving ventilation, and offering home test kits are relatively low-cost interventions that can protect workforce health and continuity.

What individuals can do

This will be the first flu season since federal officials instituted severe cuts to infectious diseases and immunization programs across the country. For individuals, this means that it is more important than ever to take pro-active steps to protect your and your family’s health. Get vaccinated if you have not already. Keep high-quality masks and home test kits available in your home. If symptoms start, test early and contact a health care provider if you are at higher risk and may benefit from antiviral treatment.

Dr. Jay K. Varma is a physician and epidemiologist. An expert in the prevention and control of infectious diseases, he has led epidemic responses, developed global and national policies, and implemented large-scale programs that saved hundreds of thousands of lives in Asia, Africa, and the United States.

Georgia parents show strong confidence in childhood vaccines as federal guidance shifts

2025-12-12T22:03:50+00:00

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At a time when federal health officials are questioning or even abandoning long-held childhood vaccine recommendations, nearly 90% of Georgia parents believe the vaccines are safe, and more than 93% trust their pediatricians to guide them, according to a new survey.

Data was released this week from the Emory University Center for Child Policy from an online survey of 1,002 parents conducted by polling firm Ipsos between Oct. 30 and Nov. 24. Results found that 87.9% believe routine childhood vaccinations are safe.

Researchers released the data earlier than planned in the wake of last week’s decision by a federal immunization advisory panel to reverse a recommendation that all newborns be vaccinated against hepatitis B.

Lead author Dr. Stephen Patrick, a neonatalogist, said he was reassured that so many Georgia parents still support the vaccines.

“Despite all of this noise, Georgia parents have the same level of confidence in vaccines that they had a year ago,” Patrick said. “My worries as a clinician and a public health professional are that this is going to weaken people’s views … it doesn’t appear that that’s happened yet.”

Georgia parents appear to be in step with national trends, which show that “the vast majority of parents believe that vaccines are effective for protecting both their children and the community,” said Scott Thorpe, executive director of the Southern Alliance for Public Health Leadership, an advocacy group that works in four Southern states, including Georgia.

More than 70% of the parents surveyed said they strongly or somewhat support the hepatitis B vaccine at birth. Close to 13% said they somewhat or strongly oppose the newborn shot. Receiving it within 24 hours of birth is “highly effective in preventing infection in newborns,” according to the American Academy of Pediatrics, and 98% of children who receive the full three-dose series achieve full immunity to hepatitis B.

Vaccine panel’s hepatitis B vote signals further turbulence for immunization policy, public trust

In Georgia, 72.7% of newborns received the vaccine within 24 hours of birth in 2021, with that number rising to 77.1% within three days of birth, according to Centers for Disease Control and Prevention data for children born in 2021, the latest available. That’s down from a decade ago, when 83.8% of newborns got the shot within three days of birth.

Georgia’s numbers are close to but slightly lower than national rates. The state’s rate has also fallen from a decade ago.

The new recommendation, that doctors and parents engage in “shared decision making” about the vaccine, was approved Dec. 5 by the CDC’s Advisory Committee on Immunization Practices. The move has sown confusion among parents, doctors, and hospitals, Patrick said. He and other medical providers already consult with parents about the newborn hepatitis B and other routine vaccinations, so the new recommendation will not change how he practices.

“There’s a conversation first, and there’s consent that is given, period,” Patrick said.

“That recommendation just broadly weakens our approach, and it gets confusing,” Patrick said. “This is just another narrative that inserts doubt into parents to something where we know it’s both safe and effective and prevents a pretty bad illness that is lifelong for children.”

The birth dose of hepatitis B has all but eliminated the disease in American children, with a 99% drop in pediatric infections since the birth dose was introduced in 1991. It helps protect people from complications from the disease, including cirrhosis and liver cancer.

Hepatitis B can spread easily through contact among family members and live on surfaces for up to a week. The birth dose has prevented more than 6 million hepatitis B infections and nearly 1 million hospitalizations, according to a CDC analysis.

As leaders like Health and Human Services Secretary Robert F. Kennedy Jr. question longstanding childhood vaccine schedules, researchers added new questions to the survey to measure parents’ knowledge of how insurers decide whether to pay for vaccines and parents’ willingness to pay out-of-pocket for the shots, Patrick said.

About two-thirds of parents reported not knowing that ACIP recommendations shape whether insurers will cover routine childhood vaccines.

That makes sense, Thorpe said, adding that parents should not be expected to understand the “inner workings” of a committee “created to provide an expert, data-driven approach to vaccine recommendations.”

Most parents said they would be willing to pay cash for a vaccine for their child if insurance did not cover it, or they could not obtain it for free through a public program. Sixty percent said they were very or somewhat likely to; 20% said they were somewhat or very unlikely to; and 19.8% remained neutral.

But the number willing to pay for children’s vaccines dropped to 47.6% for parents making less than $75,000 per year. It was higher (67.7%) for those making more than $75,000 per year.

“That raises this potential rising issue that if we see big changes from ACIP, and insurers follow, then we might start running into trouble, particularly with folks that are not high income,” Patrick said.

The overwhelming majority of parents (93.4%) trust their child’s doctor for vaccine information. They also broadly trust local, state, and federal health agencies to provide accurate safety information about childhood vaccines.

Here’s how many Georgia parents trust these entities either a great deal or somewhat, according to the survey:

Their child’s doctor: 93.4%
Georgia Department of Public Health: 83.8%
Their county’s Department of Public Health: 80.9%
CDC: 73.3%
U.S. Food and Drug Administration: 71.17%

The findings about Georgia parents’ views on cost and trust are in line with national trends, Thorpe said, adding that many Georgia parents may skip vaccines for their children not due to misinformation alone, but because of logistical and cost barriers.

“Thousands of kindergartners in Georgia this year are neither up-to-date on vaccines nor claiming a religious exemption,” Thorpe said, suggesting their parents may have faced challenges in getting them to a medical provider in part due to cost.

“While it is encouraging that parents trust their child’s health care provider, that relationship isn’t helpful if parents lack the resources to afford a visit,” Thorpe said.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

What a Supreme Court decision on inclusive curriculum could mean for vaccine laws

2025-12-12T15:04:39+00:00

This story originally published at Chalkbeat. Sign up for Chalkbeat’s free weekly newsletter to keep up with how education is changing across the U.S. Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

What does the book “Pride Puppy!” have in common with a measles vaccine?

Some religious parents don’t want their children exposed to either one.

But is that position enough to overturn New York law and force the state to offer a religious exemption to Old Order Amish parents and others who say their faith does not allow them to vaccinate their children? That’s a question the U.S. Supreme Court recently told a lower court to consider.

In its Mahmoud v. Taylor ruling last summer, the Supreme Court’s conservative majority found that Montgomery County Public Schools’ interest in having all children learn from an LGBTQ-inclusive curriculum was not greater than parents’ rights to direct their children’s religious upbringing. Parents must have the ability to opt out, the court said.

On Monday, the Supreme Court vacated a decision by the U.S. Court of Appeals for the 2nd Circuit upholding New York’s vaccine mandate, which does not allow for religious exemptions, and told the lower court to reconsider it in light of the Mahmoud decision.

Legal experts told Chalkbeat that doesn’t mean the Supreme Court is poised to require religious exemptions. It’s not unusual for the Supreme Court to ask lower courts to re-examine rulings in light of new decisions that have even a tangential connection, they said. Often, the outcome remains the same.

But if the Supreme Court were confident Mahmoud had no bearing on vaccine law, the justices could have simply declined to take the case and let New York’s law stand, said Dorit Reiss, a law professor at the University of California San Francisco who has studied religious exemptions. Vaccine supporters should be concerned by the court’s decision not to take that course, she said.

“At the very least, they think there might be something there,” Reiss said. “But how much they believe it is up in the air.”

The case is playing out during a tenuous time for public health and as the Supreme Court steadily expands the bounds of religious freedom. An investigation by NBC News and Stanford University found vaccination rates falling and the use of exemptions rising in many communities. A measles outbreak killed two unvaccinated children in Texas, and the United States is at risk of losing its measles elimination status.

Many public health experts fear that under Health and Human Services Secretary Robert F. Kennedy Jr., the federal government is dismantling a vaccine infrastructure that saved countless lives and is actively undermining public trust in vaccines.

In a Dear Colleague letter earlier this year, Kennedy warned states they risk their federal funding if they don’t allow religious exemptions.

Most states already have religious or personal belief exemptions. Any change in the legal status quo would have limited effect. But it would take away a tool — narrowing or reducing exemptions — that has been shown to increase vaccination rates. Four of the five states without religious exemptions — California, New York, Connecticut, and Maine — tightened their requirements in recent years in response to disease outbreaks.

“It adds worry at a time when we have a lot to worry about with vaccines,” Reiss said.

Religious exemptions raise questions about sincerity

School vaccine mandates go back to the 19th century, and the courts have repeatedly upheld their validity, even without religious exemptions.

A 1970 measles outbreak in Texarkana underscored the role mandates could play in increasing vaccination rates — nearly all the cases occurred on the Texas side of the city, where there was no school mandate. Arkansas, in contrast, had a school mandate and had conducted mass vaccination campaigns. Along with federal incentives, the Texarkana example contributed to more widespread adoption of school vaccine requirements.

Many states adopted religious exemptions, Reiss said, with the assumption that only very small religious minorities would use them. Most major faith traditions allow or even encourage vaccination. But over time, these exemptions became widely abused and hard to police, she said. The government could not make religious exemptions conditional on membership in a particular faith, nor could the government require, say, that a Catholic follow the Pope’s teachings, or that a Jewish person listen to their rabbi.

But more significantly, Reiss said, people lie. Anti-vaccine Facebook groups coach non-religious parents on what to say to obtain a religious exemption, and studies find that parents claiming religious exemptions often cite safety concerns when questioned.

That dynamic contributed to states like California and New York removing religious exemptions. They now allow only medical exemptions.

The Texas-based First Liberty Institute, which is representing the Amish parents, argued in its petition to the Supreme Court that because New York allows medical exemptions, the lack of a religious exemption amounts to discrimination.

“Today in New York, if a vaccine would harm your lungs, you may be exempted; but if it would harm you soul, you may not,” attorneys wrote.

While not all Amish families reject vaccines, no one doubts the religious sincerity of the families suing the state, Reiss said. That makes the case one to watch.

“Yes our Almighty God wants us to fully put our faith + trust in Him,” Joseph Miller, one of the Amish parents suing New York, said in written testimony. “Which is in conflict to put our trust in vaccines. We are also commanded to not be conformed to this world.”

West Virginia’s vaccine mandate, with no religious exemption, has been in place since 1905, and the state enjoys very high vaccination rates. Gov. Patrick Morissey, a Republican, issued an executive order allowing religious exemptions shortly after taking office in January, but the state Supreme Court blocked the order from going into effect. The mandate remains in place for now.

That shift highlights how views of vaccines are increasingly partisan, with support declining among Republicans. In a related development, vaccine legislation became nearly as partisan as abortion even before the pandemic, according to research by Kevin Estep, a sociologist and associate professor of health administration and policy at Creighton University.

“The most dangerous thing right now, in my mind, is putting fuel on the fire of the idea that the government is infringing on parental rights,” Estep said. “That might create new vaccine hesitancy where there wasn’t before.”

It’s unclear how expanding religious freedom affects vaccines

Richard Katskee, an assistant clinical law professor at Duke University, authored an amicus brief in support of the school district in Mahmoud, and he believes the case sets a dangerous precedent. But the justices were careful to stick to curriculum, which could limit how widely it applies.

“I still think there will be real wariness from the court to hurt public health,” Katskee said. “There has been a history of deference.”

Douglas Laycock, a professor emeritus at the University of Texas and the University of Virginia, wrote a brief in support of the parents in Mahmoud. But he agrees that applying Mahmoud to vaccine exemptions could be a stretch.

“One [case] is about asking kids to listen to these stories that are about topics that are pretty religiously sensitive,” Laycock said. “The other is about a medical requirement that protects every kid in the school from diseases that are at best a problem and at worst disabling or fatal.”

Mahmoud isn’t the only Supreme Court decision potentially weighing on vaccine law.

In Tandon v. Newsom, the Supreme Court overturned a California restriction on in-home gatherings during the depths of the pandemic that was challenged by a couple that held Bible study in their home. A federal judge in 2023 cited that case in ruling that Mississippi must allow religious exemptions to its school vaccine mandate.

The reason Mississippi had no religious exemption at the time was because the state Supreme Court had struck it down in 1979. In that ruling, the justices could not believe that the First Amendment requires that “innocent children, too young to decide for themselves … be denied the protection against crippling and death that immunization provides because of a religious belief adhered to by a parent or parents.”

Mississippi regularly boasted the highest vaccination rates in the nation. Now that religious exemptions are allowed, Mississippi still has high overall vaccination rates, but it’s no longer No. 1. Rates for children under 2 years old are now below the national average.

Erica Meltzer is Chalkbeat’s national editor based in Colorado. Contact Erica at emeltzer@chalkbeat.org.

Vaccine panel’s hepatitis B vote signals further turbulence for immunization policy, public trust

2025-12-12T14:36:10+00:00

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When Su Wang was in medical school, she donated blood. That’s when she learned she was infected with hepatitis B, a virus that attacks the liver and can lead to cancer and death decades later.

“I was 18, healthy, in college,” she said. “And suddenly I had a chronic illness I didn’t even know about.”

Born in Florida in 1975, Wang grew up before the hepatitis B vaccine was routinely given to newborns. For years, she assumed she had been infected by her mother, only to discover later that both her parents were negative. “It turns out my grandparents, who cared for me after birth, probably passed it to me,” she said. “That’s how easy this virus spreads — not from some exotic risk factor, just family.”

Today, Wang is the medical director for viral hepatitis programs at RWJBarnabas Health in New Jersey. Her story now sits at the center of a historic turning point in public health.

On Dec. 5, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices voted to end the universal U.S. recommendation for the newborn dose of the hepatitis B vaccine, instead adopting a policy urging individual-based decision-making.

Under the new approach, only infants born to mothers who test positive for hepatitis B will automatically receive a dose of the vaccine and hepatitis B antibodies shortly after birth. For everyone else, if the parents choose to vaccinate, the birth dose can be delayed until 2 months of age.

All the committee members were appointed by Health and Human Services Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist. In an 8-to-3 vote, the panel decided that since most pregnant women now receive hepatitis B testing, administering the vaccine at birth should be reserved for infants whose mothers test positive. They framed the shift as a way to reduce interventions deemed unnecessary, align vaccination with test results, and give parents more control over timing. Supporters of the decision described it as a move toward parental choice rather than a reflection of changing epidemiology.

Vaccine panel drops recommendation that all newborns get hepatitis B shot

But to many clinicians and epidemiologists, the change represents a dangerous rollback that could reverse three decades of progress toward eliminating a disease that still infects as many as 2.4 million Americans and kills tens of thousands each year. They see echoes of the 1980s, when risk-based vaccination left entire generations unprotected, and worry the country is about to repeat that mistake.

Moreover, the panel’s move on hepatitis B — in the face of overwhelming data that show the birth dose is effective and safe — portends further upheaval for the nation’s childhood vaccine schedule, a cornerstone of public health.

“They’re not just trying to change one vaccine,” said Angela Rasmussen, a virologist and an editor of the scientific journal Vaccine. “They’re trying to dismantle how vaccine policy is made.”

Department of Health and Human Services spokesperson Emily Hilliard responded: “ACIP reviews all evidence presented and issues recommendations based on evidence and sound judgment to best protect America’s children.”

The authors of a new independent review by the Vaccine Integrity Project, which evaluated more than 400 studies and reports, warned in a public comment that delaying the birth dose “would reduce protection for infants and increase the risk of avoidable HBV infections, undermining decades of progress” toward eliminating the hepatitis B virus. The review was led by researchers at the University of Minnesota’s Center for Infectious Disease Research and Policy, which created the Vaccine Integrity Project in response to what it regards as Trump administration actions that “put the federal vaccine landscape at risk,” and it was vetted by outside experts.

“We fought hard for that universal birth dose because targeted approaches missed too many babies,” Wang said. “We know what happens when you wait.”

What’s unfolding now is not just a technical policy update but a fundamental test of the systems meant to protect the most vulnerable. The debate turns on a few critical questions — whether testing is reliable enough to replace universal safeguards, how infectious hepatitis B truly is, why past strategies failed, and what the CDC’s internal shake-ups mean for vaccine policy writ large.

Why universal vaccination was created

Hepatitis B testing sits at the center of the new ACIP recommendation, but even the CDC acknowledges that testing alone can’t guarantee protection. Pregnant women may test negative if the virus was acquired late in pregnancy or during the “window period,” before hepatitis B surface antigens become detectable. False negatives happen. No testing system, no matter how well designed, can catch every infection. That’s why universal vaccination was created in the first place.

If a mother’s status is unknown at delivery, hospitals are supposed to give the newborn a hepatitis B vaccine within 12 hours, adding hepatitis B antibodies for premature infants or if the mother later tests positive. But in real clinical settings, these safeguards routinely break down. Results take time. Nurses miss or misread labs. Pharmacies delay deliveries. Documentation gets lost.

“Every step you add increases the chance that something falls through the cracks,” Wang said. “Delaying the vaccine just adds another.”

ACIP’s vote shows how that logic is being challenged.

RFK Jr. wants to delay the hepatitis B vaccine. Here’s what parents need to know.

Some committee members suggested dropping the third hepatitis B shot if antibody levels look high after the second.

But Brian McMahon, a liver disease specialist who has spent decades treating hepatitis B, told the panelists that the data doesn’t support that idea. “Only maybe 20% to 30%” of infants have an adequate antibody level after the first dose, he said.

“You need two doses to really reach a high level of protection,” he said, with the third shot giving a stronger, longer-lasting response.

He said the overall message coming from the committee seemed designed to “discourage the birth dose.”

“They’re making it more and more difficult,” McMahon said.

In a second vote, ACIP also encouraged parents and clinicians to order post-vaccine serology tests — blood tests that measure protective antibody levels — after the second or third dose. The tests, ACIP said, should be covered by insurance.

Hepatitis B is more infectious than HIV or hepatitis C

Hepatitis B can survive on toothbrushes, razors, and household surfaces for a week. It spreads not just from mother to child but also through ordinary family contact: shared items, open sores, small blood exposures. In the 1980s, researchers found that about half of infections in American children came not from mothers but from other household members.

That’s why state health departments continue to insist that every newborn be vaccinated within 24 hours of delivery, regardless of maternal status. “Delaying vaccination misses a crucial period of potential exposure,” a New York advisory warned this year. The vaccine, it noted, is 80% to 100% effective when given on time.

The Vaccine Integrity Project report underscores the stakes. Since the universal birth dose was introduced in 1991, pediatric hepatitis B infections in the United States have dropped by more than 99%. A 2024 CDC analysis estimated that the current schedule has prevented more than 6 million hepatitis B infections and nearly 1 million hospitalizations.

The benefits are lifelong. Infants vaccinated at birth are shielded not just from hepatitis B but also from the liver failure and cancer it can cause decades later. Yet because the disease unfolds slowly, the consequences of policy shifts may not surface for 20 or 30 years.

Trieu Pham, a California physician, doesn’t need to imagine those consequences. Born in Vietnam in 1976, he probably contracted the virus at birth. “If the vaccine had existed then, I wouldn’t have gone through what I did,” he said. Diagnosed in his 20s, he developed cirrhosis by 40. At 47, he was coughing blood from ruptured esophageal veins. Eventually, he required a liver transplant to survive.

“You live with this constant fatigue and fear,” he said. “And the saddest part is it was preventable.”

His three children, all vaccinated within hours of birth, are free of hepatitis B. “That’s the difference a day can make,” Pham said.

Data show the universal strategy is most effective

In 1982, ACIP recommended the new hepatitis B vaccine only for adults at high risk: health care workers, injection drug users, and men who have sex with men. But by the late 1980s, it was clear that risk-based vaccination couldn’t contain transmission. Many newly infected adults didn’t fit any defined risk group. Identifying high-risk people proved imperfect, stigmatizing, and ultimately ineffective.

Meanwhile, infants infected during or shortly after birth had a 90% chance of developing chronic infection, compared with less than 5% in adults. Yet public health officials repeated the same targeted strategy, this time with newborns. In 1988, the CDC recommended universal prenatal screening and linked an infant’s vaccination to the mother’s test result, again basing protection on a risk marker instead of vaccinating all infants.

As before, it failed. Many infected mothers weren’t correctly identified. Some were never tested, some were tested too early, and others had results that were misread or never communicated. Too many infants slipped through the cracks, proof that another targeted approach couldn’t reliably protect them.

In 1991, the CDC issued its landmark guidance recommending that all infants, regardless of their mother’s infection status, receive a hepatitis B vaccine at birth, followed by two additional doses in infancy. By 2005, the policy was fully embedded in the routine immunization schedule, then reaffirmed in 2018. This evolution was based on data showing that a universal strategy, rather than a targeted one, was the most effective in preventing infections.

U.S. stands alone in abandoning birth dose

The CDC’s new hepatitis B policy rests on the premise that moving the decision to parents will strengthen trust in the vaccine system. Supporters frame it as an empowerment shift — a way to give families more control.

In 1999, when it was last recommended to postpone the first dose of hepatitis B vaccine for infants born to uninfected mothers, vaccination rates also dropped among infants born to those who were infected.

“Opt-in policies sound patient-centered,” Wang said, “but in practice they’re inequitable. They leave behind the very families who need protection most” — the ones most likely to miss prenatal care and testing, have infections that go undetected or arise after testing, or slip through gaps in hospital care, as well as infants who can be exposed and infected by other caregivers and household members.

Those are often immigrant families, including from Asian and Pacific Islander communities in which hepatitis B remains endemic. “We already underdiagnose and undertreat these populations,” Wang said. “This change would deepen that gap.”

The United States is now the only country to abandon a universal hepatitis B birth dose recommendation. Though it will take decades to gather outcomes data, some researchers predict that delaying the first dose of hepatitis B vaccine to 2 months of age could result in over 1,400 preventable infections and about 300 cases of liver cancer per year.

“We don’t get to choose what we inherit,” Wang said. “But we do get to choose what we pass on.”

This story originally published at KFF Health News, Healthbeat’s national reporting partner.

Flu and RSV climb in Georgia as winter virus season starts slowly

2025-12-05T22:06:33+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

Georgia’s winter respiratory virus season is off to a slow start, with Covid numbers low. But local doctors say they are seeing an uptick in flu and RSV cases, and they expect numbers to rise over the coming months.

There are steps people can take to mitigate the spread of these viruses ahead of the holidays, Dr. Sara Turbow, a doctor at Grady Health and a professor of medicine at Emory University, and Dr. Andrew Thornton of Wellstar said, starting with vaccinations for all three illnesses.

“It’s never too late. Even if you get it five days before Christmas, I would say that that’s better than not getting it at all,” Turbow said. The vaccines are widely available at pharmacies and many doctor’s offices. The vaccines take about two weeks to provide full coverage.

Getting the vaccines is well worth it because the viral respiratory diseases can cause people to feel unwell, have to take time off work or school, and, in some cases, progress to bacterial pneumonia, the doctors said.

“I worry more about the complications that come from these illnesses, and pneumonia is a big one,” Thornton said. “We have already started to see an increase in pneumonia in the last month.”

While many patients can successfully be treated for pneumonia at home, others may require hospitalization, and it could lead to serious complications like sepsis, a systemic infection. He said people should also make sure they are up-to-date on pneumonia vaccines.

Much of the U.S. Centers for Disease Control and Prevention data collection about the three respiratory viruses was put on hold during the government shutdown. Since operations resumed Nov. 13, those surveillance systems have started to publish data again, though there is a lag of a few weeks.

The data mirror what the local doctors are reporting, with increases in RSV and flu rates and relatively low Covid rates.

“Usually, December, January, we start to see a lot of Covid cases, right along with an increase in flu, as well as RSV,” Thornton said. He reported an increase in flu and pneumonia among the patients of all ages that he sees at Wellstar urgent care clinics. Turbow said she’s seeing an increase in RSV among adult patients.

People can take other steps like masking in group settings, including airplanes and airports, and frequently washing their hands to help prevent the spread of these diseases, Turbow and Thornton said.

Turbow said she’s not as strict about masking as she was during the Covid pandemic but always tries to have a mask with her in case she’s in a crowded setting or next to someone who is coughing.

“It’s good to have that mask on hand if you find yourself near someone or sitting next to someone who’s visibly sick,” Turbow said. “You don’t want to be stuck on a multiple-hour flight next to somebody who’s coughing and sneezing.”

Drugs like Paxlovid, taken within five days of contracting of Covid, and Tamiflu, within about 48 hours of contracting flu, can help ward off more serious complications, especially for those at high risk, Thornton said.

“If you do it in the right patient and at the right time frame, it can reduce risk of complications like pneumonia,” Thornton said. Urgent care centers and retail clinics are able to test and treat the diseases, Turbow said, and people should consider going to those if they can’t get in to see their regular doctor instead of an emergency room.

Here’s what the data show:

Covid

Hospitalization rates per 100,000 are lower than last year for October and November in Georgia, with few emergency department visits (under 0.5%) for Covid in the same period.
While Covid rates are likely to grow or are already growing in many Midwestern and Northeastern states, as well as Alabama, the CDC does not predict a change in Covid rates in Georgia.

Flu

Nationally, seasonal activity is on the rise, according to the CDC, with an increase in positive tests over the past week.
That’s mirrored in a rise in positive flu tests in Georgia, according to state Department of Public Health data. More than 18% of flu tests at clinical laboratories tested positive for flu from Nov. 16 to 29, up over just 5.6% the week prior to Nov. 16. The vast majority of the positive flu tests were for Influenza A.

Visits to select outpatient health care facilities for illnesses like influenza have also increased since September, but at 3.4% are lower than in the past four flu seasons beginning in 2021, according to state data.
Flu hospitalization rates have ticked up since mid-November, with the latest data from Nov. 29 showing a rate of 1.2 hospitalizations per 100,000 people, according to data from the CDC’s Flu View. Last year, Georgia’s flu-related hospitalizations started to climb in early December and peaked in late January and early February at a rate of 13.4 per 100,000 people before falling.
In real terms, that means 194 hospitalizations in Georgia since early October, with four deaths. That’s higher than last year, when there were 75 hospitalizations in the same period.

RSV

RSV positivity rates are increasing in Georgia, from 2.8% in early October to 14.4% for the last week in November, according to DPH data. At the same time last year, about one-fifth of all RSV tests were positive.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Vaccine panel drops recommendation that all newborns get hepatitis B shot

2025-12-05T20:33:43+00:00

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A longstanding recommendation that all babies be vaccinated at birth against hepatitis B was abandoned in a divided vote Friday by a federal advisory panel at the Centers for Disease Control and Prevention.

Members of the committee who voted in favor of the change hailed it as supporting informed vaccine choice by parents, who they say have been abandoned and marginalized by pediatricians when refusing or delaying immunizations.

“True choice has not been existing in practice,” said committee member Hillary Blackburn, a doctor of pharmacy. “No child should lose their medical home because their parents are engaging in the very individually based decision making we’re encouraging.”

Those who voted against the change said parents always have the final say in what vaccines their children receive, and that the new recommendations lacked scientific evidence and will result in children suffering needless infections and serious liver damage.

“We know that three doses given according to the existing schedule are safe and effective in preventing hepatitis B,” said Dr. Cody Meissner, a professor of pediatrics at Dartmouth’s Geisel School of Medicine. “We are doing harm by changing this wording, and I vote no.”

All of the committee’s members were chosen by Health and Human Services Secretary Robert F. Kennedy Jr., who has long been critical of vaccine safety. Kennedy dismissed the panel’s previous members during the summer, then fired Trump administration CDC Director Susan Monarez for what she told Congress was her refusal to rubber stamp future recommendations of the committee.

The CDC Advisory Committee for Immunization Practices voted 8-3 that women who test negative for the hepatitis B virus should consult with health care providers to “decide when or if“ their child should be vaccinated against the virus, with any initial dose “suggested” to be administered “no earlier than 2 months of age.”

The committee did not change the current recommendation that a birth-dose of the vaccine be given to infants born to women who test positive for the hepatitis B virus.

U.S. Sen. Bill Cassidy, the Republican chairman of the Senate Health Education, Labor, and Pensions Committee urged acting CDC Director Jim O’Neill to not sign the recommendations and maintain the current standards.

“As a liver doctor who has treated patients with hepatitis B for decades, this change to the vaccine schedule is a mistake,” Cassidy, whose vote was instrumental in Kennedy’s confirmation as HHS secretary, said on the social media platform X.

“The hepatitis B vaccine is safe and effective. The birth dose is a recommendation, NOT a mandate,” Cassidy said, noting that before the birth dose was recommended, 20,000 newborns a year were infected with hepatitis B. “Now, it’s fewer than 20. Ending the recommendation for newborns makes it more likely the number of cases will begin to increase again. This makes America sicker.”

The committee makes recommendations to the CDC director, who can accept or reject them. O’Neill is a deputy secretary at HHS in addition to serving as acting CDC director. CDC and HHS did not immediately respond to questions from Healthbeat about O’Neill’s timeframe for making a decision on the recommendations.

Major medical and public health associations – including the American Academy of Pediatrics, the American Medical Association, the Infectious Diseases Society of America and the National Association of City and County Health Officials – had urged the committee not to change the recommendation that all babies receive the birth dose.

The American Academy of Pediatrics has said it is not going to change its recommendation to pediatricians that all babies should receive a first dose of hepatitis B vaccine shortly after they are born.

The associations noted that babies born to mothers who test negative for hepatitis B virus remain at risk of infection early in life from families, caregivers, and other close contacts who may be infected but often do not know it.

The hepatitis B virus is highly contagious and spreads through contact with blood and body fluids. It can cause severe liver damage and cancer. The virus can spread from person to person through sharing of personal items such as razors, toothbrushes, and nail clippers, as well as through sexual contact and use of unsterile needles.

Universal infant and childhood vaccination against hepatitis B, recommended since 1991, has reduced by 99% the number of reported cases among U.S. children, adolescents, and young adults.

“Recommendations are not mandates,” Dr. Flor Muñoz, representing the Infectious Disease Society of America at Friday’s meeting, told the committee as it prepared to vote. “The issue of consent is not being solved with these changes … 30 years of information regarding the safety and efficacy of these vaccines are very strong to continue to support the existing recommendation.”

Committee members Meissner and Dr. Joseph Hibbeln, a psychiatrist and neuroscientist, objected throughout the meeting to what they said was a lack of evidence supporting the new recommendations. No data were presented to the committee to support recommending a two-month delay before babies born to hepatitis B negative moms get their first vaccine, they said.

“We have no basis for saying that. That’s been kind of pulled out of the air,” Meissner said.

“I am hopeful that pediatricians will continue to administer the birth dose within the first 24 hours of delivery and before discharge from the hospital. I think to follow any other course is not in the interest of the infant,” Meissner said.

Added Hibbeln: “This specific point is the reason why we tabled this issue for three months to more fully discuss it. However, we have still not had any information or science presented or discussed with regards to this issue of [giving the first dose of hepatitis B vaccine ] before or after 2 months of age. This is unconscionable.”

The committee also voted to recommend parents consider antibody testing to evaluate the hepatitis B vaccine’s effectiveness before getting subsequent doses. The vote passed with six members in favor, four opposed, and one abstaining.

This blood testing, the recommendation says, should be used to determine whether adequate protection against hepatitis B has been achieved. The recommendation says the cost of the testing should be covered by insurance.

Hibbeln objected to this testing recommendation being added to what had been a changing series of proposed recommendations shared with the committee with little time for advance consideration. “This fourth iteration of votes in 96 hours is still incredibly problematic,” he said.

“There is an absolutely novel concept being put forth here to vote, that a serology test should be offered” after the first dose, he said. “There has been no data presented that this plan would actually work.”

Dr. Raymond Pollak, a transplant immunobiologist, expressed similar concerns. “We have no data whether monitoring serology actually implies immunity,” he said.

Dr. Kirk Milhoan, a pediatric cardiologist who recently was appointed the committee’s chairman, said the tests could help parents decide how many vaccines their child needs.

“I would be very happy if we were to vote to simply recommend that this needs to be studied. That would also serve the purpose,” said Milhoan, noting “there is a paucity of data.”

But none of the committee’s members made a motion to do this.

This story has been updated with more details from Friday’s meeting.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

Vaccine panel delays votes on hepatitis B shot for newborns

2025-12-05T01:20:58+00:00

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A federal vaccine advisory committee delayed votes Thursday on changes to hepatitis B immunization recommendations for infants as a top Republican senator called the group “totally discredited.”

U.S. Sen. Bill Cassidy, chairman of the Senate Health, Education, Labor, and Pensions Committee, expressed outrage over a scheduled briefing to the Advisory Committee on Immunization Practices on Friday by lawyer and vaccine critic Aaron Siri.

“Aaron Siri is a trial attorney who makes his living suing vaccine manufacturers. He is presenting as if an expert on childhood vaccines. The ACIP is totally discredited. They are not protecting children,” Cassidy, a Louisiana Republican and a physician, said on the social media platform X.

It’s unclear whether Cassidy plans to take any further action. His spokespeople did not immediately respond to questions from Healthbeat.

The committee, based at the Centers for Disease Control and Prevention, has become a flashpoint for controversy since this summer when Health and Human Services Secretary Robert F. Kennedy Jr. dismissed all its members and appointed replacements.

At Thursday’s ACIP meeting, CDC vaccine subject matter experts were largely sequestered in a “SME room” away or remote offices, away from where the committee members meet and providing expert input through video connections only when asked.

Siri, a Kennedy ally, is scheduled to brief the committee Friday morning on the childhood and adolescent immunization schedule, the evolution of the schedule, and a comparison of the U.S. schedule to those in other countries. The meeting’s agenda, as of Thursday, did not disclose any details about his presentation.

Siri, who compared himself to consumer advocates like Ralph Nader, fired back at Cassidy on X, saying vaccine manufacturers regularly speak before the committee. “Yet, I have never heard you take issue with those presenters,” he wrote.

On Thursday, the committee’s focus was on a push by some of its members to reduce the number of infants who are vaccinated at birth against hepatitis B, a serious infection that can cause chronic liver disease and cancer. The committee’s work group was led by ACIP committee member Vicky Pebsworth, research director of the National Vaccine Information Center, a group that warns against vaccine risks.

“It’s been 35 years since the universal birth dose policy was implemented,” she said. The work group was asked to assess whether the universal birth dose should continue to be given to children of mothers who test negative for the virus.

Since the universal birth dose started being given in 1991, there has been a 99% decline in cases of hepatitis B among children, adolescents and young adults.

Pebsworth said the review was prompted to address parent and stakeholder concerns about administering the hepatitis B vaccine at birth.

The committee voted 6-3 to postpone until Friday votes on any changes to the current recommendation that all infants be vaccinated against hepatitis soon after birth.

The decision to delay came after some committee members objected that they had no way to know what they were voting on. While the proposals were verbally read to the committee by vice chairman Robert Malone, they weren’t provided copies of the proposals’ text so they could assess and discuss the language.

The proposals, among other things, would recommend a birth dose of hepatitis B vaccine for babies born to women who test positive for the virus – a significant change from the current recommendation that all babies receive the vaccine. The proposals also contain language that would recommend delaying an initial dose of the vaccine until a child is 2 months old.

Text of the three proposals briefly read during Thursday’s meeting was not posted on the committee’s website.

Edward Tate, a spokesperson for the Hepatitis B Foundation, said Thursday’s meeting was concerning for many reasons.

“The meeting lacked transparency, with many of the presentations showing one-sided data, and several points made by committee members clearly showed that they have a very specific agenda,” he said.

“The committee members dismissed the extensive body of scientific data and real-life experience that prove the necessity, safety and value of the universal birth dose vaccination for hepatitis B,” Tate said.

The committee will resume its meeting at 8 a.m. Eastern on Friday. The meeting will be livestreamed at this link.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

What to watch for at this week’s CDC vaccine advisory committee meeting

2025-12-04T14:57:58+00:00

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The front line in the escalating political, cultural and scientific war over vaccination in the United States will return to a meeting room at the Centers for Disease Control and Prevention in Atlanta on Thursday and Friday.

That’s where an important CDC vaccine advisory committee – whose members were replaced with appointees of Health and Human Services Secretary Robert F. Kennedy Jr. – is scheduled to take another series of votes that could reshape longstanding recommendations to protect babies against the cancer-causing hepatitis B virus.

The two-day meeting of the CDC Advisory Committee on Immunization Practices is happening in the wake of Kennedy personally ordering changes to language on the CDC’s website that diminishes the agency’s longstanding statement that “vaccines do not cause autism” as not being an evidence-based claim – despite decades of research that has not found a link between vaccines and autism.

And it comes less than a week after a top U.S. Food and Drug Administration vaccine official asserted in a memo to agency staff – without providing data – that at least 10 children’s deaths are related to Covid-19 vaccination. The FDA has not released any information about the cases or how any links were made to vaccines.

With the advisory committee scheduled to start meeting at 8 a.m. Eastern Thursday, the CDC had not posted a final meeting agenda by Wednesday evening. The posted draft agenda – listed only broad topics of discussion, without details about the specific issues of concern, the data that will be presented, or the names of individuals who will be making presentations. Sometime overnight, a final agenda was posted that added a few lines of additional information but still few details.

Here’s what public health practitioners say they are watching for at this week’s ACIP meeting, which will be livestreamed on Thursday and Friday.

Votes that may delay or limit babies’ protection against hepatitis B

At issue: The meeting’s agenda shows that Thursday’s session will be focused on discussions and votes related to this vaccine. Overnight the committee posted draft language for two proposed recommendations.

The first vote is on language that would change current recommendations for universal vaccination of babies soon after birth. The proposed new ACIP recommendation would be for “individual-based decision-making, in consultation with a health care provider” on whether to give the hepatitis B vaccine to infants born to women who test negative for the virus or whose status is unknown.

This proposed recommendation also would leave it up to parents, in consultation with their health providers, to “decide when or if their child will begin the HBV series.”

The second vote involves draft language that would recommend that parents consult with health care providers about giving their children blood tests to check levels of immunity before receiving follow-up hepatitis B shots. The cost of these tests should be covered by insurance, the draft language says.

At the committee’s last meeting in September, the group postponed a vote on recommending a delay for when babies receive a first dose of hepatitis B vaccine.

Currently all babies are recommended to be vaccinated against this virus soon after birth. This is done to help prevent infection during the birth process if the mom’s infection hasn’t been detected during prenatal screenings, and also to protect them from exposure to caregivers and other contacts who may not know they are infected.

ACIP members have previously discussed the need for better hepatitis B screening of mothers during pregnancy. Other concerns have been raised about whether only babies deemed to be at high risk of virus infection should receive the shots.

RFK Jr. wants to delay the hepatitis B vaccine. Here’s what parents need to know.

Why it matters: Universal infant and childhood vaccination against hepatitis B has reduced by 99% the number of reported cases among U.S. children, adolescents, and young adults. The vaccine plays a significant role in preventing liver cancer caused by the virus.

“We have tried all of these methods that we’re now talking about potentially going back to and they did not work. So that is why universal vaccination is so important,” Michaela Jackson, the Hepatitis B Foundation’s program director for prevention policy, told Healthbeat before the final agenda was released.

“Prior to universal vaccination, only 50% of children who were being infected before the age of 10 were getting that from mother-to-child transmission,” she said. “The other 50% were getting it from places like day cares, from contact sports, from caregivers who didn’t know that they had hepatitis B. We’re talking about innocent interactions that you don’t really think about every day.”

The virus is highly infectious. It is transmitted through contact with blood and bodily fluids of infected people, who often have no symptoms or awareness they are living with the virus. While the virus can be spread through childbirth, sexual contact, and sharing contaminated needles, it also can be spread through contact with sharp items commonly shared in families: nail clippers, a toothbrush, even some kinds of jewelry.

Interest in changing the childhood and adolescent immunization schedule

At issue: It’s unclear what aspects of the schedule will be discussed. The posted draft agenda, which listed this as a discussion topic for Friday, didn’t say. The final agenda shows the presentation to the committee on this topic will be made by Aaron Siri, a lawyer and close adviser to Kennedy.

Critics of the current recommendations for when vaccines are given, including Kennedy, have questioned the number, timing, and spacing of shots.

The final agenda lists two sub-topics for Siri’s presentation: the evolution of the vaccination schedule and a comparison of the U.S. schedule to those in other countries.

Why it matters: “The childhood immunization schedule is an important framework that we use to protect children from harmful and potentially deadly childhood diseases,” Dr. Sean O’Leary, chair of the American Academy of Pediatrics committee on infectious diseases, said before the final agenda was posted.

“Every vaccine on that schedule and the recommended timing of it exists for a reason,” he said. “The timing of each dose of a vaccine for a child is critical, and it’s based on the age at which a child’s immune system can provide optimal protection after vaccination, and the earliest possible time for protection … There is no reason to delay or space out vaccines. Doing so just puts children at risk.”

Discussion of ‘adjuvants and contaminants’ in vaccines

At issue: The meeting’s draft agenda said there will be a discussion of adjuvants and contaminants on Friday afternoon. The final agenda describes the presentation as involving aluminum exposure from vaccines before the age of 24 months and persistent asthma at age 24 to 59 months.

Why it matters: “Just like the childhood vaccine schedule itself, every vaccine ingredient plays an important role in making sure the vaccine is safe and effective,” O’Leary said.

“I won’t be surprised if some on this committee refer to these ingredients as contaminants. This is simply false,” he said. “As with any medicine, the ingredients in vaccines are there for a reason. Aluminum, for example, they’ll talk a lot about aluminum. It’s one of the ingredients that vaccine skeptics like to go after.”

Aluminum salts, which are used in some vaccines – including diphtheria, tetanus and acellular pertussis, hepatitis A, and hepatitis B vaccines – boost the body’s immune response to the vaccine, O’Leary said.

“They’ve been safely used in vaccines for about 100 years and have been received by billions of people,” said Dr. Jesse Goodman, professor of medicine and infectious diseases at Georgetown University. “They strengthen our immune response and keep the antigens of the vaccine from disappearing too quickly.”

Wildcard issues, including alleged children’s deaths from Covid-19 shots

At issue: It’s been difficult for the public and public health stakeholders to provide focused input to the committee because information has not been shared in advance about the substance of the issues that will be discussed.

Why it matters: “There’s like zero transparency in this draft agenda,” said Rekha Lakshmanan, executive director of The Immunization Partnership, a Houston-based advocacy group. “We don’t know who’s going to be speaking. You know, it’s sort of like this rough outline that you put together in high school.”

With the ACIP meeting coming soon after last week’s internal FDA memo alleging 10 children’s deaths have been linked to Covid-19 vaccination, Lakshmanan, O’Leary and others said it’s possible the committee will raise the issue.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

RFK Jr. wants to delay the hepatitis B vaccine. Here’s what parents need to know.

2025-12-02T18:17:08+00:00

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Working out of a tribal-owned hospital in Anchorage, Alaska, liver specialist Brian McMahon has spent decades treating the long shadow of hepatitis B. Before a vaccine became available in the 1980s, he saw the virus claim young lives in western Alaskan communities with stunning speed.

One of his patients was 17 years old when he first examined her for stomach pain. McMahon discovered she had developed liver cancer caused by hepatitis B, just weeks before she was set to graduate from high school as valedictorian. She died before the ceremony.

McMahon thinks often of an 8-year-old boy who showed no signs of illness until he complained of pain from what turned out to be a rapidly growing tumor on his liver.

McMahon can still hear his voice.

“He was moaning in pain, saying, ‘I know I am going to die soon,’” he recalled. “We were all crying.” The boy died at home a week later.

The hepatitis B virus is transmitted through blood and bodily fluids, even in microscopic amounts, and the virus can survive on surfaces for a week. Like many of his patients, McMahon said, both children contracted hepatitis B at birth or in early childhood.

That outcome is now preventable. A birth dose of the vaccine, recommended for newborns since 1991, is up to 90% effective in preventing infection from the mother if given in the first 24 hours of life. If babies receive all three doses, 98% of them have immunity from the incurable virus, with the protection lasting at least 30 years.

FDA delays left recalled baby formula on store shelves, food safety expert says

In the communities of western Alaska, years of targeted testing and widespread vaccination efforts led to the number of cases plummeting.

“Liver cancer has disappeared in children,” McMahon said. “We haven’t seen a case since 1995. Nor do we have any children under 30 that have gotten infected that we know of.”

He worries those hard-won gains could soon be rolled back.

Vaccine panel may limit children’s access

A Centers for Disease Control and Prevention vaccine advisory panel appointed by Health and Human Services Secretary Robert F. Kennedy Jr. is scheduled to discuss and vote on the hepatitis B birth dose recommendation during its two-day meeting starting Thursday, potentially limiting children’s access.

On Tucker Carlson’s podcast in June, Kennedy falsely claimed that the hepatitis B birth dose is a “likely culprit” of autism.

He also said the hepatitis B virus is not “casually contagious.” But decades of research shows the virus can be transmitted through indirect contact, when traces of infected fluids like blood enter the body when people share personal items like razors or toothbrushes.

The committee’s recommendations carry weight. Most private insurers must cover the vaccines the Advisory Committee on Immunization Practices endorses, and many state vaccination policies are directly linked to its guidelines.

Neither ACIP nor the CDC is regulatory. They cannot mandate immunizations. It’s up to states to do that. But keeping the recommendation for a hepatitis B vaccine at birth preserves the widest range of options for families. They can choose to vaccinate at birth, wait until later in childhood, or not vaccinate at all, and insurance will continue to cover the cost of the shot as long as it remains approved by the Food and Drug Administration.

Health alert shows growing concerns about type of mpox spreading in Europe and California

Two senior FDA officials — Commissioner Marty Makary and top vaccine regulator Vinay Prasad — suggested at the end of November that changes to the vaccine approval process may be coming. Vaccines must be approved by the FDA to be administered in the United States.

In internal agency emails obtained by PBS NewsHour and The Washington Post, Prasad questioned the routine practice of “giving multiple vaccines at the same time.” It’s not clear whether he was referring to combination vaccines that offer immunity against multiple diseases with a single shot. Three of the nine hepatitis B vaccines currently approved by the FDA are combination vaccines. The birth dose of the hepatitis B vaccine is given only as a stand-alone vaccine.

Meeting designed around ‘sowing distrust’

If private insurers opt to still cover the shot, misinformation from the meeting still could lead families to falsely believe the vaccine could harm their babies, said Sean O’Leary, chair of the Committee on Infectious Diseases for the American Academy of Pediatrics and an assistant professor of pediatrics at the University of Colorado School of Medicine.

“Whatever comes out of this disaster of a meeting in December is going to be mainly designed around sowing distrust and spreading fear,” he said.

President Donald Trump, Kennedy, and some newly appointed ACIP members have mischaracterized how the liver disease spreads, ignoring or downplaying the risk of transmission through indirect contact. The hepatitis B virus is far more infectious than HIV. Unvaccinated people, including children, can get infected from microscopic amounts of blood on a tabletop or toy, even when the infected person is asymptomatic.

McMahon has cared for children who tested negative at birth and later became infected through indirect contact. In a study in the 1970s, nearly a third of such children went on to develop chronic hepatitis B without ever showing symptoms, he said.

“It’s a very infectious virus,” McMahon said. “That’s why giving everybody the birth dose is the best way to prevent it.”

The CDC recommends that all pregnant people be screened for hepatitis B, but it estimates that up to 16% are not tested and fall through the cracks. O’Leary and other experts say testing mothers for the virus shortly before or after delivery is unfeasible, because most hospitals lack the staff and resources.

The three-dose vaccine has a long track record of safety. Numerous studies show it is not associated with an increased risk of infant death, fever or sepsis, multiple sclerosis, or autoimmune conditions, and severe reactions are rare.

“We have an incredible safety profile,” O’Leary said. “No one expects to get in a car wreck, right? And yet we all put our seat belts on. This is similar.”

The CDC estimates that 2.4 million people in the United States have hepatitis B and that half do not know they are infected. The disease can range from an acute infection to a chronic one, often with few to no symptoms. If the disease is left untreated, it can lead to serious conditions such as cirrhosis, liver failure, and liver cancer. There is no cure.

Expert’s advice to parents: Talk to a doctor

William Schaffner, a professor of preventative medicine at the Vanderbilt University School of Medicine and a former voting member of ACIP, said some parents struggle to understand why a healthy newborn needs a vaccine so soon after birth, especially for a virus they feel certain they don’t have and often wrongly associate only with risky behaviors. Those perceptions, he said, mix with declining trust in public health and rising skepticism about vaccines.

His advice to expectant parents who are on the fence is to talk to their doctor about the shots. Even if the pregnant woman has tested negative, he said, it’s still important to give the baby the birth dose, because false negatives are possible and because the virus can spread so easily from surface contact. Babies who receive the full vaccine series starting from birth have their chance of liver cancer reduced by 84%.

“If you wait a month and if the mom happens to be positive, or the baby picks it up from a caregiver, by that time the infection is established in that baby’s liver,” Schaffner said. “It’s too late to prevent that infection.”

He said that if fewer people get vaccinated, hepatitis B will circulate at higher rates in American communities and the risk of contracting the virus will rise for everyone who doesn’t get the shots.

And more hepatitis B cases could mean higher costs for patients and the broader health care system. The CDC estimates treating someone with a less severe form of the disease costs $25,000 to $94,000 per year. For patients who require a liver transplant, annual medical expenses can climb above $320,000, depending on their treatment.

Over the past 30 years, the main adverse events parents have reported from their babies receiving the birth dose have been fussiness and crying, both of which pass quickly. Schaffner said that’s a very strong safety profile — for a newborn vaccine with a track record of protecting babies from an incurable disease.

“The data are so clear about this,” Schaffner said. “A whole array now of other countries have initiated this program. They’ve modeled it on us.”

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

How to climate-proof the world’s health systems: Brazil offers a roadmap.

2025-11-20T12:00:00+00:00

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Hello from Nairobi.

The approach of the Thanksgiving holiday is a delightful reminder of just how wildly enterprising Kenyans are. Cranberry sauce and pecans? On the supermarket shelves! Orange pumpkins? Sweet potatoes? A close-enough local fowl called the kienyeji turkey? All at the market right now!

(If you don’t understand my excitement, you may need to endure a few chicken-and-potato holidays before you really appreciate these things.)

With that, as we say in Swahili: karibu katika habari — welcome to the news.

Global climate talks meet health crises

The United Nation’s Climate Change Conference is wrapping up this week in Belém, Brazil, a city at the mouth of the Amazon. Last year was the hottest in our species’ recorded history (again!), so as you might imagine… there is plenty to discuss.

Which is why it’s especially striking that global health policy (generally) and the surge of yellow fever and dengue cases across Amazon-adjacent countries (specifically) found its way onto the main agenda. In fact, the organizers designated Nov. 13 as the conference’s first ever “Health Day.”

As a rule, I try to steer clear of stories that amount to “UN bureaucrats invent a theme day to juice visibility.” But I am making an exception here, because this wasn’t just theater.

As The Guardian reports, the conference and the government of Brazil released an action plan to “help countries … deal with climate-fueled health issues” and a 100+ page roadmap on how to implement that plan. This marks the most serious the international community has ever been about proactively addressing climate change as a force that scrambles global health systems.

The authors (including leading researchers from eight universities) spell out the scale of the issue in a way that’s impossible to ignore. “Climate change is one of the most urgent global health challenges of the 21st century,” they write. “Nearly half the world’s population … live in highly climate-vulnerable contexts, and about 1 in 12 of the world’s 200,000 hospitals faces the risk of total shutdown from extreme weather under high-emissions scenarios.”

What does this mean in practice … and how should we read these recommendations during a moment when global health investments are retracting at their fastest pace in a century? I reached out to Dr. Kristie Ebi at the University of Washington, one of the world’s foremost experts on the health risks of climate change, to help break it down.

The heart of the roadmap is not a list of shiny new, expensive programs. Instead, it is a dramatically unsexy push to make health systems more flexible and more anticipatory.

For example, the authors outline for countries how to structurally reinforce their hospitals and overhaul the power, water, and other systems that keep them running, so they don’t buckle during heat waves or floods. They also spell out how to link climate and health data and train a workforce that can catch climate-driven risks before they spiral. As Ebi noted, “climate change remains relatively new for most ministries of health, with limited internal expertise,” which makes even the basic work of adding climate data to surveillance harder than it looks.

The most difficult part of the plan, Ebi noted, is the future-facing analysis it demands. Plenty of countries have reviewed how climate change could hurt their health systems, but many still don’t have the tools to actually predict what those risks will look like in the years ahead. And that gap is not academic. If a given country’s ministry/department of health cannot anticipate how heat, rainfall, supply chains, or migration will shift over the next decade, they are basically driving without headlights. The roadmap is trying to force a shift away from emergency response and toward planning for the risks that are already coming into view.

And then, of course, there is the money question. Yes, this work is coming at an inopportune financial moment. But the report is blunt that costs will rise sharply the longer countries wait. And Ebi is clear that this is not optional.

“Nearly everywhere experienced extreme weather ... often with devastating consequences. Increasing preparedness to these events will save lives,” she said.

A second cholera vaccine?

Some good news this week: South Africa has begun clinical trials for the first cholera vaccine to be manufactured on the continent, South Africa’s Sunday Times reports.

Disease breakdown: Cholera is a bacterial infection that infects up to 4 million people each year. Because it largely spreads through water contaminated with feces, it thrives in humanitarian disasters or anywhere else that basic sanitation has broken down. (Think conflict or flooding.) Cholera’s horror is its speed. It causes sudden, violent diarrhea that can empty the body so quickly that stools turn a pale, milky white. Without treatment, cholera can kill in a matter of hours.

The trials are a joint effort between Biovac, a local pharma firm, and the South African government. To be clear, this is not the first vaccine of its kind. A firm called EuBiologics in South Korea makes the only other cholera vaccine. Two doses of that vaccine protect about 70% of recipients for about two years, but … there’s not enough of the vaccine to meet demand.

This shortfall comes as cases rise globally, fueled by overlapping climate shocks and conflicts. It’s a squeeze that Health Policy Watch says “has severely constrained the global supply of cholera vaccines, leading to rationing and global shortages.”

Africa is the hardest hit. The continent is going through the worst cholera outbreak in a quarter-century, with cases surging in countries as disparate as Sudan, Burundi, and Angola, Al Jazeera reports. So this new vaccine is timely.

That said, let me be a realist/downer for a moment. Clinical trials usually move through three phases, and this is only the first one. (Phase 1 is where researchers check basic safety, not even whether the vaccine, uh, stops cholera.) Only about 10% of vaccines make it out of this early stage, but because this is not some brand-new medical advancement, the odds here are likely much higher. Still, there is a long, unsure road ahead.

But the upside is real. Even just myopically, shoring up the cholera vaccine supply will save tens of thousands of lives. But what South Africa is doing here is bigger than one product. During (and immediately after) the pandemic, many multinational pharma companies announced various expansion plans to manufacture drugs or tests on the Africa continent, with many of those plans scaled back since.

Today’s news shows that, just maybe, durable manufacturing gains will come from homegrown institutions.

Marburg virus in humanity’s cradle

Ethiopia has just confirmed its first ever outbreak of Marburg virus after nine suspected hemorrhagic fever cases in the country’s southwest were sent for testing this week, Bloomberg reports.

Disease breakdown: Marburg virus is functionally Ebola’s first cousin. A very similar high-fatality fever that often leads to hemorrhaging and organ failure. Untreated, about 9 in 10 people who contract the disease will die. The disease exists endemically in bats, allowing it to spread and occasionally spill over into humans. While this is Ethiopia’s first record of the disease, the World Health Organization says the strain matches those seen in past regional flare-ups. There is, unfortunately, no vaccine.

The epicenter of this new outbreak is a town called Jinka, which I last visited in 2022. It is one of the most fascinating places I have ever been. It sits in a region where some of the earliest hominid fossils have been unearthed, and where dozens of strikingly unique Indigenous communities live in close proximity. The town itself is the gateway to the Mago and Omo National Parks, themselves part of a wider UNESCO World Heritage Site because of the extraordinary cultural and ecological diversity. Most relevantly here, I remember the Indigenous peoples’ access to even basic government services being shockingly poor.

The latest news is that containment is underway, and that Ethiopia is reportedly “moving rapidly.” (Although it’s worth noting that the Ethiopian government has its hands full with various other conflicts and crises … some of them directly of Prime Minister Abiy’s own making.)

Here are my biggest questions right now:

Will the outbreak stay limited to this initial cluster, or spiral? As with the Ebola outbreak still wrapping up in the Democratic Republic of the Congo, will emergency appeals for funding be enough? Finally, without a vaccine to provide a robust buffer, how effective will contact tracing and containment be in such an underdeveloped area?

Mind the funding gap, part 2

A month ago, we followed some UK political drama about British donations to the Global Fund: the massive, 23-year-old organization that collects donations from wealthy governments and funnels them into programs that fight AIDS, tuberculosis, and malaria in more than 100 countries.

Back then, the rumor was that the UK, under Prime Minister Keir Starmer, was mulling a 20% cut in the country’s £1 billion pledge. Now it’s been announced that the UK will instead commit £850 million (over $1.1 billion) for the next funding cycle, representing a roughly 15% reduction, The Guardian reports.

While not as bad as the rumors, this is a bit of a gut punch for a few reasons.

First, Starmer’s party is ostensibly the pro-foreign aid face of the UK. (The opposition Conservative Party has promised to further reduce all foreign aid by another two-thirds when next in power.) The fear is that this reduction eases the geopolitical pressure on other leaders. “There is a danger that this drop in its pledge will lead to reductions in other donor commitments, with real risks for people’s lives,” says John Plastow, executive director at Frontline Aids, a global partnership.

Secondly, while the £850 million pledge is still enormous by any standard, the impact of any cut will be directly measured in lives. Per the Guardian article: A previous study showed that “a 20% cut to the overall Global Fund would result in 330,000 additional deaths by 2040 from malaria alone,” let alone the impact on HIV and tuberculosis cases, as the “fund provides 59% of international financing for malaria.” And with malaria cases now surging again in places like Myanmar, after years of decline, the risks of even a modest funding pullback look even starker, the Financial Times reports. (Sorry, paywall.)

It’s still too early to say how this will impact the total funding picture. I’ll be following up next month after the Global Fund closes its “replenishment conference,” the part telethon, part diplomatic speed-date that decides how much money the fund will actually have to work with.

Tuberculosis declined in 2024. Good thing nothing has happened since.

In the fight against tuberculosis, we finally brought a reversal of the pandemic-era spike that interrupted decades of steady declines. New cases fell by about 2%, Euronews reports .

(Why the rise in the first place? The tuberculosis researchers and modelers I’ve spoken with largely blame that Covid-era spike on people increasingly staying indoors — where tuberculosis spreads more easily — and on a diagnostic choke point. Basically: During the pandemic, if you had a bad cough, you got tested for Covid, and if the test came back negative, you were basically told congratulations rather than being screened for something else.)

Unfortunately I can’t, in good conscience, appreciate this as the good news story it should be. Blame the WHO’s reporting bureaucracy or the glacial pace at which governments release their health data, but our global tuberculosis picture is always about 12 months out of date. And this year was a doozy!

Tuberculosis is especially exposed to this year’s global funding crunch, and today’s report warns that “cuts from wealthy countries could lead to up to 2 million additional deaths from [tuberculosis] and 10 million new illnesses over the next decade.”

My read: In all likelihood, the progress we’re seeing in last year’s data has already slipped away in the year since.

We’re off next week, so see you in December!

William Herkewitz is a reporter covering global public health for Healthbeat. He is based in Nairobi. Contact William at wherkewitz@healthbeat.org.

Louisiana took months to sound alarm after two babies died in whooping cough outbreak

2025-11-04T21:52:56+00:00

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When there’s an outbreak of a vaccine-preventable disease, state health officials typically take certain steps to alert residents and issue public updates about the growing threat. That’s standard practice, public health and infectious disease experts told KFF Health News and NPR. The goal is to keep as many other vulnerable people as possible from getting sick and to remind the public about the benefits of vaccinations.

But in Louisiana this year, public health officials appeared to have not followed that playbook during the state’s worst whooping cough outbreak in 35 years.

Whooping cough, also called pertussis, is a highly contagious, vaccine-preventable disease that’s particularly dangerous for the youngest infants. It can cause vomiting and trouble breathing, and serious infections can lead to pneumonia, seizures, and, rarely, death.

Madison Flake, a pediatric resident in Baton Rouge, cared for a baby who was hospitalized during this year’s outbreak. Less than 2 months old, he was sent to the intensive care unit.

“He would have these bouts of very dramatic coughing spells,” Flake said. “He would stop breathing for several seconds to almost a minute.”

Infants are not eligible for their first pertussis vaccine until they are 2 months old, but they can acquire immunity if the mother is immunized while pregnant.

By late January, two babies had died in Louisiana.

But the Louisiana Department of Health waited two months to send out a social media post suggesting people talk to their doctors about getting vaccinated. The department took even longer to issue a statewide health alert to physicians, send out a press release, or hold a news conference.

Doctors muffled as Florida moves to end decades of childhood vaccination mandates

That lag is not typical, according to Georges Benjamin, the executive director of the American Public Health Association.

“Particularly for these childhood diseases, we usually jump all over these,” said Benjamin, a physician who has led health departments in Maryland and Washington, D.C. “These are preventable diseases and preventable deaths.”

Because infectious diseases spread exponentially, if officials don’t alert the public quickly, they lose a key chance to prevent further infections, said Abraar Karan, an instructor at Stanford University who has worked on Covid and mpox outbreaks.

“Time is perhaps one of the most important currencies that you have,” he added.

General promotion of vaccines banned

Because pertussis vaccine immunity wanes over time, cases can ebb and flow. But in September 2024, Louisiana health officials started seeing a “substantial” increase in whooping cough cases, part of a national trend.

In late January, physicians at one Louisiana hospital warned their colleagues that two infants had died in the outbreak.

On Feb. 13, the state’s surgeon general, Ralph Abraham, sent a memo to staff ending the general promotion of vaccines and community vaccine events.

He sent that email a few hours after Robert F. Kennedy Jr., an anti-vaccine activist, won Senate confirmation as the new secretary of the U.S. Department of Health and Human Services.

Also that day, Abraham posted a public memo on the state health department’s website. In it, he said public health has overstepped with vaccine recommendations, driven by “a one-size-fits-all, collectivist mentality.” Abraham has called Covid vaccines “dangerous” and been a vocal supporter of Kennedy.

Four days later, in response to a request from WVUE Fox 8 News in New Orleans, the Louisiana Department of Health in an email confirmed the deaths of two infants from whooping cough for the first time. WVUE published the news on Feb. 20.

But Louisiana’s health department sent out no alerts, according to a review of external and internal communications by NPR and KFF Health News.

Over the next month, two more infants were hospitalized for whooping cough, according to internal health department emails obtained through a public records request.

In March, after inquiries from NPR and KFF Health News about the growing number of pertussis cases, the department put out its first social media communications about the outbreak and offered interviews to other journalists.

How measles, whooping cough, and worse could roar back on RFK Jr.’s watch

Then on May 1 — at least three months after the second infant death — the health department issued what appears to be its first and so far only official alert to physicians. It put out its first press release the next day and then held a news conference about pertussis on May 14.

By then, 42 people had been hospitalized for whooping cough since the outbreak began, three-quarters of whom were not up to date on their whooping cough immunizations, according to the Louisiana Department of Health.

More than two-thirds of those hospitalized were babies under the age of 1.

Throughout the summer, pertussis cases continued to climb in Louisiana. But there were no further public communications from the state health department.

NPR and KFF Health News contacted the department for comment on Sept. 25. Emma Herrock, a spokesperson, did not answer specific questions about the lack of communications but referred to a Sept. 30 post on X by the state surgeon general.

In the post, Abraham said the department “consistently reported cases of pertussis and provided guidance to help residents stay protected” in 2025. He called the pertussis vaccine “one of the least controversial” and said he recommends it to his patients.

The X post included a year-by-year graphic of pertussis cases that omitted 2024 and 2025. The post also provided a more specific timeframe for when the infant deaths occurred — one in late 2024 and the other in early 2025.

Louisiana sees ‘train wreck’ of cases

Louisiana should have started warning the public within days of the first infant’s death instead of waiting months, said Stanford’s Karan.

“At minimum,” he said, “it should be like heavy promotion of: ‘Hey, infants are at high risk. They get infected by people who have waning immunity. If you haven’t gotten vaccinated, get vaccinated. If you have these symptoms, get tested.’”

Deaths from a vaccine-preventable illness are tragic, but they can also serve as an opportunity to educate the public about the benefits of vaccines and try to save lives, said Joshua Sharfstein, a former Maryland health secretary and now a professor at the Johns Hopkins Bloomberg School of Public Health.

“The risk of pertussis is always there, but when you have two infant deaths it’s a really good opportunity to communicate that this is a real threat to the health of children,” Sharfstein said.

Karan said that by not acting more quickly, the Louisiana Department of Health may have set itself up for a worse outbreak.

“Because then what we see is this train wreck thereafter, of like an insanely large outbreak, a lot of hospitalizations,” he said.

The outbreak continued

As of Sept. 20, the most recent date for which data is available, Louisiana had counted 387 cases of whooping cough in 2025, according to the Centers for Disease Control and Prevention. In data going back to 1990, the previous high was 214 cases, in 2013.

Until the Sept. 30 post on X, the Louisiana Department of Health did not appear to put out any public communications about pertussis over the preceding four months, though hospitalizations continued, and case levels surpassed the 2013 levels.

The health department should be responding aggressively and consistently, said Joseph Bocchini, president of the Louisiana Chapter of the American Academy of Pediatrics.

Health officials should make sure “people are updated on a regular basis and reminded of what needs to be done,” he said. “Get your vaccines. Moms, if you’re pregnant, get vaccinated. And if you have a cough illness, see your doctor.”

Benjamin, with the American Public Health Association, said the ongoing goal of public health communication is to prevent the next hospitalization or death.

“The bottom line is, it’s not too late,” he said. “It’s not too late to be much more aggressive and proactive about dealing with pertussis.”

This article was produced by a partnership that includes WWNO, NPR, and KFF Health News, Healthbeat’s national reporting partner.

Health alert shows growing concerns about type of mpox spreading in Europe and California

2025-10-28T15:55:59+00:00

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European health officials are warning that they have identified a concerning type of mpox virus spreading locally in four countries. The announcement follows the discovery of similar mpox cases spreading locally in California.

The European Centre for Disease Prevention and Control (ECDC), in a public alert issued Friday, said that locally acquired cases of a type of clade I mpox virus have been identified in Spain, Italy, Portugal, and the Netherlands.

It is the first time this type of mpox has been detected spreading within the European Union and European Economic area, the health agency said. Previously, cases of this form of the virus were associated with international travel outside the region.

Will new type of mpox virus spread beyond California? Many at-risk people aren’t vaccinated.

Outbreaks of clade I mpox have been ongoing in parts of Central and Eastern Africa.

There are two types of mpox, clade I and clade II, and both are spread through close, intimate and sexual contact and cause potentially painful rashes. During 2022-23, outbreaks across the United States involved the milder clade II type of the virus, which continues to circulate here at low levels.

The clade I type of the virus has the potential to cause more severe disease, health officials have said.

While an mpox vaccine provides protection against both the clade I and clade II virus, Healthbeat reported last week that federal data show in most U.S. states, more than half of people at highest risk of mpox infections were not vaccinated in the wake of the 2022-23 outbreaks.

Here are four takeaways from the ECDC’s new alert.

Clade I mpox has been detected spreading locally in Europe

The ECDC says cases of mpox clade I have been spreading locally in European countries, rather than just being brought in by travelers.

Spain reported its first locally acquired clade I case on Oct. 10. The Netherlands reported a case on Oct. 17. Since then, two cases were reported in Italy and one in Portugal. The patients started showing symptoms between Sept. 16 and Oct. 7.

Among these five patients, all men, none had any history of travel to countries with known transmission of clade I mpox. Of the four patients whose vaccination status was known, only one was vaccinated against mpox.

“These new cases have been reported among men, some of whom identify themselves as men who have sex with men, with no recent travel history to mpox-endemic areas,” the ECDC said. “This indicates that transmission may be ongoing in sexual networks among men who have sex with men in European countries.”

In its alert, the ECDC noted that local transmission of clade Ib cases has also been detected in California among gay, bisexual, and other men who have sex with men and their social networks.

European risk assessment says more cases are likely to be identified

An mpox threat assessment, also released Friday by the ECDC, said the overall risk of mpox clade I infection in Europe is “moderate for men who have sex with men and low for the general population.”

But the agency noted there is “substantial uncertainty” about the extent of transmission within sexual networks. “In general, the likelihood of exposure is higher with a higher number of casual sexual partners, which is supported by historical data from the mpox outbreak in 2022/23,” the assessment said.

The assessment said it is likely there are additional mpox clade I cases that have not yet been detected.

The severity of locally spread clade I mpox is unclear

While the three recent clade I cases identified in California all required hospitalization, the ECDC said the five European cases all had mild symptoms.

Clade I mpox is divided into two subtypes: clade Ia and clade Ib. The recently identified European and California cases are all clade Ib mpox, the ECDC said.

According to the U.S. Centers for Disease Control and Prevention, infections with clade 1a mpox, especially among children younger than 15, have occurred in Central Africa through contact with infected dead or live animals and through household transmission or patient care.

Clade Ib was more recently identified as spreading through intimate and adult sexual contact.

The ECDC, in its health alert Friday, said: “Some uncertainties remain regarding the transmissibility and clinical severity of clade Ib” compared to the clade II virus that has circulated since the 2022-23 outbreaks.

Before the recent locally transmitted clade I cases were identified, there had been 29 travel-related clade I cases reported to the ECDC, with seven of them needing hospitalization. But the agency said it is difficult to estimate the severity of disease based on such small numbers.

The ECDC said the severity of clade I infections may be worse among those living with HIV, especially if they are receiving inadequate treatment. People with other underlying health conditions, including suppressed immune systems, and people over the age of 65, may also be at increased risk for severe disease.

Awareness, vaccination can protect against mpox

Both the clade I and clade II types of mpox cause a rash that may look like pimples or blisters. The rash, which may involve a few lesions or many, can appear on any part of the body, including the hands, face, mouth, chest, or near genitals.

Mpox may also cause flu-like symptoms. The virus is usually spread through close contact, such as skin-to-skin contact and during sex, health officials say.

“If an unusual rash develops, they should seek medical help by contacting a health care professional for testing and advice. It is also important to avoid close physical or sexual contact with others until they are symptom-free,” the ECDC said.

Vaccination is the best protection against both clade I and clade II, health officials in Europe and the United States said.

The mpox vaccine in the United States, called JYNNEOS, is available through retail pharmacies, usually with advance appointments, as well as through clinics, health care providers, and public health departments. Locations that may offer the vaccine can be found at: www.EmpoweredAgainstMpox.com.

The ECDC has called for European countries to ensure lab testing is easily accessible, especially in locations that serve men who have sex with men, and that those at higher risk are advised to get vaccinated.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

Doctors muffled as Florida moves to end decades of childhood vaccination mandates

2025-10-27T15:56:57+00:00

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SARASOTA, Fla. — Florida plans to end nearly a half-century of required childhood immunizations against diseases that have killed and maimed millions of children. Many critics of the decision, including doctors, are afraid to speak up against it.

With the support of Republican Gov. Ron DeSantis, Surgeon General Joseph Ladapo on Sept. 3 announced his plan to end all school-age vaccination mandates in the state.

“Every last one of them is wrong and drips with disdain and slavery,” he told a cheering crowd of vaccination foes in Tallahassee. “Who am I, as a government or anyone else,” he said, “to tell you what you should put in your body?”

History shows that mandates increase the use of vaccines. Lower vaccination rates will mean increased rates of diseases like measles, hepatitis, meningitis, and pneumonia — and even the return of diphtheria and polio. Many of these diseases threaten not just the unvaccinated but also those they come in contact with, including babies and older people with weakened immunity.

But that scientific fact is being left unsaid in Florida. Health officials have largely been silent in the face of Ladapo’s campaign — and not because they agree with him. The University of Florida muzzled infectious disease experts, said emeritus professor Doug Barrett, formerly the university’s chief of pediatrics and senior vice president for health affairs.

“They’re told not to speak to anyone without permission from supervisors,” he said. University spokespeople didn’t respond to requests for comment.

Will new type of mpox virus spread beyond California? Many at-risk people aren’t vaccinated.

County-level Department of Health officials across the state got the same message, said John Sinnott, a retired professor at the University of South Florida who is friends with one of the county health leaders.

Sarasota County’s health department referred a reporter to state officials in Tallahassee, who responded with a statement that vaccines will “remain available” to families who want them. The state did not respond to other requests for comment or for an interview with Ladapo.

Many pediatricians are silent, too, at least in public.

“A lot of them don’t take a strong stance on whether kids need to be vaccinated,” said Neil Manimala, a urologist and the president-elect of the Hillsborough County Medical Association. “They don’t want to lose business. And there are enough anti-vax people who can lambaste you on Google, spreading stories about clinicians who ‘want to instill the poison jabs.’”

Vaccine mandates prompted by ‘70s measles outbreaks

Several states ended vaccination mandates early last century when smallpox was the only widely given vaccine, said historian Robert Johnston of the University of Illinois-Chicago. None has done so since other vaccines were added to the schedule. (Routine smallpox vaccination ended in 1972).

In the 1970s, persistent measles outbreaks provoked officials to strengthen child protection with enforced school mandates in every state. Today the partisan split on vaccine policy in the wake of the Covid outbreak has changed the equation. This is nowhere more the case than in Florida, although legislators in Texas and Louisiana are also considering ending mandatory vaccination, and Idaho enables parents to get an exemption just by asking for it.

“This is really going to be a watershed moment for families who already were not sure they want to do vaccines and now are being told they don’t need them,” said Jennifer Takagishi, vice president of the Florida branch of the American Academy of Pediatrics.

It’s hard to know how fast vaccine-preventable diseases might return if Florida ends its mandates — or how the public will respond. Asked in an interview whether his office had modeled disease outcomes before his September announcement, Ladapo said, “Absolutely not.” Parental freedom of choice isn’t a scientific matter, he said. “It’s an issue of right and wrong.”

Ladapo’s Department of Health did not respond a month later when asked whether it was making contingency plans for outbreaks. During a 2024 measles outbreak in Broward County, Ladapo sent parents a letter granting them permission to send unvaccinated children to school, defying the science-supported advice from the federal Centers for Disease Control and Prevention.

In 1977, a measles epidemic that killed two children in Los Angeles County spurred a dramatic crackdown on vaccine-shunning across the country. But during an epidemic this year that killed two Texas children and 14 people in Mexico, Republican Gov. Greg Abbott of Texas signed a bill making it easier for parents to opt out of getting required shots.

“When are we going to have enough of a groundswell of people dying or becoming severely ill that leads people to push back and say, ‘No, no, we want the vaccines?’” Takagishi said. “I don’t know if we know the tipping point yet.”

“I don’t have the answer,” said Emory University emeritus professor Walter Orenstein, who worked on measles for many of his 26 years at the CDC and led the agency’s immunization program from 1988 to 2004. “Measles resurgences created the political will to support our overall immunization program. For some reason it hasn’t worked this time. It’s just sad.”

Wary of RFK Jr., Colorado started revamping its vaccine policies in the spring

Youngsters in Florida are already among the least vaccinated in the nation, because of relatively lax enforcement, the post-Covid backlash against shots, and the libertarian attitude of state officials. Statewide, only about 89% of kindergartners are fully vaccinated, with Sarasota County having the lowest rate, at about 80%. To be safe from the spread of measles, a community must be 95% immunized.

With Health and Human Services Secretary Robert F. Kennedy Jr. cutting vaccine research, filling the health agency with anti-vaccine activists, and spreading doubt about vaccination’s safety and value, little stands in the way of decisions by Florida officials that are likely to cause rates to sink further.

Ladapo’s department is ending mandates for shots against hepatitis B, chickenpox, and the bacteria causing meningitis and pneumonia. Early next year, the Florida Legislature is expected to take up reversal of a 1977 law requiring kids at school and day care to be vaccinated against seven other diseases that can kill children: whooping cough, measles, polio, rubella, mumps, diphtheria, and tetanus.

After measles, which disease returns next?

In the face of these attacks, scientists are attempting to predict which diseases are likely to make a resurgence and when.

A study published in April by Stanford epidemiologist Mathew Kiang and colleagues estimated that even at current vaccination levels, measles, declared eliminated from the United States in 2000, is likely to become a routine illness again. If measles vaccination rates drop by an additional 10%, there could be an average of about 450,000 cases yearly, with hundreds of deaths and cases of brain damage.

But the study may exaggerate the threat, said Shaun Truelove, an epidemic disease modeler at Johns Hopkins University who said he’s worried about losing public trust with alarmist predictions. Still, he said, an intensification of measles outbreaks seems certain. The country is already in the midst of its worst measles year in three decades, with more than 1,500 cases and current outbreaks in South Carolina and Minnesota.

“You don’t really need to model measles if vaccines stop,” Truelove said. “In the pockets where there are outbreaks, every kid who isn’t vaccinated will get infected.”

Measles is the “canary in the coal mine” for other vaccine-preventable diseases, said Sal Anzalone, a pediatrician with Healthcare Network in Naples, Florida. “When you start seeing measles, there’s more to come behind that.”

People who want vaccinations will still be able to get them if mandates are eliminated, Ladapo has said.

But the state’s message confuses parents, especially the poor and underserved, Anzalone said. It’s typically hard for them to get children to appointments unless they have to, he said, noting that 80% of his patients are insured through Medicaid. If policies put more of the payment burden on parents, fewer will vaccinate, he said.

And if vaccinations fall and infections increase, children won’t be the only people affected. Cancer patients and people in Florida’s numerous elderly communities would be at risk. Schools and businesses would be disrupted. Disease could disrupt the tourism industry, which brought 143 million people to the state last year. (The Florida Chamber of Commerce did not respond to requests for comment.)

“Infectious diseases don’t stop with the people who say they are willing to bear the risk,” said Meagan Fitzpatrick, a University of Maryland vaccinologist. Because of their unpredictable spread, she said, “with an infectious disease, vaccination is never an individual choice.”

Fulton epidemiologist calls measles containment a ‘public health win’ after weeks of tracing contacts

Clinicians fear that an end to mandates could allow hepatitis B, a chronic liver disease, to return with force, since an estimated 2 million Americans carry the virus. They also foresee a return to the days when infants with high fever had to undergo a painful and risky lumbar puncture and blood draw to rule out meningitis, as well as a blood infection caused by the bacteria Haemophilus influenzae type B that routine vaccination has prevented since the 1990s.

Barbara Loe Fisher, who co-founded the modern movement against vaccine mandates in the early 1980s after her son suffered a reaction to the pertussis vaccine then in use (and since replaced with a safer shot), is skeptical that Floridians will abandon vaccination en masse, despite the end to mandates.

Fisher, president of the National Vaccine Information Center, moved from Virginia to southwestern Florida in 2020. She said she believes that vaccine injuries are undercounted and that children are vaccinated without informed consent. She acknowledged that mandates have increased coverage but said their removal will increase trust in public health and medicine.

“It is time to allow biological products like vaccines to be subject to the law of supply and demand,” she said, “just like any other product sold in the marketplace.”

Sinnott, for his part, anticipates measles will come roaring back, along with intensified whooping cough, influenza, and covid outbreaks.

“They think nothing will happen. Maybe they’re right,” said Sinnott, the retired professor. “It’s an experiment.”

Polio could return, and that is not an abstraction for Sinnott, 77.

He was 7 years old when he contracted the disease, spending six months in a wheelchair. In recent years he’s suffered from post-polio syndrome — difficulty swallowing, and tightness and pain in his limbs.

The first polio vaccine was licensed in 1955, the year he got sick. “I remember one time my mother telling me, ‘The line was too long,’” he said.

Sinnott forgives his parents, and parents today who waver on vaccination. He’s less tolerant of certain public health leaders. They should know better, he said.

This story originally published at KFF Health News, Healthbeat’s national reporting partner.

Will new type of mpox virus spread beyond California? Many at-risk people aren’t vaccinated.

2025-10-22T17:45:27+00:00

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As California health officials investigate an outbreak of a more severe type of mpox virus, federal data indicate that across the country most of the people at highest risk of exposure haven’t been vaccinated against the disease.

In most states – including Georgia, Florida, Texas, Michigan, and New Jersey – more than half of at-risk people remained unvaccinated in the wake of the 2022-23 U.S. outbreak of a milder form of the virus that infected more than 30,000 people, according to Centers for Disease Control and Prevention estimates last updated in January 2024.

Mpox, which causes a rash and sores that can be painful, is spread mostly through close, intimate, and sexual contact.

Fewer than one-quarter of at-risk people in most states were fully vaccinated with two doses of the mpox vaccine, the CDC data show. Even in the jurisdictions with the highest levels of people fully vaccinated against mpox – the District of Columbia, at 68%, New York City, at 47%, and California at 43% – many at-risk people were not fully vaccinated.

It’s likely that mpox immunization rates are even lower today, as the earlier mpox outbreak has faded from the headlines and is “out of sight, out of mind,” said Dr. Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco.

“It’s a wake-up call for at-risk populations to be up-to-date on their vaccines, because a lot of people are not,” Chin-Hong said. “They might have gotten the first shot back in 2022 when everyone was afraid, and people knew a lot of people who had it.”

None of the three Southern California residents hospitalized in the new outbreak were vaccinated against mpox, the California Department of Public Health said in an email to Healthbeat.

California cases of clade I are first in the U.S. without international travel

California public health officials last week began warning that a more virulent type of mpox that has primarily caused disease in African countries, called clade I, now appears to be spreading from person to person in their state.

The three California cases identified with clade I infections didn’t have any recent history of international travel, local, county and state health officials have said. They also didn’t have any connection to each other. Two lived in Los Angeles County, one in Long Beach. All are recovering from their infections, officials said.

They are the first reported clade I infections in the United States that don’t involve international travel, the California Department of Public Health said. These cases indicate that clade I is spreading in the community, “primarily impacting communities of gay and bisexual men, and other men who have sex with men, as well as their social networks,” the department said.

New research raises concerns about local malaria infections in U.S.

The clade I form of the virus can cause more severe disease than clade II type, which was involved in the 2022-23 outbreak. Vaccination and public health education campaigns caused a sharp drop in those clade II cases, but that form of the virus continues to circulate at low levels across the country.

Both forms of mpox, formerly called monkeypox, cause rashes that can initially look like pimples or blisters that may appear on the hands, face, mouth, chest, or near genitals. Mpox also can cause flu-like symptoms. The risk of severe disease is highest among people with weakened immune systems.

The two-dose mpox vaccine, called JYNNEOS, provides protection against both clade I and clade II mpox, health officials said. For those who have already received two doses, a third booster shot is not recommended.

At-risk people encouraged to get mpox vaccine

While California health officials said the risk to the public is low, they are encouraging people at increased risk of mpox exposure to get vaccinated, including people who are gay, bisexual, and men who have sex with men, transgender, and non-binary people, and people who have been exposed to someone with mpox.

The virus primarily spreads through close contact with an infected person, such as through intimate physical contact during massages, cuddling, or sex, or sharing a living space or personal items with someone who has mpox. Casual contact, such as interactions in an airplane, office, or store, are unlikely to spread the virus, California’s state health department said.

There is no indication so far that the clade I outbreak in California is spreading to other states.

“We have to be vigilant, but not scared,” Chin-Hong said. “If it gets into the right place at the right time, like what happened in 2022, it could potentially take off again.”

While California has only identified three cases of clade I mpox, Chin-Hong said there are probably more people who haven’t sought treatment or been diagnosed, despite painful sores and other symptoms that can take three weeks to run their course.

Chin-Hong said he found it interesting that all three of the identified cases were hospitalized.

“Either it’s something about clade I, or it could be that the people who were identified happened to have more serious cases,” he said, “and people who had milder cases just didn’t bother to come to see anybody about it.”

The mpox vaccine is available across the United States through a mix of public health departments, community clinics, and retail pharmacies, said Mark Clarke, a spokesperson for Bavarian Nordic, which makes the JYNNEOS vaccine.

The vaccine, which is given as two injections four weeks apart, is generally covered by health insurance, Clarke said, and those without coverage may find free or reduced-cost vaccine from local health departments and LGBTQ+ focused clinics. The company’s locator tool www.EmpoweredAgainstMpox.com – provides locations that may offer the vaccine.

Spokespeople for CVS and Walgreens told Healthbeat that in most cases, people seeking mpox vaccination will need to make an advance appointment because it can take a few days to ship the vaccine to their local pharmacy.

Chin-Hong said the emergence of what appear to be locally spread clade I cases in California illustrate the broader importance of public health activities in the United States and around the world.

By the United States helping other countries combat infectious diseases, he said, it helps protect against the spread of diseases spreading here.

“We need to continue to invest in public health. That’s what keeps us safe,” he said. He noted that the California cases have been identified as clade I in the middle of a federal shutdown that has impacted the CDC. “You need to invest in people and surveillance, diagnostics and prevention with vaccines to keep everyone safe.”

The CDC has been doing genomic testing to learn more about the virus that infected each of the clade I cases in California, the Los Angeles County Department of Public Health has said.

The CDC did not respond to questions from Healthbeat about mpox vaccination rates across the country and the potential for clade I spreading beyond California. A spokesperson for the U.S. Department of Health and Human Services told Healthbeat to seek information about the new California outbreak from state health officials and the CDC webpage about the disease.

When asked about the impact of the federal shutdown on the mpox outbreak response, the California Department of Public Health told Healthbeat by email that the department continues to work with available staff at CDC, “but the recent federal government shutdown and other actions at the federal level have added a layer of uncertainty to the current work environment.”

Alison Young is Healthbeat’s senior national reporter. You can reach her atayoung@healthbeat.orgor through the messaging appSignalat alisonyoungreports.48

Georgians can now get updated Covid shots at pharmacies without a prescription

2025-10-07T21:11:18+00:00

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Georgians should now be able to get the updated Covid vaccines at pharmacies without a prescription after the Centers for Disease Control and Prevention approved the latest federal guidelines.

The same goes for access at county health departments, the state Department of Public Health said in a Tuesday press release.

In line with federal guidance announced Monday, “health department nurses or other providers will counsel patients on the risk-benefit of the vaccine based not only on age but other health conditions or considerations an individual may have,” DPH said.

Disruptions to the usual process for recommending who should receive the vaccines caused weeks of confusion over the availability of the shots, which started arriving in pharmacies in late August.

The Advisory Committee on Immunization Practices didn’t meet until September to vote on who should receive the shots, so many pharmacies were requiring a prescription.

Georgia law is tied to the ACIP recommendation. The panel decided to allow people to decide for themselves whether to get the shot, in consultation with a health care provider or pharmacist. Now that the ACIP recommendation has been approved by the CDC, people can get the vaccine without a prescription, and most insurance plans will cover it at no cost to patients.

“We are able to give the vaccine now without a prescription. We just have to have a convo with the patient and review the screening form,” said Dr. Johnathan Hamrick, an Atlanta pharmacist who serves on the board of directors of the Georgia Pharmacy Association. “This is no different than how our pharmacies approach any vaccine.”

Some county health departments have started offering the shots, according to a DPH press release, and the departments are ordering a supply under federal programs to distribute for free or low cost to low-income children and adults.

The cost for uninsured adults will vary depending on the situation and location, DPH spokesperson Eric Jens said.

People who want to get the vaccine at their local health department should call in advance to ensure the shots are in stock, the press release said.

National pharmacy chains like CVS and Walgreens confirmed they are offering the shot without a prescription in Georgia.

Dr. Ashley Chinchilla, a professor at the University of Georgia College of Pharmacy, hailed the move.

“I’m glad patients will once again have access to Covid-19 vaccines without a prescription,” she said. The ACIP recommendation is “not quite the same as a universal recommendation,” Chinchilla said, but adults can still get the shot at pharmacies as in past years.

Ninety percent of American adults got their Covid shots in pharmacies during last year’s respiratory season, according to CDC data.

For people without insurance, the shots cost around $225 at CVS. A Walgreens spokesperson didn’t have information on its price.

The latest federal guidance does not specifically address Covid vaccines for children. However, the American Academy of Pediatrics issued recommendations in August that said those age 6 months to 23 months are at high risk of severe Covid and should get the updated vaccine.

Children 2 years old to age 18 who do not have risk factors for severe Covid should also get the shot if their parents want them to, the recommendations say. The AAP recommends that pediatric patients with risk factors like being immunocompromised, living with people who are at high risk or in congregate settings, and not having had the vaccination before get the vaccine.

Dr. Joanna Dolgoff, an Atlanta pediatrician, said she is following those recommendations for her patients.

Georgia’s Covid rate is low based on data from wastewater samples, and emergency department visits for Covid are declining from the summer, according to CDC data. But cases are expected to rise again around the holidays, state epidemiologist Dr. Cherie Drenzek said at a September DPH board meeting.

It’s important to get vaccinated ahead of time, physicians emphasized.

“As we head into fall and winter, during these months in particular, people spend more time indoors, and those respiratory viruses like flu and RSV and Covid spread much more easily because of the close contact,” Dr. Jennifer Brull, president of the American Academy of Family Physicians, said during a fall media briefing.

“Vaccines help protect not only ourselves but those who are around us, the people we love, older adults, young children, pregnant people, and those who have chronic health conditions.”

Tell us about your experiences in trying to get the new Covid vaccine. Write to Atlanta public health reporter Rebecca Grapevine at rgrapevine@healthbeat.org with your story and questions.

Wary of RFK Jr., Colorado started revamping its vaccine policies in the spring

2025-10-07T13:28:08+00:00

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As Health and Human Services Secretary Robert F. Kennedy Jr.’s dismantling of federal vaccine policy continues to roil the Centers for Disease Control and Prevention, some Democratic-led states have struck out on their own, setting up new systems to help them assess the science and maintain immunization access for their residents.

Four Western states — California, Hawaii, Oregon, and Washington — have created a collaborative to preserve access to vaccines. Several Northeastern states have done the same.

New York’s governor declared a “statewide disaster emergency” that allows pharmacists to give Covid-19 vaccines without a separate prescription. Minnesota made a similar change, and Massachusetts is requiring insurance carriers to pay for vaccines recommended by its health department, not only those recommended by the CDC.

The changes represent a significant shift in public health authority from the federal government to the states. Traditionally, states have looked to the CDC for expertise and guidance on public health issues — including, in addition to vaccines, workplace safety, water fluoridation, vaping, and sexually transmitted infections.

Now, amid concerns that Kennedy is undermining trust in vaccines and public health science, some states are charting new paths, seeking out new sources of scientific consensus and changing how they regulate insurance companies, prescribers, and pharmacists.

Colorado has been at the front of this wave. On Sept. 3, state officials issued a standing order to let pharmacists provide Covid shots without individual prescriptions.

“I will not allow ridiculous and costly red tape or decisions made far away in Washington to keep Coloradans from accessing vaccines,” said Democratic Gov. Jared Polis.

Colorado changes law to allow other sources for recommendations

But Colorado’s leadership had been clearing the way for more autonomy on vaccine policy for months.

In March, the state legislature voted to change a law so the state could consider scientific sources other than the federal government when setting school vaccine requirements.

“You could see the writing on the wall that it was just becoming overly politicized rather than relying on actual science with this new HHS director,” said state Sen. Kyle Mullica.

Mullica, who co-sponsored the new law, is a Democrat and works as an emergency room nurse in the Denver area.

Amid confusion over U.S. vaccine recommendations, states try to ‘restore trust’

Colorado is among the first states to change its laws to allow it to recommend vaccines based on sources other than the CDC. The state health board can now also consult leading medical groups, like the American Academy of Pediatrics, American Academy of Family Physicians, and American College of Obstetricians and Gynecologists.

“We decided to protect Colorado,” Mullica said, so it “wouldn’t be as vulnerable to political upheaval that we’re seeing right now.”

The Democratic-led legislature passed the bill in a near-party-line vote. Polis signed it into law in April, despite having praised Kennedy’s selection last fall.

“Colorado I think is really leading the way on this,” said David Higgins, a pediatrician at the University of Colorado who was part of a stakeholder group that helped craft the bill.

Higgins pointed to a companion bill, signed in May, that he said makes Colorado’s push even stronger. It deals with insurance coverage for preventive health care services, aiming to ensure state-regulated insurance plans cover the cost of some vaccines, regardless of future moves by the CDC.

“Effectively, it’s meant to help ensure that Coloradans will still have access to vaccines,” he said.

The Colorado chapter of Children’s Health Defense, the anti-vaccine advocacy group that Kennedy led before taking over HHS, did not respond to a request for comment.

Another co-sponsor of the first bill, Democratic state Rep. Lindsay Gilchrist, said the circulation of so much false information about vaccines, including for Covid, makes it important to hear from a range of trusted medical experts.

Colorado had previously looked to the CDC for scientific guidance on vaccines, particularly for children entering school. Like other states, it had tracked the recommendations of a CDC panel known as the Advisory Committee on Immunization Practices.

Kennedy fired all 17 members in June and replaced them with 12 new appointees, some of whom critics warn are vaccine skeptics and aren’t qualified to provide critical guidance for Americans.

“I think where the confusion will lie is the difference in the recommendations between the ACIP, who we traditionally defer to, and then everyone else,” said Ned Calonge, Colorado’s chief medical officer.

He expects that the national professional physician groups that Colorado is now empowered to consult will likely be aligned in their overall guidance and will “look at the last evidence-based recommendations that were provided by the ACIP” before Kennedy replaced its members.

In May, Kennedy announced the federal government had removed Covid vaccines from the list of shots recommended for healthy pregnant women and children.

Colorado recommends Covid shot during pregnancy

But Colorado is still recommending a Covid vaccine during pregnancy, Calonge said.

“There’s been no new evidence of issues of safety in that population,” Calonge said. “So, we’re telling providers that our recommendation is to continue to follow the recommendation as it was in place in January of 2025.”

Federal vaccine committee recommends personal choice for new Covid shots

In a statement on its website, the American College of Obstetricians and Gynecologists strongly recommended pregnant individuals get vaccinated against Covid. “ACOG continues to recommend that all pregnant and lactating individuals receive an updated Covid-19 vaccine or ‘booster,’” it said.

Likewise, the American Academy of Pediatrics recommended in August that all children from 6 to 23 months old get vaccinated against Covid, as well as older children in certain risk groups.

For now, Colorado is following the same immunization recommendations it used last year.

The most recent ACIP meeting, on Sept. 18 and 19, was chaotic, with members admitting they did not understand what they were voting on and even opting to redo a vote on pediatric MMRV vaccine access. The next ACIP meeting is scheduled to take place Oct. 22 and 23 and could result in additional changes to vaccine recommendations.

Doctors and vaccine scientists have expressed alarm at the splintering national consensus on vaccines.

“There’s now going to be much more confusion and distrust of vaccines among the public,” said Allison Kempe, a professor of pediatrics at the University of Colorado School of Medicine, who served on the ACIP from 2013 to 2018.

Still, she said she’s glad Colorado is forging ahead with its own recommendations.

This article is from a partnership that includes Colorado Public Radio, NPR, and KFF Health News, Healthbeat’s national reporting partner.

Inside the high-stakes battle over vaccine injury compensation, autism, and public trust

2025-10-06T13:56:41+00:00

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Department of Health and Human Services Secretary Robert F. Kennedy Jr. has floated a seismic idea: adding autism to the list of conditions covered by the Vaccine Injury Compensation Program.

The program, known as VICP, provides a system for families to file claims against vaccine providers in cases in which they experience severe side effects. Kennedy has also suggested broadening the definitions of two serious brain conditions — encephalopathy and encephalitis — so that autism cases could qualify.

Either move, experts warn, would unleash a flood of claims, threatening the program’s financial stability and handing vaccine opponents a powerful new talking point.

Legally, HHS “is required to undergo notice and comment rulemaking to revise the table,” said Richard Hughes, a law firm partner who teaches at George Washington University. The “table” is a list of specific injuries that the U.S. government accepts as presumed to be caused by a vaccine if those injuries occur within a certain time window. If someone can show they meet the criteria, they have a simpler path to securing compensation without having to prove fault. Autism is not in the table because a link between vaccines and autism has been thoroughly debunked.

If autism is added, Hughes explained, the VICP could face “an exorbitant number of claims that would threaten the viability of the program.”

Asked about its possible plans, an HHS spokesperson told CBS News the agency does not comment on future or potential policy decisions.

Carole Johnson, former administrator of the Health Resources and Services Administration, which oversees VICP, cautioned that the system is already overburdened: “The backlog is not just a function of management, it’s built into the statute itself. That’s important context for any conversation about adding new categories of claims.”

Dorit Reiss, a law professor at the University of California College of the Law-San Francisco, said that any such change would be exploited: “This can, and likely will, be used to cast doubt on vaccines.”

Program creates no-fault system: compensation without causation

The Vaccine Injury Compensation Program was born of crisis. In 1982, “Vaccine Roulette,” a television documentary, aired nationwide, alleging routine childhood shots were causing seizures, brain damage, and even sudden infant death. The program alarmed parents and triggered a surge of lawsuits against vaccine makers.

“That led to a flood of litigation against vaccine makers,” recalled Paul Offit, a pediatric infectious disease specialist and vaccine inventor at the University of Pennsylvania. “I mean, to the point that it drove them out of the business. … By the mid-1980s, there were $3.2 billion worth of lawsuits against these companies.”

Were it not for the VICP, Offit said, “We wouldn’t have vaccines for American children. The companies — it wasn’t worth it for them.”

The National Childhood Vaccine Injury Act of 1986 created a no-fault system. Families who believed a vaccine caused harm could file a claim; if the injury appeared on the table within a set time frame, compensation was automatic. If not, claimants could present medical evidence. The system had two purposes: Provide compensation and protect the vaccine supply.

From the beginning, the table was understood not as a scientific document but as a legal tool.

“It’s a legal document, and things can be included for policy reasons, even if the causation evidence is weak,” Reiss said. She explained, “The program is designed to be generous, to compensate in cases of doubt.”

But, she said, “autism is not in that category. The science is clear. Adding it would be pure politics.”

This tension — between law, science, and public perception — has defined the program for nearly four decades.

What expansion would mean in practice

Since 1988, federal data show more than 25,000 petitions to the VICP have been adjudicated; of those, 12,019 were granted compensation, and 13,007 were dismissed. About 60% of compensated cases involved negotiated settlements in which HHS drew no conclusion about the cause. Over the same period, billions of vaccine doses were safely administered to millions of Americans.

Adding autism to the VICP table would change that picture overnight.

Federal estimates suggest up to 48,000 children could qualify immediately under a “profound autism” standard, with potential payouts averaging $2 million per case, at an initial cost of nearly $100 billion, followed by annual totals of about $30 billion a year — dwarfing the current $4 billion trust, a new analysis finds.

“Any case where the symptoms appeared in the past eight years and the parents blame vaccines,” Reiss said. “I don’t know how many that would be. The fund has a surplus of over $4 billion. One seriously disabled child’s care can cost millions, so a significant number, say 100,000 compensations, might exhaust it.”

Furthermore, with only eight special masters handling cases, the system would also be paralyzed by backlogs.

The stakes are not just fiscal. If the fund collapses under the weight of autism claims, vaccine makers may question whether producing vaccines for the U.S. market is worth the risk. That would mirror the crisis of the 1980s, which led to the establishment of the VICP.

Autism cases consolidated in court

In the late 1990s and early 2000s, Andrew Wakefield’s now-retracted paper alleging a link between the measles, mumps, and rubella vaccine and autism fueled a surge of VICP claims. By 2002, the VICP was swamped with petitions alleging vaccines had caused autism. The court consolidated thousands of cases into the Omnibus Autism Proceedings, selecting a handful of test cases to decide them all.

After years of hearings and expert testimony, the conclusion was unequivocal: Vaccines do not cause autism. In 2010, the court ruled against petitioners on every theory of causation. The U.S. Court of Federal Claims affirmed, and the Court of Appeals upheld, the decision.

“That precedent is binding,” said Richard Hughes, a vaccine law expert at George Washington University and former VICP legal counsel. “Autism was litigated thoroughly and rejected. That still carries weight in the court today.”

Yet, the vaccine-autism debate has never quite faded. In 2008, the government conceded a case involving Hannah Poling, a girl with a rare mitochondrial disorder who developed autism-like symptoms after vaccination. Officials stressed the concession was specific to her condition, not evidence of a general link. But headlines told another story: “Family to Receive $1.5 Million in First-Ever Vaccine Autism Court Award.”

The Poling case fueled years of confusion.

Autism begins in pregnancy, not toddlerhood

The science is clearer than ever. Autism begins early in pregnancy, not in toddlerhood when most vaccines are given.

“Vaccinations … happened around the time families were recognizing symptoms of autism in their children,” said Catherine Lord, a UCLA clinical psychologist and specialist in autism diagnosis. “However, we now know that autism begins much earlier, likely as the fetus develops during pregnancy, so it cannot be an explanation.”

Peter Hotez, a pediatric infectious disease specialist and vaccine scientist at the Baylor College of Medicine who is also the father of a young adult with autism, underscores that point: “The drivers of autism are genetics and, in rare cases, environmental exposures during pregnancy, not vaccines. We’ve been over this ground for decades, and the evidence is overwhelming.”

Sarah Despres, former legal counsel to the secretary of Health and Human Services in the Biden administration and now a consultant to nonprofit organizations on immunization policy, adds that the compensation program itself is often misunderstood.

“The table was originally written as a political document,” she said. “The purpose of the program was to be swift, generous, and fair. … There would be cases that may not be caused by the vaccine but would be compensated if you went through this table injury scheme, where you don’t have to prove causation.”

What’s at risk: harm from the diseases themselves

The stakes are not abstract. Measles, one of the most contagious pathogens on Earth, spreads so efficiently that one infected child can transmit it to 90% of susceptible contacts. Before vaccinations began in the 1960s, measles sickened hundreds of thousands annually in the United States, killing hundreds and causing thousands of cases of encephalitis and lifelong disability. Complications included pneumonia, brain swelling, and, in rare cases, a fatal degenerative brain disorder called subacute sclerosing panencephalitis, or SSPE, that can strike years later. This year, a school-age child in Los Angeles County died of SSPE after contracting measles in infancy, before being eligible for vaccination.

Mumps was once a near-universal childhood illness. Though often dismissed as mild, it can cause sterility in men, meningitis, and permanent hearing loss. Outbreaks on college campuses, as recently as the 2000s, showed how quickly it can return when vaccination rates slip.

Rubella, also known as German measles, is mild in most children, but can be devastating during pregnancy. Congenital Rubella Syndrome, or CRS, caused waves of tragedy before the development of the vaccine: Thousands of babies each year were born blind, deaf, with heart defects, or with intellectual disabilities. In medical texts, autism itself is listed as one of CRS’ sequelae, or possible consequences — proof that rubella infection, not vaccination, can contribute to developmental disorders.

Measles, mumps, and rubella “are not trivial,” said Walt Orenstein, former head of the Centers for Disease Control and Prevention’s immunization program. “Fever, high fever, is common … and they have frequent complications.”

And yet, as these diseases fade from living memory, a counternarrative has gained traction. On Sept. 29, the nonprofit Physicians for Informed Consent, a group that disputes the scientific consensus on vaccines, announced it had mailed its “Silver Booklet” on vaccine safety to every member of Congress, as well as to President Donald Trump and Vice President JD Vance. The book claims that “vaccines are not proven to be safer than the diseases they intend to prevent,” and calls on federal leaders to punish states that restrict vaccine exemptions. (The booklet isn’t free. The group sells copies for $25 on Amazon.)

Scientists say this framing misrepresents the basic math of risk. “Measles is one of the most important infectious diseases in human history,” notes “Plotkin’s Vaccines,” the field’s authoritative textbook. “The widespread use of measles vaccines in the late 20th and early 21st centuries led to a further marked reduction in measles deaths. Measles vaccination averted an estimated 31.7 million deaths from 2000 to 2020.”

Kennedy’s possible move to expand the Vaccine Injury Compensation Program hinges on casting doubt — on suggesting that science is unsettled, that vaccines may be riskier than diseases.

“One tactic used to argue that vaccines cause autism is the use of compensation decisions from the National Vaccine Injury Compensation Program to claim such a link,” said Reiss of UC Law-San Francisco. “Even the cases that most closely address the question of vaccines and autism do not show the link that opponents claim exists, and many of the cases used are misrepresented and misused.”

Offit underscores the danger on the perception side. “When people see the Vaccine Injury Compensation program, they assume that any money that is given is because there was a vaccine injury,” he said.

Kathryn Edwards, an expert in pediatric infectious diseases and vaccine safety at Vanderbilt University, said, “Expanding compensation for issues that are not clearly related to vaccines … suggests that these conditions are related to vaccines when they are not.” She compared it to the removal of thimerosal, a preservative dropped from most childhood vaccines to ease public fears, despite no evidence of harm. “Now, we are still suffering from that action.”

Public health experts stress that such narratives invert reality. The very diseases being downplayed once killed or disabled tens of thousands of American children each year. As pediatrician, psychiatrist, and medical historian Howard Markel put it: “Back a hundred years ago, everybody lost a kid or knew a kid who died of one of these diseases. … We never conquer germs, we wrestle them to a draw. That’s the best we do. And so this is a real … handicap to the other side, the microbes who live to infect.”

Families feel unsupported and exhausted

The hardest voices to reckon with are those of families. Parents of autistic children often feel abandoned — unsupported by disability programs, exhausted by care needs, searching for answers. Kennedy’s appeal to them is emotional, not scientific.

Reiss noted that families deserve far more support but argues that it shouldn’t come through VICP.

“The program is to award compensation to those injured by vaccines,” she said. “We should have more direct support — disability funding, disability aid. Kennedy has been taking HHS in the opposite direction, cutting services where we need more.”

Despres made the same point: “The goal of the program really was if there’s a close call, we’re going to err on the side of compensation. … And it’s really important that everyone understands that compensation does not mean that the vaccine actually caused the injury. … And I think we have seen statistics around the compensation program misused by those who would want to sow distrust in vaccines, to say vaccines are unsafe, when in fact … that’s not what this is.”

UCLA’s Lord urged a shift in focus. “For the last 50 years, science has focused on the biological causes of autism, which has led to great progress, especially in genetics,” she said. Of Secretary Kennedy, she said, “He could help more by acknowledging the value of science, but also the need to better attend to the actual lives of autistic people and their families.”

What comes next?

If Kennedy decides to move forward with such a plan, HHS would need to draft a rule, open it to public comment, and then defend the change in court. The pushback will be fierce: from scientists, from public health leaders, and from families who fear being misled yet again.

The debate over adding autism to the Vaccine Injury Table is not just a policy debate. The program was built on the principle of compensation without causation, a fragile balance designed to sustain both trust and supply. Adding autism could collapse that distinction entirely.

Dr. Céline Gounder is a senior fellow and editor-at-large for public health at Healthbeat’s partner, KFF Health News.

In hepatitis B vaccine debate, CDC panel sidesteps key exposure risk

2025-09-29T13:48:40+00:00

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The Trump administration is continuing its push to revise federal guidelines to delay the hepatitis B vaccine newborn dose for most children. This comes despite a failed attempt to do so at the most recent meeting of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.

Both President Donald Trump and some newly appointed ACIP members have mischaracterized how the liver disease spreads, according to medical experts, including those working at the CDC. The ACIP panel’s recommendations can determine insurance coverage for immunizations.

At a White House press conference on Sept. 22, Trump, in advocating for delaying the newborn vaccine dose, falsely claimed that hepatitis B is solely a sexually transmitted infection.

“Hepatitis B is sexually transmitted. There’s no reason to give a baby that’s almost just born hepatitis B. So I would say wait till the baby is 12 years old and formed and take hepatitis B,” Trump said.

Hepatitis B is a highly infectious virus that attacks the liver and is transmitted through contact with infected bodily fluids, including blood. It can also be passed from mother to baby.

A reporter asked if Trump had spoken with Health and Human Services Secretary Robert F. Kennedy Jr., who oversees the CDC, about making the change, and Trump said he had, as Kennedy looked on.

Although hepatitis B is often associated with high-risk behaviors such as injection drug use or having multiple sexual partners, health experts, including career CDC scientists, note that the virus can be transmitted in ordinary situations too, including among young children.

Hepatitis B can survive for over 7 days on surfaces

At the latest ACIP meeting, held Sept. 18 and 19, members debated postponing the hepatitis B newborn dose until 1 month of age.

CDC scientist Adam Langer outlined research showing incidences of unvaccinated children born in the United States to mothers who tested negative, later becoming infected with hepatitis B. Langer serves as acting principal deputy director for the National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention.

Langer told the vaccine advisory panel that the virus can survive for over seven days outside the body on surfaces. During that time, contact with even microscopic traces of infected blood on a school desk or on playground or sporting equipment is enough for a child to be infected. This means unvaccinated children not considered at high risk can still be exposed in everyday environments, or by an infected caregiver.

“We do have data that says that it can happen and that it is likely to happen,” he said. Though the exact cause of infection may not be clear in documented cases of children of hepatitis B-negative mothers becoming infected, “I can tell you that it didn’t come from the mother and it didn’t come from injection drug use and it didn’t come from sexual contact, so that means that it had to have been some kind of casual contact,” Langer said.

Yet during the debate, some members gave little credence to the risk of transmission to children through household contact.

“This is a very, very important vaccine that should be given to the high-risk populations,” said ACIP voting member Retsef Levi, a professor of operations management at the MIT Sloan School of Management. “The high-risk populations seem to be babies born to hep B-positive mothers, drug addicts, and other populations at high risk,” he said, despite Langer’s presentation highlighting other avenues of possible transmission.

Contrary to research that was presented, Levi later said the risk of not vaccinating children of hepatitis B-negative mothers was “probably close to zero” in the first few years of life.

The CDC estimates 2.4 million people in the United States have hepatitis B and half do not know they are infected. The disease can range from an acute, mild infection to a chronic infection, often with few to no symptoms. The disease has no cure and, if left untreated, can lead to serious conditions like cirrhosis, liver failure, and liver cancer later in life.

ACIP tables vote on hepatitis B recommendation

During debate on the vote to delay the newborn dose, ACIP member Joseph Hibbeln said that the proposed one-month gap would leave some children vulnerable to the virus, even if their mothers test negative for hepatitis B.

“This assumes implicitly that all the infections are coming from moms,” Hibbeln said. “You can’t decide on that simply by the mother’s status. You would have to look at the entire household’s status.”

ACIP member Evelyn Griffin, an obstetrician and gynecologist, asserted that doctors could ascertain an entire household’s hepatitis B status by asking the mother.

“How are they going to know?” Hibbeln said. “If 50% of people don’t know that they are hepatitis B-positive, you can ask all you want, and nobody knows.”

The committee members, all handpicked by Kennedy, ultimately decided to table the vote on whether to delay the newborn dose after Hibbeln brought up inconsistencies in the wording of the text of the resolution.

“The notion that hepatitis B is only confined to transmission for prostitutes, drug users, etc. is such an ignorant and uninformed way of approaching infectious disease,” internist Jason Goldman, the president of the American College of Physicians and its liaison to ACIP, said when reached after the meeting.

“The virus does not care what your behavior or lifestyle is. The virus goes from person to person through bodily fluids,” Goldman said. It can be transmitted when an unvaccinated person touches infected bodily fluids on common surfaces and then accidentally touches the eyes or mouth. “What if someone was in a car accident and got exposed to blood?”

“It is not only mother-to-fetus transmission, it is not only certain risk groups,” he said. “This is why it’s universal; everyone should get this for their protection, and it is unfortunate that it is being politicized into a sexually transmitted disease and that’s it. That’s not an appropriate way to evaluate science.”

Pediatric vaccination recommendations are widely credited with nearly eliminating the virus in American-born children.

Babies infected at birth have a 90% chance of developing chronic hepatitis B, and a quarter of those children go on to have severe complications, like liver cancer, or to die from the disease.

In 1991, federal health officials determined newborns should receive their first dose of a hepatitis B vaccine within 24 hours of birth, which can block the virus from taking hold if transmitted during delivery. From 1990 to 2022, case rates of hepatitis B declined by more than 99%. While parents may opt out of the shots, many day care centers and school districts require proof of hepatitis B vaccination for enrollment.

The next meeting of the ACIP is scheduled to begin Oct. 22. Agendas are usually posted weeks in advance, but so far, no information on the substance of the upcoming meeting has appeared on the CDC’s website. The agenda for the September meeting was posted less than a week before the meeting’s start.

This story was originally published at KFF Health News, Healtthbeat’s national reporting partner.

Cold and flu season is coming. Flu shots are widely available.

2025-09-26T16:15:43+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

As Georgia heads into the fall respiratory virus season, public health officials say now is the time to get a flu shot.

“People forget how many people die every year in the U.S. and in Georgia of influenza,” Georgia Department of Public Health Commissioner Dr. Kathleen Toomey said during the Board of Health’s September meeting.

There have been 168 deaths, including five children, and over 5,000 hospitalizations from flu in Georgia since last October, according to DPH data. The number of deaths this year is much higher than the past two years – 61 deaths last year and 53 the year before.

Measles spreads from Georgia State student to three others

Last year’s flu season was particularly severe, with the 280 pediatric flu-associated deaths nationwide, a record high, according to the Centers for Disease Control and Prevention.

Wastewater surveillance data show very low rates of Influenza A and respiratory syncytial virus rates along with moderate rates of Covid in Georgia for the week of Sept. 7-13. Flu cases typically start to increase in the fall and peak between December and February.

State epidemiologist Dr. Cherie Drenzek, speaking at the meeting, urged people to get the flu shot in September or October.

Flu shots are widely available as usual at pharmacies and public health departments. So, too, are RSV vaccines, which are recommended by the CDC for everyone 75 and older and adults ages 50 to 74 who are at increased risk of a severe case.

DeKalb Public Health is hosting a drive-through event for flu shots Saturday at the Lou Walker Senior Center, 2538 Panola Rd. in Lithonia, from 9 a.m. until 1 p.m. Three types of flu shots will be available, along with FluMist, a nasal vaccine spray for children ages 6 to 18.

People with insurance can get the shots for no cost. For low-income people without insurance, there are programs to provide the shots at low or no cost, spokesperson Eric Nickens said. For others, the shots range $50-$94 out of pocket, depending on the shot, he said.

Covid declining after summer bump

Georgia’s summer uptick in Covid cases appears to be on the decline, according to the latest wastewater surveillance, after rising since July.

“What we see is this late summer little bump in Covid activity, and then we see another one that usually occurs after the holidays,” Drenzek said.

For the last week in August and the first two weeks in September, the Covid hospitalization rate ranged between 3 and 3.6 per 100,000, around the same rate as last February and March, according to CDC data. The hospitalization rate refers to how many people are hospitalized with a confirmed case of Covid within 14 days before or during the hospitalization per 100,000 people.

The increase was also reflected in emergency department visits, when rates were over 1% for each week from Aug. 3 to Sept. 6, according to CDC data.

Confusion around federal guidance has disrupted access to this fall’s updated Covid vaccine. The shots are on the market, but pharmacies are waiting to start distributing them without a prescription until the acting CDC director signs off on new guidance from the Advisory Committee on Immunization Practices.

The ACIP, meeting last week in Atlanta, recommended that all Americans over 6 months old be able to get a Covid shot after consultation with a health care provider, a category that includes pharmacists.

Once the CDC signs off on the recommendations, Georgians should be able to get the Covid shot in pharmacies without a prescription.

DPH has not started providing the new vaccines yet, spokesperson Nancy Nydam Shirek said. The agency will review the new ACIP guidance once the CDC signs off on it, she said.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Covid declining, no flu or RSV yet in New York. What to know about Tylenol and autism.

2025-09-26T15:30:00+00:00

It’s been a whirlwind week in public health. From shifting Covid-19 vaccine recommendations and a debate over Tylenol and autism, to declining Covid levels in New York and even a case of eastern equine encephalitis, there’s a lot to sort through. Here’s what you need to know this week.

Infectious disease ‘weather report’

Covid is past its peak in New York

Forecast: Moderate and declining as measured by wastewater data, signaling that we’ve made it through the worst of the summer surge.

New York state Covid-19 wastewater activity levels.

Covid hospitalizations are still elevated. Because wastewater is a leading indicator and has just started decreasing, we can expect hospitalizations to follow and begin decreasing in the next week or two.

New York state Covid-19 hospitalizations.

The flu

Forecast: No activity in New York yet.

All states, including New York, are at the minimal influenza-like illness level, and New York wastewater shows no flu activity.

I’m planning on getting my flu shot this week before I travel out of the country in early October.

RSV

Forecast: No activity in New York yet.

Wastewater and hospitalizations still show no RSV activity in New York.

Nationally, we moved from 0 hospitalizations per 100k to 0.1, which could be a very early sign that the season is starting or about to start.

Mosquito-transmitted viruses

Human infection of eastern equine encephalitis virus in Central New York

Last week a resident of Madison County was hospitalized with eastern equine encephalitis, a virus transmitted by some species of mosquitoes. This is the county’s first ever human EEE infection. EEE is rare in New York and the rest of the United States — last year, New York had its first human case since 2015 in a resident of Ulster County, who sadly died.

Most people infected with EEE won’t have any symptoms. But for those who develop symptoms, the illness can be severe and involve inflammation of the brain (encephalitis) and spinal cord (meningitis).

About one-third of people who develop severe illness die.
There is no specific treatment available.
People over age 50 or younger than 15 are at greatest risk.

EEE is rare in New York, but is more concentrated in Central New York this year.

Since 1971, only 13 human cases have been identified in the state, including the most recent one. Of these patients, seven died.

By this time last year, 14 counties across the state detected EEE in mosquitoes, mammals, or birds. So far this year, EEE has only been detected in four counties: Madison, Onondaga, Oswego, and Oneida.

Eastern equine encephalitis virus detections in mosquitoes, humans, and animals.

But more mosquitoes have tested positive so far this year compared to last. Even though there are fewer counties detecting EEE, the detections are more concentrated in a smaller area — there’s a hotspot in Central New York.

Prevention of EEE is the same as for West Nile virus: It’s focused on reducing the mosquito populations and avoiding insect bites.

West Nile virus is active across New York

The most recent data show mosquitoes tested positive in:

Erie
Nassau
Onondaga
Oswego
Rockland
Suffolk
NYC: all five boroughs

So far, the number of human infections seen this year is comparable to the average of the previous three years.

What this means for you:

Mosquito transmitted viruses are active right now.
Protect yourself by wearing repellent (Deet or picaridin), long sleeves, or staying indoors when mosquitoes are most active at dawn and dusk.
Dump standing water around your house to reduce mosquito breeding habitat.

Follow-up on ACIP meeting updates

I tuned into last week’s Advisory Committee on Immunization Practices meeting — and it was messy. Members openly said they weren’t sure what they were voting on, some votes had to be redone or skipped, and there was repeated confusion over whether certain issues even fell within ACIP’s jurisdiction.

That said, the outcome was more patient-friendly than many expected. Katelyn Jetelina covered the details in a recent YLE National piece here.

Here are the high-level outcomes:

Covid vaccines: ACIP shifted Covid vaccine recommendations to shared clinical decision-making for everyone aged 6 months and older. That means that the decision to vaccinate now falls to conversations between patients (or parents) and clinicians — whether your primary care provider, specialist, or pharmacist.

Depending on what state you live in, though, you may still need a prescription. ACIP’s guidance is now more broad than the Food and Drug Administration’s: FDA continues to classify the Covid vaccine as “off-label” for some groups (like healthy adults and children without underlying conditions). In some states, this ACIP/CDC vs. FDA mismatch could mean patients need a prescription to access the vaccine.

In New York, this discrepancy will not disrupt vaccine access. Gov. Kathy Hochul earlier issued an executive order that allows pharmacists to both prescribe and administer Covid-19 vaccines for people aged 3 and older without a patient-specific prescription. That law means that even under the new federal guidance emphasizing shared decision-making, folks in New York should still be able to get vaccinated conveniently, including via pharmacies.

What this means for New York: The executive order put forward earlier this month ensures continued access to Covid-19 vaccines in New York. The CDC basically recommended Covid-19 vaccines off-label (different from FDA’s recommendations). This off-label use means that pharmacists can’t administer them without special authority. In New York, the EO and standing order granted pharmacists that authority, even before the ACIP meeting, which means that you can get vaccinated at your local pharmacy. Most insurers — including Medicaid, Medicare, CHIP and major private insurers (AHIP, ACHP) — have also affirmed they will keep covering the vaccine.

New York joins the Northeast Public Health Collaborative

New York state and New York City joined Connecticut, Maine, Massachusetts, New Jersey, Pennsylvania, and Rhode Island in the Northeast Public Health Collaborative to share expertise and protect evidence-based public health. A cornerstone of the voluntary regional coalition is to collaborate on vaccine recommendations.

And they are already making moves. All states in the Northeast Collaborative have taken action through executive orders, legislation, or other means to decouple Covid-19 vaccine guidelines from federal rules, protecting access within their own states.

What we do and don’t know about autism and Tylenol

What was said at the presidential press conference earlier this week is not true: We do not have evidence that Tylenol causes autism. The largest and most rigorous study to date — a Swedish sibling study of over 2.5 million pregnancies — found no link between prenatal Tylenol use and autism when controlling for genetics and environment.

That said, the picture is more complicated. Some observational studies have reported associations between Tylenol use during pregnancy and autism. But others show that fever itself during pregnancy can increase risk, making it hard to know whether the risk comes from the medication, the underlying illness, or something else entirely.

The bottom line: This science is complex, and we don’t have a clear answer. What we do know is that the association is nowhere near as strong as it was described from the podium earlier this week. Many of the statements given were misleading or straight up false. On top of that, they also create stigma against our neurodiverse community members, and pregnant women who are doing the best they can to keep their babies and themselves healthy. Katelyn and Kristen Panthagani did a great job breaking it down here for YLE National.

For now, guidelines remain unchanged: Consult with your doctor, and if you need Tylenol during pregnancy, use the lowest effective dose for the shortest possible time.

Bottom line

You’re all caught up on New York public health news this week! And a happy 220th birthday to the NYC Department of Health and Mental Hygiene. 🥳

Love,

Your NY Epi

What to know about getting a Covid vaccine in New York this fall

2025-09-25T13:59:15+00:00

This story was originally published by THE CITY. Sign up to get the latest New York City news delivered to you each morning. Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

We’re headed into cold and flu season and you want your shots, including an updated Covid booster. Where can a New Yorker go to get the jab?

After the Food and Drug Administration changed its regulations around the Covid vaccine this summer to limit access, New York state crafted a workaround to preserve people’s ability to get a booster. Nonetheless, confusion has reigned in pharmacies across New York City.

An executive order by Gov. Kathy Hochul technically allows pharmacies to administer the vaccine to anyone 3 years old and older. But the Centers for Disease Control and Prevention recently changed its guidelines around the Covid vaccine that further mixed messaging, creating a choose-your-own-adventure scenario for shot-seekers.

Here’s what to know now about finding (and paying for) the new Covid shots in New York City 2025.

Can I get a Covid booster in New York City, and where?

Yes, you can, but where you get it depends on a few factors.

At CVS, Walgreens, and independent pharmacies, the Covid vaccine is allowed to be administered, but availability and whether you will have to pay for it varies (more on this below).

Hochul’s Sept. 5 executive order allows pharmacies in the state to offer the Covid vaccine to those under 65 without an underlying health condition and without a prescription.

Amid confusion over U.S. vaccine recommendations, states try to ‘restore trust’

She did this in response to the FDA releasing the most restrictive Covid vaccine regulations since the shot’s inception. The federal policy said that only those 65 and older or people with an underlying condition are eligible to get the updated vaccine.

Hochul’s executive order suspends those federal rules until Oct. 5, and she may choose to extend it further.

Despite the governor’s order, availability of the vaccines is spotty in New York City. When THE CITY reached out to pharmacies across the five boroughs in recent days, many were not offering the shot, or were administering it only to certain populations.

At Esco Pharmacy in Hell’s Kitchen — where Hochul herself received the COVID booster last week — pharmacists are following FDA guidelines and not offering the vaccine to anyone between the ages of 18 and 65 who do not have a health condition.

“It is confusing to our staff and the patient, as well,” said Danny Dang, pharmacist at Esco, of the current guidelines. “We do see the benefits of the vaccination. I’ve seen a lot of patients who came to us for Covid treatment that could have been prevented by the vaccine if we had done it earlier.”

Dr. Marisa Donnelly, epidemiologist and author of the column “Your Local Epidemiologist New York,” explains that just because pharmacies are allowed to administer a vaccine doesn’t mean they will.

“There’s still, I think, a lot of internal policies that different pharmacy companies have,” Donnelly says. “They’re all allowed to give vaccines, but that doesn’t mean that they necessarily will. They can still go with their own guidelines and decide not to give a vaccine if they don’t want to. But they are allowed within the state.”

Who should get the booster?

Under the executive order from Hochul, everyone over 3 years old should be able to get the Covid shot. But, as stated above, the CDC and FDA says something else entirely, muddying the waters.

The New York City Health Department says it is especially important for the following groups of people to get the Covid booster:

All adults ages 65 and older
All children ages 6 to 23 months
People who are pregnant or recently gave birth
People of any age who have an underlying condition that increases their risk for severe Covid-19
People at high risk of exposure, such as health care workers and people living or working in a nursing home or other congregate setting
People living with someone with an underlying condition that increases their risk for severe Covid-19
People who have never been vaccinated before

Dr. Bruce Y. Lee, a professor at the CUNY Graduate School of Public Health & Health Policy, recommends the shot for anyone whose last vaccine was over six months ago, since immunity starts to wane after four to six months.

“On top of that, the last set of vaccines were protected against an earlier variant,” Lee says. “Right now, the variants that are circulating are different from previous, so your protection is probably even lower against the current variants. So if you haven’t gotten a vaccine for at least six months or greater, then it’s a good idea to get the vaccine, especially headed into winter.”

What about shots for city kids?

All kids 3 years to 18 are eligible to be vaccinated in New York state – no prescription or underlying health condition needed. (Six- to 23-month-old kids are considered a high-risk population and so their eligibility for the vaccine was never under threat)

However, THE CITY found that availability for shots for young people is spotty. Some independent pharmacies that are offering the vaccine for adults just don’t have it available or stocked for kids.

Kennedy’s take on vaccine science fractures cohesive national public health strategies

Lauren Naturale, a Sunset Park mom, tried to get her 6-year-old daughter vaccinated before traveling for a family wedding where a lot of older people would be in attendance.

Naturale attempted to make a vaccine appointment for her daughter at CVS, but when she went to finalize, would repeatedly get an error message. She tried again the following week and was able to make an appointment. Upon arrival at a CVS that was 40 minutes away, Naturale was told the store must have miscategorized them in CVS’s system because they did not have vaccines for children under 12.

“It sounds like you can get them, it would just be great if there was clear information,” Naturale said about children’s vaccines in New York.

She wasn’t able to get her daughter one before they left for the wedding.

“Hopefully we’ll be able to make that happen when we get back to the city,” Naturale said.

Shots for all young people under 19 years old should be covered by your insurer by law. (More on this below.)

Do I need a prescription?

No, you do not need a prescription to get the Covid shot. Hochul’s executive order from earlier this month made it clear that people seeking the Covid vaccine do not need a prescription. If a provider demands one, try another pharmacy, call your local health department about finding a vaccine, or contact your primary care doctor.

What is this going to cost me?

This really depends on your insurance and whether your insurer is choosing to cover the Covid vaccine right now.

That’s because a key committee at the CDC — the Advisory Committee on Immunization Practices — declined last week to recommend the Covid vaccine this season. Its recommendation is the federal standard insurers traditionally follow for coverage of all kinds of medical services.

What this means: Local pharmacies are allowed to give the Covid vaccine, but it may not be paid for by your insurance. At CVS, an out-of-pocket Covid vaccine could cost you up to $249.99. At Esco Pharmacy, an independent pharmacy in Hell’s Kitchen, it costs about $265, staff there said.

Earlier this month, the state’s Department of Financial Services issued guidance encouraging insurers to continue covering the Covid vaccine, but that isn’t binding. However, the letter notes that New York state law requires insurers to fully cover vaccines for children under 19, because they were deemed necessary immunizations in 2020 – a decision that still stands. Some insurers, like UnitedHealthcare, are choosing to continue covering the shot for everyone despite the ACIP declining to recommend the shot.

“For our standard commercial plans, we will continue to cover claims for Covid-19 vaccines with no cost share,” UnitedHealthcare said in a statement. The insurer said they recommend members who use an employer-sponsored plan to confirm benefits with their specific plan.

My local pharmacy isn’t offering the shot. What now?

Dr. Lee recommends contacting your doctor’s office or the local health department if you’re having trouble getting the vaccine.

Walgreens and CVS have the Covid vaccine available for those under 65 without a health condition. But to schedule an appointment online, you have to “confirm you are eligible,” or answer yes that you have a health condition.

“My guess is the reason that that is existing is because it’s a national website,” Donnelly says. “And so I imagine that they have some of those settings for everywhere across the country, even if they don’t necessarily apply to New York state. But I do think that that’s a potential source of confusion for people.”

Donnelly worries that mixed messaging around the Covid vaccine is causing fewer people to get it, and even worse, sowing distrust in the medical system.

“I think the biggest issue right now is there’s so much noise around vaccines, and it’s so confusing to follow,” Donnelly says. “So I think that’s actually a potential deterrent for a lot of families that want to get vaccinated, but that maybe don’t understand that they can or they are eligible now.”

What else can I do to prevent Covid?

Lee notes that while the Covid vaccine does protect against the worst outcomes of the virus, it doesn’t guarantee not getting it.

“You also want to continue to take other types of precautions, especially when you’re in a location or an area where the risk of getting infected is high,” Lee says. “Say you’re in a very crowded location, it’s still important to make sure that the area is well ventilated. That, and evidence has shown that masks can help cut down transmission. So, all of these things that came out during the beginning of the Covid pandemic still hold.”

During this time of mixed messaging, it’s important to distinguish which evidence is scientifically sound.

“If you see something that’s repeated across different respectable and evidence-based websites, then you can feel more confident that it’s a consensus that different folks have come to the same conclusion,” Lee says.

Some of the most reliable sources, he says, include international health organizations like the World Health Organization, Health Canada, and the U.K.’s The National Health Service. Major U.S. health systems like John Hopkins, the Mayo Clinic, and the Cleveland Clinic also provide trustworthy guidance. New York City’s health department is also considered one of the largest public health agencies in the world and offers evidence-based health recommendations.

Measles spreads from Georgia State student to three others

2025-09-24T16:31:33+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

Measles has spread from an unvaccinated Georgia State University student to three other people, bringing the total cases reported in Georgia this year to 10.

Three “close contacts” – two who were unvaccinated and one with an unknown vaccination status – got measles from the student, according to a press release from the state Department of Public Health. The three new patients are isolating at home.

Measles is highly contagious and can linger in the air for up to two hours after an infected person has been there. In a group of unprotected people, 9 in 10 of those exposed will be infected.

Earlier this month, the DPH reported that an unvaccinated person who had spent time on the Georgia State campus, at Inter Atlanta FC soccer practices and games, and at a Sweetgreen restaurant at Ponce City Market had measles.

The initial case prompted a large contact tracing effort by the Fulton County Board of Health and DPH that had identified 268 close contacts of the student as of Tuesday. Seven are enrolled in “active monitoring.”

The student had not traveled outside the United States.

Georgia State requires students to be vaccinated but allows exemptions for religious reasons. Students must sign an affidavit to obtain the exemption, a spokesperson told Healthbeat. The student did not live in GSU housing.

Georgia had six measles cases in 2024. This year, a January outbreak involved three unvaccinated children from the same Gwinnett County family after the initial patient had traveled to New York City. A second outbreak reported in May involved three unvaccinated members of the same family who contracted measles after at least one member traveled internationally.

Nationally, 1,514 cases have been reported as of Sept. 23 according to the Centers for Disease Control and Prevention. Most of the cases are connected to a large outbreak in west Texas and New Mexico. Two Texas children and a New Mexico adult – all unvaccinated – have died. Cases have been reported in South Carolina, Alabama, Florida, and South Carolina this year.

A school-age child in California recently died from a rare but fatal complication of measles, subacute sclerosing panencephalitis. The child contracted measles as an infant before they were eligible to receive the vaccine, the Los Angeles County Department of Public Health reported earlier this month.

Vaccination is the most effective way to prevent measles. Children typically get two doses of the vaccine as part of the measles, mumps, rubella regimen – the first between ages 12 and 15 months, and the second between ages 4 and 6 years.

About 95% of people need to be vaccinated to prevent widespread transmission of the virus, or achieve “herd immunity,” according to the CDC.

In Georgia vaccination rates have been on the decline.

Kindergarten vaccination data from the CDC show 86.8% of the state’s children were fully up-to-date on their MMR vaccinations last year.

Symptoms of measles include a high fever, cough, runny nose, red watery eyes, and a characteristic red rash.

People who suspect they or their child have measles are urged to call their health care providers before going to a hospital, clinic, or doctor’s office to avoid infecting staff and other patients.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Amid confusion over U.S. vaccine recommendations, states try to ‘restore trust’

2025-09-24T13:15:39+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

When the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices met last week, confusion filled the room.

Members admitted they didn’t know what they were voting on, first rejecting a combined measles-mumps-rubella-chickenpox vaccine for young toddlers, then voting to keep it funded minutes later. The next day, they reversed themselves on the funding.

Now Jim O’Neill, the deputy health and human services secretary and the CDC’s acting director (a lawyer, not a doctor), must sign off. The panel’s recommendations matter, because insurers and federal programs rely on them, but they are not binding. States can follow the recommendations, or not.

In the West, California, Oregon, Washington, and Hawaii have joined forces in the West Coast Health Alliance. Their first move was to issue joint recommendations on Covid, flu, and RSV vaccines, going further than ACIP.

“Public health should never be a patchwork of politics,” said Sejal Hathi, Oregon’s state health director.

Kennedy’s take on vaccine science fractures cohesive national public health strategies

California’s health director, Erica Pan, described the goal as “demonstrating unity around science and values” while reducing public confusion.

The bloc is also exploring coordinated lab testing, data sharing, and even group purchasing. “Our intent is to restore trust in science and safeguard people’s freedom to protect themselves and their families without endless barriers,” Hathi said.

In the Northeast, New York and its neighbors created the Northeast Public Health Collaborative. Democratic Gov. Kathy Hochul called it a rebuke to Washington, D.C.’s retreat from science.

“Every resident will have access to the Covid vaccine, no exceptions,” she said in a statement.

The group has already gone beyond vaccines. After the CDC disbanded its infection-control advisory body, the Northeast states created their own return-to-work rules. Work groups now span vaccines, labs, emergency preparedness, and surveillance.

“Infectious diseases don’t respect borders,” said Connecticut’s health commissioner, Manisha Juthani. “We had to move in the same direction to protect our residents.”

The two blocs are in regular contact. “We communicate every day,” Hathi said.

“We can’t just sit by while federal agencies are hollowed out,” said acting New York City health commissioner Michelle Morse. “Public health is local, and we have to act like it.”

State leaders describe their coalitions as filling a vacuum left by Washington, D.C.

“You would think emerging from a pandemic, we would be embracing public health, but the federal government was heading in the opposite direction,” said James McDonald, New York state health commissioner.

Massachusetts commissioner Robbie Goldstein added: “The federal government has historically been the entity that held us all together. In January of this year, that tradition seemed to be going away.”

Boston University law professor Matt Motta summarized the dilemma: “States are taking matters into their own hands, sometimes to expand access to vaccines, sometimes to roll it back. That’s technically how the system works, but it risks inefficiency and confusion.”

CDC decapitated: What comes next for public health in the United States?

Public health law has long tilted toward the states.

“If there was a public health issue, we’d say it’s for the states,” said Wendy Parmet of the Northeastern University School of Law.

States have mandated vaccines since the 1800s. Federal agencies can approve vaccines and fund programs, but they cannot force mandates except in very specific circumstances (e.g., federal employees).

UC Law-San Francisco’s Dorit Reiss agreed with Parmet: “Public health authority resides primarily with the states. Recommendations are recommendations.”

ACIP’s votes matter for coverage rules and insurance mandates, but states are free to diverge.

That divergence is already widening. Florida, led by Surgeon General Joseph Ladapo, is moving to eliminate childhood vaccine requirements altogether — a first-in-the-nation step. Georgetown Law’s Larry Gostin warned this could reopen century-old battles dating to Jacobson v. Massachusetts (1905), when the Supreme Court upheld state vaccine mandates for public safety.

Health leaders warn that competing systems risk causing confusion and costing lives. “Federal silence creates a vacuum, and states either step up together or splinter apart,” Hathi said.

Pan added that “without federal credibility, we’re left improvising.”

McDonald cautioned that partisan divides could grow sharper.

And Morse said that “blue and red states could each go their own way, leaving the public even more divided.”

Gostin put it bluntly: “That risks confusion, inefficiency, and ultimately lives.”

This state-by-state tug-of-war is not new. In the 1800s, local boards of health fought cholera with sewers and sanitation when federal authority was absent. In the 1950s, states organized mass polio clinics, with uneven uptake until federal funding smoothed disparities.

During the Covid pandemic, Trump White House response coordinator Deborah Birx saw firsthand the limits of federal power. She visited 44 states, urging governors to adopt masks, closures, and vaccines.

“I was trying to get them to tailor responses to their populations, not just follow generic federal guidance,” she later recalled.

Supreme Court Justice Louis Brandeis once said that states are “laboratories of democracy,” where leaders could test out new ideas without putting the whole country at risk. But diseases don’t follow state lines. A virus that starts in Tallahassee could spread to Times Square by the next morning.

Today, states have become laboratories of public health. Each state is experimenting — some expanding protections, others cutting them back. And those choices could, for better or worse, affect us all.

Dr. Céline Gounder is a senior fellow and editor-at-large for public health at Healthbeat’s partner, KFF Health News.

‘Sick to my stomach’: Trump distorts facts on autism, Tylenol, and vaccines, scientists say

2025-09-23T13:22:27+00:00

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Ann Bauer, a researcher who studies Tylenol and autism, felt queasy with anxiety in the weeks leading up to the White House’s much-anticipated autism announcement.

In August, Bauer and her colleagues published an analysis of 46 previous studies on Tylenol, autism, and attention-deficit/hyperactivity disorder. Many found no link between the drug and the conditions, while some suggested Tylenol might occasionally exacerbate other potential causes of autism, such as genetics.

Bauer, an epidemiologist at the University of Massachusetts-Lowell, and her team called for more judicious use of the drug until the science is settled.

On Monday, President Donald Trump stood beside Health and Human Services Secretary Robert F. Kennedy Jr. for what he called a “historic” announcement on autism. “If you’re pregnant, don’t take Tylenol, and don’t give it to the baby after the baby is born,” Trump said. “There are certain groups of people that don’t take vaccines and don’t take any pills that have no autism,” he added, without providing evidence. “They pump so much stuff into those beautiful little babies, it’s a disgrace.”

A fact sheet released alongside the White House briefing cited Bauer’s analysis. But she was alarmed by Trump’s comments. If prenatal Tylenol has any association, which it may not, it would help account for only a fraction of cases, she said. Further, research has not deeply examined Tylenol risks in young children, and many rigorous studies refute a link between vaccines and autism.

Bauer worries such statements will cut both ways: People may put themselves at risk to avoid vaccines and Tylenol, the only safe painkiller for use during pregnancy. And she frets that scientists might outright reject her team’s measured concerns about Tylenol in a backlash against misleading remarks from Trump and other members of his “Make America Healthy Again” movement.

“I’m really concerned about how this message is going to play out,” she said. “It’s a sound-bite universe, and everyone wants a simple solution.”

Autism experts at the Centers for Disease Control and Prevention were neither consulted for the White House’s long-awaited autism announcement nor asked to review a draft of the findings and recommendations, CDC scientists told KFF Health News, which agreed not to identify them because they fear retaliation.

“Typically, we’d be asked to provide information and review the report for accuracy, but we’ve had absolutely no contact with anyone,” one CDC researcher said. “It is very unusual.”

Trump and Kennedy promised this year that under their leadership the federal government would swiftly figure out what causes autism. Scientists who work in the field have been skeptical, noting that decades of research has shown that no single drug, chemical, or other environmental factor is strongly linked to the developmental disorder. In addition, both Trump and Kennedy have repeated the scientifically debunked notion that childhood vaccines may cause autism.

Helen Tager-Flusberg, director of the Center for Autism Research Excellence at Boston University, called Trump’s comments dangerous. Fevers can harm the mother and the developing fetus, she said, adding that fevers are more strongly associated with autism than Tylenol.

In an emailed response to queries, HHS spokesperson Andrew Nixon said, “We are using gold-standard science to get to the bottom of America’s unprecedented rise in autism rates.”

White House spokesperson Kush Desai wrote, “President Trump pledged to address America’s rising rate of autism, and to do so with Gold Standard Science.”

Had CDC scientists been allowed to brief Kennedy, they say they would have cautioned that simple fixes won’t make a dent in the number of autism cases in the United States: As many as 1 in 31 8-year-old children had autism spectrum disorder in 2022.

Systemic changes, such as regulations on air pollution, which has been linked to asthma and developmental disabilities including autism, and assistance for parents of disabled children, could improve lives for far more Americans with autism and other conditions than actions taken by the Trump administration on Monday, researchers say.

One federal action is to consider updating the label on Tylenol and to “encourage clinicians to exercise their best judgment in use of acetaminophen for fevers and pain in pregnancy by prescribing the lowest effective dose for the shortest duration.” The American College of Obstetricians and Gynecologists already recommends acetaminophen “as needed, in moderation, and after consultation with a doctor.”

‘Genetics is the most significant risk factor’ for autism

Despite Kennedy’s many years of speaking about autism, he rarely cites credible autism research or expert recommendations, Tager-Flusberg said. Instead, Kennedy repeats fringe, scientifically debunked theories linking vaccines to autism, despite rigorous studies published in peer-reviewed journals that refute a link.

At the Monday briefing, Trump said he spoke with Kennedy about autism 20 years ago: “We understood a lot more than a lot of people who studied it,” he said. Ahead of Trump’s first term in 2017, Kennedy said he met with the president to consider a commission on vaccine safety and autism. It didn’t happen then. But soon after Kennedy was confirmed as health secretary, he called autism “preventable,” pointed to “environmental toxins,” and contradicted the results of a CDC study finding that the main driver of rising autism diagnoses was that doctors increasingly recognize the disorder.

At a televised Cabinet meeting in April, Kennedy told Trump, “By September, we will know what has caused the autism epidemic and we’ll be able to eliminate those exposures.”

“You stop taking something, you stop eating something, or maybe it’s a shot,” Trump replied.

“He is on a political crusade,” Tager-Flusberg said of Kennedy, adding that vaccines, Tylenol, aluminum, and food dyes make for simple targets to rally against. “We know genetics is the most significant risk factor,” she said, “but you can’t blame Big Pharma for genetics, and you can’t build a political movement on genetics research and ride to victory.”

“RFK makes our work harder,” said Peter Hotez, a vaccine researcher and the author of a book about his autistic daughter, “Vaccines Did Not Cause Rachel’s Autism.” He said the book stemmed from conversations with Kennedy in 2017, in which Hotez shared studies pinpointing more than a hundred genes linked to autism, and research into the complex interplay between genetics, biological processes, and things that children and fetuses encounter during development.

“I sat down with him and explained what the science says, but he was unwilling or incapable of thinking deeply about it,” Hotez said. “He is extremely careless.”

In addition to its focus on Tylenol, the White House said it would move to update “prescribing information” on leucovorin — a medication related to the B vitamin folate — to reflect its use as an autism treatment. A small clinical trial in 2012-13 suggested the drug may help treat language problems in some children with autism. Tager-Flusberg said the findings warrant further study but clarified these were “old data, not a breakthrough.”

Likewise, studies finding a modest association between autism and prolonged Tylenol use were published years ago. Researchers have suggested the medicine might occasionally exacerbate factors associated with autism, such as genetics and oxidative stress, a biological condition that occurs for a variety of reasons that scientists are still unraveling.

Still, these studies couldn’t rule out the possibility that fevers prompting women to take Tylenol, rather than the medicine itself, might instead be to blame. Fevers and infections — including those prevented by vaccines — have also been linked to autism.

Nonetheless, Bauer’s recommendation would be to pause before taking acetaminophen while pregnant — blanket advice that doctors give for all medications during that period, but which may be ignored. “Try to alleviate discomfort in some other ways, like with a cold compress, hydration, or massage, before taking it,” Bauer said.

She welcomed the White House’s motion to consider labeling Tylenol to emphasize judicious use of the drug but worries about how the MAHA movement might distort a careful message. On Sept. 2, the right-wing news outlet One America News Network posted an interview with newly appointed CDC vaccine adviser Robert Malone, writing that Malone “speculates RFK Jr. may have an important announcement this month regarding a potential link between Tylenol, multiple vaccinations, and autism in children.”

“I was sick to my stomach,” Bauer said, concerned that Kennedy would link her study to discredited theories, causing doctors and scientists to reject her far more measured work.

RFK Jr. is ‘like the boy who cried wolf’

Several medical and scientific associations have called for Kennedy’s removal or resignation. Many scientists are skeptical of what he says because much of it has been misleading or wrong. For example, he’s said HIV isn’t the only cause of AIDS (it is), that antidepressant drugs cause mass shootings (they don’t), that older adults don’t have severe autism (some do), that the measles vaccine causes brain swelling (it doesn’t), that Covid vaccines were the deadliest vaccines ever made (they aren’t), that vaccines aren’t safety-tested (they are), and that vaccines contribute to autism (they don’t).

“This is like the boy who cried wolf,” said Brian Lee, an epidemiologist at Drexel University. “One day he might be right about something and Americans who are not prone to conspiracies won’t trust it because it’s coming from RFK’s mouth. And that could be a problem.”

What’s more, the Trump administration is eroding scientists’ ability to probe the safety of pharmaceuticals, said Robert Steinbrook, head of health research at Public Citizen, a nonprofit consumer protection group.

“Public Citizen is very supportive of research on medications that could be linked to diseases,” he said. “But it needs to be through an open process, which looks at scientific evidence, and which doesn’t cherry-pick studies to support a preconceived point of view.”

Steinbrook said the administration has undermined his confidence in the government’s ability to conduct credible work. The Food and Drug Administration has held less than a third the number of advisory committee meetings this year as it did last, meaning fewer opportunities for experts to discuss research on the risks and benefits of drugs. The Trump administration has fired hundreds of career scientists at the CDC and FDA and cut millions of dollars in research funds, including to projects studying autism.

In early September, the CDC issued an unusual contract with the Rensselaer Polytechnic Institute to analyze datasets for signs that vaccinated children were more likely to have autism. Unlike with other research initiatives, the CDC didn’t post an open call for applications in advance. This allows agency experts to review proposals and select studies best designed to answer the question at hand.

CDC researchers told KFF Health News that experts in the agency’s autism and disability group weren’t aware of the contract or asked to review the proposal. That’s important, they said, because researchers digging through data to find clues about autism must show how they’ll rule out biological and environmental exposures that muddy the results, and ensure that children have been accurately diagnosed. One researcher said, “It absolutely looks like Kennedy has subverted the grantmaking process.”

The CDC and HHS did not respond to KFF Health News’ requests for information on the grant, including through a Freedom of Information Act request.

The new vaccine study is separate from Kennedy’s autism data-science initiative, which was posted as an open call at the National Institutes of Health. “The hope is that something good comes of it, and that the government won’t cherry-pick or censor what scientists find out,” Lee said.

Bauer said she didn’t apply to be part of the initiative because of Kennedy’s outsize presence at HHS.

“I would not take his funding because it could take away from the credibility of my study,” she said, “in the same way that taking money from pharmaceutical companies does.”

Amy Maxmen is Healthbeat’s national reporter in partnership with KFF Health News.

Federal vaccine committee recommends personal choice for new Covid shots

2025-09-20T00:46:59+00:00

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After a two-day meeting marked by contention and confusion, a federal vaccine committee voted in Atlanta on Friday to allow people to decide for themselves whether to get a Covid shot – without a prescription.

The decision by the Advisory Committee on Immunization Practices will likely make it easier for Georgians to get the shots than it has been over the past month, after the Food and Drug Administration narrowed eligibility, forcing many to get a prescription. Since Georgia law relies on the ACIP recommendations, Georgians age 6 months and older should now be able to get the shots without prescriptions.

“The good news is anyone is allowed to get this vaccine,” Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Pennsylvania, said during a media briefing after the meeting. “The bad news is no one is encouraged to get it.”

Under this recommendation, the shots should be covered by private insurance and federal programs like Medicaid, the Children’s Health Insurance Plan, Medicare, and Affordable Care Act marketplace plans.

Even so, America’s Health Insurance Plans, which represents many private insurers, excluding United Healthcare, said before the meeting its members would continue to cover all vaccines that were recommended as of Sept. 1 through the end of next year.

ACIP, which advises the Centers for Disease Control and Prevention, suggested the agency substantially revise its vaccine information statements provided to patients to say evidence for the protection provided by the shots is “low quality,” that the vaccines come with potential serious risks, and other information that many scientists say lacks evidence. The ACIP resolutions still must be approved by acting CDC Director Jim O’Neill or Health and Human Services Secretary Robert F. Kennedy Jr.

The Covid working group chairman, MIT operations management professor Restef Levi, relied on opinions rather than facts and cherrypicked studies to support his position that the vaccine information statement needs to be revised, Jesse Goodman, a professor of infectious diseases at Georgetown University and a former FDA chief scientist, said at a media briefing after the meeting.

The committee narrowly voted against encouraging state and local governments to require a prescription for the shot, with Chairman Martin Kulldorff casting a tie-breaking vote.

The committee deferred votes on recommendations for Covid shots for pregnant women, but didn’t exclude them from its approved guidance.

Meanwhile, members voted to change its recommendation on the first dose of the childhood measles, mumps, rubella, and varicella (chickenpox) vaccine and deferred a decision on whether to end the recommendation of a hepatitis B vaccine at birth.

The chaotic meeting began Thursday with 12 new committee members picked by Kennedy to align with his anti-vaccine views. He had removed the previous 17 expert members. Representatives of major medical societies, including the American Academy of Pediatrics, have criticized the changes as undermining the scientific rigor of the process.

Dr. Jason Goldman, president of the American College of Physicians, urged the committee to return to the evidence-to-recommendation framework and other procedures ACIP has previously used to evaluate evidence for vaccines.

“We’re concerned about how vaccine recommendations are being developed by this new panel. Data is being selectively used to justify specific conclusions rather than considering all of the available evidence, and this lack of transparency diminishes trust, introduces bias and raises doubts,” Atlanta physician Sandra Fryhofer told committee members during the meeting on behalf of the American Medical Association.

The committee also voted to recommend that the first dose of the childhood measles, mumps, and rubella vaccine be given separately from the varicella (chickenpox) vaccine.

That change is expected to have limited impact because about 85% of American children already receive the first dose of the MMR and varicella shots separately, with only about 15% receiving the combination shot.

The combination shot eliminates the need for two shots but comes with a small increased risk of a febrile seizure – an issue that became the centerpiece of Thursday’s debate.

The CDC formerly recommended that the first shot in the series be the single MMR shot – but it gave parents the option to get the combined shot after counseling about the elevated risk of febrile seizure from the pediatrician.

The meeting served as an indicator of how the United States may handle vaccine policy going forward, with many members casting doubt on the safety of vaccines that have been used for years.

The committee established two new working groups, one focused on vaccines and pregnancy and the second focused on the childhood vaccine schedule.

The ACIP decided to postpone a vote on whether to end the universal recommendation of the hepatitis B vaccine that is typically administered within the first 24 hours of birth. The practice of vaccinating newborns before they are discharged from the hospital, introduced in 2005, has dramatically reduced the number of cases of hepatitis B in infants in the United States, according to data presented by Dr. Adam Langer, the associate director for science for the National Center for HIV, Viral Hepatitis, STD, and TB Prevention

Meanwhile, the committee unanimously voted to recommend that all pregnant women be screened for hepatitis B, a practice the CDC already recommended.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Kennedy’s take on vaccine science fractures cohesive national public health strategies

2025-09-19T15:21:05+00:00

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Health and Human Services Secretary Robert F. Kennedy Jr. has had a busy few months. He fired the director of the Centers for Disease Control and Prevention, purged the agency’s vaccine advisory committee, and included among the group’s new members appointees who espouse anti-vaccine views.

The leadership upheavals, which he says will restore trust in federal health agencies, have shaken the confidence many states have in the CDC and led to the fracturing of a national, cohesive immunization policy that’s endured for three decades.

States and medical societies that long worked in concert with the CDC are breaking with federal recommendations, saying they no longer have faith in them amid the turmoil and Kennedy’s criticism of vaccines. Roughly seven months after Kennedy’s nomination was confirmed, they’re rushing to draft or release their own vaccine recommendations, while new groups are forming to issue immunization guidance and advice.

How the new system will work is still being hammered out. Vaccine recommendations from states, medical societies, and other groups are likely to diverge, creating dueling guidance and requirements. Schoolchildren in New York may still generally need immunizations, for example, while others in places such as Florida may not need many vaccines.

There are potential financial ramifications too, because historically, private insurers, Medicaid, and Medicare have generally covered only vaccines recommended by the federal government. If the CDC and its advisory group, which began a two-day meeting Thursday in Atlanta, stop recommending certain vaccines, hundreds of millions of people could wind up paying for shots that previously cost them nothing. Some states are already taking steps to prevent that from happening, which means where people live could determine if they will face costs.

“You’re seeing a proliferation of recommendations, and the recommendations by everybody are different from the CDC,” said Michael Osterholm, a University of Minnesota epidemiologist who launched an ad hoc group that provides vaccine guidance. “States and medical societies are basing their recommendations on science. The recommendations out of CDC are magic, smoke, and mirrors.”

Ga. public health board chair: RFK Jr.’s disruptions are creating barriers to Covid shots

Kennedy has defended changes at the CDC and the revamping of the vaccine committee as necessary, saying previous advisory panel members had conflicts of interest and agency leadership botched its pandemic response.

The CDC is “the most corrupt agency at HHS, and maybe the government,” Kennedy said at a Sept. 4 Senate committee hearing. Susan Monarez, the ousted CDC director, testified Wednesday at another Senate hearing about how Kennedy told her to preapprove vaccine recommendations from the advisory panel or be fired.

Kennedy has said HHS also plans to investigate vaccine injuries he says are not thoroughly tracked or investigated. The CDC investigates injuries that are reported by providers or patients, but Kennedy has said he wants to recast the entire program. The Food and Drug Administration is already looking into cases of children who died following Covid-19 vaccination.

HHS didn’t return an email seeking comment.

States coordinating their own recommendations

The actions by states, medical societies, and other groups reflect a mounting lack of confidence in federal leadership, public health leaders say, and the break from the CDC is happening at a rapid clip.

The Democratic governors of California, Hawaii, Oregon, and Washington — fashioning themselves as the West Coast Health Alliance — are coordinating to develop vaccine recommendations that won’t necessarily follow those from the CDC. The governors said in a joint statement that the CDC shake-up has “impaired the agency’s capacity to prepare the nation for respiratory virus season and other public health challenges” and this week issued 2025-26 guidance for vaccination against viruses such as Covid, influenza, and respiratory syncytial virus.

A group of northeastern states are exploring a similar collaborative.

“The worst thing that could happen is that we have 50 different recommendations for the Covid vaccine. That will destroy public health,” said Massachusetts Public Health Commissioner Robbie Goldstein, who has been involved with the effort. He’s also spoken with leaders of the West Coast alliance. “I’m really hopeful that we do come together in larger and larger collaboratives with the same recommendations or very similar recommendations,” he said while speaking to a group of reporters this month.

CDC decapitated: What comes next for public health in the United States?

And medical societies such as the American Academy of Pediatrics are releasing Covid vaccine recommendations that diverge for the first time from the CDC’s guidance.

Some states are seizing on the split to ensure access to shots. Massachusetts is requiring insurers to cover vaccines recommended by the state health department rather than paying only for those suggested by the CDC, making it the first state to guarantee such continued coverage. AHIP, a trade group representing insurers, said on Tuesday that health plans will cover immunizations, including updated formulations of Covid and flu vaccines, that were recommended by the CDC panel as of Sept. 1 with no cost sharing through the end of 2026.

Pennsylvania is allowing pharmacists to give Covid vaccines even if they’re not recommended by the federal agency. Instead, they can follow recommendations from the pediatric academy and other medical groups.

Florida, meanwhile, plans to drop requirements for schoolchildren to get immunizations against chickenpox, meningitis, hepatitis B, and some other diseases. State lawmakers would need to take action to end mandates for all vaccines.

Joseph Ladapo, the state’s surgeon general, said in a Sept. 3 press conference that any vaccine requirement is wrong and “drips with disdain and slavery.”

Some doctors criticize the decision as a dangerous step backward.

“This is a terrifying decision that puts our children’s lives at risk,” said Richard Besser, former acting director of the CDC, in an emailed statement.

Immunization rates for kindergartners are dropping

The first school vaccine mandate was rolled out in the 1850s in Massachusetts, for smallpox. While all states have vaccine requirements for schoolchildren, immunization rates for kindergarten students declined while cases of vaccine-preventable measles and whooping cough surged in 2024 and 2025.

Rochelle Walensky, the Biden administration’s first CDC director, warned of the “polarization” of state-by-state approaches. “It’s like your head is in the oven and your feet are in the freezer and, on average, we’re at 95% vaccination. That doesn’t work in measles — every place has to be at 95% vaccination.” She was referring to the proportion of a population that needs to be vaccinated to provide herd immunity.

Kennedy’s actions have thrust vaccines center stage and made him fodder for comedy. The Marsh Family, a British musical group, released a parody on Sept. 7 of Paul Simon’s “Me and Julio Down by the Schoolyard,” with the chorus, “We’ll see measles and polio down in the schoolyard.”

HBO comedian Bill Maher said the CDC could be known by the title “Disease” during a recent episode of his show. And Stephen Colbert used his monologue on “The Late Show with Stephen Colbert” to weigh in on the revamped vaccine advisory group, calling its new members the “crème de la cuckoo.”

President Donald Trump has defended Kennedy, telling reporters “he means very well,” even as Trump said on Sept. 5 that “you have some vaccines that are so amazing.” Trump has repeatedly expressed pride in Operation Warp Speed, a government initiative during his previous administration that rapidly developed Covid vaccines. But he’s also promoted a discredited theory linking vaccines and autism.

The White House did not respond to a request for comment.

The Trump administration already narrowed recommendations for the Covid vaccine despite no new safety risks with the shots, although medical societies are continuing to recommend them for most people. The gulf is expected to widen as the agency’s advisory group reviews whether to change its guidance on a number of pediatric vaccines.

This chart shows the 2025-26 combined respiratory vaccine recommendations from several groups.

Other groups are also trying to provide vaccine and public health guidance, driven in part by concerns that Kennedy and other federal health leaders will make policy decisions and statements not grounded in science. Kennedy has promoted claims that aluminum, used in many vaccines, is linked to allergies, despite a lack of evidence for the claims. A Danish study, in fact, found aluminum was not linked to chronic disease, but Kennedy said the study’s supplemental data indicated it caused harm. The journal that published the study defended the findings.

Current and former CDC and HHS staffers, along with public health academics and retired health officials, have formed the National Public Health Coalition, a nonprofit to endorse recommendations and provide guidance on policy issues. They plan to partner with state and local health departments.

“A real benefit of the National Public Health Coalition is we are made up of current and former CDC and HHS folks, people who have deep knowledge of what government programs for public health look like, and what improvements are needed,” said Abigail Tighe, the group’s executive director.

Another new group is Grandparents for Vaccines, which bills itself as a volunteer-led effort to raise awareness about vaccines. And the Vaccine Integrity Project was launched in April by the University of Minnesota’s infectious disease center, to review evidence for medical societies on the safety and effectiveness of vaccines.

“We’re going to continue to help wherever we can to address misinformation,” said Osterholm, the center’s leader.

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

New York health update: Covid, vaccine recommendations, West Nile virus, a Legionella outbreak

2025-09-18T15:22:58+00:00

Infectious disease ‘weather report’

Ugh, even epidemiologists get Covid.

Recently, my partner and I both felt like we had “allergies” — itchy eyes, mildly scratchy throats, and some lung irritation. It was so mild that at first we didn’t even think to test. When we finally did, his turned positive instantly. Mine never did. But, based on the timing of symptoms, I’m pretty sure I caught it first and then cleared the infection by the time we tested.

Consider this my firsthand evidence that Covid activity is elevated in New York, and the data agree.

Wastewater data is showing an upward trend. I’ll note that the latest data is usually unstable as all the sites submit data, but it stabilizes after about two weeks. This likely explains what looks like a big drop near the end of August.

New York state Covid-19 wastewater activity levels.

That said, the recent rise in wastewater concentrations aligns with increased hospitalizations.

Everything else is quiet still:

Flu: Outpatient visits for flu-like illness haven’t started rising in New York yet, but I’m keeping a close eye on it. In other parts of the country, numbers have started to climb.

RSV: Still quiet.

I was planning on getting my fall Covid booster soon, but after just getting over Covid, I’m deciding to wait. Data show that after a Covid infection, delaying immunization by about ~6 months can increase its effectiveness. (YLE national covered the timing of Covid vaccines here). I’m getting my flu shot soon though!

Speaking of immunizations …

Updates to routine immunization eligibility are expected this week

There’s a lot happening right now around vaccine access and eligibility, both for Covid and routine immunizations.

Last week we covered New York’s steps to keep Covid-19 vaccination accessible, including executive and standing orders that allow pharmacists to vaccinate anyone over age 3 without a prescription. In practice, you may still need to check “yes” to the eligibility question on pharmacy websites when scheduling, but New York pharmacists have the authority to vaccinate you whether or not you have an underlying condition.

CVS appointment scheduler questions. Check “yes” that you would like to receive a Covid vaccine and are eligible.

Today, the Advisory Committee on Immunization Practices is starting a two-day meeting to vote on Covid-19, hepatitis B, and MMRV (measles, mumps, rubella, varicella) vaccine recommendations. There is a very real possibility that ACIP will vote against recommending some of them for certain ages. Such a decision would truly be unprecedented given overwhelming evidence supporting their safety and effectiveness. If that happens, the availability of these vaccines will be reduced.

I do expect New York state will step in to protect these vaccines. Gov. Kathy Hochul has issued an executive order and standing order to safeguard Covid-19 vaccine access (we covered it here), and I anticipate something similar if ACIP votes against hepatitis B or MMRV. Even so, a quick executive order can’t erase the confusion. Potentially conflicting messaging from federal and state departments will undoubtedly create uncertainty and confusion, making it harder for some to get vaccinated.

While I don’t think that Covid vaccines should be removed, most people in New York have a buffer of community immunity, and access to Covid vaccines through the executive order. If recommendations change, it will have the greatest impact on those who don’t have immunity, like young children, pregnant women, and people who are immunocompromised. But hepatitis B and MMRV are a different story. Removing these vaccines sets us back in the progress we’ve made in protecting babies, and puts kids and vulnerable populations at risk of serious, preventable diseases.

That’s why now it’s more important than ever to stay informed, and remember that vaccines remain one of the safest, most effective tools to protect babies, children, and everyone else from severe and preventable illness. I’ll be back next week with the implications for New Yorkers after we know with certainty what the ACIP votes will be.

We are in peak West Nile virus season

New York is seeing West Nile virus activity across the state. This is typical — September is when we often see the highest West Nile virus infections. This most recent data show mosquitoes tested positive in:

Erie
Nassau
Orange
Rockland
Suffolk
NYC: all five boroughs

A few mosquitoes in Oswego County also tested positive for Eastern Equine Encephalitis virus, which is rare but more dangerous than West Nile. So far, there have been 26 human West Nile cases across the state, and no cases of EEE.

In New York, it’s too early to tell if this is a normal year or not because this is the time of the year when West Nile cases typically really pick up.

Nationally, West Nile is 40% higher than normal. In New York, we’re getting close to last year’s total West Nile-positive mosquito pools (1,638 so far, compared to 2,167 last year), and the season usually runs until the first few freezes in November. So it’s too soon to tell how bad this year will be.

New York counties continue to use mosquito control to reduce risk. Many have conducted or plan to conduct aerial insecticide spraying, where a plane disperses chemicals to kill mosquitoes or prevent breeding. (You can check your local health department website for local schedules.) There are recent or upcoming events for New York City (Brooklyn and Queens this week).

To minimize exposure to insecticides during spraying:

Stay indoors
Bring pets inside
Close windows

Legionnaires’ disease in Westchester

Yes, another outbreak. This time Westchester County is investigating a spike in Legionnaires’ disease. So far this year:

38 people have been diagnosed
2 people have died

This is an increase — last year there were 24 cases total in the county. Across the state, excluding New York City, we are at 383 cases so far for this year.

Officials recently confirmed a cluster of five cases in Yonkers and said that cooling towers are being inspected in response. But we don’t know where the cases reside or where they could have been exposed. I’m concerned that not enough information is being shared, or shared quickly enough. Knowing which neighborhoods or ZIP codes are affected helps us assess personal risk. And clear, timely, and consistent communication from public health departments is essential, not just for managing outbreaks, but for building and maintaining community trust.

Legionnaires’ disease is a serious lung infection caused by breathing in tiny water droplets containing the Legionella bacteria. Symptoms usually start 2-10 days after exposure and can include:

Cough
Fever
Chills
Shortness of breath
Muscle aches
Diarrhea

Most healthy people exposed won’t get sick. Those at higher risk are adults over age 50, smokers, and people with chronic lung disease, diabetes, cancer, or weakened immune systems.

It’s not spread person-to-person because it doesn’t infect cells the same way a respiratory virus does (like Covid). You also can’t usually get it from drinking water — water rarely enters the lungs while drinking, and stomach acid likely kills it when ingested. In New York, and especially around New York City, outbreaks with cases across communities (like this one) are typically linked to cooling towers, which are separate from residential plumbing. This means that your tap water is not a risk.

Why has there been so much Legionnaires’ this summer?

The increase in Westchester Legionnaires’ cases follows the large outbreak in Central Harlem, where seven people died and 114 were diagnosed. We covered it here. And Legionnaires’ disease has been increasing nationally.

National Legionnaires’ disease rates have been increasing, though data after 2022 have not yet been published.

Several factors may be driving the increase in Legionnaires’ cases this summer in New York:

Warmer temperatures and higher humidity can promote bacterial growth in water systems. This has been one of the hottest summers on record for many parts of New York.
Potential lapses in regulation and inspection can allow Legionella to grow undetected, especially when buildings aren’t maintaining cooling towers properly. In New York, building owners are legally required to test cooling towers for Legionella every 90 days. During the Central Harlem outbreak, Gothamist reported that most of the towers linked to the outbreak were behind on testing and hadn’t been inspected by the city in over a year.
Increased awareness can lead to more identified cases. When large outbreaks happen, media and public health alerts can increase the chance that milder cases are caught. Doctors might be more on the lookout and the public may be paying closer attention to their symptoms, which are good things.
Climate change may also be playing a role, as longer and hotter warm seasons can create more opportunities for Legionella growth.

Grandparents for vaccines

Think Moms Against Drunk Driving, but for polio and measles. A new grassroots group of grandparents just launched to protect kids’ vaccine access. They’re driven by lived experience — remembering when these diseases ran rampant — and are elevating their stories.

Fueled by personal experiences, they are asking for support and stories. Learn more and join them here.

What else you need to know

Measles in NYC

The NYC Department of Health and Mental Hygiene has confirmed two adult cases of measles in Manhattan. They are investigating potential exposures at two unnamed restaurants in SOHO and the Lower East Side, and contacting those who may have been exposed. Reminder — if you are fully vaccinated, you are well protected.

Blue-green algae in Onondaga

Onondaga County has issued an advisory for a harmful algal bloom at Skaneateles Lake. These blooms, caused by overgrowth of blue-green algae (cyanobacteria), can cause skin rashes, stomach upset, or more serious illness if swallowed or inhaled. Before swimming at lakes or ponds, check local advisories and pay attention to posted signs. If you or your pet were exposed, rinse off really well and seek medical care if symptoms develop.

Bottom line

You’re all caught up on New York public health news this week!

Love,

Your NY Epi

Access to Covid shot and 2 childhood vaccines may change this week. Here’s what to know.

2025-09-17T11:00:00+00:00

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Americans may get some movement – but maybe not much clarity – this week on their future access to Covid vaccines and two childhood immunizations as a federal committee convenes in Atlanta to vote on recommendations.

The guidance that emerges from the Advisory Committee on Immunization Practices meeting on Thursday and Friday could influence how and when pharmacists and doctors give the vaccines and whether insurers will pay for them.

The committee has become a political battleground as Health and Human Services Secretary Robert F. Kennedy Jr. seeks to rework the country’s health infrastructure. Kennedy fired the previous expert members of ACIP and replaced them with his own picks, many of whom share his anti-vaccine views.

Public health experts are expecting mixed messages from the meeting. The committee may recommend some shots, with restrictions that could keep people confused as to who should get them.

“For those who are opposed to vaccination, making people feel uncertain about vaccines is kind of their stock in trade,” said Brian Abramson, an attorney who has published a textbook on vaccine law.

Here’s what to know about the meeting and how it could affect access to Covid shots, as well as hepatitis B and MMRV vaccines for children.

What is ACIP? Why does it matter?

ACIP’s recommendations guide how the CDC sets child and adult immunization schedules.

The panel’s recommendations create the standards most health care providers follow and are “considered the gold standard,” said Dr. Ashley Chinchilla, a professor at the University of Georgia College of Pharmacy.

For example, in Georgia and many other states, state law governing which vaccines pharmacists can administer relies on ACIP recommendations. That’s what caused the recent confusion around Covid shots.

While the Food and Drug Administration approved the vaccines for people over 65 and for adults with underlying health conditions last month, ACIP has not issued a recommendation for the updated Covid shots. That’s left patients and pharmacists in limbo, with many pharmacies requiring a prescription to get the shot, a departure from past practice.

“We’re in this holding pattern until there is an official recommendation,” Chinchilla said.

The recommendations also guide which vaccines insurers cover. While private insurers could decide to cover vaccines even if they are not recommended by ACIP, many government programs are bound by the ACIP recommendations, said Matt Motta, a professor at the Boston University School of Public Health.

That includes Vaccines for Children, a federal program that pays for vaccines for under- and uninsured children. About half of all U.S. children are eligible for the program, according to the CDC.

What is on the ACIP agenda?

There are three items on the ACIP agenda for this week: the MMRV vaccine, the hepatitis B vaccine, and the Covid vaccine.

MMRV

The first time on the agenda for Thursday is the measles, mumps, rubella, and varicella, or chickenpox, shot.

It combines the MMR vaccine with the varicella vaccine into one shot that was designed “to make it easier for families to give this vaccine to their children” by eliminating an extra shot, said Dr. Yvonne Maldonado, a former ACIP voting member and a professor of pediatric infectious disease at Stanford University.

There is a higher incidence of febrile seizures in young children who get the combination dose, Maldonado said, but families are advised of this risk and can decide whether to get the MMRV shot as one vaccine or separately.

“In many cases, it’s just easier to give the combination and saves the baby an extra shot,” she said.

ACIP could recommend that the MMR shot be given separately from the varicella shot, Maldonado said.

If that happens, “it’s not going to be a tremendous impact in terms of vaccination overall, as long as people continue to get MMR and V or MMRV together. But it does start to weaken the recommendations around vaccination,” Maldonado said. “It does make it harder for people to get vaccines, and it starts to make people question … what the schedule was.”

Hepatitis B

The committee is scheduled to discuss the hepatitis B vaccine on Thursday afternoon. Currently, the CDC recommends the vaccine for all infants and most adults.

The birth dose is on the agenda for the Thursday meeting, and ACIP could decide to recommend that infants get it later in life instead.

Dr. Tony Fiore, a retired CDC infectious disease expert, said it’s important for the United States to continue to provide the vaccine to infants because hepatitis B can cause serious medical conditions, like cirrhosis or liver cancer, and early death.

The blanket dose for all newborns has helped dramatically reduce cases of hepatitis B. The disease is highly contagious and can be transmitted in a variety of ways, including from mother to child.

“The vaccine is very safe,” Fiore said. He’s concerned removing the recommendation of the birth dose could lead to an increase in cases. While there are screening procedures to check pregnant women for the disease, Fiore said those are complex, and the birth dose ensures that babies born to mothers with the disease do not get it.

Covid

The committee is slated to spend Friday discussing the Covid vaccine.

Ideally, ACIP would recommend that the vaccine be recommended for everyone over 6 months, as in past years, Fiore said.

But several public health experts said it’s more likely that ACIP will follow the FDA’s decision last month to recommend the shots only for adults over 65 and adults with underlying health conditions.

That would be better than further narrowing the eligibility requirements, Motta said.

But it would mean that groups outside the ACIP recommendation may have to get a prescription to receive the shots off-label and that could jeopardize insurance coverage.

This chart shows the 2025-26 combined respiratory vaccine recommendations from various organizations.

What has changed at ACIP?

Kennedy’s remaking of ACIP has drawn criticism and lawsuits from professional medical societies, including the American Academy of Pediatrics and the Infectious Diseases Society of America.

“The committee is staffed [with] a very small number of very extreme people,” Motta said. “Yes, they have scientific credentials. Yes, many of them are medical doctors, but their opinions do not reflect where most of the scientific community is on those issues.”

The committee normally uses a rigorous scientific review process, working in close consultation with experts at the CDC. Representatives from a variety of professional organizations attend the meetings and advise the members, Maldonado said.

That hasn’t been happening this year, and it’s unclear whether the professional groups’ liaisons will participate in the meeting, Maldonado said.

“It feels like this new ACIP since the June meeting has been incredibly ideological,” she said. “That’s very concerning when it comes to understanding how we’re going to be able to utilize vaccines to protect public health.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

RFK Jr.’s vaccine panel expected to recommend delaying hepatitis B shot for children

2025-09-16T14:23:27+00:00

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A key federal vaccine advisory panel whose members were recently replaced by Health and Human Services Secretary Robert F. Kennedy Jr. is expected to vote to recommend delaying until age 4 the hepatitis B vaccine that’s currently given to newborns, according to two former senior Centers for Disease Control and Prevention officials.

“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,” said Demetre Daskalakis, former director of the National Center for Immunization and Respiratory Diseases. “Apparently this is a priority of the secretary’s.”

The vote is expected to take place during the next meeting of the CDC’s Advisory Committee on Immunization Practices, scheduled for Thursday and Friday in Atlanta.

For more than 30 years, the first of three shots of hepatitis B vaccine has been recommended for infants shortly after birth. In that time, the potentially fatal disease has been virtually eradicated among American children. Pediatricians warn that waiting four years for the vaccine opens the door to more children contracting the virus.

“Age 4 makes zero sense,” pediatrician Eric Ball said. “We recommend a universal approach to prevent those cases where a test might be incorrect or a mother might have unknowingly contracted hepatitis. It’s really the best way to keep our entire population healthy.”

In addition to the hepatitis B vaccine, the panel will also discuss and vote on recommendations for the combined measles, mumps, rubella, and varicella vaccine and Covid-19 vaccines. Pediatricians worry changes to the schedules of these vaccines will limit access for many families, leaving them vulnerable to vaccine-preventable diseases.

Ga. public health board chair: RFK Jr.’s disruptions are creating barriers to Covid shots

Typically, ACIP would undertake an analysis of the data before recommending a change to vaccine guidelines. As of the end of August, this process had not begun for the hepatitis B vaccines, Daskalakis and another former official said.

“This is an atypical situation. There’s been no work group to discuss it,” Daskalakis said.

The second former senior official spoke to NPR and KFF Health News on the condition of anonymity.

In response to questions from KFF Health News, HHS spokesperson Andrew Nixon wrote, “ACIP exists to ensure that vaccine policy is guided by the best available evidence and open scientific deliberation. Any updates to recommendations will be made transparently with gold standard science.”

The draft agenda for the upcoming ACIP meeting was released to the public less than a week before it is scheduled to begin.

At the last ACIP meeting, in June, Martin Kulldorff, the chair and one of seven new members handpicked by Kennedy, questioned the need to vaccinate every newborn, citing only two of the many ways the virus can spread. Kulldorff is a former Harvard Medical School professor who became known for opposing some public health measures during the pandemic.

“Unless the mother is hepatitis B positive, an argument could be made to delay the vaccine for this infection, which is primarily spread by sexual activity and intravenous drug use,” he said.

The virus spreads via direct exposure to an infected bodily fluid like blood or semen. The disease has no cure and can lead to serious conditions like cirrhosis and liver cancer later in life. The CDC advisory panel may maintain the recommendation to inoculate newborns whose mothers have hepatitis B or are considered at high risk of the disease, the former officials said.

Half of people with hepatitis B don’t know they have it

In 1991, federal health officials determined it was advisable for newborns to receive their first dose of the hepatitis B vaccine within 24 hours of birth, which blocks the virus from taking hold if transmitted during delivery. While parents may opt out of the shots, many day care centers and school districts require proof of hepatitis B vaccination for enrollment.

The prospect of ACIP’s altering the recommendation has left some people living with the virus deeply unsettled.

“I am goddamn frustrated,” said Wendy Lo, who has lived with the liver disease, likely since birth. Years of navigating the psychological, monetary, medical, and social aspects of chronic hepatitis B has touched almost every aspect of her life.

“I would not want anyone to have to experience that if it can be prevented,” she said. Lo learned she had the disease due to a routine screening to study abroad in college.

Lo credits the vaccines with protecting her close family members from infection.

Do pediatricians recommend vaccines to make a profit? There’s not much money in it

“I shared with my partner, ‘If you get vaccinated, we can be together,’” she said. He got the vaccine, which protects him from infection, “so I’m grateful for that,” she said.

The CDC estimates half of people with hepatitis B do not know they are infected. It can range from an acute, mild infection to a chronic infection, often with few to no symptoms. Most people with chronic hepatitis B were born outside of the United States, and Asians and Pacific Islanders followed by Black people have the highest rates of newly reported chronic infections.

When her children were born, Lo was adamant that they receive the newborn dose, a decision she says prevented them from contracting the virus.

The earlier an infection occurs, the worse the consequences, according to the CDC. When contracted in infancy or early childhood, hepatitis B is far more likely to become a chronic infection, silently damaging the liver over decades.

Those who become chronic carriers can also unknowingly spread the virus to others and face an increased risk of long-term complications including cirrhosis and liver cancer, which may not become evident until much later in life.

“Now I’m in my 50s, one of my big concerns is liver cancer. The vaccine is safe and effective, it’s lifesaving, and it protects you against cancer. How many vaccines do that?” Lo said.

30 years of universal vaccination dramatically lowers cases

Treatments like the antivirals Lo now takes weren’t available until the 1990s. Decades of the virus’s replicating unchecked damaged her liver. Every six months she gets scared of what her blood tests may reveal.

After a vaccine was approved in the 1980s, public health officials initially focused vaccination efforts on people thought to be at highest risk of infection.

“I, and every other doctor, had been trained in medical school to think of hepatitis B as an infection you acquired as an adult. It was the pimps, the prostitutes, the prisoners, and the health care practitioners who got hepatitis B infection. But we’ve learned so much more,” said William Schaffner, a professor of infectious diseases at the Vanderbilt University School of Medicine and a former voting member of ACIP.

As hepatitis B rates remained stubbornly high in the 1980s, scientists realized an entire vulnerable group was missing from the vaccination regime — newborns. The virus is often transmitted from an infected mother to baby in late pregnancy or during birth.

“We may soon hear, ‘Let’s just do a blood test on all pregnant women.’ We tried that. That doesn’t work perfectly either,” Schaffner said.

Some doctors didn’t test, he said, and some pregnant women falsely tested negative while others acquired hepatitis B after they had been tested earlier in their pregnancies.

In 1991, Schaffner was a liaison representative to ACIP when it voted to advise universal vaccination for hepatitis B before an infant leaves the hospital.

“We want no babies infected. Therefore, we’ll just vaccinate every mom and every baby at birth. Problem solved. It has been brilliantly successful in virtually eliminating hepatitis B in children,” he said.

In 1990, there were 3.03 cases of hepatitis B per 100,000 people 19 years old or under in the United States, according to the CDC.

Since the federal recommendation to vaccinate all infants, cases have dramatically decreased. CDC data show that in 2022 the rate among those 19 or under was less than 0.1 per 100,000.

Kennedy’s anti-vaccine strategy risks forcing shots off market, manufacturers warn

While hepatitis B is often associated with high-risk behaviors such as injection drug use or having multiple sexual partners, health experts note that it is possible for the virus to be transmitted in ordinary situations too, including among young children.

The virus can survive for up to seven days outside the body. During that time, even microscopic traces of infected blood on a school desk or playground equipment can pose a risk. If the virus comes into contact with an open wound or the mucous membranes of the eyes, an infection can occur. This means that unvaccinated children not considered at high risk can still be exposed in everyday environments.

Future access to vaccine is uncertain

If the CDC significantly alters its recommendation, health insurers would no longer be required to cover the cost of the shots. That could leave parents to pay out-of-pocket for a vaccine that has long been provided at no charge. Children who get immunizations through the federal Vaccines for Children program would lose free access to the shot as soon as any new ACIP recommendations get approved by the acting CDC director.

The two former CDC officials said that plans were underway to push back the official recommendation for the vaccine as of August, when they both left the agency, but may have changed.

Schaffner is still an alternate liaison member of ACIP, and hopes to express his support for universal newborn vaccination at the next meeting.

“The liaisons have now been excluded from the vaccine work groups. They are still permitted to attend the full meetings,” he said.

Schaffner is worried about the next generation of babies and the doctors who care for them.

“We’ll see cases of hepatitis B once again occur. We’ll see transmission into the next generation,” he said, “and the next generation of people who wear white coats will have to deal with hepatitis B, when we could have cut it off at the pass.”

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

New measles case confirmed in Atlanta. Exposures span GSU, Ponce City Market, and soccer fields.

2025-09-12T20:03:04+00:00

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An unvaccinated Georgia State University student has been diagnosed with measles, the seventh case in Georgia this year, after spending time on campus, at Inter Atlanta FC soccer games and practices, and at a restaurant at Ponce City Market over a nine-day period.

The amount of time the patient spent in public while potentially infectious between Sept. 2 and 11 will require “an absolutely massive contact investigation,” said Scott Thorpe, executive director of the Southern Alliance for Public Health Leadership.

The student spent time while infectious in two buildings at GSU (the Aderhold Learning Building and Langdale Hall), at the Sweetgreen restaurant on North Avenue, and at Inter Atlanta FC soccer practices and games, according to a Georgia Department of Public Health press release issued Friday.

The student had not traveled outside the United States. In the past few decades, most cases of measles in the United States came from people who were exposed while traveling abroad. But over the past year, cases caused by domestic transmission have increased.

The student did not live in GSU housing, a university spokesperson said.

Measles is highly contagious and can linger in the air for up to two hours after an infected person has been there. In a group of unprotected people, 9 in 10 of those exposed will be infected.

“DPH is working with the Fulton County Board of Health, GSU, Inter Atlanta FC, and Sweetgreen to notify individuals who may have been exposed to the virus and are at an increased risk of developing measles,” the DPH press release said. The agency said it “urges health care providers to maintain heightened awareness for patients with measles.”

The Fulton County Board of Health will conduct screenings and contact tracing, a GSU spokesperson said.

“The university has informed those impacted that they will be contacted and [is] encouraging their cooperation and compliance,” the university spokesperson said.

The university requires students to be vaccinated but allows exemptions for religious reasons. Students must sign an affidavit to obtain the exemption, a spokesperson said.

Georgia had six measles cases in 2024. The case announced Friday is the seventh this year.

A January outbreak involved three unvaccinated children from the same Gwinnett County family after the initial patient had traveled to New York City. A second outbreak reported in May involved three unvaccinated members of the same family who contracted measles after at least one member traveled internationally.

Nationally, 1,454 cases have been reported as of Tuesday, according to the Centers for Disease Control and Prevention. Most of the cases are connected to a large outbreak in west Texas and New Mexico. Two Texas children and a New Mexico adult – all unvaccinated – have died. Cases have also been reported in South Carolina, Alabama, Florida, and South Carolina this year.

About 95% of people need to be vaccinated to prevent widespread transmission of the virus, or achieve “herd immunity,” according to the CDC. The United States eliminated widespread transmission of measles in 2000.

But that status could be at risk, said Dr. Jane Seward, former deputy director of the Division of Viral Diseases at the CDC.

“The danger now … is that these importations get in, and they get into a community that has lower vaccine coverage than you need to interrupt ongoing transmission,” Seward said.

In Georgia vaccination rates have been on the decline.

Kindergarten vaccination data from the CDC show 86.8% of the state’s children were fully up-to-date on their MMR vaccinations last year.

“We’re likely to see more and more cases like this across Atlanta and across Georgia as our vaccination rates continue to fall,” Thorpe said. “The risks – particularly for vulnerable populations like small children who aren’t yet vaccinated – are significant.”

Tony Fiore, a doctor and infectious disease expert who worked at the CDC, said the latest case will put a major strain on county and state health departments working to trace people who were potentially exposed.

Several groups could be at risk if they were exposed, Fiore said. That includes babies who were too young to be vaccinated, the 2%-5% of people who don’t develop immunity after normal vaccination, the unvaccinated, and those who lost or never had immunity.

“If we are lucky, none of those scenarios will be in play since we still have high vaccine coverage in the U.S., for now,” he said.

Symptoms of measles include a high fever, cough, runny nose, red watery eyes, and a characteristic red rash.

People who suspect they or their child have measles are urged to call their health care providers before going to a hospital, clinic, or doctor’s office to avoid infecting staff and other patients.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

How Hochul’s executive order affects Covid-19 vaccine access in New York

2025-09-11T17:19:17+00:00

Amid federal vaccine regulation upheaval, last week, Gov. Kathy Hochul signed Executive Order 52 to make Covid-19 vaccines more available to New Yorkers. This was one of the first moves across the nation to ensure better access to Covid-19 vaccines. But this is a temporary Band-Aid, and much more needs to be done. The overall message is this: You can now get a Covid-19 vaccine at New York pharmacies without a prescription.

What the heck is going on?

Right now, access to Covid-19 vaccines depends on your state. Many state laws, including New York, link vaccine access directly to guidance from the Food and Drug Administration or the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices. But in June, the ACIP was replaced with members handpicked by Health and Human Services Secretary Robert F. Kennedy Jr., and they declined to vote on Covid-19 vaccine recommendations. Their next meeting is set for next week.

Until that happens, guidance is stalled, leaving state statutes tied to ACIP in limbo. In the meantime, there are a few things states can do depending on politics, legislature, etc.:

Change the legislation
Declare an emergency/executive order
Change the standing order (so pharmacists can prescribe)
Change the pharmacy board statutes

Last week, New York chose No. 2 and No. 3.

What exactly did the executive order do?

EO 52 declared a state of disaster emergency in New York effective Sept. 5 through at least Oct. 5, 2025. Declaring a state of emergency gives the governor the legal authority to temporarily change existing state regulations. In public health, states of emergency are typically declared to unlock faster action.

Within the state of emergency, the order broadened pharmacists’ ability to prescribe and administer Covid-19 vaccines to individuals age 3 and older without needing prescriptions from doctors.

The EO provides a temporary solution while New York works on long-term legislation to protect access to vaccines in the state. In other words, the law will need to change to decouple recommendations and pharmacy access from the federal government. No one ever saw the need for this before, but here we are.

This will not only help with Covid-19 vaccines, but other vaccines should the federal government continue to chip away at recommendations.

Why did New York take this step now?

There are two big reasons why New York took this step:

To broaden and protect access to vaccines. As I shared last week, current federal vaccine guidance effectively leaves many people under 65 without clear access to the Covid-19 vaccine. In practice, that looks like pharmacies, including big chains like CVS or Walgreens/Duane Reade, limiting who could get vaccinated. This executive order changes that in New York. It allows pharmacists to both prescribe and administer vaccines to anyone 3 and older, regardless of shifting CDC/ACIP recommendations.
To defend public health and science. Covid-19 vaccines remain our best protection against severe illness, and no new evidence says otherwise. Yet recent federal changes have limited their access. New York’s executive order is a safeguard against those limits, ensuring that the state government can make its own evidence-based recommendations, and help preserve access to care.

How does this impact vaccine access and equity?

More convenience and reduced barriers. Before the executive order, a prescription was required to get a Covid-19 vaccine at most New York pharmacies. Now, you can just go straight to the pharmacy, no prescription needed. This is important because 90% of Americans get their seasonal vaccines at pharmacies. Requiring a prescription would mean that many people likely wouldn’t get vaccines this year, but not everyone has time to get a prescription or even has a primary care provider.
Inclusivity: The executive order expands eligibility to cover children age 3 and older, pregnant people, and all adults, regardless of underlying conditions, groups previously squeezed out by federal restrictions. 
Strengthening the role of pharmacists: Parts of New York state, particularly rural communities and some neighborhoods in New York City, experience shortages of doctors or health clinics. Allowing pharmacists to provide and prescribe Covid-19 vaccines can be especially impactful in these underserved communities.

How does NY compare to other states?

New York is part of a growing trend of states stepping up to make Covid-19 vaccines more available in the midst of federal restrictions. It’s helping lead a regional coalition of New England states to coordinate health guidance. On the West Coast, California, Oregon, Washington, and Hawaii formed a West Coast Health Alliance to do the same.

Individual states are also taking action on their own. For example:

Massachusetts now requires insurers to cover vaccines recommended by the state.
New Jersey, Connecticut, Colorado, and New Mexico issued orders allowing pharmacists to give Covid vaccines without prescriptions.

With the Common Health Coalition, YLE recently broke down which states are moving forward — you can find that resource here (though things may change quickly as more states take action).

Conversely, some states are moving in the opposite direction. Florida, for instance, has rolled back routine school immunization requirements, raising concerns about long-term herd immunity in the state.

Will insurance cover vaccines?

This is a big “to be determined” for New York. Unlike Massachusetts, the New York executive order does not say anything about insurance coverage for Covid-19 vaccines. It’s safe to assume that if you have an underlying condition or if you’re over 65, insurance will cover the vaccine. This is because the vaccine is considered “on label.” For everyone else (who would be considered “off label”), it’s best to call your insurance provider and ask directly. Covid vaccines can run about $200 out of pocket without insurance.

What’s temporary, and what’s next?

The EO is in effect until Oct. 5 to give New York time to create more permanent vaccine protection legislation. At which point, the EO can be extended if new legislation hasn’t been put in place.

What’s my take on this?

We needed New York to act. In the absence of a stable CDC, state health leaders need to step up and fill the void. Hochul’s executive order is a big step in that direction. It enables continued, more equitable access to Covid-19 vaccines in New York, even amid federal uncertainty.

But the work can’t end here. Florida recently ended routine school immunization requirements, and similar rollbacks could spread to other states. This raises the risk of confusion not just about Covid vaccines, but about routine vaccines, too. We also know that the ACIP may be questioning other routine vaccinations in their upcoming meeting, Sept. 18-19. (I’ll be back with updates on that.) New York needs to be proactive about protecting all immunizations, not just Covid-19.

Does this solve the issue completely?

Not quite. There are a couple of important questions remaining:

Legal liability. Pharmacies and pharmacists need clarification on what legal protections they have when prescribing or administering Covid vaccines under this order because the recommendations differ from federal entities like the FDA and CDC.
Insurance coverage. It’s uncertain if Covid vaccines will be consistently covered by insurance.
Implementation. Each pharmacy will ultimately decide how its pharmacists will carry this out, which could affect access across the state if some choose to follow the more restrictive federal recommendations.

Bottom line

Pharmacies can now give Covid-19 vaccines without a prescription in New York. We’ll update you on outstanding questions, like which pharmacies are offering it, once we know.

Love,

Your NY Epi

Ga. public health board chair: RFK Jr.’s disruptions are creating barriers to Covid shots

2025-09-09T22:29:04+00:00

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Georgia Board of Public Health Chairperson James Curran criticized Health and Human Services Secretary Robert F. Kennedy Jr.’s disruption of a vaccine guidance system that was working well.

“As far as I can tell, a major goal is to diminish the CDC role in vaccines in a lot of ways,” Curran said at Tuesday’s board meeting.

Kennedy removed members of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices and replaced them with his own appointees. The panel typically provides Covid vaccine recommendations for the fall respiratory season earlier in the summer, but did not do so this year.

The U.S. Food and Drug Administration last month approved the updated shots, but only for those 65 and older and those with underlying conditions that put them at risk for severe Covid. That has prompted many Georgia pharmacies to require a prescription to get the latest Covid shots, with some doctors refusing to write prescriptions until the ACIP meets Sept. 18-19.

Curran, who was a longtime dean of the Rollins School of Public Health at Emory University, said this has created confusion and introduced barriers to getting the shots, disrupting a system that had worked well.

“The whole idea that everyone has a doctor is not true,” Curran said.

Department of Public Health Commissioner Kathleen Toomey, who was appointed by Republican Gov. Brian Kemp, as were the nine board members, said the agency has paused distributing this year’s Covid vaccines amid regulatory uncertainty, at least until the ACIP meets. She said the decision was guided by concerns over medical liability in the wake of the FDA’s narrowing of the categories of people for whom the shot is approved.

Health departments do not yet have the shots in stock, she said.

Toomey said she met with Kemp to discuss how the state will approach Covid vaccines. Four states – California, Oregon, Washington, and Hawaii – have formed an alliance to provide residents with science-backed vaccine recommendations. Governors of other states have also taken steps – such as issuing executive orders – to make it easier for their residents to get vaccines amid the regulatory confusion.

Toomey said the agency would look at the ACIP’s recommendations and make a decision about how Georgia health departments will handle the Covid shots. The agency may consider following guidelines from another organization, like the American Academy of Pediatrics, if the ACIP guidelines don’t follow good science.

This chart shows the 2025-26 combined respiratory vaccine recommendations as of Sept. 3.

Curran also criticized Kennedy’s focus on processed food as a cause of chronic disease even as the HHS chief has cut programs that help prevent chronic diseases like those focused on stopping smoking.

That decision has impacted Georgia. DPH has ended the Georgia Tobacco Use Prevention Program due to “a lack of ongoing federal funding and the closure of the CDC’s Office of Smoking and Health,” state Department of Public Health spokesperson Nancy Nydam Shirek said.

That resulted in the layoffs of five people working on the program, as well as the reassignment of an epidemiologist to another team, she said.

“DPH’s core tobacco and vaping prevention and cessation programs are continuing uninterrupted, including Tobacco-Free Schools and the Georgia Tobacco Quitline,” Nydam Shirek said.

The state also lost $334.2 million in March after the federal government “clawed back” Covid-era funding.

Curran said he anticipates additional funding cuts.

“It’s a distressing time for public health at the federal level, and it’s going to have implications at the state and local levels,” he said.

Meanwhile, an administrator who was laid off from the CDC was hired as director of the state public health laboratory, a position that had been open for “years,” Toomey said.

Ellen Kersh started the job on July 1 after leaving the CDC, where she had been the STD Laboratory branch chief.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Georgia clinics that serve uninsured are offering the new Covid vaccines

2025-09-04T21:34:08+00:00

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As retail pharmacies and many health clinics and doctors’ offices await federal guidance on who should get the new Covid vaccine, federally qualified health centers, which serve the uninsured, are offering the shots in Georgia.

Dr. Theresa Jacobs, clinical director for the Georgia Primary Care Association, which represents 34 FQHCs across the state, said they will write prescriptions for people to get the shots at pharmacies or provide the vaccine on-site.

Some clinics in the network have the shots in stock, while others do not.

“Anyone that wants it, we will write the prescription, or we will give the Covid-19” shot, Jacobs told Healthbeat on Thursday.

Unlike previous years, when the Covid vaccine was widely available at retail pharmacies, this year you may need a prescription – at least for now.

The centers typically charge fees on a sliding scale for uninsured or underinsured patients, she said. People with insurance can also be seen at the clinics and get vaccinated.

It’s a different story at the county clinics that are part of the Georgia Department of Public Health. They are holding off on providing the latest Covid shots, which have been updated to protect against the coronavirus strains that are currently circulating.

New Covid shots arriving in pharmacies. Why you may need a prescription - for now

Georgia DPH is awaiting guidance from a key U.S. Centers for Disease Control and Prevention committee on who should get the shots, according to a statement from spokesperson Nancy Nydam Shirek.

That CDC committee – the Advisory Committee on Immunization Practices, or ACIP – is set to meet Sept. 18-19 in Atlanta. The panel typically provides Covid vaccine recommendations for the fall respiratory season earlier in the summer, but did not do so this year, leaving Georgia doctors, pharmacists, and patients in limbo as the updated vaccines arrive.

Health and Human Services Secretary Robert F. Kennedy Jr., who has spread false information about vaccines, replaced the committee’s 17 members with his own picks. The new committee’s decisions about vaccine policies have drawn criticism from scientists and many professional medical organizations.

The confusion has been compounded by recent changes to Food and Drug Administration vaccine guidance, which limited eligibility for the Covid shot to those who are over 65 and those who have an underlying medical condition that puts them at risk for severe disease.

The changes only apply to the updated Covid shots. The flu and RSV vaccines are available as usual and widely recommended.

The regulatory uncertainty around the Covid shots has prompted Georgia pharmacies to require patients to get a prescription for them, a departure from prior years.

Children who qualify for the Vaccines for Children program, which provides free vaccines to un- and underinsured children, can still get the vaccines under that program at FQHCs, Jacobs said.

“Since the wholesale firing of all 17 ACIP members, trust in the integrity of ACIP recommendations has plummeted. This has many physicians turning to medical organizations for specific recommendations,” said Dr. Sandra Fryhofer, an Atlanta internist who serves on the board of the American Medical Association.

This chart shows which vaccines for the 2025-26 respiratory season are recommended by which medical associations.

“I continue to encourage my own patients to get a dose of the updated vaccine as soon as they can and when they can,” Fryhofer said. “We are in the midst of a late summer wave of Covid. I have had many patients come in recently with Covid infections.”

Some doctors in private practice are providing the vaccine or prescriptions for it. Dr. Cecil Bennett of Newnan Family Medicine Associates said his patients will be able to get the shot at his practice when it arrives in stock, which he estimates will be at the end of the month.

Bennett said he no longer trusts the CDC’s vaccine guidance and is instead turning to professional medical societies like the American Academy of Family Physicians. He recommends the new Covid vaccine for anyone 6 months or older, especially the elderly and people with underlying conditions.

“The sooner the better,” Bennett said, suggesting anytime before November is the best time to get vaccinated.

Doctors at Morehouse Healthcare, which has three clinics in Atlanta, are only writing prescriptions for patients to get the new Covid shots at local pharmacies in line with the latest FDA guidance, said spokesperson Bill Marks. That means only those who are age 65 and older and those who are at high risk for complications from Covid.

CVS pharmacies will require patients to have a prescription in Georgia, spokesperson Amy Thibault told Healthbeat.

CVS has over 50 MinuteClinics in Georgia, where medical providers can administer the updated shots to patients who meet the FDA’s eligibility criteria.

Patients are “asked to attest to their eligibility” when signing up for MinuteClinic appointments, according to a list of CDC medical conditions that increase risk for severe Covid, including obesity, diabetes, hypertension, and many others.

It’s still unclear how insurers will handle the cost, though they typically cover the shots recommended by ACIP.

The latest Covid vaccine will cost about $225 out-of-pocket at CVS stores, Thibault said.

Some doctors in private practice are not providing the shots yet. Piedmont Healthcare spokesperson John Manasso said Piedmont providers can write prescriptions “as clinically appropriate.”

Atlanta resident Ashutosh Sharma said his primary care physician in the Piedmont network asked him to wait.

“As the ACIP has not yet met, we don’t have any knowledge as to the policies/procedures that will be required by pharmacies or insurers with regard to obtaining new Covid vaccines,” a note to Sharma from his doctor said.

Shana Cohen said her doctor is in the Wellstar network and a webpage there said her physician could not offer the Covid shot at this time. And she couldn’t get the vaccine at a commercial pharmacy without a prescription.

Tell us about your experiences in trying to get the new Covid vaccine. Write to Atlanta public health reporter Rebecca Grapevine at rgrapevine@healthbeat.org with your story and questions.

What to know about Covid-19 vaccine access in New York

2025-09-04T14:10:29+00:00

Fall is right around the corner, and so are respiratory viruses. Each fall and winter, the big three viruses (Covid-19, flu, and RSV) cause hundreds of thousands of hospitalizations in the United States. The good news is that we have vaccines for all three that help prevent against severe disease.

For the flu and RSV, vaccines are business as usual. Eligibility is clear, and you can show up to most pharmacies or doctors’ offices to get vaccinated. (Check out YLE National’s fall vaccine guide to help determine which vaccines you or your child should get.)

But Covid vaccines are a different story this year. Chaotic government processes and upheaval have left Covid vaccine recommendations in limbo, especially in New York. This is a rapidly evolving situation, and while there’s still a good amount we don’t know, we’re here to help you stay grounded. We’ll share information as it comes in, and break down what it means for you as the respiratory virus season begins.

What changed last week regarding Covid-19 vaccines?

On Aug. 27, the Food and Drug Administration approved updated Covid-19 vaccines from Pfizer, Moderna, and Novavax but with limited eligibility. Specifically, they were approved for:

Adults 65 and older, and
Individuals under 65 with at least one high-risk health condition, listed here:

The FDA also revoked the Emergency Use Authorization for Pfizer’s vaccine in children under 5. This leaves only Moderna’s vaccine for children 6 months and older, but only for those who have an underlying condition or who see a doctor.

Why is this causing confusion?

It feels murky because we’re in a limbo period. While the FDA has approved the new vaccines, the Advisory Committee on Immunization Practices has not yet issued recommendations, and the Centers for Disease Control and Prevention hasn’t updated its guidance. ACIP and CDC won’t make changes until after the next ACIP meeting, which is scheduled for Sept. 18-19. Many states, including New York, require that the FDA and the CDC/ACIP approve vaccines before pharmacists are permitted to administer them.

This means that even though the updated Covid vaccines are FDA approved, not all pharmacies can actually offer them yet. It depends on each state’s individual regulations and the written protocols individual pharmacy chains have. In practice, this means that many patients who want Covid vaccines need to see their doctor or get a prescription to bring to a pharmacy. This creates barriers to vaccine access — in 2021, 80% of New Yorkers got their vaccines directly from a pharmacy. Nationally, it’s about 90%.

What’s the situation in New York specifically?

Covid-19 vaccine access via pharmacies depends on which pharmacy you go to:

Walgreens/Duane Reade: If you are over 65 or have an underlying condition (determined by self-attestation on the scheduling portal) you can make an appointment online for a vaccine at a Walgreens or Duane Reade in New York. But you need to have a prescription from a doctor and bring it to the appointment.
CVS: Not currently offering Covid vaccines to anyone in New York. CVS is being more conservative than Walgreens, likely because of how the pharmacy chain has written their protocols, but this isn’t totally clear. Until ACIP/CDC makes official recommendations, or New York changes its recommendations, I’m guessing Covid vaccines will stay on hold at CVS. However, you can make an appointment at CVS pharmacies in New Jersey or Connecticut if you are over 65 or have one of the high-risk conditions. It appears that some Minute Clinics in New York may be offering vaccines, but it’s not consistent.

There hasn’t been any formal guidance yet from the New York State Department of Health or the NYC Department of Health and Mental Hygiene. There have been reports that New York state and New York City are considering issuing their own vaccine recommendations, but no official announcements have been made.

What is the state doing about this?

New York and most other New England states recently met to discuss forming a regional health coalition to coordinate health guidance in response to instability at the CDC and ACIP. They discussed what to do when the CDC’s vaccine recommendations differ from the scientific consensus and whether New England states should follow the recommendations of professional medical societies instead. Organizations like the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists have called for broader access to vaccines for children and pregnant individuals, which contradicts the current FDA restrictions.

But the hard truth is that New York should have seen this coming. Increasing instability in federal health has been ongoing for months and has widened cracks in our vaccine systems. New York state and city health departments have yet to issue local vaccine guidance or contingency plans. We need our local health leaders to step up and provide guidance in a way that the CDC and ACIP can’t right now. Without it, the burden of understanding and navigating the complex vaccine landscape falls on the individual, which is not something we should have to do alone.

What should New Yorkers do right now?

If you are over 65 or have a high-risk condition, you can make an appointment for a Covid shot at Walgreens/Duane Reade, but you need to have a prescription from a doctor. The closest CVS pharmacies currently giving Covid vaccines are in New Jersey or Connecticut.
If you have a high-risk condition, call your primary care provider to ask if they can vaccinate you or give you a prescription, and if they have the vaccine in stock. If you’re not in a high-risk group, it could still be worth checking in with your doctor. But you can also wait: More clarity is expected in the coming weeks as guidance and state policies catch up.
Stay tuned for more information from YLE following the upcoming ACIP meeting in mid-September. If they recommend the vaccines and CDC signs on, then we can expect more pharmacies to start vaccinating those who are eligible.
For those who can’t get their Covid vaccine right now, it’s still a good idea to get your flu shot, and pay attention to your health. If you are feeling ill, avoid social gatherings, wear a mask around others, and get lots of rest.

What else to know this week: Legionnaires’ updates

The Legionnaires’ outbreak in Central Harlem has officially ended. Over the course of the outbreak there were 114 confirmed cases, 90 hospitalizations, and seven deaths.

Final lab results identified the source: two city-owned cooling towers, including Harlem Hospital. Investigators confirmed this by matching the genetic fingerprint of the Legionella bacteria found in patients samples to those collected from the cooling towers.

In response to the outbreak, New York City has proposed new policies that would require building owners to test for Legionella every 30 days instead of 90, and increase the number of Health Department employees who conduct inspections and respond to outbreaks. I’ll be watching to see if these policies are implemented.

The city is also investigating a new, unrelated cluster of Legionnaires’ at an apartment complex in the Bronx. So far, four cases have been identified over the past several months. Unlike the Central Harlem outbreak, this cluster appears to be linked to the building’s internal plumbing, not cooling towers. This usually means that the risk of widespread transmission is lower.

Under city laws, the building owners are now required to evaluate the water system, test for Legionella bacteria, and take steps to control it to prevent future infections.

Bottom line

Vaccines remain the best option to prevent severe respiratory disease this season. Given the confusion surrounding Covid vaccine eligibility and availability, it’s best to consult your doctor about getting a shot.

Love,

Your NY Epi

Do pediatricians recommend vaccines to make a profit? There’s not much money in it

2025-09-03T14:06:21+00:00

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It makes sense to approach some marketing efforts with skepticism. Scams, deepfakes, and deceptive social media posts are common, with people you don’t know seeking to profit from your behavior.

But should people extend this same skepticism to pediatricians who advise vaccines for children? Health and Human Services Secretary Robert F. Kennedy Jr. said financial bonuses are driving such recommendations.

“Doctors are being paid to vaccinate, not to evaluate,” Kennedy said in an Aug. 8 video posted on the social platform X. “They’re pressured to follow the money, not the science.”

Doctors and public health officials have been fielding questions on this topic for years.

A close look at the process by which vaccines are administered shows pediatric practices make little profit — and sometimes lose money — on vaccines. Four experienced pediatricians told us evidence-based science and medicine drive pediatricians’ childhood vaccination recommendations. Years of research and vaccine safety data also bolster these recommendations.

Christoph Diasio, a pediatrician at Sandhills Pediatrics in North Carolina, said the argument that doctors profit off vaccines is counterintuitive.

“If it was really about all the money, it would be better for kids to be sick, so you’d see more sick children and get to take care of more sick children, right?” he said.

Is your pediatrician profiting off childhood vaccines?

It costs money to stock, store, and administer a vaccine.

Pediatricians sometimes store thousands of dollars’ worth of vaccines in specialized medical-grade refrigeration units, which can be expensive. They pay to insure vaccines in case anything happens to them. Some practices buy thermostats that monitor vaccines’ temperature and backup generators to run the refrigerators in the event of a power outage. They also pay nursing staff to administer vaccines.

“Vaccines are hugely expensive,” said Jesse Hackell, a retired general pediatrician and the chair of the American Academy of Pediatrics’ Committee on Pediatric Workforce. “We lay out a lot of money up front.”

Q&A: How a vaccine advocate turns down the temperature in discussions around hesitancy

When a child with private insurance gets a vaccine, the pediatrician is paid for the vaccine product and its administration, Hackell said.

Many pediatricians also participate in a federal program that provides vaccines free of charge to eligible children whose parents can’t afford them. Participating in that program isn’t profitable because even though they get the vaccines for free, pediatricians store and insure them, and Medicaid reimbursements often don’t cover the costs. But many choose to participate and provide those vaccines anyway because it’s valuable for patients, Hackell said.

When discussing vaccine recommendations, pediatricians don’t make different recommendations based on how or if a child is insured, he said.

Jason Terk, a pediatrician at Cook Children’s Health Care System in Texas, said a practice’s ability to make a profit on vaccines depends on its situation.

Terk’s practice is part of a larger pediatric health care system, which means it doesn’t lose money on vaccines and makes a small profit, he said. Some small independent practices might not be able to secure terms with insurance companies that adequately pay for vaccines.

Suzanne Berman, a pediatrician at Plateau Pediatrics, a rural health clinic in Crossville, Tennessee, said that 75% of her practice’s patients have Medicaid and qualify for the Vaccines for Children program, which the practice loses money on. When she factored in private insurance companies’ payments, she estimated her practice roughly breaks even on vaccination.

“The goal is to not lose money on vaccines,” Terk said.

What’s driving your pediatrician’s vaccine recommendations?

Pediatricians typically recommend parents vaccinate their children following either the American Academy of Pediatrics’ or the Centers for Disease Control and Prevention’s recommended vaccine schedule.

Diasio said the driving force behind pediatric vaccine recommendations is straightforward: Trained physicians have seen kids die of vaccine-preventable diseases.

“I saw kids who died of invasive pneumococcal disease, which is what the Prevnar vaccine protects against,” Diasio said. “We remember those kids; we wouldn’t wish that on anyone.”

Still, your pediatrician will consider your child’s health holistically before making vaccine recommendations.

For example, a few children — less than 1% — have medical reasons they cannot receive a particular vaccine, Hackell said. This could include children with severe allergies to certain vaccine components or children who are immunosuppressed and could be at higher risk from live virus vaccines such as the measles or chickenpox vaccine.

“When people have questions about whether their kids should get vaccines, they really need to talk to their child’s doctor,” Diasio said. “Don’t get lost down a rabbit hole of the internet or on social media, which is programmed and refined to do whatever it can to keep you online longer.”

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

New Covid shots arriving in pharmacies. Why you may need a prescription - for now

2025-08-29T22:04:27+00:00

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As Georgia Covid rates rise, people who want to get the latest vaccine as it hits pharmacy shelves over the coming weeks will likely face a new hitch: They’ll need a doctor’s prescription, at least for now.

Pharmacies became a key distributor of Covid shots during the pandemic, and many Georgians are used to getting annual flu and Covid shots there.

But uncertainty about how the federal government is regulating the newest Covid shots, which have been updated for the 2025-26 season and are starting to arrive in stores, has created a new wrinkle in that process.

Many pharmacies in Georgia said they will require a prescription for the shot until an influential federal committee meets and makes firm recommendations on who should get the vaccine, expected in September. Those pharmacies include CVS, as well as independent drugstores.

“Everyone will need a [prescription] until ACIP makes a recommendation,” said Dr. Johnathan Hamrick, a member of the board of directors of the Georgia Pharmacy Association who formerly taught pharmacy law at Mercer University and practices in metro Atlanta.

His colleague, Dr. Jonathan Marquess, who owns independent pharmacies and serves as vice president of the Academy of Independent Pharmacy for the state pharmacy association, agreed.

CDC panel’s actions could decide access to shots

All eyes are on ACIP: the Advisory Committee on Immunization Practices. It develops policies on vaccination in the United States as part of the Centers for Disease Control and Prevention. It’s set to meet Sept. 18 and 19 in Atlanta.

The committee’s policies help govern how pharmacists in Georgia and many other states administer vaccines.

Under Georgia law, if ACIP has approved a vaccine, pharmacists can typically administer it, as long as they have an agreement with a supervising doctor, which most pharmacies do.

Sorting out Covid vaccine confusion: New and conflicting federal policies raise questions

If ACIP votes to recommend the Covid vaccine for certain or most populations in the United States, that would allow pharmacists to go back to providing the shots without a prescription, Hamrick said, although how that will work for different age groups and categories of people will depend on the exact details of the new recommendations.

It’s not clear how the committee will vote. Robert F. Kennedy Jr., secretary of the Department of Health and Human Services who has disrupted the vaccine system, dismissed the committee’s 17 members in June and appointed eight of his own picks, seven of whom remain.

Kennedy’s actions have drawn criticism and even lawsuits from professional medical societies, including the American Academy of Pediatrics and the Infectious Diseases Society of America. Medical professionals and public health experts have raised concerns that the committee will curtail its recommendations for the vaccine to only certain populations, stymieing widespread access.

This week, the Food and Drug Administration approved the latest version of the shot, but with more restrictions on who should get it than last year, raising questions about access. But Georgia pharmacists, and many others, are waiting to see what the ACIP does in September.

“That’s what we’re all waiting on,” Hamrick said.

Marquess, who owns several independent pharmacies in Georgia, said he has ordered the shots and expects them in soon.

In Georgia, as of last week, about 1.6% of emergency room visits were due to Covid, according to the latest data from the CDC, the highest rate since this time last year. And wastewater Covid levels have ticked up in Georgia from “very low” in mid-July to “moderate” as of last week, according to CDC data.

Many older people embrace vaccines. Research is proving them right.

“Immunizations have been proven to be safe and effective and healthy to keep people [from getting] those terrible diseases,” Marquess said. During the most recent Covid season, from fall 2024 to spring 2025, only about 16% of Georgia adults got at least one shot, according to the CDC.

CVS, which has over 300 pharmacy locations in Georgia, has started receiving the new shots in stores, spokesperson Amy Thibault said. She did not directly answer a question about whether the chain had ordered fewer shots than last year but said it would have “ample supply” to meet the need.

People with a prescription will be able to get the shots at drugstores or at one of the company’s nearly 50 MinuteClinic locations in the state, Thibault said.

Representatives from Publix and Walgreens did not immediately respond to requests for information on how they are handling the shots.

To be determined: insurance coverage for shots

Marquess said the pharmacists who work for him would typically be willing to put in a quick call to a patient’s doctor to get the needed approval, obviating the need for an office visit.

Thibault of CVS said it would vary by location as to whether pharmacists would call a patient’s doctor for them, or the patient would need to reach out directly.

“It makes it much simpler for the whole medical system if we can utilize our protocol and not call every time to get a prescription,” Marquess said.

Hamrick said it’s unclear how insurers will handle the cost, though they typically cover the shots recommended by ACIP.

The latest Covid vaccine will cost about $225 out-of-pocket at CVS stores, Thibault said.

‘I hope this is a tipping point’: 3 CDC leaders walk out over RFK Jr. policies

The updated vaccines are not yet available at county health departments, said Georgia Department of Public Health spokesperson Eric Jens. He said each county’s health department places its own orders, “typically based on need.”

“Covid vaccinations are administered at public health departments by nurses working under protocols established by DPH. DPH does not require a prescription for Covid vaccines,” Jens said. “At this time, DPH does not know what the cost of the updated Covid vaccine will be for individuals without insurance.”

Much of the confusion could be resolved when ACIP meets next month. But turmoil at the CDC, including the ouster of newly appointed Director Susan Monarez and the resignation of four senior officials citing political interference in the vaccine process, could affect the meeting.

U.S. Sen. Bill Cassidy, a Louisiana Republican who cast the deciding vote to confirm Kennedy as HHS secretary, this week called on ACIP to “indefinitely delay” its meeting.

“Serious allegations have been made about the meeting agenda, membership, and lack of scientific process being followed,” Cassidy said. “If the meeting proceeds, any recommendations made should be rejected as lacking legitimacy given the seriousness of the allegations and the current turmoil in CDC leadership.”

No matter what ACIP does, Georgia pharmacists may have a legal pathway to providing the shots without an individual prescription “under Georgia law pursuant to vaccine protocol agreements,” said Greg Reybold, general counsel and vice president of public policy for the American Pharmacy Cooperative.

Meanwhile, the pharmacists voiced concerns that people are growing tired of hearing about the politics of vaccines and confused by the dizzying array of policy changes.

“We have to untie health care from the politics,” Hamrick said.

“Less outbreaks, less severe complications, less hospitalizations, less death,” Hamrick said. Vaccines “keep people in the population healthier in the long run.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Q&A: How a vaccine advocate turns down the temperature in discussions around hesitancy

2025-08-27T18:32:44+00:00

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Karen Ernst is the director of Voices for Vaccines, a national organization focused on increasing vaccination rates by providing accurate information to families. The organization is part of the Task Force for Global Health in Atlanta.

Ernst, who lives in Minnesota but often travels to Atlanta, is a former English teacher who became a public health leader focused on “bringing people to this place of calm and good information, and helping to protect as many families and communities as possible.” Ernst was featured in the documentary Shot in the Arm, which aired on PBS and was executive produced by Neil deGrasse Tyson.

In Georgia, and nationally, childhood vaccination rates are decreasing, according to data recently released by the Centers for Disease Control and Prevention. Georgia has reported six measles cases in unvaccinated people this year. Some vaccine hesitancy is driven by misinformation on social media, research shows. Vaccines are safe and help save lives, scientists and doctors emphasize.

Turning down the temperature on heated conversations on vaccines is part of Ernst’s approach, and her own questions and anxieties around vaccines when she was a new parent inform her empathetic approach to those conversations.

Here are some of her thoughts about improving communication around vaccines.

How has the dialogue around vaccines changed since you started with Voices for Vaccines in 2012?

What we’re seeing right now is people really feeling less engaged in their communities in general. This is systemic beyond vaccines. I call it the age of disengagement, people really disengaged themselves from each other. They’re not as involved in their communities, they don’t know their neighbors, they don’t trust their public servants, they don’t trust scientists who seem very far away. And all of this disengagement has made it a lot more difficult to empower people with information and to get people to trust that vaccines are going to do something good for their family.

I’ve seen people cornering themselves into their own sphere and have trouble feeling trust. And trust is really engagement, that they are involved in their communities, that they’re involved with their neighbors, that they have a stake in people’s lives, that they have a stake in, and a say in, what the government is doing, and what their local public health officials are doing, and what science is happening. That’s the biggest change I’ve seen. And as I said, it makes it more difficult to engage people, even to even start those conversations. It’s gotten trickier.

What is the role of social media in the conversation around vaccines?

When I started in 2012, I was already alarmed about social media, and I used to describe those days as the wild west, because you could literally say anything on social media. There were no guardrails. We’ve taken the guardrails away again. Certainly, social media does two things: It amplifies rumors, it amplifies scary stories that are hard to verify, but it also has what I call a pufferfish effect. It makes vaccine hesitancy seem a lot more common than it is. It makes ideas about vaccines seem more prevalent than they are, because it’s easier to find someone who will think the same thing as you.

If we had some guardrails, if we had better engagement in the physical world of our communities, social media wouldn’t be as much of a factor in driving false information about vaccines.

It’s easy to blame social media, but the problem is us. We’re the problem because we’re not engaged with each other.

What are some of the top concerns people have about vaccines?

The top one is still concerns that vaccines cause autism. People hear that so much, even with the context of we’ve debunked this, they still hear it. And when they hear it, they think, if there’s smoke, maybe there’s fire here. But they don’t realize that it’s just like a smoke machine. We try to center autistic voices, but also make sure that people understand that we know a lot more about autism than we used to. We can pinpoint that autism happens before a baby is born.

Another is this idea of why do we have all of these vaccines, or how did they even make this schedule? It feels mysterious to people how the schedule is made.

It is scary to bring your baby in to get a vaccine, and they’re like, ‘Hey, look at this. We’ve got four needles. Isn’t this fun?’

I remember the first time my baby got a vaccine in 2003. I legitimately cried because I was like, this is hurting him. This is hard. It’s hard to vaccinate your baby. I don’t know what these diseases are. Why are there so many? Does my baby really need all these vaccines now? It still has not been well explained to parents. There could be a lot more education around these diseases and what exactly a vaccine does.

The last one is what’s in a vaccine? What is a vaccine made of? How do they make vaccines? It’s like hearing ingredients’ names, and they sound scary. When you hear chemical names associated with something that you’re going to be putting in your new baby, it’s very scary.

These are all answerable questions. These are all answers that we can provide parents and we should.

How can public health professionals help people understand the value of vaccines?

If you’re a person in public health, you are incredibly powerful in the community that you form around yourself. You should engage people, you should help them understand who you are, what motivates you, why this is important to the work that you’re doing, and invite them to ask questions, listen to their concerns with empathy, and trust them to understand the science if you explain it in plain English.

That might sound too simple, like, ‘Oh, you just want me to talk to people I know,’ but that’s really where we start. The other part of that is when we talk to people we know, we give them the full power of information, then they can talk to the people that they know. That’s really the best way to do it. This is where social media can be good for us.

It’s really easy not only to be judgmental, but to be really annoyed with people. Like, ‘Are you kidding? I just spent eight hours today doing this intense, incredibly difficult work. I’m trying to preserve people’s health, and you’re coming at me with this, what?’

One of the things we really need to do is take our internal temperature on it. ‘Okay, I’m annoyed right now.’ That’s okay, just put that little annoyance in your pocket, and come out with your best self. I always say turn annoyance into curiosity: ‘Hey, tell me more about what this concern is, or why you’re asking me this question? Where are you hearing this from?’ Turn it into a conversation instead of a lecture.

Is access also a challenge, in getting vaccines to people?

There are definitely access problems. I was just in Arkansas, and there are a few counties in Arkansas where the only place you can get your free Vaccines for Children vaccines is at the local health department. You can imagine being like, ‘Well, gotta take two hours out of my life to get my kid vaccinated, or I’m going to sign this form’ [for a religious exemption].

If the vaccine was just right there, you would probably just get vaccinated. Even with people who report it as vaccine hesitancy, if you talk to them a little bit, and you have the vaccine available right there, the chances that they’re going to get vaccinated are better. Sometimes it’s a timing issue, taking time off of work, not being able to take time off of work during the scheduled hours, thinking I don’t have time to have a cranky baby for a day. All of these things are part of the tapestry of it, and we always have to be concerned about access.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Kennedy’s anti-vaccine strategy risks forcing shots off market, manufacturers warn

2025-08-20T13:05:58+00:00

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Dining under palm trees on a patio at Mar-a-Lago in December, President-elect Donald Trump reassured chief executives at pharmaceutical giants Eli Lilly and Pfizer that anti-vaccine activist Robert F. Kennedy Jr. wouldn’t be a radical choice to head the Department of Health and Human Services.

“I think he’s going to be much less radical than you would think,” Trump said later that month during a news conference at his Palm Beach, Florida, resort.

Eight months have passed, and Kennedy is intensifying his attacks on the vaccine system.

High on his list of targets: a federal vaccine compensation program that settles injury claims. His strategy could bankrupt or diminish the fund, some legal scholars and public health leaders say, saddling pharmaceutical companies with liability risks and costs that would compel them to stop making vaccines altogether.

“It’s a radical agenda,” said Angela Rasmussen, a virologist at the Vaccine and Infectious Disease Organization at the University of Saskatchewan in Canada. “He’s using a bunch of different mechanisms, and there really are no guardrails. People are going to catch on, but it’s not going to be enough to stop the waves of deaths and deaths of children.”

Kennedy has said changes to the U.S. vaccine system are needed because, he asserts without evidence, immunizations are linked to autism, neurotoxicity, allergies, and death. He is a leader of the “Make America Healthy Again” movement, an informal campaign that eschews traditional medicine and espouses “medical freedom.” Many adherents oppose vaccines and believe they are unsafe despite scientific evidence to the contrary.

Emory University contract cut in Trump administration’s mRNA vaccine research ‘wind-down’

Kennedy has acknowledged he wants to reform the vaccine fund, known as the Vaccine Injury Compensation Program, writing July 28 on the social platform X that “the VICP is broken, and I intend to fix it.” HHS is working with the Department of Justice to revamp the program, which shields drugmakers from most liability over injuries.

HHS didn’t respond to a request to speak with Kennedy, but agency officials said he isn’t opposed to immunizations.

“Secretary Kennedy is not anti-vaccine — he is pro-safety, pro-transparency, and pro-accountability,” HHS spokesperson Vianca Rodriguez Feliciano said in an email.

Yet behind the scenes, Kennedy has been laying the groundwork to restrict the availability of widely used immunizations, according to people familiar with internal discussions who asked not to be identified because they’re not authorized to speak on the topic.

Multipronged strategy started with unfounded autism claims

The strategy began taking shape in the spring. The first step: Raise unfounded questions about the safety of vaccines. At a Cabinet meeting in April, Kennedy told Trump that HHS was undertaking a massive study that would identify the cause of rising autism diagnoses by September.

Kennedy tasked David Geier, a researcher who’s repeated the debunked claim that vaccines cause autism, to oversee the work, according to media reports.

Kennedy then doubled down by questioning the use of aluminum, which is added to many vaccines to help boost the immune response. He linked it to allergies at a July meeting of governors, even though a recent study in the Annals of Internal Medicine found no connection. He’s widely expected to ask a federal vaccine advisory committee to conduct a review.

The autism research and concerns about aluminum were early salvos in the push to go after the compensation fund, according to two of the people.

That fund provides money to people for injuries from vaccines and has paid out more than $5 billion since it was established in 1988, according to the Health Resources and Services Administration.

Before filing a lawsuit in court, injured individuals bring their claims to the program’s nonjury vaccine court, which reviews evidence. The fund provides compensation from a small excise tax on vaccines.

Compensation is determined in part by a table maintained by HRSA and overseen by the HHS secretary. It lists each vaccine and associated injuries and encompasses routine vaccinations recommended by the Centers for Disease Control and Prevention that are subject to the excise tax. The injuries include anaphylaxis and encephalitis. People who experience such injuries within a certain time after getting a specific vaccine can get money.

Kennedy wants to get autism or allergies added to that document, according to two people familiar with internal discussions and concerns raised publicly by some vaccine developers and former regulators. He could accomplish the goal if HHS-led research blames vaccines for autism, for example, or if a federal vaccine advisory panel recommends against aluminum in vaccines, according to some legal scholars.

“Given the rate of autism, if a lot of cases are brought, that could bankrupt the program,” said Dorit Reiss, a professor at University of California Law San Francisco.

If that were to happen, pharmaceutical companies could stop producing the immunizations, which don’t tend to be very profitable, rather than get entangled in drawn-out, expensive lawsuits from claimants who can’t get money because the federal vaccine injury fund has run dry, some legal experts and vaccine developers said.

“The compensation fund, if it’s gone, would impact decisions to proceed or not to proceed,” said David Dodd, president and CEO of GeoVax Labs, a biotechnology company developing vaccines and immunotherapies.

A federal vaccine advisory panel could also recommend against aluminum in shots, forcing drugmakers to make costly reformulations or exit the market.

Kennedy has placed people around him to execute the strategy. He’s pushed to get vaccine skeptics in decision-making positions at the CDC, which recommends vaccines, and the Food and Drug Administration, which approves them.

Kennedy’s vaccine advisers sow doubts as scientists protest U.S. pivot on shots

He also tapped leaders in the anti-vaccine movement to vet candidates for him.

The outcome has been regulatory and policy decisions that have winnowed vaccine access and development.

HHS this month said it was halting $500 million in grants and contracts for the development of mRNA vaccines, including an improved, more durable Covid mRNA vaccine.

The federal government stopped recommending Covid shots for healthy pregnant women and children, bypassing input from a vaccine advisory committee that traditionally would have weighed in.

And Kennedy reconstituted that committee with his own handpicked members, including vaccine skeptics, and removed the American Medical Association, American Nurses Association, and other industry groups that served as committee liaisons. The modified panel recommended against flu vaccines containing a preservative erroneously linked to autism.

The White House calls

Kennedy’s determination to keep vaccine skeptics in oversight positions played out in a deal he recently made with Trump and his staff, according to two people familiar with the situation. The arrangement came together on a Sunday night in July when Kennedy got a call from the White House.

The subject was Vinay Prasad, a top vaccine regulator at the FDA. He had recently touched off a wave of industry criticism for playing a role in the agency’s decision to ask biotech company Sarepta Therapeutics to halt shipments of a gene therapy over safety concerns.

Social media posts and conservative commentators whipped up a furor. Laura Loomer, a far-right provocateur, said July 21 on X that Prasad should be fired and called him “a self-proclaimed progressive liberal and Bernie Sanders fanboy,” referring to Sen. Bernie Sanders, a Vermont independent. Congressional lawmakers began peppering the White House with questions.

The furor reached Trump, who wanted Prasad out, according to the people. But Kennedy was concerned about losing Prasad. He felt he needed a critic of immunizations overseeing vaccines at the agency.

So Kennedy struck a deal. Prasad would be asked to resign as head of the FDA’s Center for Biologics Evaluation and Research, which regulates vaccine products and biologics such as gene therapies. And the center would be divided into two operations, with Kennedy empowered to select the person overseeing vaccines.

Some public health leaders publicly shared details of the arrangement and raised concerns about its potential impact. Former FDA Commissioner Scott Gottlieb said in an Aug. 1 interview on CNBC that he thought it “would be very destructive to the agency.”

After leaving the agency in July, Prasad is now returning, though it is unclear if his role has changed.

Recently, Kennedy was sued by Ray Flores, senior outside counsel for Children’s Health Defense. An anti-vaccine group founded by Kennedy, Children’s Health Defense is funding the suit, which claims Kennedy failed to launch a task force to study vaccine safety that it says is required to report findings to Congress. But Kennedy and his allies view the lawsuit as friendly, according to one person familiar with the matter, because it is seeking an outcome that he wants.

HHS on Aug. 14 announced it was reviving a federal panel, disbanded in 1998, to provide oversight of pediatric vaccines.

Kennedy’s work against vaccines has triggered unfriendly lawsuits too, including one brought by the American Academy of Pediatrics and other public health groups. His recent decision to halt funds for mRNA vaccine development yielded a swell of social media criticism.

“This is reckless. This is dangerous. This will cost lives. We must fight back,” Sen. Edward Markey, a Massachusetts Democrat, said Aug. 5 on X.

“I’ve tried to be objective & non-alarmist in response to current HHS actions – but quite frankly this move is going to cost lives,” Jerome Adams, who was U.S. surgeon general during the previous Trump administration, said Aug. 5 on the same platform.

Kennedy and his backers remain undeterred. In a counterpunch, his supporters are launching an unprecedented public relations campaign to promote the HHS secretary, spurring speculation that he may be mulling a 2028 presidential run.

The nonprofit MAHA Action held a call in July to energize Kennedy supporters and initiated a six-figure ad campaign extolling Kennedy and Trump administration health initiatives.

“Make no mistake, this is a revolution that will change the face of public health policy,” Tony Lyons, president of MAHA Action, said in a statement. “Americans are demanding radical transparency and gold standard science.”

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

It’s almost flu season. Should you still get a shot, and will insurance cover it?

2025-08-18T13:37:28+00:00

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For parents of school-aged children, the fall to-do list can seem ever-growing. Buy school supplies. Fill out endless school forms. Block off parent-teacher nights. Do the kids’ tennis shoes still fit?

Somewhere, at some point, you might remember flu shots. Get your flu shot. Get their flu shots. Or should you? Can you? Is that still a thing?

Amid political chatter about vaccines and the government entities that oversee them, it’s understandable to wonder where all this leaves the 2025-26 flu vaccine.

In short: Yes, the flu shot is still a thing. And four doctors we spoke to said they recommend you get your flu shot this year. (See the source list below this article.)

Here are some answers to common questions:

I heard the Trump administration could be changing vaccine recommendations. Does that apply to the flu vaccine?

There have been no substantial changes to the federal government’s flu vaccine recommendation: The Centers for Disease Control and Prevention still says that people 6 months old and up should get an annual flu vaccine.

That means most insurers will cover it, and it should soon be widely available.

Health and Human Services Secretary Robert F. Kennedy Jr., who has opposed vaccines, agreed that most people should get the flu vaccine. He followed a recommendation from the board that advises the federal government on vaccine policy; Kennedy replaced the members with his own.

The panel voted against recommending multidose flu shots that contained the preservative thimerosal, but the preservative had already been removed from most vaccines, including most flu shots.

Who should not get the flu shot?

Doctors acknowledged there are always exceptions to broad guidance. For example, people with severe allergies to flu vaccine components should not get vaccines that contain those components.

You should discuss your health situation with your physician for personalized guidance.

Is this season’s flu shot different from last season’s?

Yes. The flu shot was updated for the upcoming flu season, but the changes weren’t drastic. Like last year’s flu shot, this year’s vaccine is known as a three-component or trivalent vaccine that protects against three influenza viruses — two influenza A viruses and one influenza B virus.

This season’s vaccine was altered to target a specific strain of the influenza A/H3N2 virus expected to circulate this season, said Ryan Maves, a professor of medicine at Wake Forest University and a member of the Infectious Diseases Society of America. Those changes align with what the World Health Organization has recommended.

When is the best time to get vaccinated?

September, October, or early November. This allows your body time to build up its protective antibodies as flu season begins and ensures your protection doesn’t wane before it ends.

In the United States, influenza infection typically peaks in February, so you want to make sure you’re vaccinated and your protection is still strong through February and into March, said William Schaffner, a professor of infectious diseases at Vanderbilt University Medical Center.

Is this season’s flu vaccine guaranteed to protect against the influenza strain that’s circulating?

Guarantee all protection? No.

Reduce risk of death? Yes.

Similar to the Covid-19 vaccine, flu vaccines are best at “protecting us from the most severe consequences of influenza,” Schaffner said. That means the flu vaccine is most effective at keeping people out of the hospital or the intensive care unit and keeping people from dying.

“A flu vaccine may not guarantee perfect protection against the flu, but skipping your flu shot simply guarantees you’ll have no protection at all,” said Benjamin Lee, a pediatric infectious diseases physician at the University of Vermont Children’s Hospital and an associate professor at the University of Vermont Larner College of Medicine.

Will the flu shot be readily available this year?

All signs point to yes.

The FDA passed its formula recommendations to vaccine manufacturers March 13 — early enough that the agency expected there would be “an adequate and diverse supply.” The people and places that administer flu shots should have them soon, typically beginning in September, said Flor Muñoz, a Baylor College of Medicine associate professor of pediatrics and infectious diseases.

I heard Kennedy canceled $500 million in funding for vaccine development. Could this affect future flu vaccines?

Kennedy announced the cancellation of funding for mRNA vaccine development. Some companies have been researching combined mRNA flu and Covid shots, but there are currently no approved mRNA flu vaccines.

Still, experts said the federal government’s changes — funding cuts, vaccine committee purges, deviations from existing procedures — are increasing uncertainty.

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

SOURCES

Interview with Flor Muñoz, an associate professor of pediatrics and infectious diseases at Baylor College of Medicine, Aug. 4.

Interview with Ryan Maves, a professor of medicine at Wake Forest University and the medical director of the transplant Infectious Diseases Program at Wake Forest University, Aug. 4.

Interview with William Schaffner, a professor of infectious diseases at Vanderbilt University Medical Center, Aug. 4.

Email interview with Benjamin Lee, a pediatric infectious diseases physician at the University of Vermont Children’s Hospital and an associate professor at the University of Vermont Larner College of Medicine, Aug. 3.

PolitiFact, “What Is the Vaccine Preservative Thimerosal? What To Know About It and Its Removal From Flu Vaccines,” June 26.

Pharmacy Times, “ACIP Recommends Adults Receive Seasonal, Single-Dose Influenza Vaccines Free of Thimerosal,” June 26.

CNN, “After Canceling Meeting of Independent Advisers, FDA Issues 2025-26 Flu Vaccine Recommendations,” March 13.

PolitiFact, “RFK Jr. Fired Everyone on a Key Vaccine Panel. Here’s Who He Replaced Them With,” June 18.

World Health Organization, “Recommended Composition of Influenza Virus Vaccines for Use in the 2025-2026 Northern Hemisphere Influenza Season,” Feb. 28.

Food and Drug Administration, “Influenza Vaccine Composition for the 2025-2026 U.S. Influenza Season,” March 13.

The Infectious Diseases Society of America, “Statement on Cancellation of FDA Vaccine Advisory Committee Meeting,” 2025.

Pharmacy Times, “Understand the 2025-2026 Flu Vaccine Composition Recommendations,” April 2.

CIDRAP, “FDA Announces Flu Strain Picks For Next Season’s Vaccines,” March 14.

U.S. Centers for Disease Control and Prevention, “Seasonal Flu Vaccine Basics,” Sept. 17.

U.S. Centers for Disease Control and Prevention, “Adult Immunization Schedule by Age (Addendum updated July 2, 2025),” July 2.

U.S. Centers for Disease Control and Prevention, “Child and Adolescent Immunization Schedule by Age (Addendum updated July 2, 2025),” July 2.

U.S. Centers for Disease Control and Prevention, “Trivalent Influenza Vaccines,” Sept. 10.

CNN, “Disrupted US Vaccine Meetings Could Threaten Timelines, Access and Transparency Around Shots,” Feb. 28.

The Associated Press, “RFK Jr. Cancels $500M in Funding for mRNA Vaccine Development,” Aug. 5.

NBC News, “CDC Ends Covid Vaccine Recommendation for Healthy Kids and Pregnant Women,” May 27.

NBC News, “Why Is the Flu So Bad This Year?” Feb. 28.

U.S. Centers for Disease Control and Prevention, “Weekly US Influenza Surveillance Report: Key Updates for Week 17, ending April 26, 2025,” May 2.

U.S. Centers for Disease Control and Prevention, “ACIP Recommendations,” Aug. 8.

MedPage Today, “RFK Jr. Quietly Endorses Flu Vaccine for Kids and Adults,” Aug. 7.

The Associated Press, “Moderna Study Shows Immune Response in Older Adults for a Combo Flu and COVID-19 Shot,” May 7.

U.S. Department of Health and Human Services, “HHS Winds Down mRNA Vaccine Development Under BARDA,” Aug. 5.

CBC, “Breaking Down How a Massive U.S. Funding Cut Could Impact Future mRNA Vaccines,” Aug. 8.

NBC News, “Could Flu Shot Supply Fall Short This Year? FDA’s Canceled Meeting Sparks Worries,” Feb. 27.

Louisiana Blue, “Flu Shot,” accessed Aug. 11.

Florida Blue, “Flu and Other Respiratory Viruses,” accessed Aug. 11.

Aetna, “Vaccines and Health Screenings,” accessed Aug. 11.

UnitedHealthcare, “Flu Shots: Frequently Asked Questions,” accessed Aug. 11.

U.S. Centers for Disease Control and Prevention, “Flu Prevention: Information for Travelers,” accessed Aug. 11.

U.S. Centers for Disease Control and Prevention, “Who Needs a Flu Vaccine,” accessed Aug. 11.

Cleveland Clinic, “When Is the Best Time To Get Your Flu Shot?” Aug. 5.

Emory University contract cut in Trump administration’s mRNA vaccine research ‘wind-down’

2025-08-08T19:16:28+00:00

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A research project at Emory University is among the 22 grants and contracts that are being cancelled as the U.S. Department of Health and Human Services begins a “coordinated wind-down” of research studying mRNA vaccine technology.

The grants, which were being developed under the Biomedical Advanced Research and Development Authority, amounted to nearly $500 million in funding to research projects. According to the agency website, researchers at Emory received $750,000 to develop an inhalable dry powder that could be used to immunize patients against influenza and SARS-CoV-2, the virus that causes Covid-19. Emory University did not respond to a request for comment.

Vaccines using mRNA were first developed by Pfizer-BioNTech and Moderna in response to the Covid-19 pandemic, and won a Nobel Prize in Physiology or Medicine in 2023. While traditional vaccines can take years to develop, mRNA vaccines can be developed much faster, and can be more quickly adapted in response to virus mutations.

However, U.S. Health Secretary Robert F. Kennedy Jr. — who has repeatedly questioned the safety and efficacy of vaccines and promoted widely debunked claims about vaccine harm — claimed that the Trump administration was terminating the grants because mRNA vaccines “fail to protect effectively against upper respiratory infections like Covid and flu.”

In axing mRNA contracts, Trump delivers another blow to U.S. biosecurity, former officials say

“We’re shifting that funding toward safer, broader vaccine platforms that remain effective even as viruses mutate,” he said in a Tuesday announcement. Research contracts with companies like Luminary Labs, ModeX Therapeutics, and CSL Seqirus are also being cancelled.

The most recent round of grant terminations comes on the heels of a nearly $600 million contract with Moderna aimed at developing a vaccine against bird flu that was cancelled by the Trump administration in May.

Public health experts, including state Rep. Michelle Au, a Johns Creek Democrat, condemned the decision to terminate the grants.

“Many preventable diseases will not, in fact, be prevented,” she said. “We will see the result of many chronic health conditions resulting from preventable disease, and those effects are going to last decades. This is a generational change in how we approach vaccine support and funding, not just in this country, but worldwide.”

Georgia’s current childhood vaccine rates are also far below the 95% rate needed to ensure herd immunity from measles, mumps and rubella, according to data from the Centers for Disease Control and Prevention. Only 88.4% of kindergarten students in Georgia received the MMR vaccine during the 2023-24 school year.

Au, who works as an anesthesiologist, also warned of the harm that could await future patients due to vaccine research cuts.

“We’re only starting to scratch the surface of the damage that we’re going to see,” she said. “When you stop research in its tracks like this, even if you say, ‘oh, maybe we’ll restore the cuts in the future,’ these are harms that will carry through even beyond what the immediate funding cuts generate.”

This story was originally published at Georgia Recorder.

Georgia’s kindergarten vaccination rates decline as more parents claim exemptions

2025-08-06T19:14:26+00:00

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New childhood vaccination data from the U.S. Centers for Disease Control and Prevention show that Georgia vaccination rates are decreasing, with 86.8% of the state’s children fully up-to-date on their required vaccines when they entered kindergarten last year.

The state’s exemption rate is also on the rise, at 4.8%, with most granted for religious rather than medical reasons. But that’s not the whole story. Some public health experts say the remainder of unvaccinated children likely includes some who weren’t able to access the shots. It’s hard to know for sure because data released by the state Department of Public Health is limited.

The falling vaccination rates raise concerns as children return to school this week, and the United States sees the highest number of measles cases since the early 1990s, according to CDC data. Georgia has reported six measles cases this year, all in unvaccinated people. Those cases were contained to members of two families.

According to CDC data released last week, Georgia has the lowest rate for the measles, mumps, and rubella vaccine uptake among Southern states, trailing behind Alabama, where the rate for MMR is 95.2%, and Mississippi, where it is 97.6%.

It’s a matter of time before the state faces a serious measles outbreak, said Scott Thorpe, a former public health official in South Carolina and Georgia who serves as executive director of the Southern Alliance for Public Health Leadership.

“What these numbers mean is that we have a growing vulnerability to disease outbreaks,” said Jodie Guest, a professor of epidemiology at Emory University. “Georgians should be very concerned that our kids are not going to be as well protected.”

Exemptions increase amid ‘swirling’ misinformation

Georgia has one of the highest vaccine exemption rates in the South, at 4.8%, or about 5,535 kindergartners. That’s second to only Florida at 5.1% and far higher than neighboring Alabama at 2.3%.

Most exemptions for last year’s entering kindergarten class – 4.7% – were for religious and not medical reasons, which made up just 0.1%.

Under Georgia law, if parents want to claim a religious exemption, they must file an affidavit with the child’s school or child care facility affirming that “vaccination is contrary to my religious beliefs, and that my objections to vaccination are not based solely on grounds of personal philosophy or inconvenience.”

Guest attributed the falling vaccine and rising exemption rates to “swirling inaccurate information” about the safety and efficacy of vaccines.

“We are still in our state not doing a great job of addressing the inaccurate information that is out there about vaccines,” she said. That’s been fueled by top health leaders questioning the efficacy of vaccines, Guest said, referring to U.S. Health and Human Services Secretary Robert F. Kennedy Jr., who has opposed vaccines.

Kennedy removed all 17 members of the CDC’s Advisory Committee on Immunization Practices, which develops recommendations for childhood and adult vaccines, and replaced them with people whose expertise has been questioned by groups including the American Medical Association. Several professional medical societies, including the American Academy of Pediatrics, have sued the HHS over changes to vaccine policy.

“Sometimes it’s a lack of accurate information that’s easy for parents to understand and digest, or a relationship with a trusted health care provider to communicate that information,” said Melissa Haberlen DeWolf, research and policy director at Voices for Georgia’s Children, a nonprofit advocacy group.

There’s also a lapse in collective memory about the harms of deadly childhood diseases that have been eliminated in the United States.

“People tend to forget that the reason we haven’t seen many of these illnesses is because of widespread vaccination,” DeWolf said. “Diseases like polio have been eradicated in the U.S. thanks to decades of successful vaccination efforts, and we cannot take that progress for granted.”

Access to health care plays a role in vaccination rates

Exemptions aren’t the only reason children may lack immunization, Thorpe said. Some Georgia families face barriers to accessing the shots.

“I don’t think that’s being driven exclusively by ideology or personal beliefs or religious beliefs. A lot of what’s driving that is kids struggling with access to health care, and their families struggling with access to health care,” Thorpe said.

“If you’re a mom or a dad dealing with living in an extended stay motel, you just know that getting your kid vaccinated is just not going to be priority number one,” Thorpe said. “You’ve got a lot of other things in your life that make it hard to get your kid vaccinated.”

Many health department clinics and doctors offices have limited hours that make it tough for working parents – especially those without reliable transportation – to get their children to appointments, Thorpe said.

The federal Vaccines for Children program provides free vaccines to un- and under-insured children. But not all pediatricians are registered with the program, Thorpe said.

Chattahoochee County, near Columbus, had the lowest MMR vaccination rate for children between 19 and 35 months in Georgia, at 66.1%, according to the latest county-level data available from the state DPH, from the third quarter of 2023. (Children typically get two MMR vaccines, between 12 and 15 months of age and between ages 4 and 6 years.)

According to state data, Chattahoochee County has one provider enrolled in Vaccines for Children, Thorpe said.

“The counties with some of the lower vaccination rates also have access issues,” Thorpe said. “It’s not the only issue – but it’s certainly one…. There are 23 other counties in Georgia in the same boat.”

His organization plans to work in South DeKalb County to learn where the gaps are and try to increase access, he said.

“We know from data from a review of national immunization trends that vaccine coverage is lower among uninsured children, and uninsured children are more likely to live below poverty level, have no health care visits in previous 12 months, and be less likely to receive follow-up doses of multidose vaccines,” if they got the first dose, Guest said. “Access is always an issue.”

Georgia releases limited data on child vaccination

Thorpe and others said more granular data from the state about the number and location of unvaccinated children would help better target areas of need. “The data we have in Georgia (beyond that headline statewide number) is pretty limited,” he said.

The new CDC data is based on states’ self-reports, and Georgia doesn’t follow the same methods as many others, reporting only whether entering kindergarteners are fully compliant with all vaccines, instead of vaccine-specific data. For example, a child missing one shot would be categorized as unvaccinated.

For this reason, Georgia’s vaccination rate for the MMR, polio, DTAP (diphtheria, tetanus and pertussis), chicken pox, and Hepatitis B are all listed as 86.8%, down from 88.4% for the prior year. A decade ago, the rate was 94% in Georgia, according to the CDC.

The state DPH has posted online only immunization reports by county for children ages 19 to 35 months, not for older children like those entering kindergarten. Those reports have not been updated since the third quarter of 2023.

The state is in the process of updating the information, DPH spokesperson Nancy Nydam Shirek said. It collects detailed vaccination information via its online Georgia Registry of Immunization Transactions and Services.

“The data hasn’t been posted online yet because epidemiologists were improving the data cleaning process, adding geocoding, and changing how coverage by insurance was calculated,” Nydam Shirek said. “They are finalizing their review of the reports and will prioritize publishing them online once they receive final review and approval from leadership.”

Nydam Shirek provided Healthbeat with a report on vaccination rates for young children for the entire state, but not each county, as of June 30, 2025. It shows that 87.2% of children ages 19 to 35 months in the second quarter of 2025 had received the MMR vaccine.

In comparison, neighboring states Tennessee and North Carolina post data about kindergarten vaccinations at the school level.

Detailed, local level data is important because “vaccination behavior and vaccine exemption behavior is a very socially and spatially clustered behavior,” Alison Buttenheim, a professor at the University of Pennsylvania’s nursing school said during a June media briefing. “We tend to see it in clumps.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Sorting out Covid vaccine confusion: New and conflicting federal policies raise questions

2025-08-04T13:32:07+00:00

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If you want a Covid-19 shot this fall, will your employer’s health insurance plan pay for it? There’s no clear answer.

Health and Human Services Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist, has upended the way Covid vaccines are approved and for whom they’re recommended, creating uncertainty where coverage was routine.

Agencies within HHS responsible for spelling out who should get vaccinated aren’t necessarily in sync, issuing seemingly contradictory recommendations based on age or risk factors for serious disease.

But the ambiguity may not affect your coverage, at least this year.

“I think in 2025 it’s highly likely that the employer plans will cover” the Covid vaccines, said Jeff Levin-Scherz, a primary care doctor who is the population health leader for the management consultancy WTW and an assistant professor at Harvard’s T.H. Chan School of Public Health. They’ve already budgeted for it, “and it would be a large administrative effort to try to exclude coverage for those not at increased risk,” he said.

With so much in flux, it’s important to check with your employer or insurer about coverage policies before you roll up your sleeve.

Here’s what we know so far, and what remains unclear.

How have the recommendations changed?

What used to be straightforward is now much murkier. Last year, the Moderna and Pfizer-BioNTech Covid vaccines were recommended for anyone at least 6 months old.

This year, the recommendation by the Centers for Disease Control and Prevention is narrower. Although the vaccines are broadly recommended for adults 19 and older, they are no longer recommended for healthy pregnant people or for healthy children 6 months through 17 years old.

Kennedy announced the changes in a video in May, citing safety risks for young people and pregnant people as justification.

But his claims have been widely disputed by experts in vaccines, pediatrics, and women’s health. An analysis by FactCheck.org found that the secretary “misrepresented scientific research to make unfounded claims about vaccine safety for pregnant people and children.”

What RFK Jr. isn’t talking about: How to make vaccines safer

In addition, recently announced changes to the vaccine approval framework have further chipped away at eligibility.

Moderna announced July 10 that the Food and Drug Administration had fully approved its Spikevax Covid vaccine — but approval is restricted to adults 65 and older, and for people from 6 months through 64 years old who are at increased risk of developing a serious case of Covid.

Two other Covid vaccines expected to be available this fall, Novavax’s Nuvaxovid and Moderna’s mNexspike, are also restricted. They are approved for people 65 or older and those 12 to 64 who have underlying health conditions that put them at higher risk of developing severe Covid.

Notably, Pfizer’s Comirnaty Covid vaccine is still approved or authorized for people 6 months of age and older without any restrictions based on risk factors for Covid — at least for now. But the FDA could change that at any time, experts said.

Increasing restrictions “is definitely the direction they are moving,” said Jen Kates, a senior vice president at KFF who authored a KFF analysis of vaccine insurance coverage rules. KFF is a health information nonprofit that includes KFF Health News.

HHS did not provide an on-the-record comment for this article.

How might these changes alter my insurance coverage for the vaccine?

That’s the big question, and the answer is uncertain. Without insurance coverage, people could owe hundreds of dollars for the shot.

Most private health plans are required by law to cover recommended vaccines, whether for Covid, measles, or the flu, without charging their members. But that requirement kicks in after the shots are recommended by a federal panel — the Advisory Committee on Immunization Practices — and adopted by the CDC director, according to the KFF analysis. The committee hasn’t yet voted on Covid vaccine recommendations for this fall. Its next meeting is expected to occur in August or September.

Still, employers and insurers can opt to cover the vaccines on their own, as many did before the law required them to do so. But they may require people to pay something for it.

In addition, the narrower recommendations from different HHS agencies might result in some health plans declining to pay for certain categories of people to get certain vaccines, experts said.

“I don’t think an employer or insurer would deny coverage,” Kates said. “But they could say: You have to get this product.”

That could mean a 45-year-old with no underlying health conditions raising their Covid risk might have to get the Pfizer shot rather than the Moderna version if they want their health plan to pay for it, experts said.

In addition, up to 200 million people may qualify for the vaccines because they have health conditions such as asthma or diabetes that increase their risk of severe disease, according to a commentary published by FDA officials in the New England Journal of Medicine.

Health care professionals can help people determine whether they qualify for the shot based on health conditions.

Tina Stow, a spokesperson for AHIP, which represents health plans, said in a statement that plans will continue to follow federal requirements for vaccine coverage.

What are the options for people who are pregnant or have children they want to have vaccinated?

Many parents are confused about getting their kids vaccinated, according to a KFF poll released on Friday. About half said they don’t know whether federal agencies recommend healthy children get the vaccine this fall. Among the other half, more said the vaccine is not recommended than recommended.

Meanwhile, Kennedy’s recommendation that healthy children not get vaccinated has a notable caveat: If a parent wishes a child to get a Covid vaccine and a health care provider recommends it, the child can receive it under the “shared clinical decision-making” model, and it should be covered without cost sharing.

Many older people embrace vaccines. Research is proving them right.

Some policy experts point out that this is the way care for kids is typically provided anyway.

“Outside of any requirements, vaccines have always been provided through shared decision-making,” said Amanda Jezek, senior vice president of public policy and government relations at the Infectious Diseases Society of America.

There’s no similar allowance for pregnant people. However, even though Kennedy has stated that Covid vaccines are no longer recommended for healthy pregnant people, pregnancy is one of the underlying medical conditions that put people at high risk for getting very sick from Covid, according to the CDC. That could make pregnant people eligible for the shot.

Depending on the stage of someone’s pregnancy, it could be difficult to know whether someone should be denied the shot based on their condition. “This is uncharted territory,” said Sabrina Corlette, co-director of Georgetown University’s Center on Health Insurance Reforms.

How will these changes affect access to the vaccine? Will I still be able to go to the pharmacy for the shot?

“If far fewer are expected to be vaccinated, fewer sites will offer the vaccinations,” Levin-Scherz said. This could be an especially notable hurdle for people looking for pediatric doses of a Covid vaccine, he said.

In addition, pharmacists’ authority to administer vaccines depends on several factors. For example, in some states they can administer shots that have been approved by the FDA, while in others the shots must have been recommended by the ACIP, said Hannah Fish, senior director of strategic initiatives at the National Community Pharmacists Association. Since ACIP hasn’t yet recommended Covid shots for the fall, that could create a speed bump in some states.

“Depending on the rules, you still may be able to get the shot at the pharmacy, but they might have to call the physician to send over a prescription,” Fish said.

What do these changes mean long-term?

It’s impossible to know. But given Kennedy’s vocal skepticism of vaccines and his embrace of long-disproven theories about connections between vaccines and autism, among other things, medical and public health professionals are concerned those views will shape future policies.

“The recommendation changes that were made with respect to children and pregnant women were not necessarily made in good science,” Corlette said.

It’s already a challenge to convince people they need annual Covid shots, and shifting guidelines may make it tougher, some public health experts warn.

“What’s concerning is that this could even further depress the uptake of the Covid vaccines,” Jezek said.

This story originally published at KFF Health News, Healthbeat’s national reporting partner.

Fearing Medicaid coverage loss, some parents rush to vaccinate their kids

2025-07-25T13:38:07+00:00

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For two decades, Washington, D.C., pediatrician Lanre Falusi has counseled parents about vaccine safety, side effects, and timing. But this year, she said, the conversations have changed.

“For the first time, I’m having parents of newborns ask me if their baby will still be able to get vaccines,” Falusi said.

Throughout the country, pediatricians say anxious parents are concerned about access to routine childhood immunizations, especially those with children on Medicaid, the government insurance program for low-income families and people with disabilities. Medicaid covers 4 in 10 children in the United States.

“It really became an issue when RFK Jr. stepped into the role of HHS secretary,” said Deborah Greenhouse, a pediatrician in South Carolina.

The concern accelerated after the shake-up of a key Centers for Disease Control and Prevention vaccine advisory body in June, raising fears that millions of American families could soon have to pay out-of-pocket for shots now covered by their health insurance.

Vaccine coverage for young children is on the rise in New York City, but gaps persist

Health and Human Services Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist, removed all 17 members of the CDC’s Advisory Committee on Immunization Practices, the panel responsible for recommending which shots are included in the nation’s adult and childhood immunization schedules.

Kennedy replaced the panelists with new members aligned with his views, prompting alarm among medical professionals and public health experts.

“People should be worried about what’s going to happen to the availability of vaccines for children,” said Jennifer Tolbert, deputy director of the Program on Medicaid and the Uninsured at KFF, a national health information nonprofit that includes KFF Health News.

ACIP changes could affect insurance coverage for vaccines

Under the Affordable Care Act, health insurers are required to cover all ACIP-recommended vaccines. States and other jurisdictions use the childhood vaccine schedule to set immunization requirements for schoolchildren. ACIP’s recommendations also determine which vaccines get covered by the Vaccines for Children Program, a CDC-funded initiative that provides free immunizations to low-income and uninsured children. Half of children in the United States are eligible for the VFC program.

If the new ACIP members withdraw support for a particular vaccine and the CDC director agrees, Tolbert said, the consequences would be immediate. “It would automatically affect what is covered and therefore which vaccines are available to children on Medicaid,” she said.

Health insurance companies have not yet said how they would alter coverage, but Tolbert said such a move would open the door for private insurers to refuse to cover the vaccine.

Pediatricians worry about a future where parents might have to choose — pay hundreds of dollars out-of-pocket for shots or leave their kids unprotected.

The health insurance industry group AHIP said that health plans “continue to follow federal requirements related to coverage of ACIP-recommended vaccines and will continue to support broad access to critical preventive services, including immunizations.”

Pediatricians say news about President Donald Trump’s new budget law, which is expected to reduce Medicaid spending by about $1 trillion over the next decade, also prompted questions from parents.

While parents may be worried about losing their Medicaid, the law doesn’t mention vaccines or change eligibility or benefits for children’s Medicaid, Tolbert said. But less federal funding means states will have to make decisions about who is covered and which services are offered.

To raise the revenue needed to pay for Medicaid, states could raise taxes; move money earmarked for other spending, such as education or corrections; or, more likely, reduce Medicaid spending.

“And they may do that by cutting eligibility for optional populations or by cutting services that are optional, or by reducing payments to providers in the form of provider rates,” Tolbert said. “It’s unclear how this will play out, and it will likely look different across all states.”

Parents rushing to get children vaccinated

In June, Kennedy announced in a post on X that the CDC is no longer recommending the Covid-19 vaccine for healthy children and pregnant women. The move prompted a lawsuit by the American Academy of Pediatrics and other physician groups that seeks to freeze Kennedy’s directive.

Also that month, the new ACIP members appointed by Kennedy voted to recommend that adults and children no longer receive flu vaccines with thimerosal, a preservative rarely used in some flu vaccines. Anti-vaccine activists, including Kennedy, have rallied against thimerosal for decades, alleging links to autism despite no evidence of any association.

“There is no cause for concern,” Department of Health and Human Services spokesperson Emily Hilliard said in a statement. “As Secretary Kennedy has stated, no one will be denied access to a licensed vaccine if they choose to receive one.”

“When the ACIP committee met last month, they reaffirmed that flu vaccines will remain accessible and covered, and they emphasized safety by ensuring these vaccines are mercury-free,” Hilliard wrote. “The Vaccines for Children (VFC) program continues to provide Covid-19 vaccines at no cost for eligible children when the parent, provider, and patient decide vaccination is appropriate. Medicaid will continue to reimburse the administration fee.”

But the possibility that a vaccine could be restricted or no longer covered by insurance is already changing how parents approach immunization. In Falusi’s practice, parents are scheduling appointments to coincide precisely with their child’s eligibility, sometimes making appointments the same week as their birthdays.

Melissa Mason, a pediatrician in Albuquerque, New Mexico, has treated some patients who contracted measles during the multistate outbreak that started in neighboring Texas.

She’s concerned that any new limitations on access or reimbursement for childhood vaccines could lead to even more preventable illnesses and deaths.

Tribal health officials work to fill vaccination gaps as measles outbreak spreads

Nationally, there have been more than 1,300 measles cases since January, including three deaths, according to the CDC. “We’re seeing this outbreak because vaccination rates are too low and it allows measles to spread in the community,” Mason said.

Children and teens account for 66% of national measles cases. Mason has begun offering the measles vaccine to infants as young as 6 months old, a full six months earlier than standard practice, though still within federal guidelines.

Last year, overall kindergarten vaccination rates fell in the United States. At the same time, the number of children with a school vaccination exemption continued to rise.

Pertussis, or whooping cough — another disease that can be deadly to young children — is spreading. As of July 5, more than 15,100 cases had been identified in U.S. residents this year, according to the CDC.

Mason said pertussis is especially dangerous to babies too young to receive the vaccine.

For now, pediatricians are trying to maintain a sense of urgency without inciting panic.

In Columbia, South Carolina, Greenhouse used to offer families a flexible age range for routine vaccinations.

“I’m not saying that anymore,” the pediatrician said.

She now urges parents to get their children vaccinated as soon as they are eligible.

She described anxious parents asking whether the HPV vaccine, which helps prevent cervical cancer, can be administered to children younger than the recommended age of 9.

“I actually had two parents today ask if their 7- or 8-year-olds could get the HPV shot,” Greenhouse said. “I had to tell them it’s not allowed.”

With the vaccine requiring multiple doses months apart, Greenhouse fears time may run out for families to get the series covered by insurance. If they have to pay out-of-pocket, she’s afraid some families may choose not to get the second dose. A second dose could cost about $300 if no longer covered by insurance.

“I cannot be 100% sure what the future looks like for some of these vaccines,” Greenhouse said. “I can tell you it’s a very scary place to be.”

Kennedy’s newly appointed vaccine advisory committee is expected to hold its next public meeting as soon as August.

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

Tribal health officials work to fill vaccination gaps as measles outbreak spreads

2025-07-24T13:41:22+00:00

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RAPID CITY, S.D. — Cassandra Palmier had been meaning to get her son the second and final dose of the measles vaccine. But car problems made it difficult to get to the doctor.

So she pounced on the opportunity to get him vaccinated after learning that a mobile clinic would be visiting her neighborhood.

“I was definitely concerned about the epidemic and the measles,” Palmier, a member of the Oglala Sioux Tribe, said at the June event. “I wanted to do my part.”

So did her son, Makaito Cuny.

“I’m not going to be scared,” the 5-year-old announced as he walked onto the bus containing the clinic and hopped into an exam chair.

Makaito sat still as a nurse gave him the shot in his arm. “I did it!” he said while smiling at his mother.

The vaccine clinic was hosted by the Great Plains Tribal Leaders’ Health Board, which serves tribes across Iowa, Nebraska, and the Dakotas. It’s one way Native American tribes and organizations are responding to concerns about low measles vaccination rates and patients’ difficulty accessing health care as the disease spreads across the country.

Meghan O’Connell, the board’s chief public health officer, said it is also working with tribes that want to host vaccine clinics.

Elsewhere, tribal health organizations have launched social media campaigns, are making sure health providers are vaccinated, and are reaching out to the parents of unvaccinated children.

This spring, Project ECHO at the University of New Mexico hosted an online video series about measles aimed at health care professionals and organizations that serve Native American communities. The presenters outlined the basics of measles diagnosis and treatment, discussed culturally relevant communication strategies, and shared how tribes are responding to the outbreak.

Participants also strategized about ways to improve vaccination rates, said Harry Brown, a physician and an epidemiologist for the United South and Eastern Tribes, a nonprofit that works with 33 tribes in the Atlantic Coast and Southeast regions.

“It’s a pretty hot topic right now in Indian Country and I think a lot of people are being proactive,” he said.

U.S. facing largest measles outbreak since 1992

Measles can survive for up to two hours in the air in a space where an infected person has been, sickening up to 90% of people who aren’t vaccinated, according to the Centers for Disease Control and Prevention.

The United States has had 1,319 confirmed cases of measles this year as of Wednesday, according to the CDC. It’s the largest outbreak in the United States since 1992. Ninety-two percent of the 2025 cases involve unvaccinated patients or people with an unknown vaccination status. Three people had died in the United States, and 165 had been hospitalized as of Wednesday.

O’Connell said data on Native Americans’ vaccination rates is imperfect but that it suggests a lower percentage of them have received measles shots than the overall U.S. population.

The limited national data on measles vaccination rates for Native Americans are based on small surveys of people who self-identify as Native American. Some show that Native Americans have slightly lower measles vaccination rates, while others show significant gaps.

Data from some states, including South Dakota and Montana, show that Native Americans are less likely than white children to be vaccinated on schedule.

The Oyate Health Center serves Native Americans in Rapid City, South Dakota, and surrounding areas. The center’s response to the measles outbreak has included hosting mobile vaccine clinics like this one outside the community center of a predominantly Native American neighborhood.

The national measles vaccination rate is significantly lower for Native Americans who use the mostly rural Indian Health Service. About 76% of children 16 to 27 months old had gotten the first shot, according to data collected by the agency during recent patient visits at 156 clinics. That’s a 10-percentage-point drop from 10 years ago.

But the IHS data shows that its patients are at least as likely as other children to have received both recommended measles shots by the time they’re 17. O’Connell said it’s unclear if currently unvaccinated patients will continue the trend of eventually getting up to date on their shots or if they will remain unvaccinated.

The immunization rate is probably higher for older children since schools require students to get vaccinated unless they have an exemption, Brown said. He said it’s important that parents get their children vaccinated on time, when they’re young and more at risk of being hospitalized or dying from the disease.

Many Native Americans distrust health care system

Native Americans may have lower vaccination rates due to the challenges they face in accessing shots and other health care, O’Connell said. Those on rural reservations may be an hour or more from a clinic. Or, like Palmier, they may not have reliable transportation.

Another reason, O’Connell said, is that some Native Americans distrust the Indian Health Service, which is chronically underfunded and understaffed. If the only nearby health care facility is run by the agency, patients may delay or skip care.

O’Connell and Brown said vaccine skepticism and mistrust of the entire health care system are growing in Native American communities, as has occurred elsewhere nationwide.

“Prior to social media, I think our population was pretty trustful of childhood vaccination. And American Indians have a long history of being severely impacted by infectious disease,” he said.

European colonizers’ arrival in the late 1400s brought new diseases, including measles, that killed tens of millions of Indigenous people in North and South America by the early 1600s. Native Americans have also had high mortality rates in modern pandemics, including the 1918-20 Spanish flu and Covid-19.

Georgia confirms second measles case in unvaccinated metro Atlanta family

The Great Plains Tribal Leaders’ Health Board reacted quickly when measles cases began showing up near its headquarters in South Dakota this year. Nebraska health officials announced in late May that a child had measles in a rural part of the state, close to the Pine Ridge Indian Reservation. Then, four people from the Rapid City area got sick later that month and into the middle of June.

“Our phones really rang off the hook” once that news came out, said Darren Crowe, a vice president at the board’s Oyate Health Center in Rapid City. He said parents wanted to know if their children were up to date on their measles vaccines.

Crowe said the health board ordered extra masks, created a measles command team that meets daily, and called parents when its online database showed their children needed a shot.

Brown praised that approach.

“It takes a concerted outreach effort that goes individual to individual,” he said, adding that his organization helped the Mississippi Band of Choctaw Indians and the Alabama-Coushatta Tribe of Texas with similar efforts.

Brown said reaching specific families can be a challenge in some low-income Native American communities, where many people’s phone numbers frequently change since they use temporary prepaid plans.

Once a health worker reaches a parent, Brown said, they should listen and ask questions before sharing the importance of the vaccine against measles, mumps, and rubella.

“Rather than trying to preach to somebody and beat them over the head with data or whatever to convince them that this is what they need to do, you start out by finding out where they are,” he said. “So, ‘Tell me about your experience with vaccination. Tell me what you know about vaccination.’”

Most people agree to immunize their children when presented with helpful information in a nonjudgmental way, Brown said.

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

How an Atlanta pediatrician deals with climate anxiety – and finds joy in action

2025-07-11T14:12:31+00:00

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Dr. Preeti Jaggi remembers clearly the moment she became concerned about the environment. Robin Williams was there – on the television.

Jaggi was a teenager in Ohio in 1990 when Williams and other celebrities landed in her living room to talk about pollution and other environmental problems as part of “The Earth Day Special.”

“I remember they talked about climate and how we depend on a stable Earth to thrive. … I remember being concerned about it,” she said.

Jaggi, 52, went on to become a pediatrician specializing in infectious diseases. She works at Children’s Healthcare of Atlanta and as a professor at Emory University, blending her workplace focus on protecting patients with a role as an environmental advocate.

She chairs the advocacy group Georgia Clinicians for Climate Action, where she argues for more renewable energy before the state’s Public Service Commission, collaborates to electrify Georgia’s school buses so kids have cleaner air, and finds ways for the health care industry to be more environmentally sustainable.

Her “everything, everywhere, all at once” presence is driven by her belief that pediatricians have a duty to protect the Earth’s future for their young patients.

Summer heat is felt unevenly across metro Atlanta. Experts say more data is needed to address the public health threat.

“It’s becoming more and more obvious that the environment is affecting health … We just had this huge deluge flood in Texas, and all these kids in a camp were either displaced or died from that,” said Jaggi, who lives in Decatur.

Closer to home, she often talks about the death of 1-year-old twins and their mother in Thomson, Georgia, last year after a tree fell on their home during Hurricane Helene.

Rising temperatures also drive more hot days, which lead to more emergency room visits, Jaggi said.

Excess heat days increase the risk of heatstroke, and longer warm periods mean ticks, mosquitoes, and other vectors of disease are moving to new areas, bringing infections like Lyme disease, malaria, and dengue fever.

Air pollution also has a range of impacts, Jaggi said, including driving up rates of premature births, cancer, autism, and especially asthma.

Jaggi said that during the 1996 Atlanta Olympics, when there was significantly less driving, air pollutants fell, and so did the number of children going to the hospital for asthma – by 40%.

“We need to have strong air pollution standards because we know that it makes us sick,” Jaggi said.

“Our new reality” can make it tough for kids to play outdoors and connect with nature, Jaggi said, something that’s always been a key source of pleasure for her.

“There are going to be days where kids cannot go outside as much as they would otherwise do, which is really sad for them, right? We want them to be outside and be playing in that unstructured time,” she said.

While her medical training did not include much of a focus on climate change, she has enrolled in programs like the Climate Health Organizing fellowship through the Cambridge Health Alliance.

Children are tapped into the impact of climate change, and they’re worried about it, Jaggi said.

“I’ve heard a kid say, ‘I feel that adults take no initiatives into protecting the climate, and they put all the burden on future generations. .. And I don’t know if we can do that without you’,” Jaggi said.

“In Georgia, about 23% of 16- to 25-year-olds are extremely worried about climate, and 75% are worried,” Jaggi said, referring to a study published in The Lancet last year. She can relate to the concerns, since she felt them many years ago as a high school student.

Jaggi also spends a lot of time thinking about vaccines in the face of increasing hesitancy among parents. She sees a parallel with her climate work: “We want to prevent a problem. … This is why, as a mom, you would tell your child, ‘Don’t stay close to that hot stove. Don’t put your hand on that hot stove.’ …. We do things to prevent a problem.”

Jaggi said she has had patients who suffered from vaccine-preventable illnesses. For example, one child was not vaccinated for chickenpox, and suffered a bacterial infection.

“It really ate away at their muscle, and they had to be in hospital for three weeks with six or seven surgeries. The parents said to me, ‘If we would have known, we would have gotten this vaccination’,” Jaggi said. “I just listened to them, and I empathized with their suffering also, because they, I believe, had some regret.

“Giving good information to people about the safety of vaccinations is our responsibility,” Jaggi said.

Vaccination and protecting the environment are driven by a community ethos: “Your community protects you, and you protect your community. It’s similar – we want to protect our environment so that our kids can thrive.”

“The best thing that I can say to people to convince them that I love my children more than anything in this world, and I vaccinated them because I want them to be healthy,” said Jaggi, the mother of two college students.

Even as she reels off a host of climate concerns, Jaggi has found that her advocacy brings her “joy,” inspired by the marine biologist and climate activist Ayana Elizabeth Johnson.

“There are so many things that I view with confusion and bewilderment, but I can still do something, and … even small actions are important,” Jaggi said. “I find a lot of joy in at least just remembering that I can do something.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Q&A: Georgia nursing leader on how to educate patients amid information overload

2025-07-09T19:25:20+00:00

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Over the course of her 40-year career as a nurse, people have gained greater access to information, and that’s both a good and bad thing, said Patricia Horton, the CEO of the Georgia Center for Nursing Excellence.

Patients are more empowered, but many also suffer from information overload, receiving confusing messages about vaccines and other health issues, Horton said.

As trusted messengers with close links to their communities, nurses are tasked with helping people understand health information, Horton said. It takes perseverance.

Patricia Horton is the CEO and founder of the Georgia Center for Nursing Excellence, a nonprofit focused on better understanding the state’s nursing workforce.

“There’s a light at the end of the tunnel, and we just have to keep on trying and trying different ways of getting that information out there,” Horton said. Emphasizing positive stories and listening to people’s personal concerns are effective ways to share good information.

Horton founded the Georgia Center for Nursing Excellence in 2021 to gather data and insights about the state’s nursing workforce. The nonprofit’s data dashboard tracks supply and demand, wages, job postings, and other aspects of the workforce, for RNs (registered nurses), LPNs (licensed practical nurses), and CNAs (certified nursing assistants).

The organization also sponsors a summit where nursing leaders can interact with professionals from other industries and a mentorship program to help new nurses adjust to their jobs, with the hopes that they won’t leave the profession. The dashboard shows that about 153,544 nurses worked in Georgia in 2024, and the state is short by an average of 772 RNs each year, with LPNs and CNAs also facing shortages.

Healthbeat recently spoke with Horton about nursing in Georgia. This interview has been edited for length and clarity.

What role do nurses play as trusted messengers in their communities?

Nurses have been, for upward of 20 years, the most trusted profession, and so we really see that as an opportunity to work in our communities. Many times they’re the ones giving the vaccines, [they] go out and talk to their community, whether it’s in a church setting, school setting, because they have that trust, and [are] trying to share the things in a way that people understand it.

How do nurses deal with anti-vaccine messages?

It is very difficult. We’ve had lots of discussions about that, because it can be very frustrating, especially the science and the reasons behind things. But we keep on trying to put a positive spin on it. Many people have to hear the message and see things and hear stories. One of the things that we’re really trying to get better at in nursing is sharing the stories. What are the benefits? How can we help you? And how can we help you understand? It may take one in that family to believe it and do something, whereas the rest of the people in that family might come along. It’s a constant effort.

We don’t believe in giving up hope. There’s a light at the end of the tunnel, and we just have to keep on trying and trying different ways of getting that information out there … What are the other ways we can get information [to] people and have them see a different perspective and get beyond the political side? We’re more alike than we are [different], and if we can look beyond that, and see what the benefits are, then you’re more likely to reach them.

Is that something that’s changed over the course of your career?

It has changed over my career, because over time, the whole technology of looking on the internet, all of the information that’s shared now, and the way things are shared … The good part of it is, hopefully it has increased the information that patients and families have access to, but on the other hand, many times the information that they’re seeing is not always accurate. So it has made things more challenging.

People will continue to be informed in different ways, and it’ll be our responsibility in the medical field to make sure that we share the correct information and the science behind things.

What contributes to nursing turnover and people leaving the profession?

A … study that was surveying nurses and what impacts them and their intent to leave [found causes to be] stress and burnout, which has to do with workload, under-staffing, inadequate salary, and workplace violence. … Workplace violence has significantly risen to the top, more so during Covid, and has continued to remain a concern, in even nursing homes, as well as hospitals. It’s being addressed with policies and standards being put in place.

Obviously, we always focus on recruitment, because you’re constantly having a need to fill positions. But truly our focus needs to be on retention, because in order to have recruitment, you really have to have strong retention of the individuals that you bring on board.

There’s been a lot of focus and effort on residency programs to really work with our new graduate nurses that are coming along. The intent to leave is much higher early on, and that’s why many [hospital systems] have focused on residency programs and really leaning in with mentors. Turnover costs a significant amount and has an impact on the quality of care you deliver.

What other challenges face the profession in Georgia?

We saw for a period of time, especially during Covid, and a little bit after that, a decline in the number of nurses applying for the nursing programs … Now we’ve seen an increase. The challenge with that is there are many that are not able to be accepted because we also have a faculty shortage.

And the other challenge is clinical placement. Mostly their training is done in hospitals, and hospitals can only take on so many students at a time.

Are you a nurse? Healthbeat wants to hear from you. Please take our new survey about the health needs in the communities you serve. Your input helps inform our public health newsroom — and only takes 5 minutes. As a thank you, five participants will be randomly selected to receive a $50 Amazon gift card. And please pass it along to nurses in your network.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Vaccine coverage for young children is on the rise in New York City, but gaps persist

2025-06-27T19:23:43+00:00

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Vaccine coverage for young children has risen across New York City in recent years, although stark gaps persist in some pockets of the city, a new dashboard from the New York City Department of Health and Mental Hygiene reveals.

The combined seven-vaccine series is a group of routine childhood immunizations, including those against chickenpox, measles, mumps, rubella, poliovirus and other threats. Those vaccines, which follow the childhood immunization schedule, are among those required for New York City children to attend childcare and school.

As of Dec. 31, 65% of 2-year-olds across New York City had received all recommended doses of the seven-vaccine series, an increase from 59% coverage in 2019. But the data show wide variation between boroughs. Last year, only 53% of children in Staten Island and 55% in Brooklyn had completed the combined seven-vaccine series by their second birthday. In the Bronx, the coverage rate was 72%, and in Manhattan and Queens, it was 73%.

Citywide coverage rates for 2-year-olds were far higher for many individual vaccines, including 96% coverage for the polio vaccine, 95% coverage for the MMR vaccine, and 94% coverage for the varicella vaccine.

The release of the city’s vaccine dashboard comes as U.S. vaccine policy enters uncertain territory. Earlier this month, Health Secretary Robert F. Kennedy, Jr. fired all members of the Advisory Committee on Immunization Practices, a committee from the Centers for Disease Control and Prevention, which develops vaccine recommendations. This week, new members of the committee, selected by Kennedy, raised doubts about the safety and efficacy of long-established vaccines.

The committee plans to review the childhood vaccine schedule, a move which the American Academy of Pediatrics described as an attempt to “sow distrust in immunizations.” The professional association emphasized that it would continue to publish its own evidence-based recommendations and schedules.

Dr. Jennifer Duchon, a pediatric hospital epidemiologist and director of antimicrobial stewardship at the Mount Sinai Kravis Children’s Hospital, emphasized that childhood vaccinations offer critical protection against viruses that can severely harm infants and young children.

“We don’t see kids get renal failure or pneumonia from measles anymore. We don’t see patients be on ventilators with pertussis,” she said. “The reason that you don’t see these things is because of the success of vaccines.”

On Staten Island, the 81% coverage rate for the MMR vaccine for 2-year-olds was lower than the 95% citywide rate, but still higher than the borough’s 53% coverage rate for the combined seven-vaccine series.

Dr. Sheena Sangan, a Staten Island pediatrician affiliated with Cohen Children’s Northwell Health, said that in her practice, she often encounters families who seek more information about vaccines — and she’s happy to talk through any concerns.

“It’s okay to ask questions, and it really is a community health initiative,” she said. “Protecting one person means you’re protecting other people. And it’s not just the kids, it’s everybody in the community.”

Sangan added that she hopes to see the Health Department invest in local health literacy programs and public awareness campaigns around the immunization schedule, particularly for parents in the prenatal period. That work, she said, could help provide a “missing piece” in her community.

“I see patients, after the baby’s already born, and there’s already so much information out there, and they don’t really know what to focus on,” she said. “It’s not so much not wanting to vaccinate; they need more information.”

The city’s dashboard draws data from the Citywide Immunization Registry, which stores immunization records for New York City residents, as well as non-residents vaccinated in the city. That vaccine data will be updated twice a year, with coverage assessed in June and December and released a few months later.

Duchon, the Mount Sinai physician, said that if federal vaccine policy shifts, the role of local agencies like the Health Department in providing trusted expertise will become even more important.

“It’s going to fall to the cities and to the states — if there’s a deficit of national guidance or a splintering of opinions on a national basis — to take over the health of their citizens,” she said.

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org.

Kennedy’s vaccine advisers sow doubts as scientists protest U.S. pivot on shots

2025-06-27T12:52:33+00:00

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As fired and retired scientists rallied outside in the Atlanta heat, an advisory panel that Robert F. Kennedy Jr. handpicked to replace experts he’d fired earlier met inside the Centers for Disease Control and Prevention’s headquarters to plan a more skeptical vaccine future.

The new members of the Advisory Committee on Immunization Practices began their tenure Wednesday by shifting the posture of the 60-year-old panel from support for vaccine advancement to doubt about the safety and efficacy of well-established and widely administered inoculations.

Their discussions and votes this week paled in significance, however, in comparison with Health and Human Services Secretary Kennedy’s announcement Tuesday that he would withdraw a $1.2 billion U.S. commitment to global immunization.

That decision will kill children in the world’s poorest countries, critics said.

The new ACIP, meanwhile, recommended that newborn Americans get a newly licensed shot to protect them against a respiratory virus. The panel also urged doctors to stop administering influenza vaccine that contains a mercury-based preservative called thimerosal. That decision, in keeping with Kennedy’s disproven claim that thimerosal helped cause an autism epidemic, will have relatively little effect, since only about 4% of flu vaccines currently contain the preservative.

More worrying to vaccine advocates, the committee’s plans to review the government’s childhood vaccine schedule could undermine long-accepted consensus and public confidence, since at least three of the seven committee members have been outspoken opponents of current vaccines. The federal government is legally bound by ACIP’s decisions to provide vaccines it recommends to lower-income children and other groups, and states also follow ACIP’s advice.

Many older people embrace vaccines. Research is proving them right.

Former Harvard University epidemiologist Martin Kulldorff, ACIP’s new chair, set the tone in his opening remarks. “Secretary Kennedy has given this committee a clear mandate to use evidence-based medicine when making vaccination recommendations, and that’s what we will do,” he said.

He added, “There are no wrong questions,” and he announced that a new working group would investigate whether children and adolescents are getting too many vaccines. Another will consider whether to continue ACIP’s 34-year-old recommendation of a birth dose of hepatitis B vaccine, a practice that has dramatically reduced liver disease.

Kulldorff, a Covid-19 contrarian and biostatistician who said he was fired by Harvard for refusing a Covid vaccination after suffering a severe case of the disease, said the reputations of science and public health have fallen to all-time lows. But scientists and public health officials disagree on who’s to blame.

North Carolina reports first measles case

The biggest cause is “fearmongering and pseudoscience that has overtaken our country,” Caroline Brown, a pediatrician outside Winston-Salem, North Carolina, said during the remote public comment session. She noted that her state’s first measles case of the year was reported this week, panicking many of the families she treats.

Measles was declared eliminated in the United States 25 years ago. It “is back now because of declining rates of vaccination fueled by misinformation that is not only allowed but amplified by some of you sitting on this very committee,” Brown said.

The American Academy of Pediatrics declined to send official liaisons to the meeting and announced on Thursday that it would continue to publish “its own evidence-based recommendations and schedules” for vaccines, blasting Kennedy’s panel.

Georgia reports sixth case of measles of the year, health officials confirm

“What we heard in this meeting was really a false narrative that the current vaccine policies are flawed and that they need fixing,” Sean O’Leary, a physician who chairs the AAP Committee on Infectious Diseases, said in a statement. “That’s completely false. These policies have saved millions of lives, trillions of dollars.”

The CDC’s immunization safety office has conducted studies of the entire vaccine schedule and found no harms, although a 2023 study indicated a possible link between aluminum salts used in some shots and asthma.

Within the CDC conference room, there was a striking contrast between ACIP members and the CDC officials who briefed the panel. While the CDC scientists presented studies showing the safety and value of Covid and RSV (respiratory syncytial virus) vaccines, for example, many of the panel members expressed skepticism.

Biochemist Robert Malone and Massachusetts Institute of Technology management professor Retsef Levi — two panelists who have called for banning the mRNA technology used for Covid vaccines — were frequently dismissive of the CDC analysis and data.

Malone, Levi, and Vicky Pebsworth — a longtime foe of school vaccination requirements — suggested hidden harms such as “hot lots” of dangerous shots, residual spike protein in the blood from mRNA shots, and inadequate vaccine safety monitoring.

CDC scientists rebutted most of the critiques. But final recommendations on policy will be made by the committee.

Protesters rally outside ACIP meeting in Atlanta

Standing along a busy suburban thoroughfare outside the CDC’s headquarters in Atlanta as the meeting rolled on, people critical of the new ACIP were dressed in costumes representing vaccine-preventable diseases — measles, HPV, chickenpox. A small cadre carried balloon letters spelling “R-E-S-T-O-R-E A-C-I-P.” One held a leg splint, commonly used to stabilize the limbs of people with polio, a disease driven to near-extinction by vaccination. Many drivers honked in support as they drove by.

Casey Boudreau, who recently retired from a career working on vaccine-preventable diseases at the CDC, said she was upset by Kennedy’s insistence that the verdict was still out on the safety of some vaccines and by his calls for them to be studied further.

“You’re focusing on reinventing the wheel,” she said. “Do we need to go back and test air bags again? Or do we know they work?”

Tony Fiore, who served as a liaison to ACIP during his some of his time at the CDC before retiring, said he was “greatly concerned” that the committee’s words and actions would “reduce the confidence people have in vaccines and hurt our immunization programs.”

HHS spokesperson Andrew Nixon, who hovered briefly at the edge of rally as people began to gather, dismissed it as “nothing more than a dog and pony show with a lack of serious credibility, evidenced by their Halloween costumes,” in a statement later sent by text message.

HHS pulls out of Gavi, which vaccinates children overseas

At the meeting inside, Kennedy and his agenda loomed in the background, especially after the HHS secretary announced the abandonment of Gavi, an international group that estimates its vaccine programs have saved 18 million lives, mostly in the world’s poorest countries.

The United States has provided 13% of Gavi’s budget, and President Joe Biden had promised an additional $1.2 billion over four years before he left office. Kennedy’s action means that children “will miss lifesaving vaccines” against diseases causing pneumonia, diarrhea, measles, polio, and other diseases, former CDC official Deblina Datta said in an interview.

“There will be deaths,” said Datta, who retired in 2023 after 24 years at the agency. “I am not being hyperbolic. This is a big blow for children worldwide.”

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Kennedy said Gavi had not done enough to promote vaccine safety. He also accused the group of complicity in censoring vaccine skeptics like him during the pandemic.

Before Kennedy intervened, the ACIP had been preparing to propose giving children one less shot. The committee was to have voted on reducing vaccinations against HPV, which causes cervical cancer, from two doses to one — because a single shot has proved so effective.

Kennedy has earned hundreds of thousands of dollars in fees from a pending lawsuit against Merck over alleged injuries from one of the HPV vaccines.

Removal of thimerosal had no impact on autism rates

While it will have little actual impact, the vote on thimerosal also frustrated vaccine proponents. Public health agencies removed the substance from nearly all childhood vaccines beginning in 1999, out of concern that the accumulation of even tiny amounts of mercury could harm children’s brains and, some believed, cause autism.

Removal of thimerosal from childhood vaccines had no impact on autism rates, however.

But on Thursday, one of the earliest anti-thimerosal activists, nurse Lyn Redwood, presented a paper to ACIP on its dangers. Her arguments were nearly identical to a paper she co-wrote on the subject in 2001.

A summary of the evidence on thimerosal produced by CDC staff was posted online next to Redwood’s slides on Tuesday, but it was removed before the ACIP meeting began. The CDC paper concluded the evidence did not link thimerosal in vaccines to autism or other developmental issues.

According to The Washington Post, Kennedy has appointed Redwood to a position in the CDC’s immunization safety office.

“Removing thimerosal from vaccines didn’t make them safer, just more expensive,” Elias Kass, a naturopathic physician in Seattle, told the committee during a public comment session. “Re-litigation of questions already answered, like the safety of thimerosal, is not advancing radical transparency — it is an insidious attempt to suggest that something was missed or hidden previously.”

Removal of thimerosal from all flu vaccines may have drawbacks.

Two companies — Seqirus and Sanofi — still sell multi-dose flu vaccine vials that contain thimerosal as a preservative. A single vaccination from these 10-dose vials costs 10 to 40 times less than a single-shot prepackaged syringe, according to a CDC price list.

Seqirus will have no trouble replacing its remaining multi-dose vials with single syringes in time for the flu season, spokesperson Melanie Kerin said.

This story was originally published by KFF Health News, Healthbeat’s national reporting partner.

What RFK Jr. isn’t talking about: How to make vaccines safer

2025-06-25T13:49:02+00:00

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Within an hour of receiving a Covid vaccination in November 2020, Utah preschool teacher Brianne Dressen felt pins and needles through her arms and legs. In the medical odyssey that followed, she suffered double vision, chronic nausea, brain fog, and profound weakness. Once a rock climber, she became a couch potato.

Although Dressen’s symptoms were rare in that season of hundreds of millions of Covid vaccinations, they were common enough to draw the attention of a National Institutes of Health neuroscientist named Avindra Nath, who examined Dressen and more than 30 other people with a similar syndrome in 2021. He recommended Dressen take steroids and antibodies — treatments that saved her life, she said.

And then, according to emails reviewed by KFF Health News, Nath said he couldn’t help anymore. His clinical study was ending. He directed the patients to seek local help. But, Dressen said, there wasn’t any.

Nath declined to speak to KFF Health News for this article. The Food and Drug Administration searched international vaccine safety databases for small-fiber neuropathy, one of the most common symptoms he mentioned in a write-up of the patients, and found it was less prevalent in vaccinated than in unvaccinated patients, said Peter Marks, who led the FDA division responsible for vaccines until Health and Human Services Secretary Robert F. Kennedy Jr. forced him out in May.

While it’s possible that Nath’s patients suffered Covid vaccine injuries, Marks said, their symptoms were so varied it was hard to characterize a possible syndrome.

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But for Dressen and others convinced the vaccines injured them, their experiences were symptomatic of a well-intentioned but flawed U.S. system for monitoring the rare ill effects of vaccines. The system isn’t well-funded enough to answer questions that people urgently want answered, and that can feed vaccine hesitancy, safety experts say.

Its shortcomings were on particular display during the mass vaccination campaigns of the pandemic, when even rare, serious side effects could affect thousands of people.

Now some leading vaccine scientists are calling for more resources to research vaccine safety and support people with claims of injury — and asking Kennedy, who has a history as an anti-vaccine activist, to step up.

“Spending money on vaccine safety is not saying vaccines aren’t safe; it’s showing a commitment to continued improvement,” said Y. Tony Yang, a professor of health policy at George Washington University’s Milken Institute School of Public Health.

So far, they’ve been disappointed. While Kennedy gives the public the impression that vaccines are harmful, he hasn’t talked about ways to make them safer. And he’s made the problem worse by cutting programs and dismissing scientists who are most knowledgeable of the problems, according to numerous vaccine experts.

“The reduction in emphasis on the unbiased ascertainment of vaccine safety signals, and redirection toward certain specific issues like autism in vaccines, which we know is not true — that is what’s dangerous,” Marks said.

In March, the Trump administration abruptly canceled a contract with researchers just as they began a massive Covid vaccine study aimed at discovering the genetic traits that make certain people vulnerable to vaccine-triggered myocarditis. That condition struck about 1 in 13,000 teenage boys and young men who received two doses of the Pfizer or Moderna mRNA vaccine in 2020 and 2021.

Then, on June 9, Kennedy sacked the entire 17-member Advisory Committee on Immunization Practices, which during the pandemic impaneled a group of experts that reviewed safety data from nearly 700 million Covid vaccinations.

The new ACIP contains members who have said most vaccines are dangerous and improperly tested. Sen. Bill Cassidy, a Louisiana Republican who chairs the Senate committee with oversight of HHS, said Monday on X that the ACIP meeting scheduled for Wednesday and Thursday should be delayed until ACIP is staffed with less biased, more knowledgeable members.

HHS officials have suggested that Kennedy intends to throw out the whole vaccine safety system and start over. In a statement to KFF Health News, spokesperson Emily Hilliard accused the Centers for Disease Control and Prevention of “suppressing information about vaccine injuries” and said the Vaccine Adverse Event Reporting System and the Vaccine Safety Datalink. monitoring systems in place since the early 1990s, were “designed to fail” and “templates of regulatory malpractice.”

She said HHS was “building surveillance systems that will accurately measure vaccine risks as well as benefits.” Asked for details, Hilliard did not respond. The HHS budget proposal for fiscal year 2026 makes no mention of vaccine safety programs.

Many older people embrace vaccines. Research is proving them right.

The current U.S. vaccine safety system began with passage of the 1986 National Childhood Vaccine Injury Act, which aimed at stabilizing the vaccine supply by stopping lawsuits against drug companies. At the time, they were getting out of the vaccine business, finding it less risky and more profitable to produce drugs for chronic diseases. The act set up the National Vaccine Injury Compensation Program and VAERS.

CDC vaccine safety officer Robert Chen built on VAERS to create the Vaccine Safety Datalink, which looks for evidence of vaccine harms in electronic health records. In 2001, the CDC set up the Clinical Immunization Safety Assessment project, through which a network of eight U.S. centers study rare vaccine reactions.

But the vaccine safety system’s budget has been stuck at around $20 million most years. That hasn’t been enough to study rare but recurring vaccine injuries in a serious way.

“$20 million to look at all the licensed vaccines in this country is woefully inadequate,” Dan Salmon, director of Johns Hopkins University’s Institute for Vaccine Safety, said at a recent conference. Without a more serious commitment, he said, “our products won’t be as safe as they could be.”

As an HHS vaccine safety official during the Clinton, Bush, and Obama administrations, Salmon helped write two plans that called for expanded safety work, including examinations of whether the vaccine schedule might be contributing to an increase in allergic diseases.

A little-publicized CDC-led 2022 study suggested that the aluminum salts added to make some pediatric vaccines more effective might cumulatively be linked to an increased incidence of asthma. Salmon thinks it merits further research — to refute or confirm the results. The issue “should have been studied decades ago,” he said.

Government compensation program has failed

Vaccine advocates and skeptics agree that the government program established to compensate people injured by vaccines or other public health measures during emergencies — the Countermeasures Injury Compensation Program — has miserably failed those with Covid vaccine-related injuries. As of June 1, the program has compensated only 39 of nearly 14,000 people who have filed Covid vaccine injury claims. Only five have gotten awards of more than $10,000.

The program is far less generous and user-friendly than the National Vaccine Injury Compensation Program, funded since 1988 by an excise tax on vaccines. It has paid out about 12,000 awards worth a total of $4.8 billion, mostly to care for vaccine-injured children.

People with Covid vaccine injuries, however, are stuck in a kind of limbo, often without clear medical options. It’s unfair and “very bad for public confidence in vaccines,” said Amy Pisani, CEO of Vaccinate Your Family, a nonprofit that promotes vaccination, speaking on a panel with Salmon at the April conference.

Kennedy has condemned the injury compensation system for shielding drug companies from lawsuits, but if he wants to help patients, he should move Covid vaccines into the program, said Renée Gentry, who runs a law clinic for vaccine injuries at George Washington University Law School.

“The longer you hang these people out to dry, you are creating a perfect storm where nobody’s going to want to get vaccinated,” she said.

Vaccine injury investigation curtailed

In December 2021, the NIH’s Nath emailed Dressen and the other patients suffering from postvaccine problems that he could no longer help them. He told Science magazine that investigating vaccine side effects was a delicate business when public health leaders were urging everyone to get their shots.

“You have to be very careful. You can make the wrong conclusion,” he said. “The implications are huge.”

Nath published an article in 2023 calling for more investigation of vaccine-related neurological conditions. His lab also released preliminary results from its study of Dressen and the other patients, which pointed to helpful treatments. But the paper has not been published in a peer-reviewed journal.

And none of the federal agencies recognized that her condition might be vaccine-related, said Dressen, who received her shot in an AstraZeneca clinical trial. (FDA officials were concerned about the vaccine’s side effect profile, and it was never distributed in the United States.)

Dressen said Nath’s withdrawal left her distraught.

“They reassure everyone there’s a safety net, but every one of those things is a complete failure,” she said. “I didn’t speak out because of my injury. The reason I spoke out is because of what happened after my injury.”

“People are suffering, and we don’t yet understand why or how to help them,” said Harlan Krumholz, a cardiologist who is part of a research project at Yale University led by immunobiologist Akiko Iwasaki that includes hundreds of patients with postvaccine issues. “Worse, many of them have felt ignored or dismissed by the very institutions meant to help and support them.”

The NIH appears not to have funded studies of postvaccine syndrome, whose symptoms mimic those of Long Covid. Yet genetic studies could help “to determine who might be more susceptible to this condition,” Iwasaki said in an email.

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Such research appears ideal for the Clinical Immunization Safety Assessment, established to examine rare vaccine reactions. But the network has published nothing on Covid vaccines, nor are any trials related to the issue listed on government websites.

German researchers have studied postvaccine syndrome in more depth. Germany’s Paul-Ehrlich-Institut, a sort of FDA for vaccines, reported in December that it had reviewed 919 cases of postvaccine syndrome that were similar to Long Covid — a rate of about 1 in 100,000 vaccinations. It said causality was hard to establish because of the diverse symptoms reported.

Can vaccine safety move out of HHS?

In 1999, Chen, the CDC scientist, published an article suggesting that to speed studies and boost public confidence, vaccine safety should be moved to an independent agency, perhaps modeled on the National Transportation Safety Board, that could subpoena records from industry or other government agencies for its crash investigations.

Although HHS did not respond to a query about the idea, vaccine litigant Aaron Siri, who has been a personal attorney to Kennedy, told KFF Health News that Kennedy supported it.

In the meantime, some vaccinologists hope they can persuade Kennedy to spend more money on good vaccine safety research.

While it is “very painful to watch” what Kennedy is doing to HHS vaccine policy, “it would behoove us to find common ground,” Salmon said at the conference. That doesn’t mean “funding terrible studies to confirm hypotheses that some people believe,” he added.

Though that is what many see Kennedy doing. One of his first moves as secretary was to hire David Geier, whose previous publications are considered junk science by many in the field, to conduct a review of vaccine links to autism. Studies around the world have thoroughly debunked such a connection.

Loss of CDC payment halts work on myocarditis

When HHS’ Vaccine Safety Datalink was set up in the early 1990s, it was the envy of the world. There are now also good systems in Denmark, England, Israel, and Australia, but the U.S. system has worked pretty well, said Steve Black, who co-directed the Kaiser Permanente Vaccine Study Center from 1985 until 2007.

The Vaccine Safety Datalink was largely responsible for the 1999 removal of a rotavirus vaccine that triggered rare intestinal disorders in babies. And its discovery of a rare but deadly side effect helped keep the AstraZeneca Covid vaccine off the U.S. market and led to the removal of the Johnson & Johnson vaccine, Black said. It also helped pinpoint myocarditis soon after young men began getting mRNA shots in 2021.

Since 2019, Black has co-directed an ambitious, 30-country consortium called the Global Vaccine Data Network, which enables vaccine safety analyses across massive, diverse populations around the world.

The group was just beginning its study of genetic predispositions to myocarditis when the Trump administration withdrew a $2 million CDC payment, halting the work.

An email from the Department of Government Efficiency “asked a bunch of irrelevant questions like, Had we ever been funded by China? Did we have collaborators in Europe?” It ordered the network to cease and desist with no due process or means of appeal, Black said.

Research funded by the grant had progressed to the point of finding seven genetic variants known to be related to cardiac inflammation in people who got myocarditis postvaccination, said Bruce Carleton, the lead investigator, at the University of British Columbia. Work remains, but the data suggests a $6 test could clear vulnerable patients before they are vaccinated, Carleton said.

“Millions got mRNA vaccines. Very few got myocarditis,” Black said. “The public would like to know, ‘Am I at risk?’ Genetics can answer that.”

The CDC has been an honest broker of vaccine safety information, Black added, but if taking the issue out of HHS would improve public confidence, he’s for it.

Vaccines need to be safer, Dressen said, but the idea of banning them doesn’t sit well with her.

“There’s the crowd that wants mRNA vaccines to be pulled off the market, but that’s not going to fix the problem. Vaccines are not going to go away,” she said.

As of June 5, a patient group she leads had provided $1.2 million to 162 people needing medical care for injuries they attributed to vaccination.

Meanwhile, the federal countermeasures program, which doles out Covid vaccine injury awards through a trust, has committed $2.6 million for one patient and $370,376 for another. As of June 1, it had granted an additional 37 claimants a grand total of $198,809.92.

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

Many older people embrace vaccines. Research is proving them right.

2025-06-23T14:26:33+00:00

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Kim Beckham, an insurance agent in Victoria, Texas, had seen friends suffer so badly from shingles that she wanted to receive the first approved shingles vaccine as soon as it became available, even if she had to pay for it out-of-pocket.

Her doctor and several pharmacies turned her down because she was below the recommended age at the time, which was 60. So, in 2016, she celebrated her 60th birthday at her local CVS.

“I was there when they opened,” Beckham recalled. After getting her Zostavax shot, she said, “I felt really relieved.” She has since received the newer, more effective shingles vaccine, as well as a pneumonia shot, an RSV vaccine to guard against respiratory syncytial virus, annual flu shots, and all recommended Covid-19 vaccinations.

Some older people are really eager to be vaccinated.

Robin Wolaner, 71, a retired publisher in Sausalito, California, has been known to badger friends who delay getting recommended shots, sending them relevant medical studies. “I’m sort of hectoring,” she acknowledged.

Deana Hendrickson, 66, who provides daily care for three young grandsons in Los Angeles, sought an additional MMR shot, though she was vaccinated against measles, mumps, and rubella as a child, in case her immunity to measles had waned.

For older adults who express more confidence in vaccine safety than younger groups, the past few months have brought welcome research. Studies have found important benefits from a newer vaccine and enhanced versions of older ones, and one vaccine may confer a major bonus that nobody foresaw.

The new studies are coming at a fraught political moment. The nation’s health secretary, Robert F. Kennedy Jr., has long disparaged certain vaccines, calling them unsafe and saying that the government officials who regulate them are compromised and corrupt.

On June 9, Kennedy fired a panel of scientific advisers to the Centers for Disease Control and Prevention, and later replaced them with some who have been skeptical of vaccines. But so far, Kennedy has not tried to curb access to the shots for older Americans.

Vaccines can prevent much serious illness for seniors

The evidence that vaccines are beneficial remains overwhelming.

The phrase “Vaccines are not just for kids anymore” has become a favorite for William Schaffner, an infectious diseases specialist at Vanderbilt University Medical Center.

“The population over 65, which often suffers the worst impact of respiratory viruses and others, now has the benefit of vaccines that can prevent much of that serious illness,” he said.

Take influenza, which annually sends from 140,000 to 710,000 people to hospitals, most of them seniors, and is fatal to 10% of hospitalized older adults.

For about 15 years, the CDC has approved several enhanced flu vaccines for people 65 and older. More effective than the standard formulation, they either contain higher levels of the antigen that builds protection against the virus or incorporate an adjuvant that creates a stronger immune response. Or they’re recombinant vaccines, developed through a different method, with higher antigen levels.

Georgia reports sixth case of measles of the year

In a meta-analysis in the Journal of the American Geriatrics Society, “all the enhanced vaccine products were superior to the standard dose for preventing hospitalizations,” said Rebecca Morgan, a health research methodologist at Case Western Reserve University and an author of the study.

Compared with the standard flu shot, the enhanced vaccines reduced the risk of hospitalization from the flu in older adults, by at least 11% and up to 18%. The CDC advises adults 65 and older to receive the enhanced vaccines, as many already do.

More good news: Vaccines to prevent respiratory syncytial virus in people 60 and older are performing admirably.

RSV is the most common cause of hospitalization for infants, and it also poses significant risks to older people. “Season in and season out,” Schaffner said, “it produces outbreaks of serious respiratory illness that rivals influenza.”

Because the FDA first approved an RSV vaccine in 2023, the 2023-24 season provided “the first opportunity to see it in a real-world context,” said Pauline Terebuh, an epidemiologist at Case Western Reserve School of Medicine and an author of a recent study in the journal JAMA Network Open.

In analyzing electronic health records for almost 800,000 patients, the researchers found the vaccines to be 75% effective against acute infection, meaning illness that was serious enough to send a patient to a health care provider.

The vaccines were 75% effective in preventing emergency room or urgent care visits, and 75% effective against hospitalization, both among those ages 60 to 74 and those older.

Immunocompromised patients, despite having a somewhat lower level of protection from the vaccine, will also benefit from it, Terebuh said. As for adverse effects, the study found a very low risk for Guillain-Barré syndrome, a rare condition that causes muscle weakness and that typically follows an infection, in about 11 cases per 1 million doses of vaccine. That, she said, “shouldn’t dissuade people.”

The CDC now recommends RSV vaccination for people 75 and older, and for those 60 to 74 if they’re at higher risk of severe illness (from, say, heart disease).

As data from the 2024-25 season becomes available, researchers hope to determine whether the vaccine will remain a one-and-done, or whether immunity will require repeated vaccination.

Study finds shingles vaccine reduced risk of dementia

People 65 and up express the greatest confidence in vaccine safety of any adult group, a KFF survey found in April. More than 80% said they were “very “or “somewhat confident” about MMR, shingles, pneumonia, and flu shots.

Although the Covid vaccine drew lower support among all adults, more than two-thirds of older adults expressed confidence in its safety.

Even skeptics might become excited about one possible benefit of the shingles vaccine: This spring, Stanford researchers reported that over seven years, vaccination against shingles reduced the risk of dementia by 20%, a finding that made headlines.

Biases often undermine observational studies that compare vaccinated with unvaccinated groups. “People who are healthier and more health-motivated are the ones who get vaccinated,” said Pascal Geldsetzer, an epidemiologist at the Knight Initiative for Brain Resilience at Stanford and lead author of the study.

“It’s hard to know whether this is cause and effect,” he said, “or whether they’re less likely to develop dementia anyway.”

Community health workers increased Covid-19 vaccination in NYC, a new study finds

So the Stanford team took advantage of a “natural experiment” when the first shingles vaccine, Zostavax, was introduced in Wales. Health officials set a strict age cutoff: People who turned 80 on or before Sept. 1, 2013, weren’t eligible for vaccination, but those even slightly younger were eligible.

In the sample of nearly 300,000 adults whose birthdays fell close to either side of that date, almost half of the eligible group received the vaccine, but virtually nobody in the older group did.

“Just as in a randomized trial, these comparison groups should be similar in every way,” Geldsetzer explained. A substantial reduction in dementia diagnoses in the vaccine-eligible group, with a much stronger protective effect in women, therefore constitutes “more powerful and convincing evidence,” he said.

The team also found reduced rates of dementia after shingles vaccines were introduced in Australia and other countries. “We keep seeing this in one dataset after another,” Geldsetzer said.

In the United States, where a more potent vaccine, Shingrix, became available in 2017 and supplanted Zostavax, Oxford investigators found an even stronger effect.

By matching almost 104,000 older Americans who received a first dose of the new vaccine (full immunization requires two) with a group that had received the earlier formulation, they found delayed onset of dementia in the Shingrix group.

How a shingles vaccine might reduce dementia remains unexplained. Scientists have suggested that viruses themselves may contribute to dementia, so suppressing them could protect the brain. Perhaps the vaccine revs up the immune system in general or affects inflammation.

“I don’t think anybody knows,” said Paul Harrison, a psychiatrist at Oxford and a senior author of the study. But, he added, “I’m now convinced there’s something real here.”

Shingrix, now recommended for adults over 50, is 90% effective in preventing shingles and the lingering nerve pain that can result. In 2021, however, only 41% of adults 60 and older had received one dose of either shingles vaccine.

A connection to dementia will require further research, and Geldsetzer is trying to raise philanthropic funding for a clinical trial.

And “if you needed another reason to get this vaccine,” Schaffner said, “here it is.”

This story originally published at KFF Health News, Healthbeat’s national reporting partner.

Georgia reports sixth case of measles of the year, health officials confirm

2025-06-18T18:35:14+00:00

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The Georgia Department of Public Health announced Wednesday that a third member of an unvaccinated family has contracted measles.

The outbreak began after one relative living in metro Atlanta contracted measles abroad. The first case was confirmed in May, followed by a second family member earlier this month.

The latter two patients had been in home quarantine after exposure, and “there were no additional exposures,” DPH spokesperson Nancy Nydam Shirek said in a news release.

The first two patients have fully recovered, she said.

The latest case is the sixth this year in Georgia and marks the second outbreak in the state. An outbreak is defined as three related cases. In 2024, the state saw a total of six cases.

In late January, an unvaccinated child from Gwinnett County contracted measles after domestic travel. That spread to two unvaccinated siblings.

Measles misinformation is on the rise — and Americans are hearing it, survey finds

Nationally, 1,197 cases have been reported as of Thursday, according to the Centers for Disease Control and Prevention. Most of the cases are connected to a large outbreak in west Texas and New Mexico. Two Texas children and a New Mexico adult – all unvaccinated – have died.

“More than 95% of the people who receive a single dose of MMR will develop immunity to all three viruses,” Nydam Shirek said. “A second dose boosts immunity, typically enhancing protection to 98%.”

Symptoms of measles include a high fever, cough, runny nose, red watery eyes, and a characteristic red rash.

People who suspect they or their child have measles are urged to contact their health care providers rather than go to a hospital, clinic, or office without calling first, because the disease is very contagious, according to DPH. It can infect up to 9 of 10 unvaccinated people nearby.

Georgia confirms fifth measles case of the year in unvaccinated families

2025-06-06T17:24:14+00:00

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The Georgia Department of Public Health announced Friday it has confirmed a fifth case of measles this year.

The new case involves a metro Atlanta resident who is related to a person who acquired measles abroad and whose infection was confirmed in May, DPH spokesperson Nancy Nydam Shirek said. Neither had been vaccinated for measles.

The department did not disclose the identity or age of the patients. Nydam Shirek said officials will monitor about a dozen people who may have been exposed for another week and have administered measles vaccines and antibodies to reduce the risk of spread.

No new cases have been identified outside the family, Nydam Shirek said. The latest person to be infected had been quarantining at home due to their family member’s case.

In late January, in an unrelated case, an unvaccinated child from Gwinnett County contracted measles after domestic travel. That spread to two unvaccinated siblings. Georgia had six measles cases last year.

Metro Atlanta measles outbreak contained by ‘all hands on deck’ response, but low vaccination rates keep Georgia vulnerable

Nationwide, a total of 1,088 measles cases have been confirmed as of May 29. That’s much higher than in 2024, when the United States had 285 confirmed cases for the whole year.

Many of this year’s cases are related to a large outbreak in west Texas and New Mexico. Two Texas school-age children and a New Mexico adult – all unvaccinated – have died.

Measles symptoms include a high fever, cough, runny nose, red, watery eyes, and a characteristic red rash. Measles is highly contagious, but two doses of the vaccine, typically administered in childhood, are highly effective at preventing the disease.

Epidemiologists recommend a “herd immunity” vaccination rate of about 95% to prevent transmission of measles, but the latest data from Georgia shows that young children and kindergarten vaccination rates are below that. Only about 88.4% of kindergarteners in Georgia had received both doses, according to 2023-24 data from the Centers for Disease Control and Prevention.

Uptake rates for the MMR (measles, mumps and rubella) vaccine are falling in Georgia and nationwide amid an increase in measles misinformation.

Local doctors emphasize that the vaccine is safe and that it’s the best way to protect against measles. Vaccinations are available at public health departments and pediatricians’ offices, often for no cost.

“I vaccinated my own children, and I would have not done that unless I thought it was in their best interest,” pediatric infectious disease specialist Dr. Preeti Jaggi of Children’s Healthcare of Atlanta told Healthbeat recently.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Community health workers increased Covid-19 vaccination in NYC, a new study finds. Here’s why their efforts worked.

2025-06-06T15:06:37+00:00

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In the depths of the Covid-19 pandemic, community health workers played a significant role in increasing vaccine uptake in hard-to-reach New York City communities, a new study has found.

Community health workers are public health workers with close connections to the communities they serve, and often act as intermediaries between local residents and health systems or social services. Across the country, many regions invested in community health worker initiatives as part of pandemic response efforts. But the workforce is particularly vulnerable to public health’s boom and bust funding cycle.

Quantifying the impact of community health workers who don’t work in clinical settings has long been challenging, said Dr. Maureen Miller, an epidemiologist and contractor with the New York City Department of Health and Mental Hygiene. But the data that emerged from the pandemic — and the Health Department’s significant investment in community health workers — offered an unusual opportunity to show their value, she said.

At MoMA, celebrating the ‘invisible workforce’ of community health workers

In the study, recently published in the American Journal of Public Health, Miller and other researchers affiliated with the Health Department found that community health workers, in partnership with the agency and community-based organizations, helped drive sharp increases in vaccination levels among local residents.

In 75 ZIP codes targeted for public health interventions, residents were primarily Black and Latino — demographics that had experienced disproportionately high mortality rates in the early weeks of the pandemic. At the beginning of the initiative in July 2021, 44% of all residents had completed their primary series Covid-19 vaccination. By June 2022, vaccine uptake rose to 76%. The majority of those communities received high levels of engagement from community health workers, defined as interactions during at least 11 months of the year.

Dr. Maureen Miller, an epidemiologist, studied the impact of community health workers on Covid-19 vaccination in New York City along with other researchers affiliated with the New York City Department of Health and Mental Hygiene.

Over the course of that year, community health workers also provided vaccination information to local residents more than 18 million times and participated in more than 22,000 outreach events, according to the study. They made 800,000 linkages to Covid-19 vaccination appointments, created more than 200,000 referrals to testing sites, distributed 17 million face masks and handed out 73,000 at-home antigen tests. They also helped residents tackle other issues, from food insecurity to housing instability.

In an interview this week with Healthbeat, Miller discusses the study, the role of community health workers, and why their approach to community engagement proved so effective. This interview has been edited for length and clarity.

Take us back to where New York City was in the pandemic when this project began. What motivated this research?

I was hired just as [the Covid-19 variant] Omicron was taking off, as were all of my colleagues. It was a very crazy period in the pandemic. Although vaccines were increasingly available, they were kind of challenging to get in New York City. You had to make appointments through computers and online. Not everyone knows how to operate that, not everybody has access to that, and we were also in the communities that had been left behind already by vaccines, by treatments. People had already died.

The statistics are astounding: Almost half of the people who died in the pandemic in New York City died in the first month or two. That’s staggering, and I think we’ve swept that loss under the rug because it’s enormous. It has affected all of us.

Against that background, people were mistrustful. They said, ‘You want us to take this vaccine now, we don’t understand it. We hear bad things about it.’ There was already a great deal of misinformation and skepticism on the part of community members that we were working with. So the idea was not, as the city Department of Health, to go in and say, ‘Get vaccinated.’ It was to partner with community-based organizations who hire people who are centered in the community. We provided funding for the community-based organizations to hire community health workers who we would help train and keep updated on all the new variants, the new vaccines, the boosters.

The community health workers and the community-based organizations developed a lot of their own methods of interacting with the community. We would provide the information, but they would make up songs and get them on the local radio, they’d have flyers. They would do videos and put them on social media. We had biweekly meetings with community members and with community-based organizations. We had a series of trainings for community health workers. It was probably the largest effort that the New York City Department of Health has ever made to integrate community with government in the city.

How did you set up this study?

One of the reasons that community-based community health workers get no respect is because it’s been extremely difficult to find a database that shows the impact of population-level change. We wanted to change entire communities, not just one person at a time. We didn’t interact with every single person in the community, yet our impact was felt, as evidenced by the huge increase in vaccine uptake over time.

We had an outcome: how many people had received the full series of vaccinations. We had that data, and it was collected on a weekly basis for everyone who became vaccinated. I can’t even tell you how unusual that is in the world of public health — but so is a pandemic. This provided a unique opportunity to look at the outcomes and then to see how our work with the community was impacting our objective, which was vaccine uptake.

We didn’t interact with every single person in the community, yet our impact was felt, as evidenced by the huge increase in vaccine uptake over time.
Dr. Maureen Miller

The contracts were based on X number of outreach engagements, X number of handing out materials and documentation. You had to satisfy a minimum set of criteria in terms of engagement that you would then get paid for. That’s unique in my experience, but it was extremely effective, because the community-based organizations wanted to help the community in any way they could. So most of the time they exceeded [the goals].

What were the main findings of your research?

I was shocked — I hadn’t looked at the data until things started to settle down with the pandemic. I wondered: Well, how big of an impact did we have? And we had an enormous impact. I don’t know of vaccine uptake that has happened so quickly for any other disease.

Community health workers distributed face masks and Covid-19 tests, helped residents make Covid-19 vaccination appointments, and also provided connections to food and housing social services.

Within one year, from the initiation of the project in July 2021 through June 2022, we had a 30% increase in vaccine uptake in a community that is under-resourced, marginalized, distrustful, and disinvested. People went out and got vaccinated.

One of the projects that we did was a storytelling project. We wanted to know, ‘Why did you get vaccinated? Why are you encouraging others to get vaccinated?’ And it was all about family. It was about, ‘I’m going to protect my family.’ It was about community. In an individualistic society such as ours, it was really heartening to hear that that was a fundamental reason why people were choosing to get vaccinated and to convince others to get vaccinated. Not only were our community health workers acting as advocates for vaccination, eventually so were community members.

How do community health workers’ efforts to help residents with other issues, like food insecurity or housing instability, connect to the broader goal of increasing vaccine uptake?

The Health Department wanted people to get vaccinated right away. And the community came back and said, ‘Listen, my kid doesn’t have diapers. I’m not getting a vaccine before I can get diapers.’ There was such a great deal of need — and there continues to be need — for food, for housing, for money for child care, for elder care. There is just so much need in these communities that they can’t afford to think about the Health Department’s priority of getting people vaccinated and not spreading Covid.

People really wanted help, and they didn’t necessarily want the help that we came in with — to provide vaccines. They wanted help with daily living needs that were not being met, and in fact, were exacerbated by the pandemic. So we started providing referrals. We pulled together a list of organizations where people could go to get food. We partnered with the Department of Homeless Services to provide vaccine information and opportunities to make reservations to get vaccinated, and also to find housing for people. Community-based organizations also corralled their networks of food pantries and other resources so that we could amplify their ability to refer others to these services.

That’s how we build trust. We need to pay attention to what it is you need and want; it’s not only about getting vaccinated. It’s dealing with community priorities to ensure that when we would like to do an important health intervention, we’ve already built up the trust.

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org.

In axing mRNA contracts, Trump delivers another blow to U.S. biosecurity, former officials say

2025-06-06T14:00:00+00:00

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The Trump administration’s cancellation of $766 million in contracts to develop mRNA vaccines against potential pandemic flu viruses is the latest blow to national defense, former health security officials said. They warned that the United States could be at the mercy of other countries in the next pandemic.

“The administration’s actions are gutting our deterrence from biological threats,” said Beth Cameron, a senior adviser to the Brown University Pandemic Center and a former director at the White House National Security Council. “Canceling this investment is a signal that we are changing our posture on pandemic preparedness,” she added, “and that is not good for the American people.”

Flu pandemics killed up to 103 million people worldwide last century, researchers estimate.

In anticipation of the next big one, the U.S. government began bolstering the nation’s pandemic flu defenses during the George W. Bush administration. These strategies were designed by the security council and the Biomedical Advanced Research and Development Authority at the Department of Health and Human Services, among other agencies. The plans rely on rolling out vaccines rapidly in a pandemic. Moving fast hinges on producing vaccines domestically, ensuring their safety, and getting them into arms across the nation through the public health system.

The Trump administration is undermining each of these steps as it guts health agencies, cuts research and health budgets, and issues perplexing policy changes, health security experts said.

Since President Donald Trump took office, at least half of the security council’s staff have been laid off or left, and the future of BARDA is murky. The nation’s top vaccine adviser, Peter Marks, resigned under pressure in March, citing “the unprecedented assault on scientific truth.”

Trump administration is ending multiple HIV vaccine studies, scientists and officials say

Most recently, Trump’s clawback of funds for mRNA vaccine development put Americans on shakier ground in the next pandemic. “When the need hits and we aren’t ready, no other country will come to our rescue and we will suffer greatly,” said Rick Bright, an immunologist and a former BARDA director.

Countries that produced their own vaccines in the Covid-19 pandemic had first dibs on the shots. While the United States, home to Moderna and Pfizer, rolled out second doses of mRNA vaccines in 2021, hundreds of thousands of people in countries that didn’t manufacture vaccines died waiting for them.

Moderna deal on bird flu vaccines no longer stands

The most pertinent pandemic threat today is the bird flu virus H5N1. Researchers around the world were alarmed when it began spreading among cattle in the United States last year. Cows are closer to humans biologically than birds, indicating that the virus had evolved to thrive in cells like our own.

As hundreds of herds and dozens of people were infected in the United States, the Biden administration funded Moderna to develop bird flu vaccines using mRNA technology. As part of the agreement, the U.S. government stipulated it could purchase doses in advance of a pandemic. That no longer stands.

Researchers can make bird flu vaccines in other ways, but mRNA vaccines are developed much more quickly because they don’t rely on finicky biological processes, such as growing elements of vaccines in chicken eggs or cells kept alive in laboratory tanks.

Time matters because flu viruses mutate constantly, and vaccines work better when they match whatever variant is circulating.

Developing vaccines within eggs or cells can take 10 months after the genetic sequence of a variant is known, Bright said. And relying on eggs presents an additional risk when it comes to bird flu because a pandemic could wipe out billions of chickens, crashing egg supplies.

Decades-old methods that rely on inactivated flu viruses are riskier for researchers and time-consuming. Still the Trump administration invested $500 million into this approach, which was largely abandoned by the 1980s after it caused seizures in children.

“This politicized regression is baffling,” Bright said.

A bird flu pandemic may begin quietly in the United States if the virus evolves to spread between people but no one is tested at first. Indeed, the Centers for Disease Control and Prevention’s dashboard suggests that only 10 farmworkers have been tested for the bird flu since March. Because of their close contact with cattle and poultry, farmworkers are at highest risk of infection.

Hospitalizations would be first sign of spread

As with many diseases, only a fraction of people with the bird flu become severely sick. So the first sign that the virus is widespread might be a surge in hospital cases.

“We’d need to immediately make vaccines,” said Angela Rasmussen, a virologist at the University of Saskatchewan in Canada.

The U.S. government could scale up production of existing bird flu vaccines developed in eggs or cells. However, these vaccines target an older strain of H5N1 and their efficacy against the virus circulating now is unknown.

In addition to the months it takes to develop an updated version within eggs or cells, Rasmussen questioned the ability of the government to rapidly test and license updated shots, with a quarter of HHS staff gone. If the Senate approves Trump’s proposed budget, the agency faces about $32 billion in cuts.

Trump’s team cited safety in limiting Covid shots. Patients, health advocates see more risk.

Further, the Trump administration’s cuts to biomedical research and its push to slash grant money for overhead costs could undermine academic hospitals, rendering them unable to conduct large clinical trials. And its cuts to the CDC and to public health funds to states mean that fewer health officials will be available in an emergency.

“You can’t just turn this all back on,” Rasmussen said. “The longer it takes to respond, the more people die.”

Researchers suggest other countries would produce bird flu vaccines first. “The U.S. may be on the receiving end like India was, where everyone — rich people, too — got vaccines late,” said Achal Prabhala, a public health researcher in India at medicines access group AccessIBSA.

He sits on the board of a World Health Organization initiative to improve access to mRNA vaccines in the next pandemic. A member of the initiative, the company Sinergium Biotech in Argentina, is testing an mRNA vaccine against the bird flu. If it works, Sinergium will share the intellectual property behind the vaccine with about a dozen other groups in the program from middle-income countries so they can produce it.

The Coalition for Epidemic Preparedness Innovations, an international partnership headquartered in Norway, is providing funds to research groups developing rapid-response vaccine technology, including mRNA, in South Korea, Singapore, and France. And CEPI committed up to $20 million to efforts to prepare for a bird flu pandemic. This year, the Indian government issued a call for grant applications to develop mRNA vaccines for the bird flu, warning it “poses a grave public health risk.”

Pharmaceutical companies are investing in mRNA vaccines for the bird flu as well. However, Prabhala says private capital isn’t sufficient to bring early-stage vaccines through clinical trials and large-scale manufacturing. That’s because there’s no market for bird flu vaccines until a pandemic hits.

Studies find mRNA Covid vaccines are safe

Limited supplies means the United States would have to wait in line for mRNA vaccines made abroad. States and cities may compete against one another for deals with outside governments and companies, like they did for medical equipment at the peak of the Covid pandemic.

“I fear we will once again see the kind of hunger games we saw in 2020,” Cameron said.

In an email response to queries, HHS communications director Andrew Nixon said, “We concluded that continued investment in Moderna’s H5N1 mRNA vaccine was not scientifically or ethically justifiable.” He added, “The decision reflects broader concerns about the use of mRNA platforms — particularly in light of mounting evidence of adverse events associated with Covid-19 mRNA vaccines.”

Nixon did not back up the claim by citing analyses published in scientific journals.

In dozens of published studies, researchers have found that mRNA vaccines against Covid are safe. For example, a placebo-controlled trial of more than 30,000 people in the United States found that adverse effects of Moderna’s vaccine were rare and transient, whereas 30 participants in the placebo group suffered severe cases of Covid and one died.

Trump team’s $500 million bet on old vaccine technology puzzles scientists

More recently, a study revealed that three of nearly 20,000 people who got Moderna’s vaccines and booster had significant adverse effects related to the vaccine, which resolved within a few months. Covid, on the other hand, killed four people during the course of the study.

As for concerns about the heart issue, myocarditis, a study of 2.5 million people who got at least one dose of Pfizer’s mRNA vaccine revealed about 2 cases per 100,000 people. Covid causes 10 to 105 myocarditis cases per 100,000.

Nonetheless, HHS Secretary Robert F. Kennedy Jr., who founded an anti-vaccine organization, has falsely called Covid shots “the deadliest vaccine ever made.” And without providing evidence, he said the 1918 flu pandemic “came from vaccine research.”

Politicized mistrust in vaccines has grown. Far more Republicans said they trust Kennedy to provide reliable information on vaccines than their local health department or the CDC in a recent KFF poll: 73% versus about half.

Should the bird flu become a pandemic in the next few years, Rasmussen said, “we will be screwed on multiple levels.”

Amy Maxmen is Healthbeat’s national reporter through its partnership with KFF Health News.

NY public health update: Wildfire smoke, new Covid variant, diabetes, and a fish consumption advisory

2025-06-05T16:58:07+00:00

There’s a ton going on in the world of public health. This week we’ll cover wildfire smoke in New York, an emerging Covid variant, updates to Covid vaccine eligibility, diabetes in New Yorkers, and an advisory on local fish consumption.

Wildfire smoke in New York

Smoke from wildfires in Canada has made its way down to New York and surrounding states.

Poor air quality from wildfire smoke poses health risks to everyone, but some groups are especially sensitive:

Older adults
Pregnant women
Children
People with pre-existing respiratory and heart conditions

Air quality is measured by sensors that detect the concentration of pollutants in the air. Results are reported as the Air Quality Index, which is a number between 0 and 500. The higher the AQI, the more polluted the air is, and the higher the health risk. When the AQI exceeds 50 (the yellow category), people who are more sensitive to poor air quality should reduce strenuous activity outdoors (like working out). Once the AQI tops 100 (the orange category), everyone should reduce strenuous activity outdoors.

You can easily check the air quality of your local area on some weather apps, like AirNow, or download the EPA’s AirNow mobile app. And for a deeper dive on wildfire smoke, check out our post from last year.

New Covid variant in NYC

A new Covid variant has been detected in international travelers who arrived to New York City airports this month, as well as other airports in the United States. The new variant, NB.1.8.1, is getting some attention because it’s the major variant associated with a surge in Covid cases in China.

The good news is that this variant doesn’t appear to be any more severe than other circulating variants — it’s not meaningfully better at evading the immune system. The reason China may be seeing more Covid cases is not entirely clear, but we do see that this variant grows faster than many other circulating variants in cell culture, meaning it may be more transmissible.

What does this mean for you?

In New York, and the rest of the United States, we can expect another Covid wave this summer, with things likely picking up in the next two to three weeks. We’ve had summer Covid waves the past four summers, so it’s expected at this point.

New York City average SARS-CoV-2 wastewater concentrations. Data from the New York City Wastewater Testing Program.

Wastewater data for New York City is delayed, with the most recent data available as of May 6. The most recent data show that Covid began increasing earlier in May, but it was still at low levels in New York City. I’ll be back with updates once we get more data.

Will the current vaccine be effective against this new strain?

We think so. The new NB.1.8.1 strain seems to evade antibodies similarly to the last two strains vaccines were developed for, JN.1 and KP.2, meaning that the current vaccine should offer protection against severe disease. If you are moderately or severely immunocompromised or over 65, and you got a Covid vaccine in the fall, you can talk to your doctor about getting a second dose. I got the fall vaccine last year, so personally, I am not going to get another shot until this fall. But, I will be paying close attention to the Covid data (and sharing it here) and will likely mask up on the train and in grocery stores once virus activity starts to pick up more.

Covid vaccines will still be available for kids and pregnant women in New York

In last week’s post, we covered new proposed guidelines for Covid vaccines that would make it harder for adults and kids without chronic conditions to get vaccinated if they want to. Late last week, the Centers for Disease Control and Prevention released recommendations based on the proposal.

The communication over the vaccine guidelines was a total mess and is still confusing as heck (YLE National covered it here). After it was initially announced that Covid vaccines would not be recommended for healthy kids and pregnant women, the CDC walked that back, and are now recommending that kids, pregnant women, and all adults can still get vaccinated if they and their doctor agree it’s appropriate (called shared clinical decision-making).

Covid vaccine eligibility as of now:

Age 65+: Vaccines are recommended.
Under age 65 with certain health conditions: Vaccines are recommended.
Adults, kids, and pregnant women may get the vaccine if they and their clinician agree it’s appropriate.

This is a win because little kids, particularly those under 6 months old, and pregnant women are still at high risk of severe Covid. Babies continue to make up the most emergency department visits for Covid (even more so than older adults). It also upholds medical freedom and the choice to get vaccinated if one wants to.

The CDC requires insurance to cover kids’ shots that are recommended by shared clinical decision-making. But for adults, insurance coverage is still up in the air. When ACIP (an independent group of advisers to the CDC) meets at the end of June to make their recommendations, they’ll vote on whether Covid vaccines should be recommended for healthy adults, and this will likely dictate insurance coverage.

Diabetes is high in NYC

The NYC Health Department released a report last week showing just how deeply diabetes, one of the most common chronic diseases, affects New Yorkers. In New York City, and the rest of the United States, diabetes is a leading cause of illness, disability, and death.

In 2022, about 11% of the New York City adult population (800,000 New Yorkers) had diabetes. Statewide, it’s similar — 11.4% of New Yorkers have diabetes.

And risk is not evenly spread. Diabetes is highest among older adults, with 26% of New York City adults over 65 having diabetes. The risk of diabetes increases with age — as people get older, the body’s ability to produce insulin declines, muscle mass decreases, and many will have reduced physical activity, all of which contribute to insulin resistance.

Asian/Pacific islander, Black, and Latino New Yorkers have nearly twice the rate of diabetes compared to white New Yorkers. Diabetes risk among racial and ethnic groups is a combination of genetic, environmental, and socioeconomic factors.

Poverty and access to healthy food play a huge role in diabetes risk. NYC residents in high poverty neighborhoods (15%) were almost twice as likely to have diabetes as residents in low poverty neighborhoods (8%). People from lower-income households may not have access to healthy food options (often more expensive) or opportunities to exercise regularly in their communities.

How do we fix this issue?

It’s a complex issue, but more funding and smart investments would help. Diabetes, like many other chronic diseases, is shaped by a person’s environment. Do they have time to cook? Safe spaces to exercise? Access to regular medical care? These are material and environmental conditions, not just personal choices.

Lifestyle interventions, like the National Institutes of Health’s Diabetes Prevention Program (which sadly lost its funding recently) can be very effective. Here’s what we as individuals can keep in mind to reduce risk:

Get regular checkups that include lab work — prediabetes can be reversed with early action.
Strive for a balanced diet — emphasizing protein, fiber-rich carbohydrate foods, and healthy fats.
Stay physically active — exercise benefits blood sugar, insulin sensitivity, and weight management.
Manage weight — if you are carrying excess weight, just losing 5%-10% of your body weight has been shown to have substantial benefits.

New York City’s Health Department has laid out a Citywide Diabetes Reduction Plan that calls for evidence-based programs, such as peer-led education, community health workers, support for healthy food, and self-management services.

Having a plan is great, but the NYC Diabetes Report highlights that the plan’s initiatives are not yet funded at levels needed to reach all New Yorkers who could benefit. We also need long-term solutions that enable people to afford healthier lifestyles. For example, Medicaid and Medicare reimbursement of diabetes prevention and self-management programs, as well as investments in efforts that address the root causes, such as housing, transportation, and food access.

We have the blueprint. Now we need the resources to scale it.

A big thank you to Megan Maisano, MS, RDN, for her expert insight and contribution to this section.

New York advisory on fish contamination

Did you know it’s striped bass season in New York? My dad used to take me fishing when I was little as a way to connect with nature. It’s a great family activity, but some fish can accumulate pollutants from their environment, which can be dangerous if consumed in high amounts.

Last week, New York State Department of Health announced an advisory on which fish from New York state bodies of water are safe to eat, and which ones should be avoided. Some fish in New York have high levels of chemicals that can be harmful, including mercury, polychlorinated biphenyls, and PFAS.

The state is divided into four different water regions, each with its own fish consumption guidelines.

There are different guidelines based on who you are, where you fish, what you catch, and how much fish you eat. Chemicals in fish can have a greater effect on children’s development and babies, so women of childbearing age (under 50) and children under 15 are advised to limit the kinds of fish they eat and how often they eat them. The chemicals from fish can also build up in the body and affect the development of future pregnancies, so women who may become pregnant should limit their consumption of riskier fish.

In addition to the New York-specific guides, the Food and Drug Administration also has recommendations on which fish are safe to eat for women and children.

What you can do

If you fish in New York, look up the guidance for your local fishing spot. Avoid eating the fish listed as not safe to consume. If you are eating out, you can ask where fish was sourced from.

Eating fish can be part of a healthy diet, providing key nutrients like high-quality protein, omega-3 fatty acids, and iron. And not all fish are risky to consume. Fishing can still be a fun activity for the family, but equipping yourself with knowledge of your local environment can help you make healthy decisions about how much fish to eat and from where.

Bottom line

You’re all caught up on New York public health this week. We’ll be back next week with some info on the New York City mayor’s election and how it could influence public health. Stay tuned!

Love,

Your NY Epi

RFK Jr. says healthy pregnant women don’t need Covid boosters. What the science says.

2025-06-02T14:15:06+00:00

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You’re pregnant, healthy, and hearing mixed messages: Health and Human Services Secretary Robert F. Kennedy Jr., who is not a scientist or doctor, says you don’t need the Covid vaccine, but experts at the Centers for Disease Control and Protection still put you in a high-risk group of people who ought to receive boosters. The science is on the side of the shots.

Pregnant women who contracted Covid-19 were more likely to become severely ill and to be hospitalized than non-pregnant women of the same age and demographics, especially early in the Covid pandemic.

A meta-analysis of 435 studies found that pregnant and recently pregnant women who were infected with the virus that causes Covid were more likely to end up in intensive care units, be on invasive ventilation, and die than women who weren’t pregnant but had a similar health profile. This was before Covid vaccines were available.

Neil Silverman, a professor of clinical obstetrics and gynecology and the director of the Infectious Diseases in Pregnancy Program at the David Geffen School of Medicine at UCLA, said he still sees more bad outcomes in pregnant patients who have Covid. The risk of severe Covid fluctuated as new variants arose and vaccinations became available, Silverman said, but the threat is still meaningful. “No matter what the politics say, the science is the science, and we know that, objectively, pregnant patients are at substantially increased risk of having complications,” Silverman said.

Restrictions on healthy people's Covid vaccine access fuel worry

A request for comment regarding the scientific literature that supports Covid vaccination for pregnant women sent to HHS’s public affairs office elicited an unsigned email unrelated to the question. The office did not respond when asked for an on-the-record comment.

Kennedy, a longtime anti-vaccine activist before joining the Trump administration, announced Tuesday that Covid vaccines would be removed from the CDC’s immunization schedule for healthy pregnant women and healthy children. His announcement, made in a video posted on the social media platform X, blindsided CDC officials and circumvented the agency’s established, scientific processes for adding and removing shots from its recommended schedules, The Washington Post reported.

There’s still much unknown about how Covid affects a pregnant person. The physiological relationship between Covid infections and mothers and fetuses at different stages of a pregnancy is complex, said Angela Rasmussen, a virologist at the University of Saskatchewan.

How pregnancy changes the immune system

The increased risk to pregnant patients comes in part because pregnancy changes the immune system, Rasmussen said.

“There is natural immune suppression so that the mother’s body doesn’t attack the developing fetus,” Rasmussen said. “While the mother does still have a functioning immune system, it’s not functioning at full capacity.”

Pregnant patients are more likely to get sick and have a harder time fighting off any infection as a result.

In addition to changing how the immune system works, being pregnant also makes women five times as likely to have blood clots. That risk is increased if they contract Covid, said Sallie Permar, chair of pediatrics at Weill Cornell Medicine.

CDC funding cuts impact Georgia vaccine access, other public health programs

The virus that causes Covid can affect the vascular endothelium — specialized cells that line blood vessels and help with blood flow, Rasmussen said. In a healthy person, the endothelium helps prevent blood clots by producing chemicals that tweak the vascular system to keep it running. In a person infected with the Covid virus, the balance is thrown off and the production of those molecules is disrupted, which research shows can lead to blood clots or other blood disorders.

Permar said those clots can be especially dangerous to both pregnant women and fetuses. Inflammation and blood clots in the placenta could be connected to an increased risk of stillbirth, especially from certain Covid variants, according to studies published in major medical journals as well as by the CDC.

When the placenta is inflamed, it’s harder for blood carrying oxygen and nutrients to get to the developing baby, said Mary Prahl, an associate professor of pediatrics at the University of California-San Francisco School of Medicine.

“If anything is interrupting those functions — inflammation or clotting or differences in how the blood is flowing — that’s really going to affect how the placenta is working and being able to allow the fetus to grow and develop appropriately,” she said.

It makes sense that we see the effects of Covid in the placenta, Silverman said. “The placenta is nothing more than a hyper-specialized collection of blood vessels, so it is like a magnetic target for the virus.”

Blood vessels in the placenta are smaller and may clot more easily than in the mother’s circulatory system, he said.

How Covid can complicate pregnancy

Permar said recent data suggests that pregnant women sick with Covid still have a higher risk of pregnancy complications such as preeclampsia, preterm birth, and miscarriage, even with existing immunity from previous infection or vaccination. Covid, she said, can still land women in the hospital with pregnancy complications.

Prahl said the connection between stillbirth and Covid may be changing given the immunity many people have developed from vaccination or prior infection. It’s an area in which she’d like to see more research.

There’s already strong evidence that both mRNA-based and non-mRNA Covid vaccines are safe for pregnant women.

Prahl co-authored a small, early study that found no adverse outcomes and showed antibody protection persisted for both the mother and the baby after birth. “What we learned very quickly is that pregnant individuals want answers, and many of them want to be involved in research,” she said. Later studies, including one published in the journal Nature Medicine showing that getting a booster in pregnancy cut newborn hospitalizations in the first four months of life, backed up her team’s findings.

Prahl expects more evidence will be available soon to support the benefits of mothers receiving a Covid booster during pregnancy.

“I can say, kind of behind the scenes, I’m seeing a lot of this preliminary data,” she said.

She blames the delay in part on the Biden administration’s scaling back of federal efforts to track Covid. “A lot of the surveillance of these data were pulled back,” she said. The Trump administration is further cutting money used to track Covid.

But because the vaccines give a pregnant woman’s immune system a boost by increasing neutralizing antibodies, virologist Rasmussen is confident that getting one while pregnant makes it less likely a pregnant woman will end up in the hospital if she gets Covid.

“It will protect the pregnant person from more severe disease,” she said.

How Covid vaccine in pregnancy protects newborns

Getting a Covid vaccine while pregnant also helps protect newborns after birth. Pregnant women who get vaccinated pass that protection to their young babies, who can’t get their own shots until they are at least 6 months old.

According to data released by the CDC in 2024, nearly 90% of babies who had to be hospitalized with Covid had mothers who didn’t get the vaccine while they were pregnant.

As recently as April 2024, research showed that babies too young to be vaccinated had the highest Covid hospitalization rate of any age group except people 75 and older.

The Trump administration’s decision to remove the Covid vaccine from the list of shots it recommends for pregnant women means insurance companies might no longer cover it. Pregnant women who want to get it anyway may have to pay hundreds of dollars out-of-pocket.

“I don’t want to be that doctor who just says, ‘Well, it’s really important. You have to vaccinate yourself and your kids no matter what, even if you have to pay for it out-of-pocket,’ because everyone has their own priorities and budgetary concerns, especially in the current economic climate,” Silverman said. “I can’t tell a family that the vaccine is more important than feeding their kids.”

But he and his colleagues will keep advising pregnant women to try to get the shots anyway.

“Newborns will be completely naive to Covid exposure,” he said. “Vaccinating pregnant women to protect their newborns is still a valid reason to continue this effort.”

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

New York public health update: Salmonella outbreak in cucumbers, measles at Shakira concert, Covid vaccines

2025-05-28T15:30:13+00:00

I hope you all had a restful Memorial Day weekend. For those honoring loved ones lost in service, my heart is with you, and I’m deeply grateful.

Let’s get into this week’s dose of New York public health news, what you can do, and why it matters.

Cucumber recall affecting New York

A multistate Salmonella outbreak has been traced to cucumbers grown in Florida. As of Friday, 26 people across 15 states — including New York— have fallen ill, with nine hospitalized.

The Food and Drug Administration has issued a nationwide recall of cucumbers grown by Florida-based Bedner Growers and distributed by Fresh Start Produce Sales.

The affected cucumbers were:

Sold between April 29 and May 19.
Distributed to various retailers, restaurants, and food service providers. In New York these include Albertsons, Walmart, and other grocery stores.
Added to sushi rolls, salads, and other veggie mixes.

What this means for you

If you have cucumbers, or cucumber-containing premade salads or sushi at home that was purchased between April 29 and May 19, it’s safest to throw them out. Sanitize any surfaces that may have come into contact with the cucumbers. If you are eating out, consider asking the restaurant if they’re aware of the recall before ordering foods with cucumbers.

Symptoms of Salmonella infection include diarrhea, fever, and stomach cramps, which typically appear 12 to 72 hours after consumption. The Centers for Disease Control and Prevention reports an average of 420 Salmonella-related deaths annually in the United States. Children under 5 years old, adults over age 65, and people with weakened immune systems are at highest risk for severe illness.

Measles exposures in New Jersey

New Jersey has reported two possible measles exposures in the past week: one at Newark Airport and one at the MetLife Shakira concert. Anyone who visited the following locations during the specified times may have been exposed. Potentially exposed people should contact a health care provider if they develop any measles symptoms, which usually start like a cold and progress to a rash.

Newark Liberty International Airport, Terminal B. May 12, 12:30-4 p.m. Monitor for symptoms until Monday.
MetLife Stadium at the Shakira concert. May 15, 7:30 p.m.-1 a.m. Monitor for symptoms until June 6.

So far, no cases have been identified following these two exposure events. If you do develop symptoms, it’s important to call your doctor or clinic before you visit in person so special precautions can be taken to prevent further spread.

With measles continuing to spread in Texas and other states — and more than 1,060 cases reported nationwide — it’s not entirely surprising to see exposures at large events like the Shakira concert. Around 55,000 people attended (and as a Shakira fan, I’m a little jealous).

What this means for you

If you went to the concert or were at Newark Airport during the exposure period, monitor your symptoms over the next two weeks. If you are vaccinated, you likely have little to worry about. Fortunately, the Shakira concert mostly had adults in attendance, and most adults are vaccinated against measles, which helps limit the risk of an outbreak.

Being fully vaccinated is still the best way to prevent getting measles. Here are common FAQs on the vaccine from YLE National.

Tuberculosis in Suffolk County

A tuberculosis case was reported at Sachem High School East in Suffolk County, Long Island. On May 15, more than 120 students and staff were notified via letter about potential exposure to an individual diagnosed with TB.

TB is an infectious disease that’s transmitted mainly through the air. It primarily affects the lungs and can be serious if untreated. Symptoms include persistent cough, fatigue, fever, and weight loss. Public health officials take any TB exposure seriously because the disease is relatively rare in the United States, and infections can cause serious illness.

Tuberculosis is on the rise in NYC. Here’s why — and what to know about the disease.

The Suffolk County Department of Health is offering free testing to those with prolonged contact with the infected person. For TB, prolonged contact means several hours in close proximity, not just passing them in the hallway. Unlike measles and other pathogens, TB infection generally requires a longer period of exposure. So it’s common to only test people who have had prolonged close contact. In college, I was tested for TB after spending several hours near someone in my dorm who was later diagnosed. (I tested negative.)

In 2024, there were 250 confirmed TB cases in New York state, a 19% increase from 2023. Suffolk County reported 52 TB cases in 2024, the highest in New York.

2024 tuberculosis cases in New York counties.

What this means for you

TB is treatable if identified, and it’s much better to get it treated before symptoms start. So if you got a letter from the county health department, getting tested is a good idea. This TB FAQ from the New York Health Department is helpful.

Update on Medicaid cuts

Last week, the House of Representatives passed multiple health care revisions as part of the budget reconciliation bill. According to analysis done by Gov. Kathy Hochul’s office, these bills have two significant implications for health care in New York:

A potential annual loss of nearly $13.5 billion for New Yorkers’ health care sector, and
Nearly 1.5 million New Yorkers could lose Medicaid coverage and become uninsured

The bills would cut over $7.5 billion in federal funding from the Essential Plan (New York’s Medicaid expansion) and shift almost $3 billion of other costs to New York state. This means that the state would have to take on those costs or reduce funding for health care. We cover this in more detail in our recent Medicaid deep dive here.

Another major change included in the bill is a new work requirement: Starting in 2029, adults without children who are not disabled need to prove they’re working at least 80 hours per month to qualify for Medicaid. Community service, work training programs, and going to school also qualify.

Work requirements for Medicaid are being proposed to reduce federal spending — by shrinking the number of people who qualify — and to encourage employment. There are a couple of important issues with this:

Administrative difficulties would reduce access. When work requirements for Medicaid eligibility were tested in Arkansas, over 18,000 people lost coverage, and 60% delayed medical treatment due to costs, without increasing employment in the state. The study found that most of those who lost coverage were working and still eligible for Medicaid, but struggled with new reporting requirements, paperwork, and red tape.
The health insurance-work feedback loop. Research shows that having health insurance improves someone’s ability to find and maintain work, while poor health is associated with job loss. Taking away someone’s health insurance could leave them without health resources, making finding or keeping a job harder.

From my perspective, no matter how you slice it, reducing Medicaid funding and adding work requirements will result in millions losing health care coverage. When people lose access to health care, they are more likely to wait until they are sicker to get care, and often depend on emergency rooms. This will increase health care costs for people.

What happens next?

The bills will move on to the Senate for debate and approval. Congress will vote on them later this summer. You can call your representatives to let them know how you feel about the budget proposals. Here are some tips. Find their contact information here. If you’re a Medicaid recipient, it will be important to keep up to date with the latest information and reporting requirements as this evolves, so your coverage doesn’t fall through the cracks.

Changes to Covid-19 vaccine availability

Big changes may be coming to Covid-19 vaccine access in the United States, including here in New York. Last week, FDA Commissioner Marty Makary and his new adviser, Vinay Prasad, proposed limiting new Covid vaccine access to only people over 65 or those with chronic conditions. That means if you’re generally healthy and under 65, you may not be eligible for a booster this fall, or your insurance may not cover the shot. For more details, see YLE National’s deep dive.

If the proposed FDA policy goes through, the eligible chronic conditions are as follows:

Conditions for Covid-19 vaccine eligibility under the new proposed guidelines.

Judging from the New York State Department of Health estimates of chronic disease rates and our age demographics, only about half of New Yorkers may still qualify for Covid vaccines if the proposed changes go through. But nothing is final yet. The decision also depends on what specific vaccine the FDA recommends, who the CDC recommends should get it, and if a new formula is needed if a new variant comes onto the scene.

We’ll be watching closely and providing updates. This could impact millions of New Yorkers — and your ability to stay protected this respiratory season.

Bottom line

You’re all caught up! See you next week. 🙂

Love,

Your NY Epi

Trump’s team cited safety in limiting Covid shots. Patients, health advocates see more risk.

2025-05-23T15:32:52+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

Larry Saltzman has blood cancer. He’s also a retired doctor, so he knows getting Covid-19 could be dangerous for him — his underlying illness puts him at high risk of serious complications and death. To avoid getting sick, he stays away from large gatherings, and he’s comforted knowing healthy people who get boosters protect him by reducing his exposure to the virus.

Until now, that is.

Vaccine opponents and skeptics in charge of federal health agencies — starting at the top with Health and Human Services Secretary Robert F. Kennedy Jr. — are restricting access to Covid shots that were a signature accomplishment of President Donald Trump’s first term and cost taxpayers about $13 billion to develop. The agencies are narrowing vaccination recommendations, pushing drugmakers to perform costly clinical studies, and taking other steps that will result in fewer people getting protection from a virus that still kills hundreds each week in the United States.

“There are hundreds of thousands of people who rely on these vaccines,” said Saltzman, 71, of Sacramento, California. “For people who are immunocompromised, if there aren’t enough people vaccinated, we lose the ring that’s protecting us. We’re totally vulnerable.”

The Trump administration on Tuesday rolled out tougher approval requirements for Covid shots, described as a Covid-19 “vaccination regulatory framework,” that could leave millions of Americans who want boosters unable to get them.

The Food and Drug Administration will encourage new clinical trials on the widely used vaccines before approving them for children and healthy adults. The requirements could cost drugmakers tens of millions of dollars and are likely to leave boosters largely out of reach for hundreds of millions of Americans this fall.

Under the new guidance, vaccines will be available for high-risk individuals and seniors. But the FDA will encourage drugmakers to commit to conducting post-marketing clinical trials in healthy adults when the agency approves Covid vaccines for those populations.

For the past five years, the shots have been recommended by the Centers for Disease Control and Prevention for everyone 6 months and older. They have been available each fall after being updated to reflect circulating strains of the virus, and the vaccines have been shown to be safe and effective in clinical trials.

CDC funding cuts impact Georgia vaccine access, other public health programs

Vinay Prasad, who leads the FDA’s division overseeing vaccines, cited “distrust of the American public” as he announced the new guidelines at a briefing on Tuesday.

“We have launched down this multi-year campaign of booster after booster after booster,” he said, adding that “we do not have gold-standard science to support this for average-risk, low-risk Americans.”

The details were outlined in a Tuesday article in the New England Journal of Medicine, written by FDA Commissioner Marty Makary. He and Prasad later followed up with the briefing, which appeared the same day on YouTube.

The added limits on access aren’t the result of any recent data showing there are new health risks from the Covid vaccines. Instead, they reflect a different regulatory stance from Kennedy, who has a history of anti-vaccine activism, and Makary, who has questioned the safety data on Covid mRNA shots.

Announcing a major regulatory change in a medical journal and YouTube video is a highly unusual approach that still leaves many questions about implementation unanswered. It remains unclear when the changes will go into effect or whether there will be any public comment period. The changes were announced by the administration before an FDA advisory committee meeting on Thursday to consider the 2026 Covid vaccine formula.

It’s a sharp reversal from the first Trump administration, which launched Operation Warp Speed — the effort that led to the development of the Covid shots. Trump called the vaccines the “gold standard” and a “monumental national achievement.”

Concerns raised about higher transmission

The announcement is rattling some patient advocacy groups, doctors, nursing home leaders, and researchers who worry about the ramifications. They say higher-risk individuals will be more likely to get Covid if people who aren’t at risk don’t get boosters that can help reduce transmission. And they say the FDA’s restrictions go too far, because they don’t provide exceptions for healthy individuals who work in high-risk settings, such as hospitals, who may want a Covid booster for protection.

The limits will also make it harder to get insurance coverage for the vaccines. And the FDA’s new stance could also increase vaccine hesitancy by undermining confidence in Covid vaccines that have already been subject to rigorous safety review, said Kate Broderick, chief innovation officer at Maravai Life Sciences, which makes mRNA products for use in vaccine development.

“For the public, it raises questions,” she said. “If someone has concerns, I‘d like them to know that of all the vaccines, the ones with the most understood safety profile are probably Covid-19 vaccines. There is an incredible body of data and over 10 billion doses given.”

Some doctors and epidemiologists say it could leave healthy people especially vulnerable if more virulent strains of Covid emerge and they can’t access Covid shots.

“It’s not based on science,” said Rob Davidson, an emergency room doctor in Michigan and executive director of the Committee to Protect Health Care, which works to expand health care access. “It’s what we were all worried would happen. It risks peoples’ lives.”

Current federal regulators say there is no high-quality evidence showing that vaccinating healthy people, including health workers who are near or around immunocompromised people, provides an additional benefit.

“It is possible, actually, that such approvals and strategies provide false reassurance and lead to increased harms,” Prasad said.

NIH cuts halted CUNY research on Covid-19 vaccination and mental health. Here’s what that means for the unfinished project.

The Covid vaccines underwent clinical trials to assess safety, and they have been subject to ongoing surveillance and monitoring since they obtained emergency use authorization from the FDA amid the pandemic. Heart issues and allergic reactions can occur but are rare, according to the CDC.

On a separate track, the FDA on Wednesday posted letters sent in April to makers of the mRNA Covid vaccines to add information about possible heart injury on warning labels, a move that one former agency official described as overkill. The action came after the Permanent Subcommittee on Investigations, a panel of the Senate Homeland Security and Governmental Affairs Committee, held a hearing on alleged adverse events associated with Covid vaccines.

Limiting boosters to healthy people goes against guidance from some medical groups.

“The Covid-19 vaccine is safe, effective, and the best way to protect children,” Sean O‘Leary, chair of the Committee on Infectious Diseases at the American Academy of Pediatrics, said in an email. “Young children under 5 continue to be at the highest risk, with that risk decreasing as they get older.”

Unsupported claims circulating about mRNA vaccines

The Covid booster clampdown is supported by many adherents of the “Make America Healthy Again” movement, which casts suspicion on traditional medicine. Some opponents of Covid mRNA vaccines say without evidence that the shots cause “turbo” cancer, are genetic bioweapons, and cause more heart damage than the Covid virus.

There is no evidence the shots lead to rapid and aggressive cancers. Cancer rates decreased an average of 1.7% per year for men and 1.3% for women from 2018 to 2022, according to the National Institutes of Health. The Covid vaccines debuted in 2021.

Federal regulators say narrowing who can get the boosters will align the United States with policies of European nations. But other countries have vastly different economic structures for health care and approaches to preventive care. Many European countries, for example, don’t recommend flu shots for the entire population. The United States does in part because of the financial drain attributed to lost productivity when people are sick.

They also want more information. “I think there’s a void of data,” Makary told CBS News on April 29. “And I think rather than allow that void to be filled with opinions, I‘d like to see some good data.”

A massive five-year study on Covid vaccine safety by the Global Vaccine Data Network, involving millions of people, was underway, with about a year left before completion. The Trump administration terminated funding for the project as part of cuts directed by the president’s Department of Government Efficiency, and work on the study has stopped for now.

There are a multitude of studies, however, on the vaccines’ effectiveness in preventing severe illness, hospitalization, and death.

Limiting boosters for healthy people can be risky, some doctors say, because people don’t always know when they fall into higher-risk categories, such as individuals who are prediabetic or have high blood pressure. The Covid vaccine restrictions could deter them from getting boosted, and they might experience worse complications from the virus as a result. For example, about 40% of people with hepatitis C are unaware of their condition, according to a 2023 study.

The number of people getting Covid vaccines has dropped significantly since the height of the crisis. More than half of the more than 258 million adults in the United States had gotten a Covid vaccination as of May 2021, according to the CDC. In each of the past two seasons, less than 25% of Americans received boosters, CDC data shows.

While deaths from the virus have dropped, Covid remains a risk, especially when cases peak in December and January. Weekly Covid deaths topped 2,580 as recently as January 2024, according to CDC data.

Some high-risk individuals are worried that the new restrictions are just the first salvo in halting all access to mRNA shots. “The HHS motivation really is hidden, and it’s to dismiss all mRNA technology,” said Michael Osterholm, an epidemiologist at the University of Minnesota.

Officials at the NIH have told scientists to remove references to mRNA in grant applications. HHS also announced plans in May to develop new vaccines without mRNA technology, which uses messenger RNA to instruct cells to make proteins that trigger an immune response.

Rose Keller, 23, is concerned about future access to Covid shots. She would be eligible under the current announcement — she has cystic fibrosis, a progressive genetic condition that makes the mucus in her lungs thick and sticky, so Covid could land her in the hospital. But she is concerned the Trump administration may go further and restrict access to the vaccines as part of a broader opposition to mRNA technology.

“I‘ve had every booster that’s available to me,” said Keller, a government employee in Augusta, Maine. “It’s a real worry if I don’t have the protection of a Covid booster.”

This story originally published at KFF Health News, Healthbeat’s national reporting partner.

Emory survey of Georgia parents finds most believe childhood vaccines are safe

2025-05-06T11:00:00+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

In an Emory University survey of nearly 1,000 Georgia parents released Tuesday, 86% said they believe childhood vaccines are very or somewhat safe.

The purpose of the survey – which its organizers hope will become an annual report that helps track changes over time – was to find out what parents think about the well-being of their children.

The Emory professors worked with polling company Ipsos to conduct an online poll between late January and early March that represented the population of Georgia parents and analyzed the results.

Overall, nearly 86% of parents were confident vaccines are safe.

“Generally, parents trust the information they get,” said pediatrician Dr. Stephen Patrick, a professor at Emory’s Rollins School of Public Health who helped organize the survey.

Vaccination rates for deadly childhood diseases like measles are on the decline in Georgia, falling to 88% for young children, as measles cases surge across the country and newly appointed public health leaders like U.S. Health and Human Services Secretary Robert F. Kennedy Jr. promote misinformation about vaccines.

The survey, which also captured parents’ top concerns and unmet needs for their children’s health, broke down results by racial group, as well as geography. That analysis showed that a lower percentage of Black parents, 81.7%, thought routine childhood vaccines are very or somewhat safe; 91.7% of Hispanic parents thought the same.

Nearly three-quarters of respondents said they trust their child’s doctor to provide accurate information about vaccines. Other trusted sources include the Centers for Disease Control and Prevention, the Georgia Department of Public Health, county health departments, and the U.S. Food and Drug Administration.

Measles misinformation is on the rise — and Americans are hearing it, survey finds

Parents in rural and urban areas said they trust their child’s doctor at about equal levels, but rural parents placed greater levels of trust in the DPH and their county health department for vaccine information than urban parents did.

Doctors and others can be key “trusted messengers” to provide vaccine information to parents, Patrick said.

“Everything is local, especially in rural communities. That connection is paramount,” he said.

The survey also asked parents what they thought about school vaccine requirements.

Most parents – 55% – said childhood vaccines should be required, with many saying exemptions should be allowed for medical or religious reasons.

Georgia requires children to be vaccinated to attend school, including preschool, but parents can obtain religious or medical exemptions. Georgia’s vaccination rates are below the community or “herd” immunity rate needed to prevent widespread transmission of measles.

State public health workers contained an outbreak of three cases in one family earlier this year.

Education, bullying, violence among other concerns

The survey also asked parents to rank their top concerns for their children. These were the top five:

1. Education and school quality: 39%

2. Social media use: 34%

3. Bullying, including cyberbullying: 32%

4. Gun violence: 27%

5. Mental health and suicide: 25%

The results varied by ethnicity, the report said. Hispanic and Black parents were most concerned about gun violence, while white parents were most concerned about social media use. Hispanic and Black parents were also concerned about racism, while white parents were not.

Rural parents listed drug and alcohol use as one of their top concerns, while urban parents ranked gun violence in the top five.

Even though bullying or social media may not be traditional public health issues, they are important to children’s health.

“All of these things are intertwined,” Patrick said. “You can’t neatly piece them apart.”

The study also asked parents about their concerns about alcohol and drug use.

Overall, about one-third of parents believed unused prescription opioid pills were the main cause of adolescent overdose deaths. Another third thought counterfeit pills that contained fentanyl or other dangerous drugs were the main cause.

Patrick said the leading cause of overdose deaths among adolescents is counterfeit pills that contain fentanyl.

“Talk to your kids about counterfeit pills and their dangers,” Patrick said. While prescription pills can be a risk, parents need to talk about counterfeit pills to their children.

Nearly two-thirds of the parents surveyed said they thought schools are less safe than they were 10 years ago.

Nearly half of parents reported keeping firearms in their home or garage. While the American Academy of Pediatrics recommends counseling families on firearm safety, only about a quarter of the parents in the survey said their pediatrician had asked about safe gun storage.

Unmet needs include mental health services, food

The study also found that 3 of 5 children in Georgia, or 63%, have been diagnosed with mental or behavioral conditions but are not receiving mental health services.

“There are incredible challenges to getting access to mental health services in the entire U.S.,” Patrick said.

Federal data show that more than one-third of Georgia households with children are food insecure. More than half of parents in the survey reported changing their food spending habits in the past year, including by stopping or reducing eating out, changing the types of food they eat, and changing where they buy groceries. Nearly a quarter, or 23%, of parents reported skipping meals.

Ninety-one percent of the parents polled supported free breakfast and lunch for all children in Georgia public schools.

It’s important to ensure Georgia children have the services they need, said Mindy Binderman, executive director of the Georgia Early Education Alliance for Ready Students.

“Children’s most rapid and consequential brain growth happens in early childhood — at a rate of 1 million new neural connections formed every second. … I, too, worry about kids’ mental health, access to care, and education quality,” Binderman said.

GEEARS is pushing to preserve programs like Medicaid, which provides health insurance to low-income children, and Head Start, which provides early childhood education, in Georgia.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Trump team’s $500 million bet on old vaccine technology puzzles scientists

2025-05-05T13:57:10+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

The Trump administration’s unprecedented $500 million grant for a broadly protective flu shot has confounded vaccine and pandemic preparedness experts, who said the project was in early stages, relied on old technology, and was just one of more than 200 such efforts.

Health and Human Services Secretary Robert F. Kennedy Jr. shifted the money from a pandemic preparedness fund to a vaccine development program led by two scientists whom the administration recently named to senior positions at the National Institutes of Health.

While some experts were pleased that Kennedy had supported any vaccine project, they said the Thursday announcement contravened sound scientific policy, appeared arbitrary, and raised the kinds of questions about conflicts of interest that have dogged many of President Donald Trump’s actions.

Focusing vast resources on a single vaccine candidate “is a little like going to the Kentucky Derby and putting all your money on one horse,” said William Schaffner, a Vanderbilt University professor and past president of the National Foundation for Infectious Diseases. “In science we normally put money on a number of different horses because we can’t be entirely sure who’s going to win.”

Others were mystified by the decision, since the candidate vaccine uses technology that was largely abandoned in the 1970s and eschews techniques developed in recent decades through funding from the Department of Health and Human Services and the Defense Department.

“This is not a next-generation vaccine,” said Rick Bright, who led HHS’s Biomedical Advanced Research and Development Authority in the first Trump administration. “It’s so last-generation, or first-generation, it’s mind-blowing.”

The vaccine is being developed at the National Institute for Allergy and Infectious Diseases by Jeffery Taubenberger, whom Trump named as acting chief of the institute in late April, and his colleague Matthew Memoli, a critic of U.S. Covid-19 policy whom Trump picked to lead the NIH until April 1, when Jay Bhattacharya took office. Bhattacharya named Memoli his principal deputy.

Taubenberger gained fame as an Armed Forces Institute of Pathology scientist in 1997 when his lab sequenced the genome of the 1918 pandemic influenza virus, using tissue samples from U.S. troops who died in that plague. He joined the NIH in 2006.

Broadly protective flu shot is not a new idea

In a Thursday news release, HHS called the Taubenberger-Memoli vaccine initiative “Generation Gold Standard,” saying it represented “a decisive shift toward transparency, effectiveness, and comprehensive preparedness.” Bhattacharya said it represented a “paradigm shift.”

But the NIH vaccine-makers’ goal of creating a shot that protects against multiple or all strains of influenza — currently vaccines must be given each year to account for shifts in the virus — is not new.

Then-NIAID Director Anthony Fauci launched a network of academic researchers in pursuit of a broadly protective flu vaccine in 2019. In addition to that NIH-led consortium, more than 200 flu vaccines are under development in the United States and other countries.

Many use newer technologies, and some are at more advanced stages of human testing than the Taubenberger vaccine, whose approach appears basically the same as the one used in flu vaccines starting in 1944, Bright said.

Public health labs are being defunded. Here’s what that means for disease surveillance.

In the news release, HHS described the vaccine as “in advanced trials” and said it would induce “robust” responses and “long-lasting protection.” But Taubenberger and his colleagues haven’t published a complete human study of the vaccine yet. A study showing the vaccine protected mice from the flu appeared in 2022.

For Operation Warp Speed, which led to the creation of the Covid vaccine during Trump’s first term, government scientists reviewed detailed plans and data from academic and commercial laboratories vying for federal money, said Greg Poland, a flu expert and president of the Atria Health Academy of Science and Medicine. “If that’s happening here, it’s opaque to me,” he said.

When asked what data beyond its press release supported the decision, HHS spokesperson Andrew Nixon pointed to the agency’s one-page statement. Asked whether the decision would curtail funding for the Fauci-created consortium or other universal vaccine approaches, Nixon did not specifically respond. “Generation Gold Standard is the most promising,” he said in an email.

Taubenberger did not respond to a request for comment. Nixon and NIH spokesperson Amanda Fine did not respond to requests for an interview with Taubenberger or Memoli.

The HHS statement stressed that by developing the vaccine in-house, the government “ensures radical transparency, public accountability, and freedom from commercial conflicts of interest.” While any vaccine would eventually have to be made commercially, NIH involvement through more stages of development could give the government greater influence on any vaccine’s eventual price, Schaffner said.

Inactivation method is a blast from the past

If the mRNA-based Covid shots produced by Moderna and Pfizer-BioNTech represented the cutting edge of vaccine technology, applying ultra-sophisticated approaches never before seen in an inoculation, the approach by Taubenberger and Memoli represents a blast from the past.

Their vaccine is made by inactivating influenza viruses with a carcinogenic chemical called beta-propiolactone. Scientists have used the chemical to neutralize viruses since at least the 1950s. This whole-virus inactivation method, mostly using other chemicals, was the standard way to make flu vaccines into the 1970s, when it was modified, partly because whole-virus vaccines caused high fevers or even seizures in children.

The limited published data from the Taubenberger vaccine, from an initial safety trial involving 45 patients, showed no major side effects. The scientists are testing the vaccine as a regular shot and as an intranasal spray with the idea of stopping the virus in the respiratory tract before it causes a broad infection.

“The notion of a universal influenza A pandemic vaccine is a good one,” said Poland, who called Taubenberger an excellent scientist. But he added: “I’m not so sure about the platform, and the dollar amount is a puzzler. This vaccine’s in very early development.”

Paul Friedrichs, a retired Air Force general who led the Office of Pandemic Preparedness and Response Policy in President Joe Biden’s White House, said that “giving $500 million upfront with very little data to support it is unlike anything I’ve ever seen.”

“The technology for developing vaccines has tremendously evolved over many decades,” Friedrichs said. “Why would we go back to an approach historically associated with greater or more frequent adverse events?”

The government appeared to be transferring the money for the Taubenberger vaccine development from an existing $1.3 billion vaccine fund at Project NextGen, a mostly Covid-focused program at BARDA, Friedrichs said. Most of that money was earmarked to support advanced research on Covid and other viral vaccines, including those protecting against emerging diseases.

It is “very concerning that we’re de-emphasizing Covid, which we may live to regret,” Poland said. “It assumes we won’t have a Covid variant that escapes the current moderately high levels of Covid immunity.”

Measles misinformation is on the rise — and Americans are hearing it, survey finds

Nixon said Project NextGen, for which some funds were earmarked for mRNA research, is under review. Kennedy is critical of mRNA vaccines, once claiming, falsely, that they are the deadliest vaccines in history.

Ted Ross, director of global vaccine development at the Cleveland Clinic, said he was “happy to see them investing in respiratory vaccines, including a universal flu vaccine, with all the programs they’ve been cutting.”

“But I don’t think this is the only approach,” Ross said. “Other universal flu vaccines are in progress, and their success and failure are not known yet.”

His team, part of the NIAID-funded flu vaccine consortium, is using artificial intelligence and computer modeling to design vaccines that produce the broadest immunity to influenza, including seasonal and pandemic strains.

As interim director, Memoli oversaw the start of the administration’s massive cuts at the NIH, with the elimination of some 800 agency grants worth over $2 billion. More than 1,200 NIH employees have been fired, and many researchers, including Ross, are in limbo.

His lab is close to testing a candidate vaccine on people, Ross said, while waiting to find out about its NIH funding. “I’m not sure whether my contract is on the chopping block,” he said.

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

Measles misinformation is on the rise — and Americans are hearing it, survey finds

2025-04-23T15:24:05+00:00

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While the most serious measles epidemic in a decade has led to the deaths of two children and spread to 27 states with no signs of letting up, beliefs about the safety of the measles vaccine and the threat of the disease are sharply polarized, fed by the anti-vaccine views of the country’s most senior health official.

About two-thirds of Republican-leaning parents are unaware of an uptick in measles cases this year, while about two-thirds of Democratic ones knew about it, according to a KFF survey released Wednesday.

Republicans are far more skeptical of vaccines and twice as likely (1 in 5) as Democrats (1 in 10) to believe the measles shot is worse than the disease, according to the survey of 1,380 U.S. adults.

Some 35% of Republicans answering the survey, which was conducted April 8-15 online and by telephone, said the discredited theory linking the measles, mumps, and rubella vaccine to autism was definitely or probably true — compared with just 10% of Democrats.

The trends are roughly the same as KFF reported in a June 2023 survey. But in the new poll, 3 in 10 parents erroneously believed that vitamin A can prevent measles infections, a theory Health and Human Services Secretary Robert F. Kennedy Jr. has brought into play since taking office during the measles outbreak.

About 900 cases have been reported in 27 U.S. states, mostly in a West Texas-centered outbreak.

Georgia contained a measles outbreak. But low vaccination rates keep the state vulnerable.

“The most alarming thing about the survey is that we’re seeing an uptick in the share of people who have heard these claims,” said co-author Ashley Kirzinger, associate director of KFF’s Public Opinion and Survey Research Program. KFF is a health information nonprofit that includes KFF Health News.

“It’s not that more people are believing the autism theory, but more and more people are hearing about it,” Kirzinger said. Since doubts about vaccine safety directly reduce parents’ vaccination of their children, “that shows how important it is for actual information to be part of the media landscape,” she said.

“This is what one would expect when people are confused by conflicting messages coming from people in positions of authority,” said Kelly Moore, president and CEO of Immunize.org, a vaccination advocacy group.

Numerous scientific studies have established no link between any vaccine and autism. But Kennedy has ordered HHS to undertake an investigation of possible environmental contributors to autism, promising to have “some of the answers” behind an increase in the incidence of the condition by September.

The deepening Republican skepticism toward vaccines makes it hard for accurate information to break through in many parts of the nation, said Rekha Lakshmanan, chief strategy officer at The Immunization Partnership, in Houston.

Lakshmanan on Wednesday was to present a paper on countering anti-vaccine activism to the World Vaccine Congress in Washington. It was based on a survey that found that in the Texas, Louisiana, Arkansas, and Oklahoma state assemblies, lawmakers with medical professions were among those least likely to support public health measures.

“There is a political layer that influences these lawmakers,” she said. When lawmakers invite vaccine opponents to testify at legislative hearings, for example, it feeds a deluge of misinformation that is difficult to counter, she said.

Eric Ball, a pediatrician in Ladera Ranch, California, which was hit by a 2014-15 measles outbreak that started in Disneyland, said fear of measles and tighter California state restrictions on vaccine exemptions had staved off new infections in his Orange County community.

“The biggest downside of measles vaccines is that they work really well. Everyone gets vaccinated, no one gets measles, everyone forgets about measles,” he said. “But when it comes back, they realize there are kids getting really sick and potentially dying in my community, and everyone says, ‘Holy crap; we better vaccinate!’”

Ball treated three very sick children with measles in 2015. Afterward his practice stopped seeing unvaccinated patients. “We had had babies exposed in our waiting room,” he said. “We had disease spreading in our office, which was not cool.”

Although two otherwise healthy young girls died of measles during the Texas outbreak, “people still aren’t scared of the disease,” said Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, which has seen a few cases.

But the deaths “have created more angst, based on the number of calls I’m getting from parents trying to vaccinate their 4-month-old and 6-month-old babies,” Offit said. Children generally get their first measles shot at age 1, because it tends not to produce full immunity if given at a younger age.

Arthur Allen is a reporter for KFF Health News, Healthbeat’s national reporting partner.

CDC funding cuts impact Georgia vaccine access, other public health programs

2025-04-23T14:32:59+00:00

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Groups that work to provide access to vaccines, especially for Black Georgians and others in underserved communities, are among those affected as the state Department of Public Health absorbs a $334.2 million loss from the Centers for Disease Control and Prevention.

The abrupt cancellation of funds announced March 25 sent DPH leaders scrambling to understand the impact and inform contractors, including many community organizations, to stop work immediately, according to emails Healthbeat obtained under open records laws.

“I personally called several of these recipients myself, as these funds were not slated to end until late 2026,” Georgia Public Health Commissioner Kathleen Toomey wrote March 28 to Amy Doehrman and Russell Crutchfield, the deputy and chief operating officers, respectively, in the governor’s office.

Cuts to CDC Covid-era funding totaled nearly $12 billion nationwide. “These grants and cooperative agreements were issued for a limited purpose: to ameliorate the effects of the pandemic. Now that the pandemic is over, [they] are no longer necessary as their limited purpose has run,” stated a federal notice to grant awardees.

Federal cuts force Out of Hand Theater to halt vaccine outreach, affecting overall operations

A group of Democratic-led states have filed a lawsuit challenging the cuts, prompting a federal judge to issue a temporary restraining order blocking the reductions. But the order does not apply to Georgia, which is not among the states that sued.

DPH has shared few details about how the cuts will impact its work and did not respond to multiple requests for more information. Leaders at the Cobb and Douglas Public Health said in March that they would lose about $467,000. State officials have said the agency’s core services will continue.

Many of the affected community groups couldn’t be reached or declined to comment.

Here’s what we know.

Epidemiology lab capacity funding cut

State epidemiologist Dr. Cherie Drenzek notified Toomey and DPH agency leaders at 10:10 a.m. on March 25 that she had received a notice terminating CDC “epidemiology laboratory capacity” Covid funding. The funding was a Covid supplement to regular CDC lab funding to support state public health laboratory capacity.

Later that day, Drenzek wrote to senior leaders that only one grant had been impacted: “‘Only’ but HUGE.” The grant apparently had a previous end date of July 31, 2026. DPH did not respond to requests for additional information about how the state’s lab services would be impacted.

By that evening, the agency had started sending out termination notices to temporary employees “due to loss of funding.” The agency laid off 170 temporary contact tracers, according to DPH spokesperson Nancy Nydam.

Another 13 employees were laid off, including four who worked in epidemiology, four who worked on lab services, and three who worked on emergency preparedness, Nydam said.

Sean Penn’s CORE loses $3.3 million for vaccine work

The Community Organized Relief Effort, founded by actor Sean Penn, lost nearly $3.3 million of Vaccines for Children Covid funding, according to a preliminary spreadsheet Healthbeat obtained via an open records request.

Penn co-founded CORE in 2010 in response to an earthquake in Haiti. CORE now bills itself as a “global humanitarian organization.” It started working in Georgia during the Covid-19 pandemic and has since continued to help underserved communities get access to vaccines, according to its website.

Georgia contained a measles outbreak. But low vaccination rates keep the state vulnerable.

CORE hosted 90 mobile vaccination events and administered 385 vaccines in March 2025 at a women’s shelter, a flea market in Pendergrass, Ga., a community shower and hygiene event in Clayton County, and others, according to a report submitted to DPH last month. Since March 2021, CORE has administered more than 149,000 Covid vaccines in Georgia.

“While DPH would like to provide sufficient notice, we must ask CORE to cease all activities effective tomorrow,” DPH Deputy Commissioner Chris Rustin wrote in a March 25 email to Sam Archbold, CORE’s Georgia area director.

The loss of CDC funds comes after CORE in February lost about $5 million of a $12 million contract with DPH to coordinate and manage Covid and flu vaccine events and outreach in high-risk and underserved communities, according to documents.

Atlanta nonprofit loses about $500,000 for vaccine equity work

Atlanta nonprofit BLKHLTH Inc. lost about half a million dollars in federal funding, co-founder Kadijah Ameen said.

The organization received notice of the cuts in late March, resulting in the cancellation of 10 upcoming events under a federal grant focused on Covid vaccine equity, Ameen said. BLKHLTH had planned to use information gleaned from listening sessions across the state to shape vaccine outreach efforts.

“We’re using data from the listening sessions to form our community-based vaccine clinics….We had to halt that programming,” Ameen said. “It was disruptive.”

Concerns over whether information about Covid and vaccines could be removed from the CDC website under orders from the Trump administration added urgency to BLKHLTH’s work, Ameen said.

“We don’t know how long Covid-19 info is going to be on the CDC website, and so we want to make sure that folks had a space to access information that was culturally responsive,” Ameen said. The group’s listening sessions had revealed that Black Georgians want reliable vaccine information that can help “cut through … disinformation.”

The hit to her organization’s budget was large, Ameen said. “We are a small non-profit and this was a million-dollar reimbursable grant, so that was a large percentage of our anticipated budget for the year.”

The organization has rearranged funding and plans to find alternative sources to continue its vaccine work, Ameen said.

Center for Black Women’s Wellness loses funds

The news prompted swift dismay from Jamea Dorsey, president and CEO of the Atlanta nonprofit Center for Black Women’s Wellness, which lost about $438,000 in the cuts, according to the preliminary spreadsheet.

“We are saddened and disappointed, especially due to the fact that we are receiving this communications after our Covid outreach event and listening session, which occurred on 3/25, and we have another event scheduled for tomorrow,” Dorsey wrote in a March 26 email to Jamillia Valentine, director of office of procurement and contracting services at DPH.

The organization was notified March 26 that its contract had ended at midnight two days before.

“Will we not be compensated for this work? These expenses were committed and allocated prior to 3/24,” Dorsey wrote. “Please advise, as this will cause hardship for our organization.”

“We are also deeply concerned about the loss of trust in the community,” Dorsey added.

Dorsey did not respond to a request for comment. The center provides health care services and maternal and postpartum support. It had about $3.3 million in revenue in 2023, according to its tax documents.

Red Covid testing kiosks removed

Red self-serve Covid testing kiosks DPH set up during the pandemic are being removed. They were provided under a contract with Longview International Technology Services, according to the spreadsheet of preliminary cuts.

The kiosks were programmed to deactivate on March 31, with Longview set to pick them up, according to an email from Rustin to district health directors.

“DPH has already paid for the test kits in the machines, so any expense between 3/24 and 3/31 will be absorbed by LTS.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

NIH cuts halted CUNY research on Covid-19 vaccination and mental health. Here’s what that means for the unfinished project.

2025-04-18T16:44:04+00:00

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As the Covid-19 pandemic spread through New York City in March 2020, researchers affiliated with the City University of New York launched a nationwide research project tracking the disease, its financial and mental health impacts, and eventually, vaccine uptake.

Over time, they became particularly interested in understanding the barriers to Covid-19 vaccination for people with anxiety and depression. That led to a research project funded by about $3 million from the National Institutes of Health, exploring what prevents people with anxiety and depression from getting vaccinated, and testing out possible interventions.

But last month, the project’s grant was terminated, part of a wave of deep cuts to NIH funding that has impacted research institutions throughout New York and the United States. The team of about 15 people working on the project had completed collecting data, but still had significant analysis and writing to do, said Dr. Denis Nash, a distinguished professor of epidemiology at the CUNY School of Public Health and one of the project’s principal investigators, alongside Dr. Angela Parcesepe, an associate professor at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill.

Dr. Denis Nash is a distinguished professor of epidemiology at the CUNY School of Public Health and the executive director of the CUNY Institute for Implementation Science in Population Health in New York.

It was a “devastating” development for research that took root at the start of the pandemic, Nash, who is also the executive director of the CUNY Institute for Implementation Science in Population Health, told Healthbeat.

Last spring, CUNY researchers had recruited about 1,500 people from their CHASING COVID Cohort Study who had received a primary series Covid-19 vaccination but were not up to date on their vaccines. As part of the study, participants were texted or emailed a questionnaire that included a link to one of three videos showing an interaction between a doctor and patient. One video used cognitive behavioral therapy techniques to encourage vaccination, another countered vaccine misinformation, and a third presented standard public health messaging on the benefits of vaccination. Researchers returned to the participants after four weeks and again at six months to record their vaccination status.

In this interview, edited for length and clarity, Nash describes what his team’s research involved, and what it means to have their grant terminated.

Where did this research emerge from?

[The CHASING COVID Cohort Study] measured mental health and depression and anxiety pretty frequently over the course of the four or five years that we followed the cohort. When things started to subside with the pandemic, we were realizing that the next set of problems is: How do we contribute to an understanding of improving vaccination outcomes?

Amid fears of deeper federal cuts, New York health leaders affirm commitment to health equity

When we started this latest study, maybe 21% of adults around the U.S. had received the latest Covid vaccine, which is not nearly as high as it needs to be. Angela and I decided to do something we hadn’t done with the cohort before, which was to develop some kind of intervention that we could deploy to see if we could improve outcomes. Before that, we were just observing people and gathering information about them. It was useful and important, but we had not tried to see if there were things that we could do to influence their health behaviors and outcomes.

We had another researcher on the team who had done some intervention work around inoculation theory, around misinformation and disinformation. It’s this idea that if you prepare people in advance that they might be exposed to inaccurate information, or deliberately deceptive information, when they are confronted with those messages later on, they’re better prepared to deal with it and not be manipulated by it.

Based on our research, we learned that people with common mental disorders in our cohort were more likely to endorse misinformation and disinformation. In other words, they were more likely to cite that as reasons for not being vaccinated. And they also reported barriers that especially the mental health experts on our team thought could be overcome, with cognitive behavioral therapy-type interventions.

So we designed these three brief videos, and we wanted to see if we randomized people to get one of these three videos, did it have an effect on people’s decision to get vaccinated over the subsequent four weeks? Did it change their likelihood of making an appointment, or deciding to make an appointment, and then actually going to get vaccinated?

What did your research find?

We didn’t, unfortunately, see an impact of the intervention on outcomes. But it was important for us to do the study to assess whether there was a theory-informed low-touch strategy that could be used here. There have been other studies in the literature, for example, where pharmacies would send text outreach reminders to people, and [differences in vaccine uptake] tended to be pretty small, like a 1% increase. That’s in line with what we saw. But we were taking a different approach, in that we were trying to get people to engage in a way of thinking about what might be delaying them or getting in the way of something they want or feel that they need.

Did the research suggest interventions that could work better?

The things that are getting in the way among people who have been vaccinated before, but are not up to date, are bigger than a brief one-minute video could potentially overcome. It doesn’t mean that an approach like this couldn’t work; it may need to be a little more intensive in some ways.

How did you find out your funding was terminated?

I was at an HIV conference in San Francisco at the time, and I heard from a reporter at Science that a reputable source at NIH leaked a list of canceled grants. Mine was on it; did I care to comment?

Local health projects across New York in limbo after abrupt HHS cuts

We had heard in the days before that there were going to be a bunch of vaccine-related grants canceled. We were bracing ourselves, but the messaging was such that everyone whose grant was canceled had been told the night before. So part of me was thinking, maybe we dodged a bullet. But the fact was, they hadn’t told everyone yet. A few hours after that interaction with the reporter, we got the official notice from NIH.

It was devastating. It was a horrible time. The feeling at this conference was kind of like a funeral. I was running into so many people with cancelled grants. The Columbia cancellations had just happened, and my colleagues from Columbia were there. It was a horrible week.

Where does this leave your research?

The devastating thing is that we still had a lot of analysis and writing to do, and it was all abruptly halted when the grant was canceled. So we have the paper with the four-week outcomes that was already submitted to a journal. We are busily revising that, but there are many other papers that we want to write to contribute to this knowledge, that we’re not going to be able to do, or it’s going to happen way more slowly.

We have faculty and staff, and many of the staff are PhD and master’s students that we pay to work on these research projects, and they learn how to do research in the process. [Now] they’re not allowed to work on it because we don’t have funding to support it. They can volunteer their time to do that, but that’s not the same as paying someone 40 hours a week to do data cleaning, to help us do literature searches, and analyze data in support of preparing a manuscript. It’s really a team effort. Without paid staff, it’s going to move much more slowly.

What did it mean for you to have NIH supporting this research?

We launched the [CHASING COVID Cohort] of our own accord, with very limited institutional funds, but we thought it was important to start. At the same time, we wrote a grant to NIH to support it going forward, including the blood specimens we needed to collect from all participants over time. And we did get emergency funds from NIH to do the cohort.

So the investment in this work goes way back, to March of 2020, on the part of NIH. If you want to think about efficiency, in this particular grant, they paid for all the data collection. And participants have volunteered their time and contributions to the work, only to have the most important part — the contributions to knowledge, to science, to the field — be abruptly curtailed. It is a huge loss, and definitely not part of the mission of NIH and [the U.S. Department of Health and Human Services]. They’re all about trying to contribute to scientific knowledge and improving public health outcomes. It’s a very untimely termination.

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org.

Beyond Ivy League, RFK Jr.’s NIH slashed science funding across states that backed Trump

2025-04-17T13:54:38+00:00

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The National Institutes of Health’s sweeping cuts of grants that fund scientific research are inflicting pain almost universally across the United States, including in most states that backed President Donald Trump in the 2024 election.

A KFF Health News analysis underscores that the terminations are sparing no part of the country, politically or geographically. About 40% of organizations whose grants the NIH cut in its first month of slashing, which started Feb. 28, are in states Trump won in November.

The Trump administration has singled out Ivy League universities including Columbia and Harvard for broad federal funding cuts. But the spending reductions at the NIH, the nation’s foremost source of funding for biomedical research, go much further: Of about 220 organizations that had grants terminated, at least 94 were public universities, including flagship state schools in places such as Florida, Georgia, Ohio, Nebraska, and Texas.

The Trump administration has canceled hundreds of grants supporting research on topics such as vaccination; diversity, equity, and inclusion; and the health of LGBTQ+ populations. Some of the terminations are a result of Trump’s executive orders to abandon federal work on diversity and equity issues. Others followed the Senate confirmation of anti-vaccine activist Robert F. Kennedy Jr. to lead the Department of Health and Human Services, which oversees the NIH. Many mirror the ambitions laid out in Project 2025’s “Mandate for Leadership,” the conservative playbook for Trump’s second term.

Affected researchers say Trump administration officials are taking a cudgel to efforts to improve the lives of people who often experience worse health outcomes — ignoring a scientific reality that diseases and other conditions do not affect all Americans equally.

KFF Health News found that the NIH terminated about 780 grants or parts of grants between Feb. 28 and March 28, based on documents published by the Department of Health and Human Services and a list maintained by academic researchers. Some grants were canceled in full, while in other cases, only supplements — extra funding related to the main grant, usually for a shorter-term, related project — were terminated.

Among U.S. recipients, 96 of the institutions that lost grants in the first month are in politically conservative states including Florida, Ohio, and Indiana, where Republicans control the state government or voters reliably support the GOP in presidential campaigns, or in purple states such as North Carolina, Michigan, and Pennsylvania that were presidential battleground states. An additional 124 institutions are in blue states.

Sybil Hosek, a research professor at the University of Illinois-Chicago, helps run a network that focuses on improving care for people 13 to 24 years old who are living with or at risk for HIV. The NIH awarded Florida State University $73 million to lead the HIV project.

“We never thought they would destroy an entire network dedicated to young Americans,” said Hosek, one of the principal investigators of the Adolescent Medicine Trials Network for HIV/AIDS Interventions. The termination “doesn’t make sense to us.”

NIH official Michelle Bulls is director of the Office of Policy for Extramural Research Administration, which oversees grants policy and compliance across NIH institutes. In terminating the grant March 21, Bulls wrote that research “based primarily on artificial and nonscientific categories, including amorphous equity objectives, are antithetical to the scientific inquiry, do nothing to expand our knowledge of living systems, provide low returns on investment, and ultimately do not enhance health, lengthen life, or reduce illness.”

The U.S. was on track to end the HIV epidemic. Budget cuts threaten that progress.

Adolescents and young adults ages 13 to 24 accounted for 1 in 5 new HIV infections in the United States in 2022, according to the Centers for Disease Control and Prevention.

“It’s science in its highest form,” said Lisa Hightow-Weidman, a professor at Florida State University who co-leads the network. “I don’t think we can make America healthy again if we leave youth behind.”

HHS spokesperson Emily Hilliard said in an emailed statement that “NIH is taking action to terminate research funding that is not aligned with NIH and HHS priorities.” The NIH and the White House didn’t respond to requests for comment.

“As we begin to Make America Healthy Again, it’s important to prioritize research that directly affects the health of Americans. We will leave no stone unturned in identifying the root causes of the chronic disease epidemic as part of our mission to Make America Healthy Again,” Hilliard said.

Cuts bring harm to HIV, vaccine studies

The NIH, with its nearly $48 billion annual budget, is the largest public funder of biomedical research in the world, awarding nearly 59,000 grants in the 2023 fiscal year. The Trump administration has upended funding for projects that were underway, stymied money for new applications, and sought to reduce how much recipients can spend on overhead expenses.

Those changes — plus the firing of 1,200 agency employees as part of mass layoffs across the government — are alarming scientists and NIH workers, who warn that they will undermine progress in combating diseases and other threats to the nation’s public health. On April 2, the American Public Health Association, Ibis Reproductive Health, and affected researchers, among others, filed a lawsuit in federal court against the NIH and HHS to halt the grant cancellations.

Two National Cancer Institute employees, who were granted anonymity because they were not authorized to speak to the press and feared retaliation, said its staff receives batches of grants to terminate almost daily. On Feb. 27, the cancer institute had more than 10,800 active projects, the highest share of the NIH’s roughly two dozen institutes and centers, according to the NIH’s website. At least 47 grants that NCI awarded were terminated in the first month.

Local health projects across New York in limbo after abrupt HHS cuts

Kennedy has said the NIH should take a years-long pause from funding infectious disease research. In November 2023, he told an anti-vaccine group, “I’m gonna say to NIH scientists, ‘God bless you all. Thank you for public service. We’re going to give infectious disease a break for about eight years,’” according to NBC News.

For years, Kennedy has peddled falsehoods about vaccines — including that “no vaccine” is “safe and effective,” and that “there are other studies out there” showing a connection between vaccines and autism, a link that has repeatedly been debunked — and claimed falsely that HIV is not the only cause of AIDS.

KFF Health News found that grants in blue states were disproportionately affected, making up roughly two-thirds of terminated grants, many of them at Columbia University. The university had more grants terminated than all organizations in politically red states combined. On April 4, Democratic attorneys general in 16 states sued HHS and the NIH to block the agency from canceling funds.

Researchers whose funding was stripped said they stopped clinical trials and other work on improving care for people with HIV, reducing vaping and smoking rates among LGBTQ+ teens and young adults, and increasing vaccination rates for young children. NIH grants routinely span several years.

For example, Hosek said that when the youth HIV/AIDS network’s funding was terminated, she and her colleagues were preparing to launch a clinical trial examining whether a particular antibiotic that is effective for men to prevent sexually transmitted infections would also work for women.

“This is a critically important health initiative focused on young women in the United States,” she said. “Without that study, women don’t have access to something that men have.”

Other scientists said they were testing how to improve health outcomes among newborns in rural areas with genetic abnormalities, or researching how to improve flu vaccination rates among Black children, who are more likely to be hospitalized and die from the virus than non-Hispanic white children.

“It’s important for people to know that — if, you know, they are wondering if this is just a waste of time and money. No, no. It was a beautiful and rare thing that we did,” said Joshua Williams, a pediatric primary care doctor at Denver Health in Colorado who was researching whether sharing stories about harm experienced due to vaccine-preventable diseases — from missed birthdays to hospitalizations and job loss — might inspire caregivers to get their children vaccinated against the flu.

He and his colleagues had recruited 200 families, assembled a community advisory board to understand which vaccinations were top priorities, created short videos with people who had experienced vaccine-preventable illness, and texted those videos to half of the caregivers participating in the study.

They were just about to crack open the medical records and see if it had worked: Were the group who received the videos more likely to follow through on vaccinations for their children? That’s when he got the notice from the NIH.

“It is the policy of NIH not to prioritize research activities that focuses gaining scientific knowledge on why individuals are hesitant to be vaccinated and/or explore ways to improve vaccine interest and commitment,” the notice read.

Williams said the work was already having an impact as other institutions were using the idea to start projects related to cancer and dialysis.

Grant terminations hit work to improve rural health care

Congress previously tried to ensure that NIH grants also went to states that historically have had less success obtaining biomedical research funding from the government. Now those places aren’t immune to the NIH’s terminations.

Sophia Newcomer, an associate professor of public health at the University of Montana, said she had 18 months of work left on a study examining undervaccination among infants, which means they were late in receiving recommended childhood vaccines or didn’t receive the vaccines at all. Newcomer had been analyzing 10 years of CDC data about children’s vaccinations and had already found that most U.S. infants from 0 to 19 months old were not adequately vaccinated.

Her grant was terminated March 10, with the NIH letter stating the project “no longer effectuates agency priorities,” a phrase replicated in other termination letters KFF Health News has reviewed.

CDC cuts hit HIV prevention program, jeopardizing decades of progress on reducing infant transmission rates

“States like Montana don’t get a lot of funding for health research, and health researchers in rural areas of the country are working on solutions to improve rural health care,” Newcomer said. “And so cuts like this really have an impact on the work we’re able to do.”

Montana is one of 23 states, along with Puerto Rico, that are eligible for the NIH’s Institutional Development Award program, meant to bolster NIH funding in states that historically have received less investment. Congress established the program in 1993.

The NIH’s grant terminations hit institutions in 15 of those states, more than half that qualify, plus Puerto Rico.

Researchers can’t ‘just do it again later’

The NIH’s research funds are deeply entrenched in the U.S. health care system and academia. Rarely does an awarded grant stay within the four walls of a university that received it. One grant’s money is divvied up among other universities, hospitals, community nonprofits, and other government agencies, researchers said.

Erin Kahle, an infectious disease epidemiologist at the University of Michigan, said she was working with Emory University in Georgia and the CDC as part of her study. She was researching the impact of intimate partner violence on HIV treatment among men living with the virus. “They are relying on our funds, too,” she said.

Kahle said her top priority was to ethically and safely wind down her nationwide study, which included 418 people, half of whom were still participating when her grant was terminated in late March. Kahle said that includes providing resources to participants for whom sharing experiences of intimate partner violence may cause trauma or mental health distress.

Rachel Hess, the co-director of the Clinical & Translational Science Institute at the University of Utah, said the University of Nevada-Reno and Intermountain Health, one of the largest hospital systems in the West, had received funds from a $38 million grant that was awarded to the University of Utah and was terminated March 12.

The institute, which aims to make scientific research more efficient to speed up the availability of treatments for patients, supported over 5,000 projects last year, including 550 clinical trials with 7,000 participants. Hess said that, for example, the institute was helping design a multisite study involving people who have had heart attacks to figure out the ideal mix of medications “to keep them alive” before they get to the hospital, a challenge that’s more acute in rural communities.

After pushback from the university — the institute’s projects included work to reduce health care disparities between rural and urban areas — the NIH restored its grant March 29.

Among the people the Utah center thanked in its announcement about the reversal were the state’s congressional delegation, which consists entirely of Republican lawmakers. “We are grateful to University of Utah leadership, the University of Utah Board of Trustees, our legislative delegation, and the Utah community for their support,” it said.

Hilliard, of HHS, said that “some grants have been reinstated following the appeals process, and the agency will continue to carry out the remaining appeals as planned to determine their alignment.” She declined to say how many had been reinstated, or why the University of Utah grant was among them.

Other researchers haven’t had the same luck. Kahle, in Michigan, said projects like hers can take a dozen years from start to finish — applying for and receiving NIH funds, conducting the research, and completing follow-up work.

“Even if there are changes in the next administration, we’re looking at at least a decade of setting back the research,” Kahle said. “It’s not as easy as like, ‘OK, we’ll just do it again later.’ It doesn’t really work that way.”

KFF Health News is Healthbeat’s national reporting partner.

Metro Atlanta measles outbreak contained by ‘all hands on deck’ response, but low vaccination rates keep Georgia vulnerable

2025-04-16T19:56:10+00:00

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Georgia successfully contained an outbreak of three measles cases early this year with an “all hands on deck” response as the disease surged nationwide, with seven outbreaks and 712 confirmed cases as of last week.

But the state remains vulnerable, with overall measles vaccination rates below national averages — and below the 95% rate needed to prevent widespread community transmission, known as herd immunity. Georgia’s vaccination rates have been on the decline for years and lag those of neighboring states.

The January outbreak involved three unvaccinated children from the same Gwinnett County family. The first child to fall ill had traveled to New York City. Georgia alerted New York health officials, but no related cases were reported there, according to emails from Georgia health workers obtained by Healthbeat through an open records request.

The first suspected Georgia case was identified on Friday, Jan. 24. Keisha Francis-Christian, epidemiology manager for the Gwinnett, Newton and Rockdale health department, called for an “all hands on deck” response in an email to her team the following Monday.

By Feb. 11, public health workers had identified 290 close contacts, 31 of whom did not have measles immunity or were at high risk. Workers gave 21 of those people an MMR vaccine, state Department of Public Health epidemiology program manager Jessica Pavlick said in an email to colleagues.

“For 21 days, they have to report their symptoms to us. If they don’t report, we’re calling them.” That included working over weekends, Francis-Christian said at a February Gwinnett Board of Health meeting.

DPH did not respond to Healthbeat’s requests for information about the cost of the outbreak investigation, or whether the contact tracers who worked on it are among the 170 laid off due to recent federal funding cuts at the state agency.

The state last year saw six measles cases. This year’s nationwide 712 cases, including the three in Georgia, outstrip last year’s 285 cases. The outbreak centered in west Texas has spread to New Mexico and killed two children and an adult, all unvaccinated.

Georgia epidemiologist Dr. Cherie Drenzek said during a DPH board meeting last week that a widespread outbreak across the country is unlikely because “we do have good, for the most part, overarching MMR coverage.”

Measles vaccination rates have been declining in Georgia

Georgia’s measles vaccination rates have fallen over the past decade, and some counties report very low rates, according to available data from DPH and the Centers for Disease Control and Prevention. That could lead to increases in cases of the highly transmissible disease, which kills up to three in 1,000 unvaccinated people, experts said.

Children typically get two measles vaccinations as part of the “MMR” or measles, mumps, and rubella shot. The first should be between age 12 and 15 months, and the second should be between ages 4 and 6 years, the CDC says.

In most counties in Georgia – 150 of 159 – measles vaccination rates for young children are below the 95% recommended rate, according to the latest data about children between 19 and 35 months from DPH. Statewide, it’s at 87.8%, according to the data from early fall 2023.

DPH does not provide data online about older children’s vaccination rates, although some CDC data are available.

Since then, vaccination rates have decreased nationwide and in Georgia.

In the 2011-12 school year, 96.6% of Georgia kindergartners had received two doses of the MMR vaccine, above the herd immunity target.

Metro Atlanta pediatrician discusses the impact of Georgia measles outbreak

But last year, 2023-24, that was down to 88.4%, according to the CDC’s School Vax View.

Measles is a “highly contagious virus” that can spread up to two hours after a person with measles leaves a room, according to the CDC. Nine of 10 people exposed will get measles if they are not vaccinated.

Cases are transmissible for up to four days before infected people get a rash, a common symptom, said Dr. Jane Seward, who retired in 2016 after about a decade at the CDC, where she worked as the deputy director of the Division of Viral Diseases. People can be exposed to the virus in a supermarket, airport, or hotel lobby.

“Prevention of an outbreak depends entirely on local coverage rates,” said Charles LeBaron, an epidemiologist who retired from the CDC in 2017. “With a world awash in measles, and foreign travel essential to our economy, we can’t stop measles imports, but we can stop outbreaks.

“That’s entirely a function of the immunity rate in the first case’s immediate micro-environment (e.g., kindergarten class). If it’s above 95%, the immunity sprinkler system will put out the outbreak. If it’s lower, then spread is likely,” LeBaron said. “And sooner or later, it finds an immunocompromised or otherwise frail person (like an infant too young to be vaccinated), and somebody dies.”

Measles vaccination rates are even lower for Georgia’s youngest children, who need their first dose by 15 months, according to the CDC.

Slashed federal funding cancels vaccine clinics amid measles surge

Nearly a fifth of children born in Georgia in 2021 (18.3%) did not get the shot by 19 months old, four months after the recommended deadline, according to the most recent CDC data. In other words, just 81.7% of Georgia children born in 2021 got the shot on time, compared to 87.9% nationwide.

It hasn’t always been this way in Georgia. For children born in 2011, the MMR vaccination rate was more than 5 percentage points higher, at 87.2% for children at 19 months.

“For measles, you can’t afford to wait till school. … There’s a lot of susceptibility under [age] 6,” Seward said.

The three cases in Georgia this year, as well as 97% of cases in the outbreak that started in Texas, were in unvaccinated people.

Closer to home, Tennessee has reported four cases this year, and last year, all of Georgia’s neighboring states except for Alabama reported measles cases.

Which Georgia counties have the lowest measles vaccination rates?

There are some parts of Georgia where measles vaccination rates are especially low, according to county-level data about vaccinations for young children from DPH from July to September 2023, which has not been updated since then.

Among the five core Atlanta counties, Clayton had the lowest rate, at 86% in the third quarter of 2023. It was 89.6% in Cobb County, 88.4% in Gwinnett, 88.2% in DeKalb, and 86.7% in Fulton.

The low rates in metro Atlanta are worrying, said pediatric infectious disease specialist Dr. Preeti Jaggi of Children’s Healthcare of Atlanta.

“It makes me anxious in the sense that if we don’t have adequate community protection, we have more chance for transmission.” She pointed out that babies typically can’t get the measles vaccine until 12 months old, putting them and others who can’t get it for medical reasons at higher risk.

Dr. Stephen Patrick, a neonatologist and professor at Emory University’s Rollins School of Public Health, agreed, calling the metro Atlanta rates “too low.”

Jaggi and Patrick said they hear more concerns from parents about vaccine safety than in the past. Doctors emphasized the vaccine is safe and helps keep kids from getting sick.

“We have study after study after study …. We know that the MMR vaccine does not cause autism,” Patrick said. Jaggi said she tells parents, “I vaccinated my own children, and I would have not done that unless I thought it was in their best interest.”

“What we’ve seen has not been a change in access over the last few years, to my knowledge, but what we have seen is a change in attitude,” Patrick said, pointing to the rise of social media misinformation as a key reason for downward vaccination rates.

“Parents are just processing a slew of information and they just want to do what’s best for their child,” Patrick said. Conversations with “trusted messengers” like pediatricians and other parents can help reassure parents that vaccines are safe and help protect kids.

“The measles vaccine is the best way to to prevent measles transmission — period,” Patrick said. ”The outbreaks we’re seeing now are preventable.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Federal cuts force Out of Hand Theater to halt vaccine outreach, affecting overall operations

2025-04-10T21:30:03+00:00

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On April 3, Atlanta’s Out of Hand Theater announced the immediate suspension of its innovative Equitable Vaccines program following a decision by the U.S. Department of Health and Human Services to rescind previously allocated public health funding.

The sudden funding cut is a major blow to the theater company, which says the grant was essential to its partnership with the Georgia Department of Public Health and crucial to its overall operations for the 2025 fiscal year.

“This was a massive, multiyear program that we started developing in 2020 and have been doing ever since,” said Out of Hand Artistic Director Ariel Fristoe. “In 2025, this was a million-dollar program, and we’re a $2 million-dollar organization. That is half our budget, so we had to lay off five out of our 15 employees.”

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Launched to combat vaccine misinformation, EqVax used a unique blend of theater, art, storytelling, and community dialogue to build trust in vaccines among underserved communities. The program primarily served rural Black and Hispanic Georgians — groups that have faced historic barriers to health care and often lack access to accurate health information.

Over the years, Out of Hand has produced a range of creative outreach projects through the program, including a play about a Black family reconnecting after lockdown, an animated educational film, and a Spanish-language comic book designed for distribution at health fairs to children and families across the state.

The cuts come as part of broader shifts under the Trump administration, which has signaled major rollbacks in arts and public health funding. In response, a coalition of 23 states — including Colorado, California, and New York — filed a federal lawsuit on April 4, seeking an emergency restraining order to block the rescission of funds. Out of Hand is closely watching the case to see what happens with the potential reinstatement of the HHS funds.

Out of Hand will continue to fight for the program’s survival. “Our mission remains clear: We will use theater as a tool for social justice, and we will keep advocating for a fairer and more equitable world for everyone,” Fristoe stated.

The Georgia Council for the Arts is also facing a proposed $3 million cut under the state’s current budget, placing further strain on arts nonprofits across the region.

The company is urging supporters to contact Gov. Brian Kemp and ask the federal government to restore the funding. Those interested in learning more or getting involved can reach the EqVax team at contact@outofhandtheater.com.

This story was originally published by ArtsATL, Atlanta’s source for arts news.

Slashed federal funding cancels vaccine clinics amid measles surge

2025-04-09T19:31:22+00:00

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More than a dozen vaccination clinics were canceled in Pima County, Arizona.

So was a media blitz to bring low-income children in Washoe County, Nevada, up to date on their shots.

Planned clinics were also scuttled in Texas, Minnesota, and Washington, among other places.

Immunization efforts across the country were upended after the federal Centers for Disease Control and Prevention abruptly canceled $11.4 billion in Covid-related funds for state and local health departments in late March.

A federal judge temporarily blocked the cuts last week, but many of the organizations that receive the funds said they must proceed as though they’re gone, raising concerns amid a resurgence of measles, a rise in vaccine hesitancy, and growing distrust of public health agencies.

“I’m particularly concerned about the accessibility of vaccines for vulnerable populations,” former U.S. Surgeon General Jerome Adams told KFF Health News. Adams served in President Donald Trump’s first administration. “Without high vaccination rates, we are setting those populations and communities up for preventable harm.”

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The Department of Health and Human Services, which houses the CDC, does not comment on ongoing litigation, spokesperson Vianca Rodriguez Feliciano said. But she sent a statement on the original action, saying that HHS made the cuts because the Covid-19 pandemic is over: “HHS will no longer waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago.”

Still, clinics have also used the money to address other preventable diseases such as flu, mpox, and measles. More than 500 cases of measles so far in a Texas outbreak have led to 57 hospitalizations and the deaths of two school-age children.

Pima County cancels 20 events with Covid, flu vaccines

In Pima County, Arizona, officials learned that one of its vaccination programs would have to end early because the federal government took away its remaining $1 million in grant money. The county had to cancel about 20 vaccine events offering Covid and flu shots that it had already scheduled, said Theresa Cullen, director of the county health department. And it isn’t able to plan any more, she said.

The county is home to Tucson, the second-largest city in Arizona. But it also has sprawling rural areas, including part of the Tohono O’odham Nation, that are far from many health clinics and pharmacies, she said.

The county used the federal grant to offer free vaccines in mostly rural areas, usually on the weekends or after usual work hours on weekdays, Cullen said. The programs are held at community organizations, during fairs and other events, or inside buses turned into mobile health clinics.

Canceling vaccine-related grants has an impact beyond immunization rates, Cullen said. Vaccination events are also a chance to offer health education, connect people with other resources they may need, and build trust between communities and public health systems, she said.

County leaders knew the funding would run out at the end of June, but Cullen said the health department had been in talks with local communities to find a way to continue the events. Now “we’ve said, ‘Sorry, we had a commitment to you and we’re not able to honor it,’” she said.

Cullen said the health department won’t restart the events even though a judge temporarily blocked the funding cuts.

‘What should I look out for?’ Pediatrician shares insights on measles and its metro Atlanta impact

“The vaccine equity grant is a grant that goes from the CDC to the state to us,” she said. “The state is who gave us a stop work order.”

The full effect of the CDC cuts is not yet clear in many places. California Department of Public Health officials estimated that grant terminations would result in at least $840 million in federal funding losses for its state, including $330 million used for virus monitoring, testing, childhood vaccines, and addressing health disparities.

“We are working to evaluate the impact of these actions,” said California Department of Public Health Director Erica Pan.

Money to pay vaccine workers running out

In Washoe County, Nevada, the surprise cuts in federal funding mean the loss of two contract staffers who set up and advertise vaccination events, including state-mandated back-to-school immunizations for illnesses such as measles.

“Our core team can’t be in two places at once,” said Lisa Lottritz, division director for community and clinical health services at Northern Nevada Public Health.

She expected to retain the contractors through June, when the grants were scheduled to sunset. The health district scrambled to find money to keep the two workers for a few more weeks. They found enough to pay them only through May.

Lottritz immediately canceled a publicity blitz focused on getting children on government insurance up to date on their shots. Vaccine events at the public health clinic will go on, but are “very scaled back” with fewer staff members, she said. Nurses offering shots out and about at churches, senior centers, and food banks will stop in May, when the money to pay the workers runs out.

“The staff have other responsibilities. They do compliance visits, they’re running our clinic, so I won’t have the resources to put on events like that,” Lottritz said.

The effect of the cancellations will reverberate for a long time, said Chad Kingsley, district health officer for Northern Nevada Public Health, and it might take years for the full scope of decreasing vaccinations to be felt.

“Our society doesn’t have a collective knowledge of those diseases and what they did,” he said.

Measles is top of mind in Missouri, where a conference on strengthening immunization efforts statewide was abruptly canceled due to the cuts.

The Missouri Immunization Coalition, which organized the event for April 24-25, also had to lay off half its staff, according to board president Lynelle Phillips. The coalition, which coordinates immunization advocacy and education across the state, must now find alternative funding to stay open.

“It’s just cruel and unthinkably wrong to do this in the midst of a measles resurgence in the country,” Phillips said.

Dana Eby, of the health department in New Madrid County, Missouri, had planned to share tips about building trust for vaccines in rural communities at the conference, including using school nurses and the Vaccines for Children program, funded by the CDC.

New Madrid has one of the highest childhood vaccination rates in the state, despite being part of the largely rural “Bootheel” region that is often noted for its poor health outcomes. Over 98% of kindergartners in the county received the vaccine for measles, mumps, and rubella in 2023-24 compared with the state average of about 91%, and rates in some other counties as low as 61%.

“I will say I think measles will be a problem before I retire,” Eby, 42, said.

Also slated to speak at the Missouri event was former surgeon general Adams, who said he had planned to emphasize the need for community collaboration and the importance of vaccinations in protecting public health and reducing preventable diseases. He said the timing was especially pertinent given the explosion in measles cases in Texas and the rise in whooping cough cases and deaths in Louisiana.

“We can’t make America healthy again by going backwards on our historically high U.S. vaccination rates,” Adams said. “You can’t die from chronic diseases when you’re 50 if you’ve already died from measles or polio or whooping cough when you’re 5.”

California correspondent Christine Mai-Duc contributed to this article, which was originally published at KFF Health News, Healthbeat’s national reporting partner.

Montana may start collecting immunization data again amid U.S. measles outbreak

2025-04-01T13:35:39+00:00

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When epidemiologist Sophia Newcomer tries to evaluate how well Montana might be able to ward off the measles outbreak spreading across the United States, she doesn’t have much data to work with.

A federal state-by-state survey last year showed that just over 86% of Montana’s 2-year-olds had recently received the measles, mumps, and rubella immunization. That figure has decreased in recent years, according to earlier surveys, and Newcomer, an associate professor at the University of Montana, said the latest rate is “well below” the ideal 95% threshold for community protection against highly contagious diseases.

But beyond that statewide estimate, information about Montana’s local and regional immunization trends is hard to come by. State officials no longer collect aggregated vaccination reports from schools and child care centers, or the included data about medical and religious exemptions. The administration of Republican Gov. Greg Gianforte discontinued the practice after he signed a 2021 bill striking the requirement.

The last of the localized reports were from the 2018-19 school year, before the disruptions of Covid-19. Without the information, Newcomer said, local and state officials have struggled to strategically prevent the spread of vaccine-preventable disease.

“State averages are helpful, but really drilling down to county level or smaller geographic levels are really what we need to assess risk of outbreaks,” she said.

Move to ensure medical privacy created gap in data

Montana is the only state that no longer collects immunization reports from local schools, creating a data gap for the Centers for Disease Control and Prevention. The information shortage also affects city and county health officials who may not have their own data-sharing agreements with school districts.

Supporters of the 2021 measure to stop collecting data said they were aiming to protect students’ personally identifiable information and medical records and did not intend to cancel the reporting system in its entirety.

‘What should I look out for?’ Pediatrician shares insights on measles

“I wasn’t trying to bomb the system. I was just trying to make sure children had their privacy respected,” said Jennifer Carlson, a former Republican legislator and the sponsor of the bill the state health department cites as the reason for discontinuing the data collection.

State lawmakers are considering a bill to undo the 2021 policy, while keeping privacy protections for individual student records. After stalling earlier this session, the Democratic-sponsored HB 364 advanced in March with bipartisan support, clearing the House with a 66-31 vote.

The bill, sponsored by Democratic Rep. Melody Cunningham, has also received support from the state health department, an agency within the Gianforte administration.

Republican Rep. John Fitzpatrick said he believes the bill is good policy for the state.

“It’s important that public health authorities have access to aggregate information so they can track where vaccinations are not being used,” he said.

Montana hasn’t confirmed a case of measles since 1990. But with more than 480 cases reported across Texas, New Mexico, and 17 other states, one child confirmed to have died from the disease, and another death under investigation, Newcomer said she and other disease experts are “on edge” about Montana’s defenses. Three cases have been confirmed in March south of Calgary, in the Canadian province of Alberta, which shares a border with Montana.

“I like to say that when vaccination rates drop in a community, it is not a question of if. It’s a question of when measles is going to come, because it is so incredibly contagious,” said David Higgins, a pediatrician and researcher at the University of Colorado Anschutz Medical Campus.

Higgins used to work in Montana when the law requiring schools and state officials to share data was still in place. He said he’s disappointed in the 2021 rollback, given how outbreaks begin at the hyperlocal level.

“When community leaders don’t have a good understanding of the local level of vaccination and community immunity, that’s a significant challenge,” Higgins said. “They’re hamstrung without having that data readily available.”

Measles is dangerous and spreads easily

Measles is one of the world’s most contagious diseases, according to the World Health Organization, much more so than Covid. It can be very dangerous, especially for infants and children under 5 who have not completed the two-dose vaccination series. Infectious particles can hang in the air and on surfaces for up to two hours. People carrying the virus can spread it up to four days before they begin showing symptoms.

“If we do have a measles case arrive in Montana, and particularly if it arrives in a community that has low vaccination coverage, we’re going to see spread over like a multi-week or even multi-month period,” Newcomer said. “So an unvaccinated person can get sick simply by going into a school, store, or home where someone infected with measles recently was.”

The infection can have short-term and long-term consequences for people who are not immunized, including encephalitis, pneumonia, deafness, blindness, and death. State and community health departments have been advertising free MMR vaccinations at clinics throughout the state for anyone who needs them.

While HB 364 is aimed at increasing data collection, other vaccine measures in the state legislature are advancing that would make it easier for children to be exempted from standard immunizations required to attend schools or child care centers.

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A recent version of SB 474, which has been amended several times, would create an “informed consent” exemption in which a parent or guardian could decline immunizations for school-age children without stating a reason.

Supporters of the bill said that some families struggle to receive exemptions on the grounds of religious beliefs or medical causes and want broader flexibility to opt out of requisite vaccinations against measles and other infectious diseases, such as pertussis. According to Montana’s most recent reporting, from the 2018-19 school year, roughly 3% of children in public schools had a religious or medical exemption.

SB 474 also would strike another part of state law that allows schools and day cares to deny admission to children because they are unvaccinated, an exemption included in a 2021 law aimed at protecting unvaccinated people from discrimination. The lawmaker sponsoring the current bill called the carve-out for schools and day cares an “aberration” in Montana law.

“There’s no reason that they should be discriminating based on vaccine status,” Republican Sen. Daniel Emrich said during a March debate on the Senate floor.

Emrich and others framed the bill as enabling individual decision-making around vaccinations based on how well a parent knows their own child.

“Vaccines are pretty effective,” Emrich said. “If you’re concerned about unvaccinated children, you have the option to get your kid a vaccine to protect them in whatever way you want. This bill is really about choice.”

During the debate, opponents of the bill contended that the lower Montana’s overall immunization rate drops, the more at risk many community members are, including those who, because of age or medical issues, can’t be vaccinated.

Sen. Cora Neumann, a Democrat representing Bozeman, said that vaccinated Montanans, including children, are acting as “shields” against contagious diseases like measles and pertussis. But if vaccination rates continue to drop, Neumann said, that protection will only get weaker.

“We just saw a kid die of measles [in Texas]. It’s going to continue, and it is going to be scary. It is going to be deadly,” Neumann said. “It feels like a luxury right now. We can choose. It is not going to be if we continue down this path.”

The bill passed the state Senate on a 28-21 vote. It is now under consideration in the House.

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

Scientists say NIH officials told them to scrub mRNA references on grants

2025-03-17T13:49:03+00:00

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National Institutes of Health officials have urged scientists to remove all references to mRNA vaccine technology from their grant applications, two researchers said, in a move that signaled the agency might abandon a promising field of medical research.

The mRNA technology is under study at the NIH for prevention and treatment of infectious diseases, including flu and AIDS, and also cancer. It was deployed in the development of Covid-19 vaccines credited with saving 3 million lives in the United States alone — an accomplishment President Donald Trump bragged about in his first term.

A scientist at a biomedical research center in Philadelphia wrote to a colleague, in an email reviewed by KFF Health News, that a project officer at NIH had “flagged our pending grant as having an mRNA vaccine component.”

“It’s still unclear whether mRNA vaccine grants will be canceled,” the scientist added.

NIH officials also told a senior NIH-funded vaccine scientist in New York state, who does not conduct mRNA vaccine research but described its efficacy in previous grant applications, that all references to mRNA vaccines should be scrubbed from future applications.

Scientists relayed their experiences on the condition of anonymity for fear of professional retaliation by the Trump administration.

A senior official at the National Cancer Institute confirmed that NIH acting Director Matthew Memoli sent an email across the NIH instructing that any grants, contracts, or collaborations involving mRNA vaccines be reported up the chain to Health and Human Services Secretary Robert F. Kennedy Jr.’s office and the White House.

MRNA vaccines, once a Trump boast, now face attacks from some in GOP

Memoli sent a similar message ahead of the agency canceling other research, such as studies of vaccine hesitancy.

Memoli’s email on that topic bluntly stated that NIH was not interested in learning why people shun vaccines or in exploring ways to “improve vaccine interest and commitment.”

The National Cancer Institute official, who also spoke on the condition of anonymity for fear of reprisals, said that “it is reasonable to assume mRNA vaccine work is next.”

The official said a similar memo also went out regarding NIH-funded work in South Africa, which the White House has targeted over false claims that the country’s government is persecuting white people. More recently, another one went out regarding all global research collaborations, the official said.

Spokespeople for the White House, HHS, and the NIH did not respond to requests for comment.

NIH funds are critical to biomedical research

The NIH, whose latest annual budget was $47 billion, is one of the world’s most critical sources of funding for basic biomedical research. Its mission and programs are under unprecedented scrutiny from Trump’s White House and the Department of Government Efficiency, the Elon Musk-led agency created by a Trump executive order that has directed federal agencies to prepare for widespread layoffs.

The NIH is funding at least 130 studies involving the mRNA technology in Covid vaccines produced by Pfizer-BioNTech and Moderna that have been administered to billions of people worldwide.

A former government official familiar with internal discussions said that the Trump administration intends to cut some grants for mRNA vaccine research but that the timing is unclear. The person spoke on the condition of anonymity to protect relationships with the administration.

Political conservatives in the United States have promulgated conspiracy theories, unsupported by scientific evidence, that the shots and their relatively new technology are dangerous. This has undermined public support for Covid vaccinations and mRNA research.

“There will not be any research funded by NIH on mRNA vaccines,” the scientist in New York said in an interview. “MAGA people are convinced that these vaccines have killed and maimed tens of thousands of people. It’s not true, but they believe that.”

Meanwhile, hundreds of other vaccine-related studies are in limbo. Kawsar Talaat, a vaccine researcher at the Bloomberg School of Public Health at Johns Hopkins University, has been waiting since the fall for money needed to recruit subjects for a study of an antidiarrheal vaccine.

“NIH approved our funding,” she said, “and now we’re waiting, and we don’t know if it’s going forward or going to be killed.”

The scientist in Philadelphia signaled that he believes Kennedy, a longtime anti-vaccine activist, is responsible for the NIH’s turn against mRNA research.

“Kennedy’s war on vaccines has started,” the scientist told his colleague.

The scientist in New York said that it was “ridiculous” to remove mRNA language from the grant applications. But “if my grant is rejected for any reason,” the scientist said, “people in my lab will lose their jobs.”

“I’ve worked with some of them for 20 years,” the scientist added. “They have children and families. There is a real climate of fear in academia about this now, especially among vaccine scientists.”

“My grant does not involve a request for funds to conduct mRNA vaccine experiments,” the scientist said, “so my principal concern was to avoid word-search flags that, at minimum, would lead to delays in any funding.”

mRNA work garnered 2023 Nobel Prize

While tenured research professors at universities generally receive a salary from their institution, the staffers who work in their labs and offices are often paid through NIH grants. The 2023 Nobel Prize in physiology or medicine was given to two scientists for developing mRNA vaccines, through work that relied on pharmaceutical companies and on NIH scientists working under infectious disease specialist Anthony Fauci.

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According to Sen. Bill Cassidy, a Louisiana Republican who chairs the chamber’s Health, Education, Labor and Pensions Committee, Kennedy promised during his Senate confirmation process that he would protect “the public health benefit of vaccination” and “work within the current vaccine approval and safety monitoring systems, and not establish parallel systems.”

Cassidy, a physician, had expressed reservations about confirming Kennedy to the HHS post and challenged his anti-vaccine views during a confirmation hearing. He ended up voting for him, he said, because Kennedy had agreed to work closely with Cassidy and his committee.

However, Kennedy has faced scrutiny in his first weeks in office for his handling of a large measles outbreak among mostly unvaccinated people in Texas that has led to the death of a child, the first U.S. measles death in more than a decade. A patient who tested positive for measles died in New Mexico, but the cause hasn’t been confirmed. Instead of urging vaccination against the disease, an almost surefire way to prevent infection, Kennedy has blamed malnourishment for the outbreak, promoted unproven treatments for measles, and falsely claimed in one Fox News interview that the vaccine is ineffective and even dangerous.

Cassidy did not respond to a request for comment on the NIH’s potential abandonment of mRNA vaccine research.

As part of the Trump administration’s push to examine spending on mRNA vaccines, health officials are reviewing a $590 million contract for bird flu shots that the Biden administration awarded to Moderna, Bloomberg News has reported. Legislation introduced by GOP lawmakers in at least seven states is aimed at banning or limiting mRNA vaccines. In some cases, the measures would hit doctors who give the injections with criminal penalties, fines, and the possible revocation of their licenses.

Stephanie Armour and Dr. Céline Gounder contributed to this article from KFF Health News, Healthbeat’s national reporting partner.

MRNA vaccines, once a Trump boast, now face attacks from some in GOP

2025-03-11T11:00:00+00:00

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Researchers racing to develop bird flu vaccines for humans have turned to a cutting-edge technology that enabled the rapid development of lifesaving covid shots.

There’s a catch: The mRNA technology faces growing doubts among Republicans, including people around President Donald Trump.

Legislation aimed to ban or limit mRNA vaccines was introduced this year by GOP lawmakers in at least seven states. In some cases, the measures would hit doctors who give the injections with criminal penalties, fines, and possible revocation of their licenses.

Some congressional Republicans are also pressing regulators to revoke federal approval for mRNA-based covid shots, which President Donald Trump touted as one of the signature achievements of his first term.

The opposition comes at a critical juncture because vaccines using mRNA have applications well beyond avian flu and covid. They hold the promise of lifesaving breakthroughs to treat many diseases, from melanoma to HIV to Zika, according to clinical trials. The proposed bans could block access to these advances.

MRNA is found naturally in human cells. It is a molecule that carries genetic material and, in a vaccine, trains the body’s immune system to fight viruses, cancer cells, and other conditions. An advantage of mRNA technology is that it can be developed more quickly to target specific variants and is safer than developing a vaccine made from inactivated virus.

“Right now, if we had a bird flu pandemic, we would have a shortage of the vaccine we need,” said Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy. “The one thing that could save us is mRNA vaccine. The challenge would be if mRNA is banned. This is truly dangerous policy.”

The pushback conflicts with innovations championed by Trump. He assembled tech tycoons at the White House just after his inauguration to announce Stargate, a $500 billion artificial intelligence initiative that could help transform cancer treatment by creating tumor-targeting mRNA vaccines. The fledging partnership between Oracle, SoftBank Corp., and OpenAI, co-founded by Elon Musk, envisions leveraging AI in part to improve health outcomes. Patients would undergo blood tests and AI would be used to find cancer.

Scientists would examine the DNA and RNA (RNA and mRNA serve different functions in a cell) of a specific patient’s tumor to create a vaccine to teach that person’s immune system to target and destroy cells driving cancer growth.

“Imagine early cancer detection, the development of a cancer vaccine for your particular cancer aimed at you, and have that vaccine available in 48 hours,” Oracle co-founder Larry Ellison said at the White House event.

Scores of mRNA clinical trials for cancer vaccines are underway and some have shown dramatic results, cutting the risk of death and recurrence roughly in half for certain patients. In research led by the Yale School of Medicine, for example, patients with advanced kidney cancer remained cancer-free about three years after an mRNA-based treatment in an early-phase trial.

But some politically conservative doctors, lawmakers, and researchers question the safety of mRNA vaccines, especially covid shots made with the technology. Robert F. Kennedy Jr. unsuccessfully petitioned the FDA in 2021 to rescind approval for covid shots and called them “the deadliest vaccine ever made” — a controversial statement that has been refuted.

Now that he’s newly confirmed as Health and Human Services secretary, Kennedy is poised to oversee federal approvals of vaccines, with the power to shape policy such as immunization schedules and appoint vaccine opponents to committees that advise on the approval of shots.

Bloomberg reported late last month that Trump administration health officials were reevaluating a $590 million contract for bird flu shots that the Biden administration awarded to Moderna as part of its push to examine spending on mRNA vaccines.

HHS and White House spokespeople didn’t return emails seeking comment.

Support for an mRNA ban is coming from other sources too. Florida Gov. Ron DeSantis on March 5 urged the Centers for Disease Control and Prevention to stop recommending the covid-19 vaccine for children and called for a state ban on mRNA vaccine mandates. In February, Rep. Thomas Massie (R-Ky.) said on X that the “FDA should immediately revoke approval of these shots,” and Sen. Ron Johnson (R-Wis.) is leading an investigation into the safety of the vaccines. Trump in February signed an order to strip federal funds from schools that require covid shots for attendance.

Vaccine skepticism has become pronounced among Republicans since the pandemic. Four in 10 Republicans who responded to a KFF poll published in January said it was “probably” or “definitely true” that “more people have died from covid-19 vaccines than from the virus itself.” Just a quarter of Republicans reported holding that view in 2023.

The effort is also finding traction at the local level. A district health departmentoutside Boise, Idaho, last year banned its health department from administering covid-19 vaccines, and local lawmakers in Franklin County, Washington, passed a resolution in February against mRNA vaccines.

The ABCs of mRNA

The CDC recommends covid vaccines for anyone 6 months and older, especially seniors and people who are immunocompromised. About 29 million doses had been administered to adults in the 2024-25 season in retail pharmacies and doctors’ offices through Feb. 8, based on federal data.

Given as a shot, mRNA enters muscle cells and teaches them to produce a spike protein found on the surface of a virus. The body’s immune system then targets the spike protein, priming it to identify and fight the virus — in this case, the coronavirus that causes covid. The body’s cells then break down the mRNA and remove it, according to federal health researchers.

More than 13 billion covid vaccines had been administered worldwide as of August 2024.

Researchers say the vaccinations saved countless lives — estimates for the first year alone go as high as 19.8 million — in the throes of a pandemic that had hospitals ordering refrigerated mobile morgues and deliberating over which patients to put on ventilators. Two University of Pennsylvania scientists credited with developing the mRNA technology behind the shots were awarded the Nobel Prize for medicine in 2023.

The FDA says the covid vaccines are safe, with fewer than 1 in 200,000 vaccinated individuals experiencing a severe allergic reaction or heart problems like myocarditis or pericarditis, and the agency notes that “inaccurate informationabout these vaccines, particularly the mRNA COVID-19 vaccines, continues to circulate.”

While many people hadn’t heard of the mRNA platform until the covid shots were rolled out, it was discovered in the 1960s. The first mRNA flu vaccines were tested in mice in the 1990s. A clinical trial involving direct injection of mRNA to fight cancer occurred in 2008. Clinical trials involving the covid mRNA vaccines involved tens of thousands of volunteers.

Reviews of mortality data showed “no unusual patterns of death were detected that might suggest a potential safety concern,” based on a September 2024 report by a technical working group that provided guidance to the CDC.

But those calling for a ban on all mRNA vaccines say there is a dearth of long-term safety data, and they say covid vaccines by Pfizer-BioNTech and Moderna were hastily approved without proper vetting. They assert without strong evidence that the vaccines cause serious injuries to the heart, nerves, and immune and reproductive systems, and can lead to cancer.

The vaccine has been linked to rare cases of heart inflammation and inflammation of the sac surrounding the heart, although the severity has varied and most patients fully recovered, the CDC says.

“The allegations are beyond reason,” said Anne Schuchat, a career scientist who worked on covid and who twice served stints as acting director of the CDC. “The mRNA covid vaccines were extensively studied after use and do not have those problems.”

“I’m concerned about the whole mRNA technology. I don’t trust anything that fools the body,” said Stephanie Seneff, a computer scientist and anti-vaccine activist at the Massachusetts Institute of Technology. “I’m really glad people are waking up and realizing it’s not the thing to do anymore.”

Vaccines generally work by tricking the body into producing antibodies to fight illnesses.

Pfizer spokespeople didn’t return an email seeking comment. A Moderna spokesperson, Chris Ridley, said legislative efforts to ban or restrict mRNA medicines are largely driven by misunderstandings about their safety profile and mechanism of action. While mRNA-based shots do not modify DNA, for example, that misconception is frequently cited in support of restrictions, Ridley said.

“If enacted, these measures could hinder important research and limit patient access to innovative treatments, potentially delaying life-changing medical advancements,” Ridley said in a written statement.

Networks of Opposition

Groups opposed to the mRNA technology have built a vast and well-funded legal, marketing, and social media network. Members hold conferences to discuss strategies, fund lawsuits against vaccine mandates, and produce reports on the covid vaccines.

As for state legislative efforts, measures introduced this year have varied and their progress has been mixed. Montana’s measure, for instance, was blocked. Idaho lawmakers in February held a hearing on its bill, which calls for a 10-year moratorium on mRNA vaccines. Idaho’s proposal, likely to be amended, as well as Iowa’s and Montana’s have featured criminal penalties for providers who administer all or certain mRNA vaccines. In addition, some state bills, such as legislation in Pennsylvania and Tennessee, focused on the use of the vaccine in livestock and food production.

Various bills are pending in the Texas Legislature to restrict mRNA vaccines in both livestock and humans. South Carolina’s pending bill would require anyone administering certain covid mRNA vaccines to inform patients that the shot is contaminated with fragments of “bacterial plasmid DNA.”

Covid mRNA shots may have minute amounts of residual DNA from production processes but they are heavily degraded and pose no risk, according to the Global Vaccine Data Network, which evaluates vaccine safety concerns.

Speakers at some legislative proceedings have included representatives from Children’s Health Defense, an activist, anti-vaccine group founded by Kennedy.

The Florida surgeon general in January 2024 called for a halt in the use of covid mRNA vaccines. And in Texas, Attorney General Ken Paxton in January moved to appeal a lawsuit he filed claiming Pfizer misrepresented the safety of its mRNA shot.

Efforts to restrict the shots have raised the profile of groups such as the Independent Medical Alliance, which advocates for mRNA-based covid vaccines to be withdrawn from the market.

“We should stop it and test it more before we move forward,” said pediatric cardiologist Kirk Milhoan, a senior fellow at the alliance.

Groups opposed to mRNA shots are pointing to a recent study to urge more caution. Yale University researchers reported in February that they found spike protein still circulating in a subset of individuals with a debilitating, post-vaccination condition. Some of the individuals who experienced chronic illness after getting the shots had detectable levels of spike protein more than 700 days after vaccination. This study was small — 42 participants — and not peer-reviewed.

Its findings also don’t show the spike protein is a health risk or a cause of vaccine injury.

“It’s an initial, provocative study in which you can’t draw conclusions,” said William Schaffner, past medical director of National Foundation for Infectious Diseases. “This is one of the most widely used vaccines around the globe. It’s the furthest thing from an experimental vaccine.”

But what this growing pushback shows, according to some researchers, is that distrust isn’t coming only from fringe groups anymore.

“There are truly amazing mRNA cancer vaccines out there,” said Kate Broderick, chief innovation officer at Maravai LifeSciences, which works on vaccine development. “My fear as a scientist is that it’s been tainted in the public.”

This story originally published at KFF Health News, Healthbeat’s national reporting partner.