A federal judge in Massachusetts has halted enforcement of several key vaccine policies imposed by Health Secretary Robert F. Kennedy Jr., ruling that the Trump administration illegally overhauled a Centers for Disease Control and Prevention committee dedicated to issuing immunization recommendations.

The decision, which comes in response to a filed by the American Academy of Pediatrics last July, temporarily blocks the enforcement of all recommendations voted on by the panel. That includes the overhaul of a decades-old recommendation that all newborn babies receive a vaccine against , a push to emphasize the risks of and a ban on vaccine preservatives like .

The ruling also temporarily halts participation from 13 of the panel鈥檚 15 members, complicating a meeting that was to begin later this week.

The CDC鈥檚 committee, known as the Advisory Committee on Immunization Practices, is charged with setting national guidelines around which people should be vaccinated against a wide range of preventable diseases and when those vaccines should be administered. The recommendations play a key role in determining which vaccines insurance companies are willing to cover and how accessible those immunizations are to the public.

Last June, Kennedy all 17 members of the committee and replaced them with a slate of hand-picked appointees, many of whom are seen as vaccine skeptics. In his Monday , District Court Judge Brian E. Murphy ruled that the Trump administration likely violated the Administrative Procedure Act by failing to appoint qualified, nonpartisan experts, as the panel鈥檚 charter requires.

By ignoring those requirements, 鈥渢he Government has disregarded those methods and thereby undermined the integrity of its actions,鈥� Murphy鈥檚 ruling reads.

Dr. Andrew Racine, the president of the American Academy of Pediatrics, celebrated the ruling, calling it 鈥渁 historic and welcome outcome for children, communities, and pediatricians everywhere.鈥�

鈥淔or decades, the AAP partnered closely with the federal government to advance our mission of attaining the optimal health and well-being of children and youth,鈥� Racine added. 鈥淲e would much prefer to return to that partnership and collaborate with federal healthcare agencies instead of litigating against them.鈥�

A spokesperson for the U.S. Department of Health and Human Services did not immediately reply to a request for comment.

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If such a change goes into effect, 鈥減ediatric hospitals will be overwhelmed with [childhood] infections that have virtually been non-existent for the last 40 years,鈥� said Florida-based infectious disease specialist Frederick Southwick. Southwick attended a Dec. 12 public comment workshop on the issue hosted by the Florida Department of Health. 

鈥淲e鈥檙e in trouble right now,鈥� he added, pointing to and the likelihood that some diseases could become endemic. 鈥淲e鈥檙e getting there, and this [ending the mandate] would just do-in little kids.鈥�

The session delved into the proposed language the department has drafted for a rule change that would do away with vaccine mandates for four key immunizations: varicella, more commonly known as chickenpox; hepatitis B, pneumococcal bacteria and Haemophilus influenzae type B, or HiB. Currently, children cannot attend school in Florida without proof of these four immunizations, among others, including the measles, mumps and rubella vaccine. 

Although Florida is not considering removing the mandate for the MMR vaccine, health experts see the move it is contemplating as eroding childhood immunization generally. It comes when in South Carolina because of a burgeoning measles outbreak.

Rana Alissa, president of the Florida Chapter of the American Academy of Pediatrics, was also in attendance to express her concerns. She told 社区黑料 this week that thanks to the success of vaccines, she鈥檚 never had to treat some of these 鈥渉orrible diseases,鈥� including HiB, which can lead to meningitis.

鈥淒on鈥檛 make our kids 鈥� Florida鈥檚 kids 鈥� guinea pigs to teach me and my classmates and other pediatricians how to manage these diseases,鈥� she implored.

Tallahassee parent Cathy Mayfield lost her 18-year-old daughter, Lawson, to meningitis in 2009, a few months before she was supposed to leave for college and just before she was due for a booster shot. (At the time, the booster was not recommended until college, according to Mayfield.)

鈥淵ou just don鈥檛 realize until it happens to you,鈥� she said.

She hopes others will learn the importance of vaccinating their own kids from her family鈥檚 story. 

鈥淎ll the information I learned through our tragedy about vaccinations made me very supportive of the safeguards [they] offer,鈥� she said.

鈥淵ou’ve also got to realize,鈥� Mayfield added, 鈥渢hat your decisions affect your community, and that鈥檚 something I think has gotten lost in 鈥� all this conversation and hesitancy about vaccinations.鈥�

Equating vaccine mandates to slavery

The workshop, which was announced the day before Thanksgiving, was held in Panama City Beach, in the Florida Panhandle, far from the state鈥檚 main population centers. About 100 people showed up to the session, which was characterized by attendees as but civil. Northe Saunders, president of the pro-vaccine advocacy organization and who was there, estimated that about 30 people spoke in favor of keeping the current vaccine mandates, while approximately 20 spoke in opposition.

Some speakers opposed to vaccine mandates included conspiracy theories in their arguments, according to news reports and numerous people present at the workshop, echoing language heard from the federal government since Secretary Robert F. Kennedy Jr., a long-time vaccine skeptic, took over the Department of Health and Human Services.

One attendee argued that giving children multiple jabs in a 30-day period 鈥渁ccounts to attempted murder,鈥� according to . A number of others questioned if this year鈥檚 reported measles outbreaks, which resulted in the in Texas, had actually occurred.

Florida leaders鈥� desire to become the first state to was announced in September by its surgeon general, Joseph A. Ladapo, standing beside Gov. Ron DeSantis in the gym of a private Christian high school. In sharing their plan, Ladapo claimed that 鈥渆very last [mandate] is wrong and drips with disdain and slavery.鈥� 

Only four vaccines are mandated through a Department of Health rule and are therefore under Lapado鈥檚 purview. The remaining nine, which in addition to the MMR shot include polio, are part of state law and can only be changed through legislative action. 

Experts told 社区黑料 this is a much more difficult feat, one that state legislators 鈥� even conservative ones 鈥� don鈥檛 seem to have an appetite for. Richard Hughes, a George Washington University law professor and leading vaccine law expert, said such a legislative attempt would 鈥渨arrant legal action.鈥�

鈥榃e really need to turn this around鈥� 

The debate in Florida and other states over mandatory childhood immunization comes as the country teeters on the edge of losing its measles elimination status. This year alone has seen nearly confirmed cases, the most since 2000, when measles was declared eliminated in the U.S. by the World Health Organization. Just over 10% of cases have led to hospitalization. The current South Carolina outbreak has infected at least , and among those forced to quarantine are students from nine schools. 

Significant educational implications from the outbreaks emerged in a by the Annenberg Institute at Brown University, which found that absences increased 41% in a school district at the center of the West Texas outbreak, with larger effects among younger students.

The spread of measles is also a warning of the ramifications of dropping vaccine rates, according to William Moss, executive director at Johns Hopkins鈥� International Vaccine Access Center.

鈥淢easles often serves as what we [call] the canary in the coal mine,鈥� he said. 鈥淚t really identifies weaknesses in the immunization system and programs, because of its high contagiousness.鈥�

鈥淯nfortunately, I see a perfect storm brewing for the resurgence of vaccine preventable diseases,鈥� he added, 鈥�… We really need to turn this around.鈥�

Earlier this week, the Centers for Disease Control and Prevention , and in the preceding months changed policies surrounding the measles, mumps, rubella and varicella (chickenpox) combination vaccine and this year鈥檚 COVID 19 booster 鈥� all based on recommendations from an advisory committee hand-picked by Kennedy. The universal birth dose of the hepatitis B vaccine, in place for decades, was credited with nearly eliminating the highly contagious and dangerous virus in infants.

Lynn Nelson, the president of the National Association of School Nurses, fears that other, more conservative states will now look to Florida as an example.

鈥淲e already have seen outbreaks all over, and they’re only going to escalate if you have an area of the country whose herd immunity levels slip down further than they already are, which I think will happen if those [anti-mandate rules] come into effect,鈥� she said. 鈥淭hat, in combination with some of the other misinformation that’s coming out, people will feel validated in decisions not to immunize their children.鈥�

Florida鈥檚 Department of Health appears to be moving ahead to end requirements for the four vaccines it controls, despite indicating nearly two-thirds of Floridians oppose the action. Proposed draft language presented at the Dec. 12 workshop would also allow parents to opt their kids out of the state鈥檚 immunization registry, Florida SHOTS, and expand exemptions. 

Currently, all 50 states have vaccine requirements for children entering child care and schools. Parents across the country are able to apply for exemptions if their child is unable to get vaccinated for medical reasons and most states 鈥� including Florida 鈥� also have religious exemptions. Part of the proposed changes presented at the Dec. 12 meeting would add Florida to the 20 states that additionally have some form of , further widening parents鈥� ability to opt their kids out of routine vaccines. 

The public comment period remains open through Dec. 22, after which the department will decide whether or not to move forward with the rule change. In the interim, advocates are pushing state health officials to conduct epidemiological research around the impact of removing the vaccine mandates and studies on the potential economic costs. Florida is and out-of-state visitors. 

Without that information, pro-vaccine advocate Saunders said these critical public health care decisions will be made 鈥渁t the whim of an appointed official.鈥� 

鈥淭he nation,鈥� he added, 鈥渋s looking at Florida.鈥�

The 12 members, who were recently handpicked by controversial Health and Human Services Secretary Robert F. Kennedy Jr., also debated overturning decades of established practice around hepatitis B shots for newborns, though they ultimately tabled that vote.

The other two shots in play were the measles, mumps, rubella and varicella (chickenpox) combination vaccine, also known as MMRV, and this year鈥檚 COVID 19 booster. 

By the end of the week, the Advisory Committee on Immunization Practices, also known as ACIP, voted to no longer recommend the MMRV combination vaccine for kids under 4 years old, rendering it largely inaccessible for that age group. 

The committee also voted to shift the COVID 19 booster recommendation to 鈥渟hared clinical decision making鈥� for all people over 6 months old 鈥� regardless of age or risk level 鈥� meaning that before getting the shot, individuals will need to talk through the pros and cons with a health care provider, which includes pharmacists. 

Through this departure, the committee largely preserved access and insurance coverage, while also raising doubts about the effectiveness and safety of the vaccine, at times citing debunked theories.

鈥淭here is just widespread confusion about, 鈥榃hat should I do as a parent? Who should I listen to?鈥欌�� said Northe Saunders, executive director of the pro-vaccine advocacy organization , formerly called SAFE Communities Coalition. 

鈥淎merican parents and American providers don’t actually know what the best recommendations are anymore,鈥� he added, 鈥渁nd so that is going to lead to more hesitancy, because there’s uncertainty about what the right thing to do is, and that’s going to lead to declining immunization rates.鈥�

Before the ACIP meeting, MMRV and hepatitis B vaccine recommendations were based on decades of established practices supported by science, which experts described as 鈥渟ettled,鈥� so it was unclear why they were being relitigated, according to numerous medical professionals, including those who spoke during the meetings as well as those interviewed by 社区黑料.

The point of these conversations is, 鈥渢o raise doubt, to confuse people,鈥� said Paul Offit, the director of the and an attending physician in the Division of Infectious Diseases at Children鈥檚 Hospital of Philadelphia. Offit was instrumental in the creation of the rotavirus vaccine and previously served as an ACIP member. 

鈥淭he degree to which the public is confused about vaccines is the degree to which they will be less likely to get them,鈥� he said, 鈥渁nd that is RFK Jr’s goal: to make vaccines less available, less affordable and more feared.鈥�

The meetings themselves appeared to be marked by moments of pronounced confusion for the new committee members, some of whom asked for clarification around what they were voting on multiple times.

At least some of this was likely due to their unusual level of inexperience, which committee Chair Martin Kulldorff even noted as he opened day two on Friday.

鈥淲e are rookies,” Kulldorff “With one exception, this was either our first ACIP meeting or our second.”

Typically, committee members are highly qualified medical professionals who are vetted for months to years before serving. In an unprecedented upheaval earlier in June, Kennedy Jr. fired all 17 existing advisory members via a Wall Street Journal 鈥� after promising he would leave the committee鈥檚 recommendations intact. 

Almost immediately he brought on eight new members, a number of whom have espoused anti-vaccine rhetoric and other scientific misinformation. One of them eventually stepped down and Kennedy then added an additional five members leading up to last week鈥檚 sessions.

Measles, mumps, rubella and varicella

The MMR vaccine was in the United States in 1971, followed by the MMRV vaccine in 2005. Two doses of the combined shot were preferred until 2008, when monitoring studies showed an increased risk of febrile seizures 鈥� convulsions in a young child caused by a fever 鈥� following the first dose. 

While these seizures are short-lived, resolve themselves and are not associated with any long-term negative outcomes, 鈥渢hey鈥檙e hard to watch,鈥� said Offit.

So by 2009, the CDC released updated recommendations, in place up until Thursday鈥檚 vote, which advocate for separating MMR and varicella for the first dose at age 12-47 months and administrating the combined shot for the second dose at age 4-6 years old. These vaccines are among those required for school entry in all 50 states, though numerous states have recently introduced legislation to loosen mandates, and exemptions are on the rise.

The vast majority of parents (85%) opted to follow that recommendation for separating the shots, with 15% still choosing the combination vaccine for the first dose, often to avoid multiple jabs of an infant.

The committee鈥檚 recent update to the recommendations will mean that choice no longer exists.

While this change itself is 鈥渘ot a huge deal,鈥� Offit said, the arguments brought up by committee members were 鈥渋ntellectually disingenuous鈥� and will only continue to 鈥渞aise doubt.鈥�

Stacy Buchanan is a pediatric nurse practitioner and a clinical professor who is the National Association of Pediatric Nurse Practitioners鈥� liaison to ACIP

鈥淚 really feel like this was brought up to just further confuse caregivers that are already questioning whether or not they want to have their child vaccinated,鈥� said Buchanan. 鈥淎nd in a time where we’re seeing unprecedented numbers of measles in communities, I think that we need to be really clear that the MMR vaccine 鈥� whether you’re getting the combined or two separate injections 鈥� is really key and needs to be administered routinely based on the schedule.鈥�

In past years, the liaisons like Buchanan, who have on-the-ground clinical experience, would weigh in during the committee鈥檚 working group meetings to help evaluate the evidence. That precedent was unexpectedly overturned in late July when the liaisons received an email accusing them of being and no longer permitted to serve. Now they can only be heard during the public comment portion of the meetings.

In a statement released Thursday, the American Academy of Pediatrics wrote, 鈥淭oday鈥檚 meeting of the federal Advisory Committee on Immunization Practices (ACIP) promoted false claims and misguided information about vaccines as part of an unprecedented effort to limit access to routine childhood immunizations and sow fear and mistrust in vaccines. Following today鈥檚 meeting, instead of emerging with clear guidance about vaccines that we know protect against serious illnesses, families are left with confusion, chaos and false information.鈥�

The AAP also emphasized that they had released their own , which includes unchanged MMRV vaccination recommendations.

Committee members elected for the combination shot for those under 4 to remain covered by Vaccines for Children, which provides vaccines to millions of kids who otherwise wouldn鈥檛 be able to afford them, despite their recommendation against its use. Some members apparently misunderstood what they had voted on Thursday and reversed their stance the next morning. 

COVID 19 booster

On Friday, the committee voted on four measures surrounding the COVID 19 booster shot. Three passed, and the fourth, which was the most controversial and would have recommended required prescriptions for anyone seeking to get the shot, ended in a tie vote that ultimately failed.

During his presentation, Retsef Levi, put in charge of the working group on COVID, raised a number of concerns around mRNA vaccines that have been widely disputed, including the assertion that they could change the way the body reacts to its own genetic material. Levi is a professor of operations management at MIT鈥檚 Sloan School of Management and has no formal medical training.

The three provisions that did pass will mean that while the vaccine is not actively recommended for anyone 鈥� including those at high risk of infection 鈥� those over the age of 6 months can access it as long as they make the decision in conjunction with a health care provider.

Richard Hughes, a George Washington University law professor and leading vaccine law expert, said the committee appears to be using the practice known as 鈥渟hared clinical decision making,鈥� because it 鈥済ets at that medical freedom rhetoric 鈥� and provides an option other than 鈥榥o recommendation鈥� 鈥� but is not a good option.鈥�

While this sort of policy sounds like it鈥檚 creating greater choice, ultimately evidence shows it leads to struggles for health care providers who haven鈥檛 been given clear risk factors, Hughes said. This can be cumbersome, time consuming and lead to patient distrust.

鈥淲hen you know that it鈥檚 an automatic 鈥榶ou should get it鈥� that鈥檚 different than 鈥業 don鈥檛 know, it鈥檚 kind of murky,’鈥� he added.

The new policy is particularly confusing, said Offit, since last month the Food and Drug Administration only licensed the boosters for those . 

鈥淭he good news is, anybody can use it,鈥� Offit said, 鈥渆ven though, according to the FDA, they’d be using it off label. But we don’t recommend it for anybody. Basically, that’s what they’re saying.鈥�

He described this as a 鈥渂ad choice鈥� which will lead to fewer people being vaccinated and fragmented state-by-state policies.

Earlier this month, the governors of Washington, California and Oregon announced they鈥檇 be forming to establish their own vaccine recommendations, which Hawaii quickly joined. A few weeks later, seven northeastern states, including New York and Pennsylvania, formed with a similar goal.

Hepatitis B

The hepatitis B vaccine was first recommended by ACIP in Before that point, an estimated 200,000 to 300,000 people, including about 20,000 children, were infected with the highly contagious virus each year. 

This was particularly dangerous for infants who have a 90% chance of developing liver cancer or chronic liver disease, if they contract the virus. For 4- and 5-year-olds, that chance remains high at 30-40%.

At one point, the vaccine was only recommended for infants whose mothers tested positive for the virus, since it can be transmitted during birth, but for a number of reasons 鈥� including inaccurate test results 鈥� this was found to be ineffective. So by 1991, ACIP鈥檚 recommendation was expanded to include universal birth doses. Since then, infant infections have dropped by 95%.

According to Offit, the birth dose 鈥渉as always been a target of anti-vaccine activists,鈥� since the hepatitis B virus can be transmitted sexually. But it can also be transmitted in many other ways, including through surfaces. 

On Thursday, ACIP members were meant to vote on an updated recommendation which would have delayed the initial dose until an infant is one month, a move that would likely lead to a serious reduction in uptake, according to doctors.

Ultimately, after hours of arguments, which included research Offit called 鈥渂ogus,鈥� the committee ran out of time to vote on the measure Thursday. Friday morning they chose to table it indefinitely. 

Buchanan, the nurse practitioner, expressed concern that the safety of the well-established vaccine was even being reargued in the first place: 鈥淭he 鈥榳hy鈥� was never there, and that’s so important, because we should not be bringing things to a formal ACIP committee vote without having a science-based rationale for bringing the question forward.鈥�

While Hughes was relieved the vote was punted, Offit was more pessimistic, expressing fears that the committee will eventually try to push the first dose even later than one month.

鈥淎nd that would be a tragic decision,鈥� he said. 鈥淭hat would mean that there will be children in this country who will get hepatitis B in the first year of life, or in childhood 鈥� which will limit their life for no reason.鈥�

The federal government鈥檚 latest guidelines for COVID-19 vaccines make it difficult to know who, exactly, will be able to access shots this fall. While Health and Human Services Secretary Robert F. Kennedy Jr. and some of his staff claim anyone will be able to access a shot in consultation with their doctor, medical groups are warning that the new guidance will impact a broad swath of people, including postpartum people and healthy children.

鈥淔or children and young adults that I see, there are constraints, and they are significant,鈥� said Dr. Molly O鈥橲hea, a pediatrician in Michigan and a spokesperson for the American Academy of Pediatrics (AAP).

It might also take several more weeks to know who will be able to receive no-cost COVID-19 vaccines covered by health insurance. That decision partly depends on formal recommendations from a vaccine panel that isn鈥檛 scheduled to meet until mid-September. 

Actions by the Food and Drug Administration last week mean that none of the COVID-19 vaccines that are slated to be on the U.S. market this fall will have an emergency use authorization at the height of the pandemic. The removal of this designation means the drug company Pfizer will no longer offer COVID-19 vaccines to very young children, limiting parents鈥� brand options and potentially impacting supply.

, and , the three main COVID-19 vaccine manufacturers, have all shared news releases about what they鈥檝e been approved to offer:

• Moderna, Pfizer or Novavax will offer shots to anyone who is 65 and older, irrespective of medical history.
• Pfizer will offer shots to anyone between the ages of five and 64 if they have at least one underlying condition that puts them at high risk for severe outcomes from COVID-19.
• Moderna will offer shots to anyone between six months and 64 if they have at least one underlying condition that puts them at high risk for severe outcomes from COVID-19.
• Novavax, the only company providing a non-mRNA COVID-19 vaccine, will offer shots to anyone between 12 and 64 if they have at least one underlying condition that puts them at high risk for severe outcomes from COVID-19.

The vaccine panel known as the Advisory Committee for Immunization Practices (ACIP) is expected to make formal recommendations on these FDA-approved vaccines, and those recommendations have historically determined whether insurance providers will cover a vaccine at no cost under insurance.

An HHS spokesperson did not immediately respond to a request for information and comment from The 19th, but , Kennedy said: 鈥淭hese vaccines are available for all patients who choose them after consulting with their doctors.鈥� Separately, on a document from HHS stating the FDA鈥檚 actions do 鈥渘ot affect access to these vaccines for healthy individuals. These vaccines remain available to those who choose them in consultation with their healthcare provider.鈥�

Dr. Marty Makary, FDA commissioner, : 鈥�100% of adults in this country can still get the vaccine if they choose. We are not limiting availability to anyone.鈥�

But what that means practically for everyday people who want to access a COVID-19 shot 鈥� everything from whether their doctor will prescribe it, or if a pharmacy will be able to administer it, and whether there will be an out-of-pocket cost 鈥� is unclear for now. 

How will it impact postpartum people?

Pregnant people are expected to still have access to the vaccine because the CDC continues to list pregnancy as an underlying condition that puts an individual at high risk for severe outcomes from COVID-19. ( also includes chronic health conditions and immunocompromised conditions.)

But Kennedy, who has repeatedly questioned the safety of COVID-19 vaccines despite , that the CDC would no longer formally recommend such vaccines , a move that seemed to contradict . 

Lactating and postpartum individuals must have an underlying medical condition to be eligible for one of the FDA鈥檚 approved vaccines, according to the American College of Obstetricians and Gynecologists (ACOG)鈥檚 understanding of the announcement. ACOG COVID-19 vaccination to people who are contemplating pregnancy, are pregnant, were recently pregnant or are now lactating.

鈥淲e recognize that now, disappointingly, only lactating and postpartum individuals with an underlying condition will be eligible for vaccination. Still, it remains critical that pregnant patients receive the vaccines so that they are able to provide passive immunity from COVID-19 to their infants in those first few months of life before they can be vaccinated,鈥� said ACOG President Steven J. Fleischman in an email.

How will it impact healthy children?

Healthy children will likely still be able to access the COVID vaccine, but the cost for a parent or guardian, as well as availability, will be impacted by these decisions.

Charlotte A. Moser, co-director of the Vaccine Education Center at Children鈥檚 Hospital of Philadelphia, said parents who want to get their kids the COVID-19 vaccine should still be able to do so through what is called in consultation with their child鈥檚 health care provider, according to the CDC鈥檚 current vaccine schedule. But it鈥檚 unclear whether this will change when ACIP meets again.

But physicians who prescribe a COVID-19 vaccine outside of the parameters of how the FDA approved them would be OKing use of the shot 鈥渙ff-label鈥� 鈥� a designation that means a medical product is being used outside of how the FDA approved it. That raises questions about access and cost. Physicians might not be willing to prescribe off-label because of concerns about liability.

鈥淚 think that there will be a substantially smaller number of pediatricians, pharmacies, etc., who will be comfortable taking that risk,鈥� O鈥橲hea said.

Dr. Dial Hewlett, medical director of tuberculosis services at Westchester County Department of Health in New York and a spokesperson for the Infectious Diseases Society of America, said an off-label prescription might also not be covered by insurance.

鈥淎 mother or father can go in with their child and say, 鈥業’d like for them to have the vaccine,鈥� but they may be told, 鈥榃ell we鈥檒l give it, but you鈥檙e going to have to pay $200,鈥欌�� he said.

Depending on the circumstances, pharmacists may also not be able to provide off-label vaccines. Some states tie pharmacist immunization authority to FDA approval,which has the potential to create a hodgepodge of access. that CVS and Walgreens, the country鈥檚 largest pharmacy chains, have begun restricting COVID-19 shots in some states to people with a prescription. 

鈥淭here may be some variability from state to state, but it’s a big barrier if FDA approval is not there, and the FDA approvals have been pulled back from where they were previously,鈥� Hewlett said.

The FDA announcement is 鈥渃oncerning,鈥� added Moser, who noted that limiting Pfizer鈥檚 vaccine will make it more difficult for all children to get a COVID-19 vaccine this year because of anticipated supply limitations.

O鈥橲hea, the pediatrician in Michigan, said her office is currently deciding how many COVID-19 shots to stock, and it鈥檚 proving tricky as they weigh the cost vs. demand 鈥� the percentage of children under 18 getting the shot .

鈥淔iguring out how much we want to have at any one time, and how we are going to give it to people 鈥� this really makes it a lot more complicated,鈥� she said.

What happens next?

Moser said the announcement adds confusion for providers and families, and noted that the unilateral approach by Kennedy so far when it comes to vaccine policy 鈥渞emoves hundreds of voices of clinicians and scientists that were part of the process.鈥� Moser recently served on ACIP and . He has replaced the panel with people who do not have relevant experience.

鈥淭hat army of voices ensured a process informed by clinical experience and scientific expertise to which the small group making these decisions now cannot possibly compare,鈥� she said in an email.

The revamped ACIP panel is scheduled to meet over two days beginning on September 18. Republican Sen. Bill Cassidy, a doctor who is chair of the Senate Health, Education, Labor, and Pensions (HELP) Committee, whether that panel has enough legitimacy to meet, especially amid . 

鈥淪erious allegations have been made about the meeting agenda, membership, and lack of scientific process being followed for the now announced September ACIP meeting,鈥� . 鈥淭hese decisions directly impact children鈥檚 health and the meeting should not occur until significant oversight has been conducted. 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.鈥�

AAP called Kennedy鈥檚 latest COVID guidelines 鈥渄eeply troubling鈥� and urged COVID vaccine decision-making to remain between medical experts and families. 

Dr. Susan J. Kressly, president of AAP, said in a statement that any barrier to COVID-19 vaccination as the nation enters the respiratory virus season creates 鈥渁 dangerous vulnerability for children and their families.鈥�

鈥淎ny parent who wants their child vaccinated should have access to this vaccine,鈥� she said, adding that HHS鈥� action 鈥渘ot only prevents this option for many families, but adds further confusion and stress for parents trying to make the best choices for their children.鈥�

was originally reported by Barbara Rodriguez of . .

Eleven of 12 Democratic Senate Finance Committee members called on Robert F. Kennedy Jr. to resign Thursday just before a charged 鈥� and at times explosive 鈥� committee hearing with the embattled health secretary.

Committee Democrats and two Republicans, both of them physicians, accused Kennedy of peddling misinformation, pressuring officials to rubber stamp policies not based on science and making it harder for Americans to access COVID vaccines. Sen. Maria Cantwell, D-Washington, called Kennedy a charlatan.

Sen. Michael Bennet, D-Colorado, said he was questioning Kennedy on behalf of 鈥減arents and schools and teachers all over the United States of America who deserve so much better than your leadership.鈥�

Sen. Maggie Hassan, D-New Hampshire, accused the secretary of denying parents the right to vaccinate their children against COVID.

鈥淵ou鈥檙e making things up to scare people,鈥� Kennedy loudly interrupted. 鈥淎nd it鈥檚 a lie.鈥�

Kennedy defended his running of HHS, which was thrust into turmoil after his decision last week to fire the Senate-confirmed Centers for Disease Control and Prevention director, issue confusing new COVID vaccine guidelines and cut funding for mRNA vaccine research, among other contentious moves. A number of committee Republicans applauded Kennedy for his work, noting he had reduced spending and shifted the agency鈥檚 focus to 鈥減romoting prevention first.鈥�

During a moment that appeared to confuse senators, Kennedy said he had fired former CDC head Susan Monarez because he asked her, 鈥淎re you a trustworthy person?鈥� and she replied, 鈥淣o.鈥� Several in response cited Monarez鈥檚 claim that that she鈥檇 sign off on forthcoming recommendations from a newly installed vaccine committee. Kennedy refuted these claims and repeatedly accused Monarez of lying.

He also appeared to double down on his assertions that childhood vaccines and autism are linked, citing

Sen. Tina Smith, D-Minnesota, attempted to push the secretary on his past statements: 鈥淲hen were you lying, sir? When you told this committee that you were not anti-vax, or when you told Americans that there鈥檚 no safe and effective vaccine?鈥�

鈥淏oth things are true,鈥� he replied.

Kids are heading back to school this fall as the country experiences some of the lowest childhood vaccine rates and highest levels of public health uncertainty in known memory.

Amid the swirling currents: the defunding of vaccine research and competing messaging around COVID shots for children; a rare federal attempt to influence a West Virginia legal battle over childhood vaccine exemptions; and a dramatic leadership struggle within the Centers for Disease Control and Prevention that could solidify more power in the hands of Health and Human Services Secretary Robert F. Kennedy Jr. 

Kennedy is seen by many as the destabilizing figure at the center of the chaos, and 2025-26 will be the first full school year that the longtime vaccine skeptic is in charge of childhood public health. The controversial secretary, who earned a this week from every one of his predecessors going back to the Carter administration, is scheduled to testify before the Senate Finance Committee later today.

Sen. Bill Cassidy, R-Louisiana, who heads the Senate health committee and played a pivotal role in Kennedy’s confirmation, has of the CDC amid the turmoil, citing children’s health as his major concern.

On Wednesday, three West Coast governors announced they鈥檇 be forming to establish their own vaccine recommendations, protesting those of the CDC, which, they said in a statement, 鈥渉as become a political tool that increasingly peddles ideology instead of science, ideology that will lead to severe health consequences.鈥�

The governors of California, Oregon and Washington said the alliance will 鈥渆nsure residents remain protected by science, not politics.鈥� Meanwhile, Florida Gov. Ron DeSantis and his surgeon general announced their intention Wednesday to become , including for schoolchildren.

As the states splintered on vaccines, 1,000 current and former HHS staff released formally calling for Kennedy鈥檚 resignation, writing that he 鈥渃ontinues to endanger the nation鈥檚 health.鈥� The group condemned a series of actions including the of the Senate-confirmed CDC director, Kennedy鈥檚 refusal to be briefed by CDC experts on vaccine-preventable diseases and his 鈥渕isleading claims鈥� about physician and hospital liability for following vaccine guidance that he opposes.

They also denounced the Food and Drug Administration鈥檚 recent of emergency use authorization for COVID vaccines, which 鈥� alongside the the CDC鈥檚 newest recommendations 鈥� will likely make it significantly harder for children, especially those under 5 years old, to access the shots. Recently released FDA memos show its vaccine chief overruled staff scientists who, citing high hospitalization rates among young children with COVID, recommended a wide range of age groups continue to get the vaccine, according to .

All of this, partnered with Kennedy鈥檚 long history of disseminating scientific misinformation, including the debunked claim that vaccines can cause autism, has led to great confusion for parents just as their kids are returning to school. Kennedy has promised to later this month, which he said would expose 鈥渨hat the environmental toxins are that are causing” autism.

鈥淭here is a lot of inaccurate information right now coming from the highest levels of HHS,鈥� said Kawsar Talaat, physician and associate professor at the Johns Hopkins Bloomberg School of Public Health, whose research focuses on vaccines. 鈥淚 would think that for family members, who don’t necessarily have expertise, it would be hard to know who to trust, and it will certainly contribute to a decline in vaccination rates.鈥�

Indeed, during the 2024-25 school year, immunization rates among kindergarteners across the country decreased for all reported vaccines, according to the latest available . Rates for the measles, mumps, and rubella vaccine fell to 92.5% from approximately 95% pre-pandemic. And of states had MMR vaccination rates below the 95% needed for herd immunity, with some, like Idaho at 78.5%, well below it. 

As these numbers were falling, exemptions to mandatory vaccines for school-aged kids were on the rise, increasing to 3.6% nationally, driven by non-medical exemptions and up from in the 2019-20 school  year. Seventeen states 鈥� spiking from pre-pandemic 鈥� reported exemptions exceeding 5%, threatening herd immunity.

Lynn Nelson is the president of and has seen this uncertainty and hesitancy firsthand.

鈥淲e get a lot of families who are confused,鈥� she said, “who may have immunized children until this point and now are having second thoughts about it.鈥�

Increasingly, conflicted parents are bringing messages they鈥檝e heard from HHS or Kennedy himself to their school nurses, wondering why they contradict what they鈥檝e historically been told by their pediatricians.

鈥淚t tends to be things like, 鈥淲ell, it sounds like maybe autism is caused by [vaccines]. We want to wait and see,鈥欌�� Nelson said. 

But as these parents hold off on immunizing their kids, communities remain at heightened risk for infection and outbreak, she added.

And even if medical providers are able to fight the misinformation and have conversations with parents that ultimately lead them to want to vaccinate, some kids might not be able to access the shots, amid funding cuts to public health vaccination clinics in rural areas. 

Vaccine hesitancy also plays out at the district level, since school system leaders are 鈥渏ust as susceptible to misinformation as anyone else鈥� and they often make the decision on whether or not to enforce the policies requiring most children be vaccinated in order to attend school, Nelson said. 

鈥淚t鈥檚 a question for most of us probably of when 鈥� not if 鈥� there鈥檚 going to be an outbreak.鈥�

Chaos and pushback at the CDC

An already anxious back-to-school season for mandatory immunizations was intensified by the firing of CDC head Susan Monarez on Aug. 27, and her subsequent refusal to leave the post, following a clash over vaccine policy, according to reporting by  

Monarez鈥檚 lawyers her removal was 鈥渓egally deficient,鈥� and said, 鈥渢he attack on Dr. Monarez is a warning to every American: Our evidence-based systems are being undermined from within.鈥�

She has since been replaced by who has no medical training and, during the pandemic, posted conspiracy theories on social media and voiced support for unproven treatments 鈥� such as ivermectin, according to reporting by Before being appointed as acting head of the CDC, O鈥橬eill served as a HHS deputy to Kennedy.

At least four other powerful agency leaders some with claiming they were asked to participate in an unscientific vaccine recommendation process. 

My resignation letter from CDC.

Dear Dr. Houry,

I am writing to formally resign from my position as Director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention (CDC), effective August 28, 2025, close of business.鈥�

— DrDemetre (@dr_demetre)

In response, CDC employees 鈥� a “clap out” protest to show support for their departing colleagues. An August investigation by revealed how badly the department has been depleted under Kennedy, with at least 20,500 total HHS workers gone since January, including at least 15% of all CDC staff.

Last week鈥檚 high-profile exodus comes after a tumultuous month: On Aug. 20, over 750 employees of the CDC and other health agencies signed a rare , imploring Kennedy to stop spreading misinformation. The authors argued his rhetoric contributed to an attack earlier that month on their headquarters by a gunman who fired more than onto the agency’s main campus and appeared to be, at least in part, motivated by COVID

鈥淗ealth and Human Services Secretary Robert F. Kennedy, Jr., is complicit in dismantling America鈥檚 public health infrastructure and endangering the nation鈥檚 health by repeatedly spreading inaccurate health information,鈥� the letter reads. The authors accused Kennedy of sowing public mistrust in the CDC鈥檚 workforce; firing critical workers; making false and dangerous claims about mRNA and measles vaccines; and misusing data to falsely claim childhood vaccines are the cause of autism.

HHS did not respond to requests for comment on the confusion surrounding vaccine policies nor on the allegations that inaccurate information is coming out of the agency, eroding faith in its work.

In response to mounting criticism, Kennedy published an op-ed in this week, arguing he was, 鈥渞estoring public trust in the CDC,鈥� which had been destroyed by 鈥渂ureaucratic inertia, politicized science and mission creep.鈥�

鈥淲e have shown what a focused CDC can achieve,鈥� he wrote, citing and defending his response to the measles outbreak, which he said, 鈥渨as neither 鈥榩ro-vax鈥� nor 鈥榓ntivax.鈥欌��

He identified six areas of focus, including investing in the workforce, that he wrote will 鈥渞estore the CDC鈥檚 focus on infectious disease, invest in innovation, and rebuild trust through integrity and transparency.鈥�

The American Academy of Pediatrics recently signaled its lack of confidence by filing a alongside a number of other health care organizations, arguing Kennedy had violated federal law and made 鈥� unscientific changes to federal vaccine policy鈥� by moving to curb COVID vaccines for young children. The plaintiffs include an immunocompromised mother to two teenage boys who were denied COVID vaccines.听

They鈥檝e also issued their own guidance, the COVID vaccines for all young children. Kennedy responded to this move on X, calling it a 鈥渓ist of corporate-friendly vaccine recommendations鈥� and 鈥減erhaps, just a pay-to-play scheme.鈥�

Last week, the Food and Drug Administration approved updated COVID vaccines, but with new restrictions: they鈥檒l only be available to people 65 and older or younger people with at least one underlying medical condition that increases their risk for severe disease. In a post on Kennedy said the Moderna vaccine had been approved for use in those older than 6 months, Pfizer in those older than 5 years and Novavax in those older than 12 years.

鈥淭hese vaccines are available for all patients who choose them after consulting with their doctors,鈥� he wrote, though it鈥檚 still not clear who will have the shots

While healthy children and adults without underlying conditions were eligible to receive the vaccine historically, HHS claimed, 鈥淭oday鈥檚 decision does not affect access to these vaccines for healthy individuals.鈥� 

鈥淗HS is not limiting access,鈥� a department spokesperson wrote to 社区黑料. 鈥淭he COVID vaccine remains available for anyone who chooses it in consultation with their healthcare provider.鈥�

In response to a request for clarification to determine if this means children and healthy adults under 65 can access the vaccine with permission from a doctor, the agency spokesperson just repeated the same language.

All of this back and forth has contributed to confusion for parents, as increase in many areas of the country. Recent by KFF, a nonpartisan, nonprofit health policy organization, found that half (48%) of parents are not sure if federal health agencies are currently recommending that healthy children receive a COVID vaccine this fall or not.

A federal push for vaccine exemptions

While many eyes are on the debate surrounding COVID vaccines, researchers and physicians also remain laser focused on measles, following this year鈥檚 outbreak, which infected over across 41 states and killed two unvaccinated children. 

Case numbers this year are already the they鈥檝e been since the disease was declared eradicated in the U.S. in 2000. Some 92% of reported infections have involved a person who was unvaccinated or whose status was unknown and 13% have resulted in hospitalization.

Throughout the outbreaks, Kennedy has the severity and has been in his support of the MMR vaccine.

In a recent and highly unusual move for the federal government, Kennedy expressed his support for a philosophical and religious exemption to mandatory vaccines for school-aged kids in West Virginia. 

Up until a recent opened the door for broader exemptions, the state had some of the nation鈥檚 strictest childhood vaccination policies and was one of only five that exclusively allowed for medical exemptions. Already around 500 requests for religious and philosophical exemptions have been submitted 鈥� and approved 鈥� for the 2025-26 school year, according to records obtained by 社区黑料, though those numbers are not yet reflected in the CDC鈥檚 data.

According to that data, Georgia and Michigan saw exemptions rise faster than any other state 鈥� by 1.2 percentage points year-over-year 鈥� driven almost exclusively by non-medical exemptions. They were closely followed by Idaho, Pennsylvania, South Dakota and Utah.

In West Virginia, conflict between the governor鈥檚 order and current state law has and over how officials should proceed. Beginning on Aug. 21, the federal government publicly weighed in, apparently attempting to tip the scales. 

First, HHS鈥檚 Office for Civil Rights sent to all West Virginia health departments participating in the federal which provides vaccines to millions of kids who otherwise wouldn鈥檛 be able to afford them. The communication stated that if they did not comply with the governor鈥檚 executive order, they would no longer be eligible to participate in the program. 

Richard Hughes, a George Washington University law professor and leading vaccine law expert, called this move an unheard-of 鈥渋mplied threat.鈥�

鈥淚 just think that鈥檚 got to be unprecedented for a federal agency 鈥� the Office for Civil Rights 鈥� to go and pick out a state law and say, 鈥榊ou need to comply with that.鈥� That just boggles my mind,鈥� Hughes said.

鈥淲hat I worry about is that we鈥檙e about to see a push at the federal and the state level encouraging religious exemptions,鈥� he added.

Hours after Kennedy testified before the Finance Committee, the Office for Civil Rights announced they had issued similar letters to all states participating in the Vaccines for Children program stating they “must respect state religious and conscience exemptions from vaccine mandates.”

Earlier, the health secretary had posted on , voicing his support for the West Virginia governor and urging state legislators to comply.

Del Bigtree, CEO of the, an anti-vaccine advocacy group, told 社区黑料, 鈥淲e’re happy that Robert Kennedy Jr. and HHS are supporting Gov. Morrissey. I think this is a pivotal moment for this conversation in this nation.鈥�

Other states have joined West Virginia in pursuit of such bills, according to Caitlin Gilmet, the communications director for , a pro-vaccine advocacy organization formerly called SAFE Communities Coalition.

鈥淲e鈥檙e seeing medical freedom bills in a number of states. Idaho, Montana, Tennessee, Texas, Florida are all kind of national bellwethers where those parental rights bills are being tested,鈥� she said. 

Kids in those states are particularly vulnerable to 鈥渘ew exemption policies, weak enforcement and then the conditions to create exemption clusters,鈥� she added, which can then lead to outbreaks.

A number of these types of bills contain language or policies that are unclear, leading to more confusion and conflicting guidance. 

Further complicating the issue is Kennedy’s recent firing of all members of the group responsible for making recommendations on the safety, efficacy and clinical need for vaccines to the CDC as well as the cancellation of $500 million in federal grants to mRNA vaccines, the technology used to develop the COVID vaccination. 

In a post on , he claimed the vaccines are ineffective and cause 鈥渕ore risks than benefits,鈥� while 鈥減aradoxically鈥� prolong[ing] pandemics as the virus constantly mutates to escape the protective effects of the vaccines鈥� 鈥� assertions that are echoed by activists like Bigtree, yet have been widely debunked by researchers and medical professionals.

鈥淚t is incredibly misleading, not to mention just false, to say that the vaccines are more harmful than they are beneficial,鈥� said Talaat, the Johns Hopkins professor. 鈥淭hey are incredibly beneficial. They’ve saved millions of lives.鈥�

While COVID vaccines were the first on the market to use mRNA technology, others were in development before the funding cancellation, including ones to fight cancer and bird flu.

鈥淸Bird flu] could be the next pandemic,鈥� Talaat said, 鈥渁nd they canceled the contracts to create mRNA vaccines against this virus.鈥�

鈥淚t’s really important,鈥� she added, 鈥渢hat people understand that, unfortunately, this is not a time where we can trust those in the highest positions of power at HHS.鈥�

A trained doctor, he spent 26 years working in pediatric infectious disease and studying the rotaviruses before ultimately creating the strain that became the RotaTeq vaccine. That breakthrough saves 165,000 lives globally each year, he said, and has essentially eliminated the 70,000 annual U.S. hospitalizations caused by the contagious diarrhoeal virus common in young kids.

Now the director of the and an attending physician in the Division of Infectious Diseases at Children’s Hospital of Philadelphia, Offit also serves as a member of the Food and Drug Administration鈥檚 . And about 20 years ago, he spent half a decade on the committee responsible for making recommendations on the safety, efficacy and clinical need for vaccines to the Centers for Disease Control and Prevention.

That committee, also known as the , or ACIP, experienced an unprecedented upheaval earlier this month when Robert F. Kennedy Jr. fired all 17 advisory members via a Wall Street Journal 鈥� after promising he would leave the committee鈥檚 recommendations intact.

鈥淭he committee has been plagued with persistent conflicts of interest and has become little more than a rubber stamp for any vaccine,鈥� wrote Kennedy, the head of the U.S. Department of Health & Human Services and a longtime vaccine skeptic.

In a statement released by HHS, Kennedy said he was 鈥減rioritizing the restoration of public trust above any specific pro- or anti-vaccine agenda,鈥� and later promised via that none of the replacement members would be 鈥渋deological anti-vaxxers.鈥� Public health experts are now disputing that claim in light of his eight recent appointments.

鈥淭his is a slate that lacks a balanced viewpoint,鈥� said Richard Hughes, a George Washington University law professor and leading vaccine law expert. 鈥淎nd it’s deeply concerning that many of them are outright anti-vaccine and have their own very concerning conflicts of interest, despite the fact that the secretary claims that he鈥檚 trying to avoid conflicts of interest on the committee.鈥�

This could be particularly dangerous for children, some warn, as the committee鈥檚 recommendations often dictate which vaccines are covered by insurance and which are mandated for school-aged kids. Programs that provide free vaccines for kids could also see their funding cut.

社区黑料鈥檚 Amanda Geduld recently spoke with Offit to better understand the implications of the mass firing, what kids and their families can expect moving forward and how future administrations might work to rebuild trust in the public health vaccine system. 

This interview has been edited for length and clarity. 

社区黑料: Are you in touch with any of the folks who were fired from ACIP? If so, how did they receive that news and what was the mood among the members?

Offit: Well, they found out about it, typically, from reading the newspaper and learning that they had been fired from that position. The mood was one of sadness, because obviously there was no good reason to do it. 

The reason given by Robert F Kennedy Jr. was that all the members were horribly conflicted with pharmaceutical companies [and] that their financial ties to pharmaceutical companies made it such that they couldn’t give advice that would be beneficial to the American public, and that wasn鈥檛 true.

I mean, they have very strict conflict of interest rules at the ACIP whereby you have to make it very clear that you have no association with the pharmaceutical industry and no association with the government, which then allows you to be an independent advisor. And should there be a conflict 鈥� then you can’t vote on that company’s product, and you can’t vote on any product that that company makes. That’s very clear. That’s been clear ever since I was on the committee back 25 years ago.

So it sounds like there was confusion, disappointment and a feeling that the reasons given for the firing weren鈥檛 based in reality? 

They were angry. They were angry that they felt that they’d been dismissed for no good reason and that their willingness to serve the American public had been set aside. I mean, it’s not like you’re paid to do this. It’s just a voluntary position for the most part.

In your knowledge, has anything like this ever happened before?

No, but we’ve never had a secretary of Health and Human Services that was an anti-vaccine activist, science denialist and conspiracy theorist before.

Zooming out a little bit, what鈥檚 the significance of these firings? And what impacts can we anticipate?

I think we can anticipate that Robert F. Kennedy Jr. will put people on that committee who are like minded to him. We’re already seeing evidence of that with the first eight people that he picked. 

So I think what’s going to happen is that there are going to be groups that look elsewhere from the ACIP to try and get information that they think is reliable and up to date and informative. 

What I imagine is that, for example, the American Academy of Pediatrics has its so-called Red Book committee, or . I would imagine that that committee will start to speak with insurance companies to make sure that their recommendations would then have kind of the force of law 鈥� Because I can’t imagine the insurance companies are going to be looking to ACIP, given its current members.

My understanding is, up until this point, insurance companies and states 鈥� when they’re trying to determine school vaccination policies 鈥� have looked to ACIP for guidance. You’re saying that maybe insurance companies will look elsewhere for that information, but is there any concern that this will just mean vaccines are no longer covered by insurance, or that school-age vaccine policies are undermined altogether?

Yes, there’s concern, but it is to the financial advantage of insurance companies to pay for vaccines. I mean, you’d much rather pay for an HPV vaccine than to pay for the care of a woman who has cervical cancer. You’d much rather pay for a measles-containing vaccine than to pay for measles hospitalization.

So there isn’t necessarily concern here that suddenly these vaccines won’t be accessible to families from lower-income backgrounds?

I don’t know. I mean, I think it’s a frantic, chaotic time, and it’s really hard to know. Everything that you sort of counted on to make sense doesn’t make sense anymore. 

It used to be that solid, good science was how we made decisions, and that’s not true anymore with the ACIP. You can tell when Robert F Kennedy Jr. says we want gold standard science, that’s not what he means. What he really means is he wants quote, unquote scientific studies that support his fixed, immutable belief that vaccines cause more harm than good.

In a post on recently Kennedy wrote, 鈥淭he most outrageous example of ACIP鈥檚 malevolent malpractice has been its stubborn unwillingness to demand adequate safety trials before recommending new vaccines for our children.鈥� Has there been an unwillingness to demand adequate safety trials for new vaccines for children in America?

The opposite is true. I had the fortune of working with a team that created the rotavirus vaccine. Before that vaccine was put on the infant immunization schedule, it was tested in a prospective, placebo-controlled trial of more than 70,000 infants. It was done over four years in 11 countries to prove that that vaccine was safe and effective. That was a 70,000- person prospective, placebo-controlled trial that probably cost $350 million. 

I don’t know what he’s talking about. Name the vaccine. Name a new vaccine that hasn’t been tested in a large, prospective, placebo-controlled trial. They all are. 

The problem is that when they’re shown to work and they’re safe, he doesn’t believe it, because he’s a science denialist. That’s what he really means.

Are there any other ways this could impact school-aged kids in particular?

Now what worries me is, I think if RFK Jr. really wants to bring down vaccines, he can do it through the What he could do is he could hold up a paper and say, 鈥淟ook, aluminum adjuvants cause autism or multiple sclerosis or diabetes or asthma, and now I’m going to add that to the list of compensable injuries.鈥�

So anybody with asthma who’s gotten a vaccine that contains an 鈥� and there are seven different vaccines that contain aluminum adjuvants [an ingredient that helps create a stronger immune response] 鈥� is now on the list of compensable injuries. 

Or [he could say] 鈥淚’m going to take these vaccines out of the Vaccine Injury Compensation Program and then just subject them to civil litigation.鈥� That would really disrupt vaccines in this country. I think companies would then do what they did in the 1980s 鈥� They’d leave the market. We had 18 companies that made vaccines in 1980. By the end of the decade, we only had four. 

So does that mean that while this ACIP move might introduce anger and distrust there are no real trickle-down effects that you think we’ll see yet in terms of what vaccines are available or what vaccines are covered?

I think you’ll know a lot when you watch the June [advisory committee] meeting, to hear that discussion, and to hear how pharmaceutical companies react to that discussion and how insurers react to that discussion. I think you’ll learn a lot in the next couple of weeks.

Can you tell me a little bit about the folks who replaced the 17 members? Eight people have been announced so far.

They’re who you would most fear. 

You have people like Robert Malone, in front of Marjorie Taylor Green’s committees 鈥� that the mRNA vaccines cause cancer and heart disease and autoimmune disease. Robert Malone has been an expert witness on behalf of Robert F. Kennedy Jr. in a lawsuit against the mumps component of the MMR vaccine. 

You have somebody like Martin Kulldorff who has represented 鈥� for 鈥� Robert F. Kennedy Jr. in a lawsuit against Merck鈥檚 Gardasil [HPV] vaccine. 

You have people who have published papers claiming that the mRNA vaccines caused heart attacks and sudden death in healthy, young people. You have Vicky Pebsworth, who is a member of the , which is an anti-vaccine group that has lobbied against state vaccine mandates for years. 

This is exactly the cavalcade of stars that you would expect RFK Jr. to feel comfortable with: people who are 鈥� like him 鈥� anti-vaccine activists, who are science denialists. 

It’s the worst of all worlds. It’s like a bad Saturday Night Live skit.

During Kennedy鈥檚 HHS confirmation hearings back in January, Republican Sen. Bill Cassidy 鈥� a former physician 鈥� expressed a lot of trepidation around the nomination, but ultimately voted to confirm, citing various commitments he had received from the administration. One of those promises, Cassidy was that 鈥渋f confirmed [Kennedy] will maintain the Centers for Disease Control and Prevention鈥檚 Advisory Committee on Immunization Practices recommendations without changes.鈥濃��

Critics have since argued that Kennedy鈥檚 move to fire all members amounts to a broken promise, a claim Cassidy himself has since disputed. Is this a broken promise?

He鈥檚 been breaking promises right from the beginning. I think Cassidy put out a list of 10 or so things [Kennedy] promised he wouldn鈥檛 do. And he proceeded to do it.

I鈥檓 reading: He has committed that he would work within current vaccine approval on safety monitoring systems. That he hasn’t done. 

He’ll maintain the CDC Advisory Committee Immunization Practices recommendation without changes, and he hasn’t done that either. 

He’s already, for example, changed the recommendation on pregnancy, changed the routine recommendation for young children to get COVID vaccines. And now Cassidy also put out saying that for those of you who think [Kennedy] may just put vaccine skeptics on [the committee], he’s not gonna do that. Then he proceeds to do that. 

What Cassidy does is he draws a line. He says, 鈥淒on’t cross this line.鈥� Then Kennedy crosses the line, and he doesn’t do anything 鈥� just draws another line. I think he is weak and ineffectual. And I think his legacy will be the harm that’s caused to children and adults in this country because of this massive disruption of the public health vaccine system. I think that will be Sen. Cassidy’s legacy.

Have you spoken to Sen. Cassidy? If you could speak to him today, what would you say to him?

I spoke to him four times before that second confirmation hearing, and once afterwards. I said to him exactly what you would think I would say to him, which is, 鈥淒on’t hire this guy. She knows. She told you exactly who he is.鈥�

It鈥檚 really frustrating. I was sure [Cassidy] was a 鈥渘o鈥� vote. He clearly had problems with him. But in the end, politics trump science. I think when you mix politics and science, you always get politics.

My last question is around this idea of trust. Kennedy has said that he removed all these members and is replacing them in response to a 鈥渃risis of public trust.鈥� On the other side, there are folks who do not at all trust Kennedy. Looking forward, what will it take to rebuild trust in these systems?

I think there was a tremendous loss of trust in the first two years of the pandemic 鈥� I think people saw [many COVID-era policies as] a real impingement on their freedom, and that’s what you’re seeing now. 

I think that RFK Jr. represents the disdain that people ended up having for the CDC and for Dr. Fauci, unfortunately. I think that’s what happened 鈥o the point that there were states that were trying to ban mRNA vaccines. The term 鈥渕RNA vaccines鈥� has become a dirty word, even though it probably saved 3 million lives and probably cost more than 250,000 people their lives when they chose not to get the vaccine. But somehow that all got linked with sort of stepping on our medical freedom, and that’s what you’re seeing now. 

So what’s it going to take to get that back? I think slowly, we’re just going to have to make sure that we 鈥� as scientists and clinicians and academicians and public health people 鈥� explain in careful detail why we do everything.

But public health is also about the public. I mean, you have to care about your neighbor in order to have public health. I think right now, we’re sort of at a point where people go, 鈥淒on’t tell me what to do. If I want to catch and transmit a potentially fatal infection, that’s my right.鈥� And I don’t think we used to be like that.

Is there anything else I haven’t asked you that you want readers to understand, specifically through an education- and child-centered lens?

What’s that line from Bette Davis in All About Eve? 鈥淏uckle up. It’s going to be a bumpy night鈥� 鈥� although everybody says bumpy ride.  鈥�

I think it is going to be a bumpy ride for a while, and then we’ll just see. I believe that the forces of good will prevail. I do. 

I think that there’s a basic feeling among virtually everyone that vaccines are a good thing, and that as people see them erode or maybe become less available or less affordable or more feared that people will rally on behalf of children. I do.

Two groups filed a lawsuit against West Virginia鈥檚 state Department of Health, its Bureau for Public Health and agency leaders on Friday, challenging Gov. Patrick Morrisey鈥檚 January executive order, which opened the door for religious and philosophical exemptions to mandatory school vaccination policies. The American Civil Liberties Union鈥檚 West Virginia chapter and Mountain State Justice filed the suit in Kanawha County Circuit Court on behalf of two parents with immunocompromised children, according to reporting by

Just over 330 requests for religious and philosophical exemptions to West Virginia鈥檚 school vaccine policy have been submitted 鈥� and approved 鈥� for this school year and 35 have been granted for the coming year, according to records obtained by 社区黑料.

The newly approved religious and philosophical exemptions already outpace the 203 permanent medical exemptions granted in the state over the past decade, at one time the only exemptions allowed in West Virginia.

Before January, when Gov. Patrick Morrisey signed an opening the door for broader exemptions, the state had some of the nation鈥檚 strictest childhood vaccination policies. 

The loosening of those policies is occurring amid a deadly measles outbreak that has infected over  across 30 states and despite state legislators rejecting a bill in March which would have codified religious exemptions into state law. The conflict between the governor鈥檚 order and the legislature鈥檚 action has over how West Virginia officials should proceed and could ultimately lead to legal action between the two branches of government. 

In the meantime, the West Virginia Department of Health is granting religious and philosophical exemptions based on the governor鈥檚 order and shared those numbers in response to a Freedom of Information Act request by 社区黑料.

No requests for the newer category of exemptions has been denied, the department said. In contrast, 125 requests for medical exemptions to mandatory school vaccines have been rejected since 2015. Temporary medical exemptions have been granted to 288 West Virginia children in the past decade.

Richard Hughes, a George Washington University law professor and leading vaccine law expert, said the 331 religious and philosophical exemptions sought in just five months represent a 鈥渄rastic, dramatic increase in the request for exemptions, and that鈥檚 going to potentially have public health consequences.鈥�

He added the state appears to be approving them liberally and without real scrutiny.

鈥淐learly, when you open the door to these types of exemptions, people use them,鈥� he said. 鈥淭here has been evidence before that when only religious exemption is available, people request them without any really sincerely held belief. This just opens the floodgates.鈥�

While the 331 students who have received exemptions represent a very small percentage of the approximately enrolled in public schools across the state, experts fear the number will continue to rapidly climb, especially at the start of the coming school year.

鈥淵ou see how fast we approved those? Hundred percent approved … So if we keep allowing an executive order that goes against West Virginia code, it鈥檚 going to change the vaccination rate 鈥︹�� said Sissy Price, a registered nurse who serves as co-director of West Virginia Families for Immunization. 鈥淎nd it鈥檚 not a matter of if it鈥檚 going to happen, it鈥檚 a matter of when.鈥�

Experts also emphasized the importance of knowing which regions or schools in West Virginia the exempted students come from to better understand the impact on herd immunity and to allow parents 鈥� especially those of immunocompromised students 鈥� to make informed decisions about where to send their kids to school.

Despite the governor鈥檚 insistence that the state collect that information, an official at the Health Department wrote in an email to 社区黑料, 鈥淣obody in the Department of Health or the Bureau for Public [Health] tracks that.鈥�

鈥淭here’s a failure of government there,鈥� said Northe Saunders, executive director of the pro-vaccine . 鈥淭here’s a failure of making sure that parents can make the best informed decision that they can if we don’t know what immunization rates are like at the school level.鈥�

The governor鈥檚 office and the Department of Health did not respond to requests for comment.

So far, West Virginia has no reported measles cases. Two children, both of whom were unvaccinated, have died during the current outbreak, whose case numbers have already surpassed 2024鈥檚 total and mark the second-highest number of confirmed cases in a year since the disease was declared eradicated in the U.S. in 2000. Some 96% of reported infections have involved a person who was unvaccinated or whose status was unknown and 13% have resulted in hospitalization. 

In issuing his Jan. 14 executive order, Morrisey relied on an interpretation of the state鈥檚 2023 Equal Protection for Religion Act.

He argued that the law as it stood 鈥渇orces鈥� some West Virginians 鈥渢o choose between their religious belief and their children’s fundamental right to public education,鈥� and directed the commissioner of the Bureau for Public Health and the state health officer to establish a process for parents to object. The executive order noted that a 鈥渨ritten, signed objection鈥� was sufficient.

Based on the legislature voting down the measure to codify the broader exemption category, state schools Superintendent Michele Blatt issued a memo earlier this month to county superintendents recommending that students not be allowed to attend school next year without required immunizations, regardless of requests for religious exemptions. 

鈥淲e are faced with the fact that state law has not been changed by the Legislature and there is no religious exemption provided for in West Virginia law,鈥� Blatt wrote, according to reporting by

But, by the end of the day she rescinded the memo, she had done so 鈥渁t the Governor鈥檚 request.鈥� 

Morrisey then issued May 9 saying that despite the legislative hurdle, the executive order 鈥渟till stands, and I have no intention of rescinding it.鈥� He further clarified the process to receive an exemption: Each year, parents or guardians must send a signed letter with basic information including their child鈥檚 name, date of birth and mailing address. Notably, the letter does not need to include the reason for the requested exemption.

In the wake of this confusion, some school districts have begun seeking about how to respond. 

West Virginia is not an outlier in its quest to allow parents to opt their children out of the measles, mumps and rubella vaccine that is a requirement in all 50 states for children entering child care and schools. 

鈥淚t goes towards the general erosion of vaccine policy,鈥� said Saunders. 鈥淲e’ve seen these kinds of small, incremental changes that are eroding vaccine policy in states across the country. There are still school entry requirements in West Virginia 鈥� just like there are in every single state 鈥� but this is one other chink in the armor of strong vaccine policy driving strong immunization rates.鈥�

Childhood vaccination since COVID, and there鈥檚 fear that decline will accelerate now that Robert F. Kennedy Jr., a well-known vaccine skeptic, is heading the U.S. Department of Health & Human Services. He initially in late February, and on May 14, at his in Congress since his confirmation, he waffled on the importance of vaccines.

When asked if he would vaccinate a child of his own against measles today 鈥淧robably for measles. What I would say is my opinions about vaccines are irrelevant.鈥�

He continued, 鈥淚 don鈥檛 want to make it seem like I鈥檓 being evasive, but I don鈥檛 think people should be taking medical advice from me.鈥�

Last week, the Food and Drug Administration, which falls under HHS, released guidance for COVID vaccines, saying they may require additional studies before approving the shots for healthy Americans younger than 65.

Candice Lefeber, executive director of West Virginia鈥檚 chapter of the American Academy of Pediatrics, said this move played into one of her fears: 鈥淚 think the administration is going to make it harder for vaccines to be available.鈥�

鈥淣ot only are we not going to require it, but then access to vaccines would be compromised,鈥� she continued. 鈥淚t’s just really disheartening for science and for our country 鈥� and we’re in big trouble.鈥�

In 2011, the Maryland Board of Physicians , who is not a physician and has only a bachelor鈥檚 degree, with illegally practicing medicine alongside his father, Mark Geier, a doctor who died last month. The two treated children with Lupron, a drug used to lower testosterone or estrogen levels in patients with prostate cancer, endometriosis and other diseases, along with chelation therapy, which leaches heavy metals from the body, as in lead poisoning.

Those treatments follow a widely discredited theory that blames autism on exposure to mercury in preservatives used in vaccines. Kennedy has promulgated that theory even though more than two dozen large, rigorous studies have discredited any link between vaccines and autism.

Autistic advocates decried Kennedy鈥檚 appointment, fearing his refusal to give up on efforts to establish one would refocus federal resources on finding a 鈥渃ure鈥� for what most scientists now believe is a naturally occurring human neurotype.  

鈥淎nyone who would fleece families with fake cures should not be trusted to interpret a scientific study, let alone conduct one,鈥� the Autistic Self Advocacy Network said in David Geier鈥檚 hiring. 鈥淭his move toward conspiracy theories and junk science puts all our lives at risk.鈥�

A request for comment from the U.S. Department of Health and Human Services was not immediately answered. The Geiers鈥� Institute of Chronic Illnesses, Inc., does not have a website.   

The network’s statement calls Kennedy鈥檚 selection of Geier 鈥渁 clear indication that the Trump administration plans to rig the upcoming study and claim that it proves vaccines cause autism. This will set public health back decades at a time when vaccine hesitancy and infectious disease are both spreading at alarming rates.鈥�

Among other claims, the Maryland board found that the Geiers diagnosed precocious puberty 鈥� a medical condition where children鈥檚 bodies mature too early 鈥� in an unusually large number of patients, did so without using the standard protocol for establishing whether the children in fact had the condition and failed to tell their families that the chelation drug prescribed was not authorized for use in the United States. 

Mark Geier鈥檚 medical licenses eventually were suspended by the seven states where he and his son operated autism treatment centers under a variety of names, including the Genetic Centers of America. The Geiers conducted several studies linking vaccines to autism, only to have them from publication by scientific journals. They in hundreds of lawsuits brought by people who claim to have been injured by immunizations. 

Lupron is a brand name for a GnRH analogue drug that pauses puberty without causing permanent physical changes. The drugs are for children who experience gender nonconformity or gender dysphoria at the onset of puberty. 

In January, a published in JAMA Pediatrics found the drugs were prescribed for fewer than 0.1% of youth in an insurance claims database covering more than 5 million patients ages 8 to 17. Only 926 youth with a gender-related diagnosis received puberty blockers from 2018 through 2022. No patient under the age of 12 was given the drugs.

Nonetheless, in recent years, 26 states have banned gender-affirming care for young people. The U.S. Supreme Court is expected to rule soon on challenges to the laws. In a January executive order, President Donald Trump to restrict such care.  

The West Virginia House Monday rejected its version of a Senate bill that would have loosened school vaccine requirements and expanded exemptions, voting it down

The bill’s defeat came after the House twice amended the Senate’s version of the legislation, first to remove both the philosophical and religious exemptions approved by the Senate and then to and to allow private and parochial schools to set their own mandatory vaccine requirements.

鈥淭he pro-vaccine messaging won out,鈥� Northe Saunders, executive director of the pro-vaccine , told 社区黑料 Monday.

West Virginia now has among the country’s strictest regulations governing the immunizations required for children entering child care and schools, allowing for medical exemptions only. It’s unclear what might come next.

While the House’s vote effectively killed the current legislation, over a dozen other vaccine-related bills have been introduced in the West Virginia legislature and the governor signed an executive order in January establishing the religious and philosophical exemptions that House members rejected.

Saunders said time may be running out for the other vaccine-related bills to move forward during this legislative session.

An amendment that would give West Virginia parents much greater leeway to exempt their children from mandated school vaccinations was deleted from a House bill at the last minute this week, but the prospect of far fewer students in the state getting immunized remains strong.

As written, the would still expand and loosen requirements for medical exemptions for students, making them 鈥渢he broadest 鈥� in the country,鈥� one advocate said. The religious and philosophical exemptions that were struck from the House version of the legislation could also be reintroduced and, while it doesn鈥檛 carry the same force of law, Gov. Patrick Morrisey鈥檚 January order establishing similarly far-reaching exemptions is also hanging in the balance.

Historically, West Virginia has had some of the nation鈥檚 strictest childhood vaccination policies and the current move to soften them is occurring against a deadly measles outbreak that has infected in 15 states and taken the life of one school-age child in Texas. 

鈥淚t’s hard to wrap your head around why we would do this right now 鈥� or anytime,鈥� said Candice Lefeber, executive director of West Virginia鈥檚 chapter of the . 鈥淏ut at such heightened alertness with measles spreading in our country, it should be a wake-up call. And unfortunately, I don’t think that’s happening,鈥�

West Virginia is not an outlier in its quest to allow parents to opt their children out of the measles, mumps and rubella vaccine that is a requirement in all 50 states for children entering child care and schools. 

On Wednesday, Idaho lawmakers passed a that would significantly broaden an existing law banning COVID vaccine mandates to include mandates on any 鈥渕edical treatment.鈥� If the governor signs it, the bill would apply to public and private schools as well, making Idaho the first state in the country to remove all mandatory school vaccination requirements.

Childhood vaccination since COVID, and there鈥檚 fear that decline will accelerate now that Robert F. Kennedy Jr., a well-known vaccine skeptic, is heading the U.S. Department of Health & Human Services. He initially in late February, and in a March 4 seemed to link the ongoing outbreak and child fatality to malnutrition and poor health while pointing to unproven treatments, such as cod oil.

“The best thing Americans can do is to keep themselves healthy,鈥� Kennedy said in the interview. 鈥淚t is very, very difficult for measles to kill a healthy, well-nourished person.”

Three months in, the number of measles cases has already surpassed 2024鈥檚 total and in the 15 states where it鈥檚 spread, 95% of infections have involved a person who was unvaccinated or whose status was unknown. Three of those states border West Virginia, although, so far, the Mountain State has no reported cases. 

鈥榃e just want the policy left alone鈥�

The latest House bill still has a more wide-ranging medical exemption that also protects health care providers who grant them 鈥渋n good faith鈥� from civil liability, except in cases of 鈥済ross negligence or willful misconduct.鈥� 

It also includes no enforcement mechanism from a government oversight body nor is there guidance as to what qualifies someone for a medical exemption. 

Northe Saunders, executive director of the pro-vaccine , fears this might lead to bad actors writing 鈥渂ogus鈥� exemptions. Saunders鈥� group, which is based in Portland, Maine, opened a West Virginia chapter in February after local advocates asked for their help amid the exemptions push.

鈥淲e’re glad that the religious and philosophical exemptions were not part of the bill that came out of committee,鈥� said Saunders, who believes the measles outbreak was a factor in their being cut, 鈥渂ut we expect [attempts to modify the bill] going forward.鈥� 

Saunders said his organization is tracking an additional 20 vaccine-related bills in the West Virginia legislature. And, across 20 states, 47 bills have been introduced which would add or broaden vaccine exemptions.

Parents across the country are able to apply for exemptions if their child is unable to get vaccinated for medical reasons. Most states also have religious exemptions, and 20 have some form of leaving a varied landscape. 

West Virginia is currently one of only five states that don鈥檛 allow any exemptions, beyond medical ones. Last school year, they had the for four of the major mandated vaccines, significantly outperforming national averages. Almost all kindergarteners there 鈥� 98.3% 鈥� had received both doses of the measles, mumps and rubella vaccine. 

The state also had the lowest rate of exemption, with less than 0.1% of kindergarteners being exempt from one or more vaccines. And it was the only state that supported Donald Trump for president in November that did not see an average rise in official exemptions. 

That could change, depending on the fate of the pending legislation and the governor鈥檚 executive order.

鈥淭he current policy as is, is something that is highly favored among myself and my colleagues,鈥� said Andrea Lauffer, an internal medicine doctor and pediatrician at WVU Medicine – Thomas Memorial Hospital in South Charleston. 鈥淲e just want the policy left alone.”

Michael Ramey, president of the , noted the role the pandemic has played in the current vaccine skepticism. He said that while his organization does not hold a position on the safety or efficacy of vaccines, it stands in support of bills like the one in West Virginia.

鈥淲e welcome a move to give parents greater authority to make the decision that’s best for their individual child,鈥� he said. 

The vast majority of Americans 鈥� 88% 鈥� believe the benefits of the childhood vaccine for measles, mumps and rubella outweighs the risks, compared with just 10% who say the risks outweigh the benefits, according to a 2023 Seventy percent of Americans say healthy children should have to be vaccinated to attend school, down from 82% in 2019. And the share of parents who think they should be able to decide against vaccination is up 12 percentage points from four years ago, to 28%.

This shift is being driven by Republicans, 57% of whom now support vaccination requirements 鈥� down from 79% in 2019.

鈥楾he heat is on鈥�

The debate over vaccine mandates in West Virginia is not new, but 鈥渢his year, definitely, the heat is on, for sure, at a higher temperature,鈥� said Sissy Price, a registered nurse who serves as co-director of .

Last year, former Gov. Jim Justice vetoed a bill which would have allowed private and parochial schools to set their own vaccination policies. Meanwhile, Morrisey signed his executive order creating religious and philosophical exemptions on his first full day in office.

The governor wrote that current mandatory vaccine laws force West Virginians who have objections 鈥渢o choose between their religious belief and their children鈥檚 fundamental right to public education.鈥� The order, he said, was based on his interpretation of the Equal Protection for Religion Act, signed by Justice in 2023. 

The pending legislation was meant to clarify and codify his order. Even if the bill鈥檚 final version does not include religious and philosophical exemptions, the governor鈥檚 executive order would still stand, said Richard Hughes, a George Washington University law professor and leading vaccine law expert. 

While the ability to set new laws lies only with the legislature, the governor does have the ability to interpret those laws, which is what his executive order does, Hughes said.

If the executive order is not in line with what the legislature passes, however, it would remain vulnerable to court challenges.

鈥淭he governor could be checked by the courts on this interpretation,鈥� he said.

Introduced Feb. 13, would have allowed parents to simply provide a written statement to exempt their child from vaccines for religious or philosophical reasons and applied to public, private and parochial schools.

In addition to loosening the medical exemption process and protecting medical professionals from disciplinary actions, it would also eliminate the position of state immunization officer and no longer require schools to report a violation if an unvaccinated child without an exemption attempted to enroll.  

At a Feb. 21 committee meeting, both Democratic and Republican senators spoke out in opposition to the bill. Many cited the measles outbreak that began in West Texas in late January as core to their concerns.

GOP Sen. Mike Oliverio read aloud from a letter written by one of his constituents, a retired physician.

鈥淟oosening these requirements will eventually lead to outbreaks of these diseases, including in our children, as the number of vaccinated individuals fall,鈥� he read. 鈥淚 urge you to vote against this bill for the sake of West Virginia鈥檚 children.鈥�

A number of Republican lawmakers also spoke in favor of the bill, which ultimately passed by a 20-12 vote, with two senators absent, before going to the House. 

The House bill that came out of committee this week is now expected to move to the floor, where it will be debated and potentially amended again. If the final House bill that passes still differs from the initial Senate bill, senators will need to either accept the House鈥檚 version or head to a conference committee to reconcile the two before sending it on for Morrisey鈥檚 signature. 

of those infected so far are vaccinated. The remaining patients are either unvaccinated or their vaccine status is unknown. 

Robert F. Kennedy Jr., the newly confirmed head of the U.S. Department of Health and Human Services, has a long history of around vaccines, including the one for measles. He recently put vaccine advisory meetings 鈥� where a panel of experts establish a vaccine schedule used to inform state policies 鈥� on indefinite and wields power over how organizations within HHS, such as the Centers for Disease Control and Prevention, respond to such crises. 

Earlier this month, his anti-vaccine organization, Children鈥檚 Health Defense, put out a blaming the Texas outbreak on the vaccines themselves, arguing, 鈥淭he real issue is not a failure to vaccinate but a failing vaccine.鈥�

鈥淎s measles outbreaks continue to surface, the mainstream media is now using them as a political weapon, attempting to blame 鈥� Secretary Robert F. Kennedy Jr. for so-called 鈥榓nti-vaccine rhetoric,鈥欌�� the statement read. 鈥淗is warnings about vaccine-induced injuries and failures are validated by the very outbreaks being reported today.鈥�

Rekha Lakshmanan, chief strategy officer at The Immunization Partnership, a Texas-based education advocacy organization that promotes childhood and adult immunization, said she is 鈥渏ust absolutely flabbergasted that there is intentionality to put blame on the vaccine when that is not where anybody should be spending their time or their effort. Our effort should be supporting families, making sure they鈥檝e got the right information and supporting helping our public sector partners so we can try to get to the end of this crisis sooner rather than later.鈥�

鈥淐DC is aware of the death of one child in Texas from measles, and our thoughts are with the family,鈥� Andrew Nixon, director of communications at HHS, wrote in a statement to 社区黑料. 鈥淐DC continues to provide technical assistance, laboratory support, and vaccines as needed to the Texas Department of State Health Services and New Mexico Department of Health, which are leading the response to this outbreak.鈥�

There are now also at least nine reported cases in neighboring  

Kennedy that he鈥檚 following updates on the outbreak, which he noted was mainly in the Mennonite community. Despite the confirmed death of a child, Kennedy appeared to downplay the spread, saying, 鈥淚t鈥檚 not unusual. We have measles outbreaks every year.鈥�

Measles were declared eliminated in the United States in but there鈥檚 been a resurgence of cases as vaccination rates have dropped.

Mary Koslap-Petraco, a pediatric nurse practitioner who treats underserved children in New York state, said that when she heard about the child鈥檚 death Wednesday morning, 鈥淨uite frankly, I broke down in tears. This was [99%] preventable.鈥�  

She placed much of the onus on the anti-vaccination movement, saying they planted 鈥渟eeds of distrust鈥� that ultimately scared parents.

鈥淚 know this family only wanted the best for this child,鈥� she said, 鈥渁nd I鈥檓 really sorry that they weren鈥檛 able to encounter someone who could help them through this misinformation that they鈥檙e hearing to feel comfortable enough to vaccinate their child.鈥�

鈥楶rimed for something like this to happen鈥� 

Measles is a highly contagious which can be serious and sometimes fatal in children. If one person has it, up to 9 out of 10 people nearby will become infected if they , though spread is preventable through the measles, mumps and rubella vaccine, which is safe and about . The infection is often marked by a high fever, sore throat and rash; more severe complications can include pneumonia and swelling of the brain.

In a statement Wednesday, the Texas Department of State Health Services said the best way to prevent measles is through the vaccine. The department  it was 鈥渨orking with local health departments to investigate cases, provide immunizations where needed, and keep the public informed.鈥�

Texas is one of 18 states that allow school-aged children to of vaccine requirements for medical, religious or 鈥減ersonal belief鈥� reasons.

The majority of measles cases so far are in Gaines County, a small, rural county in West Texas, with one of the state鈥檚 highest vaccine exemptions rates: up from just over 4% a decade ago. And the actual number of unvaccinated kids in the county is likely significantly higher, because there鈥檚 no data for the many children who are homeschooled, according to reporting from the

Some of the initial cases appeared to be connected to . 

To be exempted for 鈥渞easons of conscience,鈥� a parent or legal guardian has to submit a form to the school. Under certain circumstances 鈥� like an official emergency or epidemic 鈥� these students might not be allowed to go to school.

None of the four public school districts serving Gaines County immediately responded to a request for comment. The county鈥檚 small Loop Independent School District of K-12 students had a conscientious exemption for immunizations in 2023-24. The statewide vaccine exemption rate is 2%.

鈥淲e know based on a ton of research that these kinds of exemptions cluster,鈥� Lakshmanan said. 鈥淭hey cluster geographically, they cluster in schools, they cluster in neighborhoods, they cluster in faith-based communities. Sadly we are seeing the practical reality of this type of loophole 鈥� when we start to see high exemption rates, we are bound and we are primed for something like this to happen.鈥�

Kindergarten measles vaccination rates in Texas generally have fallen to below 95% since the pandemic, though they still remain just above national averages, according to a recent data analysis from  

A number of Texas parents who previously had not vaccinated their children are now changing course. 鈥淲e鈥檝e vaccinated multiple kids that have never been vaccinated before, some from families that didn鈥檛 believe in vaccines,鈥� Katherine Wells, director of public health for Lubbock’s health department, told

Yet, as the outbreak spreads, Texas lawmakers are preparing to consider bills that would further loosen exemption requirements.

鈥淣ow is not the time to be playing a game of roulette with children’s lives or Texans鈥� lives and even contemplate making the exemption process easier,鈥� Lakshmanan said.

The former independent presidential candidate has a complicated past as a member of a famous Democratic political dynasty that includes his uncle, former President John F. Kennedy, and his father, U.S. Sen. Robert Kennedy, both assassinated in his youth. He struggled with addiction, and an arrest for heroin possession in the 1980s led him to volunteer with the Natural Resources Defense Council to fulfill community service hours, which jump-started his career in . 

Then, about two decades ago, Kennedy became interested in vaccine conspiracy theories, including the disproven link between vaccines and autism, which has become a focal point of much of his work since. He has peddled other , including that Wi-Fi causes cancer, that chemicals in water can lead to children becoming transgender and that AIDS may not be caused by HIV. In 2021, he was named one of the of misinformation about COVID vaccines on social media. 

Doctors and advocates have expressed alarm about the impact he could have on the department, while some have applauded his more mainstream views, such as a focus on preventative care through healthy eating and exercise and a commitment to removing processed foods from .

His beliefs and proposals are particularly relevant for kids, amid heated debates around school vaccination policies and a in the percentage of kindergarteners who have gotten state-required vaccinations.

If confirmed by the Senate, Kennedy would take control of an agency with one of largest federal budgets 鈥� 鈥� that employs about 90,000 people across 13 agencies, including , (the latter pays for a host of for eligible children), the and the

To better understand the pediatric and school-based health care implications of some of Kennedy鈥檚 proposals, 社区黑料鈥檚 Amanda Geduld spoke with Leana Wen, an emergency physician and contributing opinions columnist for . The parent of two school-aged kids is also a professor of health policy and management at George Washington University, a non-resident senior fellow at the and Baltimore鈥檚 former health commissioner.

Geduld then spoke with medical legal expert Richard H. Hughes IV about how likely Kennedy鈥檚 confirmation is and what kind of power he would wield if confirmed. Hughes is a professor at George Washington University鈥檚 law school, where he teaches a course on vaccine law, and a partner at the firm . He formerly worked as the vice president of public policy at Moderna 鈥� one of the co-producers of the first FDA-approved COVID-19 vaccines 鈥� guiding the company鈥檚 policy strategy during the pandemic.

These interviews have been edited for length and clarity.

The medical perspective

社区黑料: Kennedy has a long record of promoting and even before the pandemic had built a following through his anti-vaccine nonprofit group, . 

In the past few weeks, he鈥檚 backed off these assertions a bit, but I鈥檓 still wondering what impact his rhetoric around vaccines could have鈥� especially around parents vaccinating their kids. Can you also speak to some of the science behind vaccinating kids in the first place and what impact that鈥檚 had on pediatric health care?

Leana Wen: I think it’s important for us to start with the facts and to talk about what happened before there were vaccines for a variety of diseases. In the decades past, prior to vaccines, we used to see children succumbing to diseases that we now do not see anymore. We used to see children becoming paralyzed from polio and their parents being too scared for them to interact with others and go to school. We used to see children with severe, lifelong problems 鈥� including with their brains and other organs 鈥� because of measles, mumps and other diseases that we now consider to be eliminated thanks to vaccines. 

And so I think part of why vaccine misinformation has caught on is that the current generation of Americans have not experienced how terrifying these diseases have been that vaccines prevent. And I would really hate for us to see these diseases return before people recognize how much vaccines are life saving. 

I think it’s also important for us to mention the facts. It’s a fact that in 1900, 30% of all deaths in America occurred in kids under 5. Now that number is 1.4%. Back in 1900, the three leading causes of death were all infectious diseases. Now they aren’t. Thanks to antibiotics, thanks to sanitation, also thanks to vaccines. 

There was done recently that was published in the journal The Lancet. The study found that vaccines against the 14 most common pathogens saved 154 million lives globally over the past five decades, and that these vaccines cut infant mortality by 40%. 

And so it’s really heartbreaking to hear anyone spread misinformation about vaccines, but certainly it would be extremely concerning from a public health standpoint, if the individual in charge of science and health in this country is the one spreading such falsehoods. This could have a huge impact on trust in vaccines. And unfortunately, that could reduce vaccine uptake and lead to the return of these diseases that we thought were eliminated.

Kennedy has proposed removing processed foods from and limiting the use of food dyes, saying that the U.S. obesity epidemic, as well as a rise in chronic diseases like diabetes, are the result of He recently called out the nutrition department, which he says is Can you talk a little bit about what impact the food that we see showing up in school lunches has on kids, and what we know about food dyes?

I want to focus on ultra-processed food. We know that ultra-processed foods are associated with a whole variety of health problems 鈥� certainly things like diabetes, obesity, other chronic diseases like that 鈥� but also with depression and early dementia and potentially behavioral developmental issues in children as well. 

Unfortunately, some studies show that as much as 70% of the diet that Americans consume come from ultra-processed foods 鈥� that the calories from these diets come from ultra-processed food. I think it would be great if we can start reducing or removing ultra-processed food from school lunches. There has been some research done on food dyes and other additives. Reducing these in school lunches would also be a positive step.

He’s also mentioned that the same way that a doctor can prescribe Ozempic to treat obesity, they should also be able to prescribe, say, and have that covered by health insurance policies. I’m wondering what that might look like for kids as well, and what role pediatricians might play.

I don’t think any pediatrician would disagree with the idea that we have to focus more on prevention 鈥� that promoting healthy lifestyle, increasing exercise, improving diet, these would all be excellent for the promotion of health and well-being in our children. 

To be clear, it’s not these ideas that Kennedy is promoting that the medical profession would have an issue with. It鈥檚 that mixed in with many of these good ideas, are our concerns about misinformation around vaccines and that traditionally have not been considered to be safe and effective. 

After Kennedy’s nomination, he wrote on on Jan. 20, 鈥淭he Trump White House will advise all U.S. water systems to remove fluoride from public water.鈥� Can you talk a little bit about the role of fluoride in drinking water 鈥� specifically for kids.

This is an area where re-examination of the current policy would be a good idea, because this is a nuanced and complicated issue. On the one hand, we know that fluoridating the water supply has reduced cavities in children, but that effect was seen the most before widespread use of fluoride toothpaste.

We also know that fluoride in large quantities has toxic effects, including on bone development, on teeth discoloration and potentially on the developing brain if consumed by the pregnant woman. And so the question then is, what is the amount of fluid that would be optimal for promoting both dental health and reducing other effects? 鈥�

I think these are all reasonable questions to be asking 鈥� again, though, using science as the basis and not approaching this as an activist who already has a preconception in mind.

Are there any other policy ideas that Kennedy has put forward that you have thought of as either welcome news and an exciting change or particularly concerning?

None of what we’re talking about here is new. I think we can divide the proposals by Kennedy into three categories. One are things that are good ideas. For example, removing ultra-processed lunch or ultra processed food from school lunches. 

The second category are things that deserve a re-examination, and depending on what we find, may or may not be a good idea. That includes the fluoridation.

And then the third area would be things that have been proven to be wrong. For example, misinformation around vaccines.

And so again, I think to your point, none of these things that have been brought up in the category of good ideas is new, but that’s how I would think about this.

The legal perspective

社区黑料: Speaking about Kennedy at a rally recently, Trump said, How accurate is that? Can he really go wild on health? What are some of the congressional stopgaps there, and how much power does Kennedy actually have to enact these proposed policies? 

Richard H. Hughes: I think we could break that down into sort of two parts: Is Trump going to make good on that promise? and How far will RFK go? 

I would say that President Trump is very intent on making good on that promise. He went through with the selection of RFK. If you look at the appointments across the board, the nominees he selected are very unconventional. He’s very intent on disruption. 

And if you look at the health appointees in particular, there is some consistency there, right? They all hold really unconventional views. They come from very unconventional backgrounds for these types of roles. There are some questions about the adequacy of some of their experience and qualifications for these roles. There is also some consistency across the nominees that this sort of unconventional, non-mainstream views on COVID and the COVID response, as well as this focus around infections versus chronic disease. A lot of them have said we think we should be focused on chronic disease. A lot of them have espoused misinformation about vaccines. 

In terms of the legal authority, Congress has given a lot of really sweeping power to the secretary. When Congress gives the authority to the executive branch to do something, and it does it really clearly, the executive branch has a lot of leeway 鈥� 

So I’ll just give you an example. A lot of the questions I’m getting are about vaccine recommendations and vaccine requirements. There is the (ACIP). That is a committee that is created by the secretary鈥� 

There are all of these requirements for programs or payers to provide coverage of the vaccines that are recommended by the committee. And so there are really interesting questions about, well, if he stopped convening the committee, if he eliminated the committee, what impact would that have?

There’s a potential trickle down effect, because a lot of states actually either look to that committee to determine what their [vaccine] policy should be, or they just refer to the committee and require, say, you know, for school entry, they require vaccination in accordance with the schedule that’s determined by the ACIP. 

That’s sort of a very specific area 鈥� 

At the FDA, there’s a lot of room for someone to come in, introduce subjective views on science, and say, 鈥淲ell, what do we mean by safety? What do we mean by efficacy? Your traditional randomized, controlled trial, that doesn’t tell me what I need to know鈥︹�� [That] might be the view of somebody at the agency in this administration, and they might try to introduce alternative evidence, and they would have some latitude to do that.

Just turning a little bit more to vaccines, it sounds like whoever is running this agency and convening this committee has a lot of power to potentially help determine what vaccines are going to be covered by health insurance. Is that correct?

That’s right. Congress requires payers to cover vaccines that are recommended by that committee. If those recommendations are rescinded by the secretary, which the secretary has the authority to do, that really throws a lot into question there. 

Now I’m having a really healthy, friendly debate with one of my mentors over the legal challenges that one could bring to challenge that sort of decision. There are some potential checks on this in the courts, but it’s all going to be really circumstantial.

Thinking specifically about schools, you mentioned that folks look to this committee to help determine what vaccines are required for students. Can you explain a little bit about how that works? How might RFK鈥檚 policies impact that?

If you鈥檙e interested 鈥� it鈥檚 open access 鈥� I just wrote in this month鈥檚 issue of Health Affairs on the relationship between ACIP recommendations and state school requirements 鈥� 

But, this is the authority of the states, and it’s really interesting in a Republican administration to think about the federalism debate 鈥� and you’re going to see this tension play out in this administration over the role of the states and the federal government. 

And it’s going to play out in the arena of public health and around vaccine policy 鈥� The federal government can come in and play a really important role when you have a threat that, say, goes across state lines. But states have to be able to enact these measures to protect themselves, to protect their people. 

The Jacobson v. Massachusetts case recognized that states can require immunization. [In] 1922, [in] the case Zucht v. King 鈥� lesser known but very important case when we talk about school requirements 鈥� the Supreme Court came back and said that a school district was able to exclude a young girl from school when she wasn’t vaccinated, even though there was no active outbreak. 

And so that’s a really, really important case, because if you think about why we require kids to get vaccinated to go to school, it’s a decision that the state makes to impose these requirements so that we don’t have disease outbreaks. It’s the suppression of endemic disease. You take those requirements away, you weaken those requirements, you’re going to see outbreaks potentially. And we’ve seen that with measles outbreaks, where we weaken those policies. 

So it sounds to me less like RFK can put out a mandate that schools federally cannot require vaccines, but more that there could be a trickle-down effect of some of what he does at the federal level, and that might impact then state policies. Is that correct?

Well, yes, but this is something I鈥檓 thinking a lot about right now because there is this statute that some of us have looked at over time 鈥� 鈥� which is the old isolation and quarantine statute that allows, essentially, the CDC to come in and and impose certain measures when necessary to control communicable disease. 

And every semester, I ask students, 鈥淲ould this actually allow the federal government to impose a vaccine mandate?鈥� And we debate that endlessly, whether that language actually would allow it or not. 

And right now, I think that poses the question: there is preemption language in that statute, so could it potentially be used to set a policy that would undermine state requirements or weaken state requirements? And it’s just a really interesting academic question. I don’t know that realistically that’s something that RFK or the CDC would pursue, but I think we’re living in an era where everything’s on the table.

Well, all of that said, how likely is Kennedy to actually get confirmed? And could there be, from a policy or a legal standpoint, any roadblocks put up in his way?

Yeah, so I do think he’ll get confirmed. I think that what you have seen is President Trump came forward and put together a slate of nominees very rapidly. And all of the ways that you could say that President Trump is inconsistent, he has been very consistent with his health nominees 鈥� a lot of similarly held views, a lot of unconventional backgrounds. 

I think just if you look at the pool of appointments as a whole, there’s a lot to take aim at, whether it was Matt Gaetz, his AG nominee () or the selection of the defense secretary nominee (), there’s a lot to provide sort of political fog. And I think that in all of that noise you lose sight of the fact that RFK does not have really the ideal qualifications for the role [and] holds some views that are anti-science. 

And you look to the Senate and ask, 鈥淲ell, is someone going to stand up and push back and say, 鈥榃e’re not going to confirm this nominee because they lack the qualifications?鈥欌�� 鈥� No one has come out and sort of put a stake in the ground and said, 鈥淲e’re not going to confirm nominees who don’t meet these qualifications,鈥� or 鈥淚f they hold these views, there’s no way that they’re going to get a hearing.鈥� 

We just haven’t seen that. And so I do think they’ll get confirmed. I think President Trump expects loyalty from his party. 

Variants and Vaccines

BA.2.86 Variant

• This caused quite a bit of buzz a few weeks ago because scientists were concerned Some have dubbed the new variant 鈥淧irola.鈥�
• “ which burst onto the scene in the winter of 2021, resulting in a spike in infections.”
• “Two more lab groups 鈥� one from Sweden’s Karolinska Institute and the other from Harvard University 鈥� have reported results of antibody neutralization lab experiments, which suggest vaccination or previous infection offer some protection against the highly mutated BA.2.86 SARS-CoV-2 variant.”
• Early indications are that the new boosters will work against this variant too:
  • “Moderna, Pfizer say versus BA.2.86.”
  • “These data were published () with Moderna鈥檚 XBB.1.5 booster and show very good levels of neutralizing antibodies induced against BA.2.86, in keeping with the response to the target of XBB.1.5. Also note the similar response to 2 of the major current circulating variants of EG.5.1 and FL.1.5.1.” 
  • We’re lucky,” Topol said. “This one could have been really bad.”
  • “Early research data has shown that antibodies produced by prior infection or existing vaccines against the coronavirus .”
    

Reformulated Vaccines

• The updated COVID vaccine is based on variant.
• CDC advisers make universal COVID vaccine recommendation: .
  • “The advisory committee voted 13-1 to recommend updated COVID-19 vaccines for people ages 6 months and older.” It came one day after the for emergency use mRNA vaccines from Moderna and Pfizer-BioNTech.
  • “Shortly after [Advisory Committee on Immunization Practices] vote, , which allows immunization campaigns to begin.”
  • Epidemiologist summarized the meetings.
• But: (Associated Press/NBC News)

State of Affairs

Another Summer Wave

• and continue to rise.

• : 鈥淩ecent analysis of the data shows the number of children under age 18 with confirmed COVID-19 at hospital admission increased nearly five-fold from 237 new admissions the week ending June 17 to 1,175 in the week ending Sept. 9.鈥�
• 鈥淛une had the lowest level of pediatric COVID-19 hospital admissions since data collection began in 2020.鈥�

Variants Fueling the Latest Wave

• The main variants driving cases are and , both XBB variant descendants that share a mutation known as F456L, which appears to be helping them spread more than other virus siblings. 

• 鈥淭he Biden administration [this week] that it is providing $600 million in funding to produce new at-home COVID-19 tests and is 鈥� aiming to prevent possible shortages during a rise in coronavirus cases that has typically come during colder months.鈥�

More Key Insights

• Schools Grapple With COVID Safety Amid Late Summer Surge:

• CDC Director Mandy K. Cohen in the NYT: ““

• Anti-Vaccine Movement on the Rise:
• How Long Should You Wait?: with a good summary about when to get vaccinated after an infection and the latest on mixing-and-matching shots.
  
• Chronic Absenteeism: Via the and
• A Generation at Risk: Published by the Building Bridges Initiative, the is the product of a partnership between

鈥� And on a Lighter Note

• The Best of America: When Jaylan Gray’s mom died, he quit school to care for his brother. Shortly after, their house was in need of repair, that鈥檚 when a nonprofit stepped in to fix their home.

• Bear Cubs Getting in a Hammock:

Living the Good Life: A dog making

The Louisiana House of Representatives gave final passage to a bill that would prohibit schools from requiring students to be vaccinated against COVID-19 as a requirement for attendance.

, sponsored by Rep. Kathy Edmonston, R-Gonzales, would apply to both public and private schools from the K-12 to university level.

No public K-12 schools are requiring the COVID-19 vaccine as a condition of attendance. LSU-Shreveport is the only public university still requiring the shot.

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Edmonston shared COVID-19 misinformation during her presentation of the bill, falsely claiming COVID-19 is not a vaccine-preventible disease and that there are no Food and Drug Administration-approved vaccine doses available in Louisiana.

The proposal was passed on a party-line 63-28 vote and picked up 15 co-authors. The bill will next be heard in a Senate committee.

is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Louisiana Illuminator maintains editorial independence. Contact Editor Greg LaRose for questions: info@lailluminator.com. Follow Louisiana Illuminator on and .

A former public school band teacher, Brooks said she was largely inspired by the grim pandemic realities of her kids鈥� schooling: Her 7-year-old, born late in the year, was stuck in kindergarten even though she knew the alphabet and could already read. Her 9-year-old was being bullied at a private Christian school, while her oldest, a 16-year-old rising , was simply too busy for typical school calendars.

鈥淎t the end of last school year, I was like, 鈥業 don’t think I can do this again,鈥欌�� Brooks said.

So she quit her job 鈥� her husband still teaches music 鈥� and began homeschooling all three girls.

Brooks鈥� experiences sync with those of many parents who have turned to homeschooling since the pandemic. A from the online education platform Outschool found that this group is increasingly concerned about the quality of education their kids are getting in school. They鈥檙e also more likely to be politically centrist or liberal and less likely to homeschool for religious reasons.

Other recent research suggests that they鈥檙e also more likely to be non-white: The U.S. Census Bureau in 2021 reported that homeschooling among Black families in the school year following the start of the pandemic, from 3.3% in spring 2020 to 16.1% that fall.

In the , which tapped 622 homeschool families in August, Black families comprised 9% of respondents, but the results didn鈥檛 probe whether there has been a rise in these families. The survey did find, however, that parents鈥� concerns around racism in school during the pandemic rose: Among pre-pandemic homeschoolers in the survey, just 2% said racism was their No. 1 reason for leaving school; among newer homeschoolers, the figure was 5%.

And it found that the reasons families began homeschooling in the past year are 鈥渟hifting away from being a values-driven decision to an environment-driven decision.鈥�

Among other findings:

• 12% of new homeschooling parents said their decision was primarily because their child鈥檚 neurodiversity wasn鈥檛 supported in traditional schools, up from 7% before the pandemic;

• Just 1% of new homeschooling parents said their No. 1 reason was based on religious beliefs, down from 14% of parents already homeschooling who said the same;

• 47% of new homeschoolers described themselves as 鈥減rogressive鈥� or 鈥渓iberal,鈥� up from 32%;

• 6% of new homeschoolers said they had conservative views vs. 27% of pre-Covid homeschoolers.

Significantly, few parents said their decision, either in 2020 or 2022, was based on politically charged issues such as vaccines or schools鈥� political stances.

Traditional schools鈥� 鈥榟ot mess鈥�

Outschool co-founder Amir Nathoo said the findings suggest that parents are homeschooling for many reasons, including having children whose learning differences 鈥渨eren’t being satisfied by the local school.鈥�

Homeschooling families have traditionally valued its flexibility, Nathoo said. 鈥淏ut now what we’re seeing come bubbling up is just: Pure quality is a top concern.鈥�

Alessa Giampaolo Keener, who directs the Maryland Homeschool Association, said the pandemic 鈥渃hanged a lot about homeschooling,鈥� including the number of families willing to give it a try: In March 2020, just before widespread school closures, she counted fewer than 28,000 homeschoolers statewide. That figure now stands at about 45,000.

Keener noted that the recent uptick, especially in Black homeschoolers, stems from many public schools being caught 鈥渃ompletely unprepared鈥� in 2020. Educators 鈥渁bsolutely did the best that they could, given the circumstances. But it was a hot mess for a lot of kids.鈥�

Tracking homeschooling is a bit slippery. The National Home Education Research Institute about 6% of school-aged children, or 3.1 million students, homeschooled in the 2021-2022 school year, up from 2.5 million in spring 2019.

The journal Education Next, using Census Bureau data, that the percentage of U.S. households with at least one child being homeschooled essentially doubled from spring 2020 to fall 2020, from 5.4% to 11.1%.  

Many of these parents said they were finding education at home 鈥渢o be an exhausting undertaking.鈥� One-fourth said they didn鈥檛 plan to continue.

But Alex Spurrier, who studies policy at the consulting firm Bellwether, said recent polling shows the pandemic has helped break a kind of psychological link in parents鈥� minds between education and a five-day, in-person school week. For many families, learning from home 鈥渨orked really well and probably opened their eyes to a different way forward.鈥� 

As a result, he said, 鈥渋t doesn’t look like we’re on a path to heading back鈥� to pre-pandemic ideas about homeschooling.

One-on-one attention, bullying trump religious reasons

Michael McShane, director of national research for the research and advocacy group EdChoice, said the Outschool findings his organization has done recently.

鈥淲hen we asked people why they homeschool, things like religious reasons or political reasons, those were at the bottom of the list,鈥� he said. At the top: School shootings, bullying, school violence, and wanting more one-on-one attention for their children.

McShane said his school choice work has changed his outlook on things like the socialization that homeschoolers enjoy. His conversations with their parents shine a light on the often 鈥渢remendously negative鈥� experiences many students have had in school. 鈥淚 can’t tell you how many parents were like, ‘Let me tell you about the socialization my kid got: It was getting the crap beaten out of them,鈥欌�� he said.

Homeschooling researchers have also long noted that a top reason Black families often give for turning to homeschooling is in schools 鈥� particularly against young boys of color. Black homeschoolers, McShane said, often say they 鈥渏ust didn’t think their schools were respecting them, or respecting their kids, or treating them fairly. And so they wanted to kind of strike out on their own.鈥�

Bellwether鈥檚 Spurrier said more families are likely interested in more flexible learning environments like homeschooling or microschools if the barriers to entry are lower. He鈥檚 keeping an eye on places like Arizona and , which are both experimenting with generous education savings accounts for families. 

Singing, dancing, being kind

In Atlanta, Brooks has discovered an focused on helping Black homeschoolers thrive 鈥� she has even begun posting humorous videos that encourage other Black homeschool moms. 鈥淚t’s been awesome, just being able to talk to people that look like me, that are probably going through the same thing.鈥�

Like many families find, homeschooling has allowed her kids to focus less on grades and more on interests.

Brooks now posts joyous TikTok and Instagram videos of herself and her kids as they ,,, and meet people like Georgia gubernatorial candidate at public events. They鈥檝e lately been trying out in an informal family .

Brooks said she鈥檚 also able to focus more on character education, a top priority that she said doesn鈥檛 get much love in school.

鈥淲e learn how to have conversations with each other,鈥� Brooks said. 鈥淎nd I’ve seen from the beginning of the school year til now that they’ve changed drastically. They’ll catch themselves if they’re not being nice to their sister. They’re like, 鈥業’m sorry, I didn’t mean to yell like that.鈥� Those kinds of things are happening without me telling them. And so I just know for sure it’s working.鈥�

This Week鈥檚 Top Story

• The latest Kaiser Family Foundation COVID-19 Vaccine Monitor survey finds , with about half of adults saying they鈥檝e heard 鈥渁 lot鈥� (17%) or 鈥渟ome鈥� (33%) about the new shots.
• “About one in five (19%) parents of children ages 6 months through 4 years old say their child has gotten vaccinated for COVID-19, up from 7% in July.鈥�
• The September survey finds about half (53%) of parents of children in this age range say they will 鈥渄efinitely not鈥� get their child vaccinated for COVID-19.

The Big Three 鈥� October 7, 2022

U.S. Schools Now Employing 160,000 鈥楿nderqualified鈥� Teachers

• 社区黑料 on a new
• “U.S. schools currently employ at least 163,650 underqualified educators, teachers working without state certification or outside their subject area. In 2017, at least 109,000 underqualified teachers were estimated to be in classrooms.”
• “States with the highest ratios of these hires relative to the student population include Washington, Utah, Minnesota, New Hampshire, Massachusetts, New Jersey, North Carolina, Louisiana, Alabama, Florida and Maryland.”

• “At least 10.1 million students were chronically absent during 2020-21, the first full academic year of the pandemic, according to federal data. 鈥� That鈥檚 25% more than the typical 8 million chronically absent students each year.”
• “Already, four states 鈥� , , and a subset of 鈥� have posted figures for 2021-22 that show the doubling that [experts] predict.”
• “Researchers also created a , showing a wide range of chronic absenteeism. The highest rates, of more than 30 percent statewide, were reported in Kentucky, Arizona, Nevada, Rhode Island, Oregon and New Mexico.”

• “Last month, the U.S. Department of Education launched an effort to address teacher shortages. Secretary Miguel Cardona went on national TV to call attention to the school staffing crisis and announce the initiative. But is there a national staffing crisis? Are vacancies higher than normal? If so, in what subjects and in which schools? The truth is no one knows. There is no useful teacher labor data in U.S. schools.”
• “The dearth of data in education is reaching four-alarm status. This fall, after three pandemic-affected school years, there is little to no data on which interventions are working to get which students up to speed in what subjects.”
• “We need data collection processes that allow schools to gather information 鈥� in real time 鈥� on how kids are doing.”
• “Here鈥檚 one way to chip away at this data desert: State education agencies can use a share of the nearly $20 billion they got in relief funds to create real-time reporting systems to track daily student attendance, monthly learning, real-time labor trends by role and location, and much more.”

Federal Updates

Department of Health and Human Services + Department of Education: Through the Health Resources and Services Administration, the departments are for health professionals in schools and in emergency departments.

City & State News

ARIZONA: State returns for its second year

ILLINOIS:

MARYLAND: Baltimore City Public School staff hope

NORTH CAROLINA:

OHIO: , nearly double the pre-pandemic rate

COVID-19 Research

• “The team used survey data to classify respondents as eligible or ineligible for COVID-19 vaccines based on survey completion date and policy effective date and applied state guidelines to self-reports of age, occupation, health conditions and residence in a long-term care facility. .”
• “Participants living in states with more complex vaccine guidelines (i.e., California, New York and Pennsylvania) were less likely than those in states with simpler guidelines (i.e., Florida, Georgia and Texas) to correctly indicate their eligibility (61% vs. 78%, respectively).”
• “More complex vaccine guidelines were associated with lower participant comprehension, potentially hindering eligible persons from seeking vaccines during a period of scarcity. To optimize public health communication, brevity and simplicity should not be undervalued.”

• published in JAMA Pediatrics.
• 鈥淐OVID-19 vaccination during pregnancy was not associated with increased risks of peripartum adverse outcomes, including preterm birth, small size for gestational age, low Apgar score at 5 minutes, cesarean delivery, postpartum hemorrhage and chorioamnionitis.鈥�
• 鈥淔urthermore, COVID-19 vaccination during pregnancy was associated with lower risks of neonatal intensive care unit admission, intrauterine fetal death and maternal SARS-CoV-2 infection.鈥�
• “Our data support the safety and efficacy of COVID-19 vaccination during pregnancy, facilitating the vaccination rates among pregnant individuals even if they do not get vaccinated before pregnancy.”

• “We estimate substantially higher excess death rates for registered Republicans when compared to registered Democrats, with almost all of the difference concentrated in the period after vaccines were widely available in our study states.” 
• “Overall, the excess death rate for Republicans was 5.4 percentage points, or 76%, higher than the excess death rate for Democrats. Post-vaccines, the excess death rate gap between Republicans and Democrats widened from 1.6 percentage points (22% of the Democratic excess death rate) to 10.4 percentage points (153% of the Democratic excess death rate).”

In COVID-19 Health Messaging, Focus on Risks Increases Anxiety with Little to No Benefit

• “Given that subtle differences in information framing can have meaningful effects on behavior, behavioral science research highlights a pressing question: Is it more effective to frame COVID-19 health messages in terms of potential losses (e.g., 鈥業f you do not practice these steps, you can endanger yourself and others鈥�) or potential gains (e.g., 鈥業f you practice these steps, you can protect yourself and others鈥�)?”
• “Loss- (vs. gain-) framed messages increased self-reported anxiety among participants cross-nationally with little-to-no impact on policy attitudes, behavioral intentions or information seeking relevant to pandemic risks.”
• “These results were consistent across 84 countries, three variations of the message framing wording and 560 data processing and analytic choices.”

Viewpoints

Future of Data in K-12 Education Initiative Can Help Inform a Critical Impasse 

• 鈥淚n response to the dire need for more data and information鈥� the U.S. Chamber Foundation has launched an initiative on the Future of Data in K-12 Education.鈥�
• 鈥溾�楬istoric learning loss has occurred across the board, and we need to find a way to get kids caught up,鈥� Caitlin Codella Low, vice president of policy and programs at the U.S. Chamber Foundation, said. 鈥業t takes time. It鈥檚 not even a problem that money can solve alone. And so right now is the time to make sure that the federal and state and local policies that are in place are serving the kids in a way that ends up giving them what they need to be successful in the future.鈥欌��

• Via Rick Hess
• Tune out the noise
• Catch kids up
• Maintain transparency
• Expand options
• Rewrite the pandemic playbook

…And on a Lighter Note

I Have Questions: A  in Worcester cathedral during animal blessing service.

• The BBC 

For even more COVID policy and education news, .

Disclosure: John Bailey is an adviser to the Walton Family Foundation, which provides financial support to .

Earlier this month, the virus was detected in the United States for the first time since 2013. for poliomyelitis, the scientific name for the illness; where he contracted it is still unclear. 

Although the last case that originated in the U.S. occurred in , unvaccinated people are at risk. and missed doctor鈥檚 appointments because of COVID-19 mean some kids aren鈥檛 getting the protection . 

The Centers for Disease Control and Prevention children receive four doses of the polio vaccine between 2 months and 4 years old, and schools and child care facilities in every state require the shots, which are safe and effective, before children can attend. But around the United States, vaccination rates vary widely. 

Every state allows children to be exempted from the immunizations for medical reasons. Washington, D.C., and 44 states allow religious exemptions, and 15 allow philosophical exemptions, according to the . 

Within a state, vaccination coverage can vary widely as well. In Rockland County, New York, for example, where the first case of 2022 was detected, about , according to recent state data. In Nearby New York City, where the virus has , the overall rate is about 86%. Even within the city, rates differ, with some neighborhoods reaching higher than 99% while others are .

The map below shows the in each state who received the recommended series of vaccines 鈥� which includes immunization against polio as well as measles, mumps, rubella, varicella and other illnesses 鈥� by 35 months old.

Share of Children Who Have Received Recommended Series of Vaccines by 35 Months

For herd immunity from polio, about 80% of people in a community need to be immunized, according to the . The vaccination rate associated with herd immunity 鈥� the minimum share of people who must be protected to stop an illness from spreading鈥� varies by disease. 

Polio is often asymptomatic but . In rare cases, the virus can result in muscle weakness, paralysis or death. Anyone who is not vaccinated can contract polio, but it most commonly affects children under 5 years old, .

This map shows the percentage of kindergartners in each state who have received the recommended doses of the polio vaccine.

Share of Kindergarteners Vaccinated Against Polio By State

In the early 1950s, before the vaccine was available, polio caused 鈥� of paralysis each year,鈥� according to the CDC. Schools played a vital role in vaccine trials in the later part of that decade.

One reason vaccines are less popular than they were when polio was widespread is because they work, David Oshinsky, a medical historian at New York University and the author of Polio: An American Story, .

Effective vaccines have “obliterated evidence of what [polio] can cause: kids on crutches, in wheelchairs, in iron lungs,” he said. “I remember seeing the occasional empty desk in school because a child had died. People had seen polio every summer, and they wanted kids vaccinated as soon as possible.”

In a press conference Thursday, White House COVID Response Coordinator Ashish Jha outlined the possible timeline for when young children, the last group in the U.S. still ineligible for immunizations, could begin rolling up their sleeves.

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Here are the key dates:

鈥擩une 1, Pfizer-BioNTech formally asked the Food and Drug Administration to grant emergency use authorization to their doses for kids under 5. Moderna submitted its application in late April for kids 6 months to 6 years old.

鈥擩une 3, states became able to order vaccine doses for kids under 5. A total of 10 million are currently available, the White House said.

鈥擩une 14 & 15, the FDA鈥檚 vaccine advisory committee is scheduled to meet to review the Moderna and Pfizer-BioNTech doses. Should the committee vote in favor of authorization, the White House expects the FDA to greenlight the vaccines in the days immediately after the meeting.

鈥擩une 18-20, if the FDA has authorized shots, doses will begin to arrive at doctors鈥� offices. The White House can begin sending vaccine shipments immediately following FDA authorization.

鈥擩une 21, after the long holiday weekend, if the previous steps proceed without setbacks, kids under 5 may begin receiving vaccine doses. The Centers for Disease Control and Prevention must also recommend the shots, but the agency typically follows the guidance of the FDA.

The White House has asked states to first provide vaccines to sites that can handle large volumes of supply, such as children鈥檚 hospitals. But as soon as Atlanta-based pediatrician Jennifer Shu receives the green light from local officials, she will order doses for her office.

鈥淧arents have been asking me about vaccine availability for kids under 5 for several months. I plan to order them as soon as I get the notice from our health department,鈥� she wrote in a message to 社区黑料.

The White House also stressed that providers should offer vaccinations outside traditional working hours.

鈥淲e want to make this as easy as possible for working parents and their families,鈥� said Jha.

The Department of Health and Human Services did not immediately respond to a question from 社区黑料 asking how many doses have been ordered so far and by which states.

With COVID case counts once again high amid a second Omicron surge, the updated vaccine timeline for young kids appeared as a light at the end of the tunnel to many pandemic-weary parents.

鈥淚 teared up in the car today thinking about being able to get my kid vaccinated,鈥� Marisol LeBr贸n, professor at UC Santa Cruz, wrote on Twitter.

Parents of young children awaiting vaccines for little ones have been on a months-long roller coaster that has repeatedly raised their hopes only to later send them crashing down. In late February, Pfizer-BioNTech first submitted a request asking the FDA to grant emergency authorization for a two-dose regimen of their vaccine for children 6 months to 4 years old, only to then withdraw the application just five days later.

Then in April, when Moderna was on the verge of submitting its EUA application for the age group, Politico reported that the FDA might postpone the review process until Pfizer鈥檚 shots were also ready, a reveal that angered many parents and spurred a congressional letter asking the agency to explain the reported delay. The FDA鈥檚 current timeline appears to confirm those speculations of a simultaneous review.

The Moderna and Pfizer-BioNTech doses have several differences. Moderna鈥檚 shots are a two-dose regimen spaced four weeks apart, while the Pfizer-BioNTech vaccine requires three doses each spaced three weeks apart. The Pfizer-BioNTech shots were 80% effective in clinical trials, while Moderna鈥檚 were 51% protective in toddlers 6 months to 2 years old and 37% protective in youngsters 3 to 5 years old.

Researchers believe both vaccines offer a strong defense against severe illness and hospitalization in the age group.

In a clip from the Thursday press conference that has circulated widely on Twitter, White House Press Sec. Karine Jean-Pierre cut off Jha before he could respond to a reporter’s question asking whether 鈥渁ll schools will and must be open this coming fall.鈥�

Any speculations that the Biden administration would advise school closures next year, however, starkly contrast with the administration鈥檚 prior actions and messaging. Biden has continually underscored his commitment to keeping schools open and oversaw a push to 99% of schools offering in-person learning in his first months in office. Although early in the pandemic an in-person learning divide existed between red and blue states, virtually all school systems reopened their classrooms for the 2021-22 school year, regardless of their partisan leaning.

But with toddler vaccines possibly rolling out in just a few weeks, many older children have not yet been immunized. Just 29% of children 5 to 11 years old and 59% of youth 12 to 17 years old had received two vaccine doses as of June 1, according to data from the American Academy of Pediatrics. The rates that have remained nearly stagnant for months.

The winter鈥檚 massive Omicron surge demonstrated the importance of youth vaccination, said Shu, the Atlanta pediatrician. Children under 5 were hospitalized with the virus at five times the rate they were during the Delta surge, a study from the CDC recently found. And in February, the agency鈥檚 data revealed that 3 in 4 kids under 18 had been infected by the virus.

鈥淭he kids who are ending up in the hospital are more likely not to be vaccinated,鈥� the doctor told 社区黑料 in May.

Homeschooling Surge Continues Despite Schools Reopening: Via .

• “In 18 states that shared data through the current school year, the number of homeschooling students increased by 63% in the 2020-21 school year, then fell by only 17% in the 2021-22 school year.”
• “The rising numbers have cut into public school enrollment in ways that affect future funding and renewed debates over how closely homeschooling should be regulated. What remains unknown is whether this year鈥檚 small decrease signals a step toward pre-pandemic levels 鈥� or a sign that homeschooling is becoming more mainstream.”
• “Minnesota, for example, reported that 27,801 students are being homeschooled now, compared to 30,955 during the last school year. Before the pandemic, homeschool figures were around 20,000 or less.”
• “Black families make up many of the homeschool converts. The proportion of Black families homeschooling their children increased by five times, from 3.3% to 16.1%, from spring 2020 to the fall, while the proportion about doubled across other groups, according to U.S. Census surveys.

The Big Three 鈥斕鼳pril 22, 2022

Pfizer Says Its Booster Shot Strengthens the Immune Response for Children 5-11 Years Old: and

• “A third dose produced a 36-fold increase in neutralizing antibodies against the Omicron variant and a 6-fold increase in neutralizing against the SARS-CoV-2 wild-type strain.”
• “Pfizer and BioNTech plan to submit a request for Emergency Use Authorization of a booster dose for children ages 5 through 11 in the U.S. in the coming days. The companies also plan to share these data with the European Medicines Agency and other regulatory agencies around the world as soon as possible.”
• 鈥淚 think a bottom line is that in order to protect from the Omicron, we know from studies and from adults and adolescents that you need three doses,鈥� said Dr. Kathryn M. Edwards, a pediatric vaccine expert at Vanderbilt University School of Medicine.She predicted regulators would authorize the companies鈥� request.”

As Teen Mental Health Worsens, Schools Learn How to Help: Via .

• “Last year, 38 states enacted nearly 100 laws providing additional resources to support mental well-being in K-12 schools, according to the National Academy for State Health Policy, a Portland, Maine-based policy research group. Dozens of additional school mental health bills became law this year in at least 22 states, according to the group.”
• “At least 16 states, from Alaska to Massachusetts, plus the District of Columbia, now require K-12 teachers and other school staff to take training courses on how to recognize mental distress in students and what to do when they see it.”
• “California, Connecticut, Illinois, Kentucky, Rhode Island, Utah and Washington enacted new laws recommending high school students take mental health training courses so they can help their friends, family and classmates.”

Hospitalizations of Children Aged 5-11 Years:

• “Among 397 children hospitalized during the Omicron-predominant period, 87% were unvaccinated, 30% had no underlying medical conditions and 19% were admitted to an intensive care unit.”
• “The cumulative hospitalization rate during the Omicron predominant period was 2.1 times as high among unvaccinated children as among vaccinated.”
• “Non-Hispanic Black (Black) children accounted for the largest proportion of unvaccinated children (34%) and represented approximately one third of COVID-19-associated hospitalizations in this age group.”

Federal Updates

New ESSER Expenditure Dashboard: From Edunomics that .

Masks Mandates:

• 鈥淎 federal judge in Florida has ,鈥� the AP reports.
• “
• : “It is CDC鈥檚 continuing assessment that at this time an order requiring masking in the indoor transportation corridor remains necessary for the public health. CDC will continue to monitor public health conditions to determine whether such an order remains necessary. CDC believes this is a lawful order, well within CDC鈥檚 legal authority to protect public health.”
• Public opinion: “A new finds 59% of voters support the CDC鈥檚 original extension of the federal travel mask mandate. Only 32% oppose the extension.”
• Related: SARS-CoV-2 Transmission on Planes: by Katelyn Jetelina.

City & State News

California:

• California .
• .

Idaho: Students in rural high schools , thanks to a gift from Direct Communications.

Maryland: .

New Jersey: . Includes a database of district data.

• “The number of students in the Camden City School District who missed 10 or more school days 鈥� the definition of chronically absent 鈥� jumped to 57% that year, up from 34% during the 2018-19 school year.”

New York: .

Texas: picks up steam in rural Texas districts.

Utah: .

• “The da Vinci XI robotic-assisted surgical systems, which are used for surgeries in American Fork Hospital, include a training game that keeps track of a user鈥檚 score.”
• “The sales representatives consistently score in the mid-90s on the game, but several Lone Peak students scored a 99 out of 100 the first time they touched the equipment.”

Wisconsin: .

COVID-19 Research

School Closures and Effective In-Person Learning during COVID-19: When, Where and for Whom: and .

• “We match cell phone data to administrative school records and combine it with information on school learning modes to study effective in-person learning (EIPL) in the U.S. during the pandemic.”
• “We find large differences in EIPL for the 2020-21 school year. Public schools averaged less EIPL than private schools. Schools in more affluent localities and schools with a larger share of non-white students provided lower EIPL. Higher school spending and federal emergency funding is associated with lower EIPL.”
• ” These results are explained in large part by regional differences, reflecting political preferences, vaccination rates, teacher unionization rates and local labor conditions”

Moderna Says Redesigned COVID Booster Provides Better Protection: Moderna said its modified COVID-19 booster shot, designed to target two strains of the coronavirus, generated a strong immune response against multiple variants of concern, including Omicron. and .

• CNBC reports: “The company said the modified shot appeared to , which is still formulated to target the original form of the coronavirus identified in late 2019.鈥�
• “Health officials have made clear that giving boosters every few months isn鈥檛 the answer to the mutating virus. . Just switching to a vaccine that targets the latest variant is risky, because the virus could mutate again. So Moderna and its rival Pfizer both are testing what scientists call 鈥榖ivalent鈥� shots 鈥� a mix of each company鈥檚 original vaccine and an Omicron-targeted version,” the AP reports.

CDC Forecasting: “”

• ” ‘We think of ourselves like the National Weather Service, but for infectious diseases,’ said Caitlin Rivers, an epidemiologist and associate director for science at the initiative, run by the Centers for Disease Control and Prevention.”
• “About 100 scientists will analyze technical data and communicate policy options to decision-makers and the public about how the virus is behaving and who is most at risk 鈥� in user-friendly terms.”

COVID Hasn鈥檛 Given Up All Its Secrets. Here Are 6 Mysteries Experts Hope to Unravel: Via

• How will the virus evolve next?
• What will future waves look like?
• If you鈥檝e never had COVID, how worried should you be right now?
• How, exactly, does the virus transmit from person to person?
• Will we get a new, better generation of vaccines, therapeutics and tests?
• How long before we understand long COVID?

The Case for Testing Pfizer’s Paxlovid for Treating Long COVID: Via .

Upper Airway Infections in Kids With COVID-19 Rose with Omicron Surge: “Rates of upper airway infections such as croup and bacterial tracheitis among pediatric COVID-19 patients, though low, rose after the Omicron variant became dominant in December 2021, , estimates a today in JAMA Pediatrics.”

An Omicron Outbreak in a Primary School in Geneva: .

• “Among the children without indication of previous infection or vaccination who were tested, 20 (50%) of 40 were infected. Five (50%) of 10 teachers and one (20%) of five non-teaching staff members at the school tested positive during the Omicron outbreak. Two (13%) of 15 staff members were not vaccinated against COVID-19, and both tested positive.”
• “We also investigated the introduction of SARS-CoV-2 infections in 24 households of children who tested positive. 52 household members were tested once or twice within the week after their child or sibling tested positive.”
• “Infections with the SARS-CoV-2 Omicron variant were found in 15 (63%) of 24 households and 25 (48%) of 52 investigated household members (which increased to 27 [50%] of 54 if including probably cases), a household cumulative infection incidence that was similar to the findings of another report from South Korea.”
• “In summary, this prospective, school class-based study provides evidence of higher transmission of infections in school settings with the Omicron variant than was reported with previous variants. Children appear to be an important source of extra-household infections and have a key role in community transmission.”

FDA Authorizes First COVID-19 Diagnostic Test Using Breath Samples: The InspectIR COVID-19 Breathalyzer delivers results in less than three minutes. .

Viewpoints

The Time Has Come for Truly Personalized Learning 鈥� With a Navigator to Make Sure Each Child Succeeds: Paul Reville and Geoffrey Canada in 社区黑料.

• “The concept of navigator has some modest footholds in education. There are guidance counselors who can in theory play such a role but are undermined by unworkable student-counselor ratios. A few schools feature advisories that provide some navigation services.”
• “Special education students have Individualized Education Programs. But even so, navigation and success planning are rare in schools. Personalization is not the norm as it is, for example, in medicine, where patient navigators 鈥� primary care physicians 鈥� advocate for the unique needs of each individual and guide families in producing better health outcomes for their loved ones.”
• “To implement a navigator strategy, leaders must create a system that enables a designated adult to reach out to a particular student on a regular basis to see how they鈥檙e doing, with an emphasis on making kids feel seen, heard, understood and cared for. Such an initiative, which could be funded using abundant federal COVID relief funding, meets the urgent, immediate need of providing a quality adult relationship that connects each student and family to supports and opportunities while enhancing their sense of belonging to a community.”

Unlocking Innovation in Schools:

Pods in Action:

VELA Micro Grants: .

Dubious Research, Vexing Guidance: CDC Struggles to Help Schools During Pandemic: Via Matt Barnum in

Schools Spend Millions in Pandemic Funds on Tutoring, Often with Little Proof It Will Work: Via

How You Can Avoid Missing Out on COVID Relief Money:

Has Federal Crisis Spending for K-12 Schools Served Its Intended Objectives?: Asks

Educating English Learners During the Pandemic: Via

Rediscovering 鈥淭hird Place鈥� Friendships in a Post-Pandemic World: Via

鈥� And on a reflective note

Love and Underdog: .

• “When Robbie goes to the animal shelter, he gravitates toward the seemingly oldest of the bunch.”
• “Robbie, who was adopted out of foster care, says he knows 鈥榟ow it feels to not be loved or cared for 鈥� and I don’t want any pet of mine to feel that way.鈥� “

ICYMI @The74

Weekend Reads: In case you missed them, our top five stories of the week:

• Immigration: ‘Without Papers, Without Fear鈥�: Meet the NM Activist Dedicated to Lifting Up Undocumented Young People 鈥� Just Like Him
• Research: Babies Born During COVID Talk Less with Caregivers, Slower to Develop Critical Language Skills
• Commentary: This Is a Once-in-a-Generation Opportunity to Expand High-Quality Tutoring for all Students Who Need It. Our New Nonprofit鈥檚 Grants Can Help
• Critical Race Theory: Political Science Research Suggests That More CRT Bills Could Come to Washington Next Year
• Teacher of the Year: National Winner Kurt Russell to Emphasize Diversity as Lawmakers in His Home State of Ohio Rail Against 鈥楧ivisive鈥� Topics

For even more COVID policy and education news, .

Disclosure: John Bailey is an adviser to the Walton Family Foundation, which provides financial support to .

Calling it a “significant encroachment,” the Supreme Court on Thursday that would have impacted about a quarter of the nation’s school districts and potentially contributed to further staff shortages.

“Permitting [the听Occupational Safety and Health Administration]听to regulate the hazards of daily life 鈥� simply because most Americans have jobs and face those same risks while on the clock 鈥� would significantly expand OSHA鈥檚 regulatory authority without clear congressional authorization,” the opinion听said.

The court’s three left-leaning justices, Stephen听Breyer, Sonia Sotomayor and听Elena Kagan, dissented, arguing that the decision “stymies the federal government鈥檚 ability to counter the unparalleled threat that COVID鈥�19 poses to our nation鈥檚 workers.”

As schools struggle to handle COVID-19 outbreaks amid staff shortages, the U.S. Supreme Court Friday heard a lawsuit over an employee vaccine mandate that some experts suggest could stretch districts even thinner.

In November, President Joe Biden that employees in organizations with at least 100 workers be vaccinated or wear a mask and test weekly. The requirement applies to about of the nation鈥檚 public school teachers and staff members, after factoring in the several states that have already imposed their own vaccine requirements for district employees.

The plaintiffs, 27 states and the National Federation of Independent Businesses, sued the U.S. Department of Labor and the Occupational Safety and Health Administration, arguing that the mandate 鈥� set to go into effect Monday 鈥� would create a 鈥渓abor upheaval鈥� and that many employees will quit rather than comply. The plaintiffs asked the court to block the mandate from being implemented, and a ruling on that could come as early as this weekend.

鈥淭his is going to cause a massive economic shift in this country,鈥� said Scott Keller, representing the businesses. He and Ohio Solicitor General Ben Flowers argued that states and Congress 鈥� not OSHA 鈥� have the authority over public health regulations and that COVID-19 transmission is a risk everywhere, not just in the workplace.

Solicitor General Elizabeth Prelogar, speaking for the Biden administration, stressed that 鈥済rave danger exists鈥� when people gather indoors together, which they are more likely to do at work.

The hearing took place as other challenges to vaccine mandates 鈥� for both educators and students 鈥� move through the legal system. The San Diego Union School District鈥檚 vaccine mandate is facing two challenges, one of which also awaits a response from the Supreme Court. And a federal judge in Louisiana last week blocked the Biden administration鈥檚 requirement that all Head Start staff be vaccinated by the end of January. 

Even the judge in that case expects the administration to appeal.

鈥淭his issue will certainly be decided by a higher court than this one,鈥� Judge Terry Doughty, of the Western District of Louisiana, wrote in his ruling. A Trump appointee, he argued that the Biden administration has overstepped its authority and the mandate could make it difficult to keep classrooms fully staffed.

鈥淚f the executive branch is allowed to usurp the power of the legislative branch to make laws, then this country is no longer a democracy 鈥� it is a monarchy,鈥� he wrote.

鈥楾housands of people dying鈥�

In Friday鈥檚 oral arguments on the OSHA case, members of the Supreme Court鈥檚 conservative majority also questioned the the legality of the agency鈥檚 mandate.

鈥淭his is something that the federal government has never done before,鈥� said Chief Justice John Roberts.

But the more liberal justices focused on case and hospitalization rates.

鈥淏y this point, we know that the best way to prevent spread is for people to get vaccinated,鈥� said Justice Elena Kagan. 鈥淲e are still confronting thousands of people dying every time we look around.鈥�
On Wednesday, there were more than 700,000 new cases in the U.S. and more than 1,500 deaths, according to the Centers for Disease Control and Prevention The , however, has declined since the Delta surge in September.

According to Nat Malkus, an education policy expert at the conservative American Enterprise Institute, the mandate would directly apply to districts in 26 states that have their own OSHA plans. But even in those states that are exempt, it could 鈥渃hange the calculus for districts鈥� and make them more likely to require vaccines or regular testing if most other employers in their communities are already enforcing the mandate. In the 24 states directly under OSHA authority, state and local employers are not included.

He noted that if the court opens the door to OSHA having broad authority in this case, it will be 鈥渉arder to close it in the future,鈥� and would strengthen the government鈥檚 argument in the Head Start case. 

While some children turn 5 while in Head Start, most in the federal preschool program for children in poverty, are still too young to be vaccinated. Children are less likely to become seriously ill from COVID-19. But with Omicron leading to higher positivity rates and recent in pediatric COVID-related hospitalizations, medical experts have stressed the importance of surrounding young children with family members and caregivers who are vaccinated.

The National Head Start Association, which represents Head Start families and programs, is calling for a compromise between the administration鈥檚 hard-line position and the 24 states that sued over the mandate. The rule also requires children ages 2 and up to wear masks.

鈥淔ace masks and vaccinations play a critical role in reducing the spread of COVID-19 in early care and educational settings. But the rule wants it all one way and the lawsuit wants it all the other way,鈥� Yasmina Vinci, executive director of the association, said in a statement. 鈥淗ead Start leaders are seeking the middle ground, where local programs have the flexibility to work within local guidelines to keep classrooms open and ensure children don鈥檛 lose access to crucial services because of a mandate that is impossible to operationalize.鈥�

鈥楾he uphill effort鈥�

But district leaders are concerned about the immediate impact of vaccine mandates on the classroom. 

鈥淚t will make shortages worse and exacerbate the uphill effort to get and keep schools open and kids in schools,鈥� Noelle Ellerson Ng, associate executive director for advocacy and governance at AASA, the School Superintendents Association, said about the OSHA rule.

As they monitor court rulings regarding vaccine mandates for employees, school districts are also watching decisions regarding students.  

The Supreme Court is expected to decide before Jan. 24 whether to hear the case of a pro-life student from Scripps Ranch High School in the San Diego district who objects to human cell lines being used in the testing and creation of the COVID-19 vaccines. Cell lines, developed in laboratories and commonly used to manufacture vaccines, come from fetuses aborted decades ago. 

The mandate applies to students 16 and up. Students who don鈥檛 comply would be enrolled in remote learning.

鈥淭he irony about the mandate is that teachers are allowed to get religious exemptions, but students, who are at far lower risk [from COVID-19], are not,鈥� said attorney Paul Jonna, who represents the plaintiffs.

In a separate San Diego case, the district plans to appeal a superior court judge鈥檚 decision . Let Them Choose, an advocacy organization, argues that only the state legislature or public health department 鈥� not districts 鈥� have the authority to mandate childhood vaccinations. The law also allows parents and students to opt out for personal beliefs. 

Two advocacy organizations made the same argument over the Los Angeles Unified School District鈥檚 vaccine mandate for students, which has been delayed until fall. In December, a Los Angeles Superior Court judge to block implementation of the mandate.

We Learned Our Lesson Last Year: Do Not Close Schools: :

• “The argument for keeping schools open rests on two constants ever since the COVID pandemic began: The risk of severe outcomes to kids from coronavirus infection is low, and the risks to kids from being out of school are high.”
• “As the American Academy of Pediatrics stated in a report released this month, 鈥楾he available data indicate that COVID-19-associated hospitalization and death is uncommon in children.鈥�”
• “The latest data from South Africa for the week ending Dec. 12 shows that school-age children (5- to 19-year-olds) had the lowest hospitalization of any age group, and even with the Omicron uptick, the hospitalization rate is 4 to 6 per 100,000 鈥� higher than 1 in 100,000 but still quite low. The latest data from Britain is similar. As of Dec. 12, the hospitalization rate for 5- to 14-year-olds is 1.4 per 100,000 鈥� the lowest hospitalization rate of any age group.”
• “As pressures to close schools again grow, we should recognize that the patterns of school closures and reopenings last year were defined by racial inequality. Black and Hispanic students were twice as likely as white students to be remote and were twice as likely to have no live access to a teacher. This disparity persisted into the spring of 2021 as schools reopened.”
• “We also need to mandate vaccination for all adults in schools and day cares.”
• “Schools should address ventilation and filtration shortfalls through basic measures that can be put in place quickly.鈥�
• “We need to stop quarantining entire classrooms when there is a positive case and instead establish so-called test-to-stay policies as the default.”
• “We should make masking in schools voluntary rather than mandatory.”

December 23, 2021 鈥斕齌he Big Three

Education Secretary Urges Schools to Stay Open: “Our parents have done enough,” Secretary Miguel Cardona said Tuesday.

• “I don鈥檛 think we should be considering remote options,鈥� Cardona said Tuesday in an interview with 社区黑料. 鈥淥ur students deserve more, not less, and our parents have done enough to help balance school closures the first year of the pandemic.鈥�
• President Joe Biden echoed those comments later Tuesday: 鈥淭oday, we don鈥檛 have to shut down schools because of a case of COVID-19. 鈥� We know how to keep kids safe.鈥�

CDC Embraces 鈥楾est-to-Stay鈥� Policy for Schools: The Centers for Disease Control and Prevention finally released around test-to-stay, which can, in certain situations, replace the quarantines that have disrupted so much learning this fall.听听

• of the research; .
• CDC also released two studies of test-to-stay programs.听
  • , students at schools that did not participate in the pilot program, and who had to quarantine, lost an estimated 92,455 in-person school days between Sept. 20 and Oct. 31, while students exposed to the virus in schools trying out the program lost no days. Schools that used test-to-stay also did not see increases in virus rates among students.
  • , researchers estimated that up to 8,152 in-person learning days were saved between August and October in schools that participated in the program. Of the 16 students in the program who tested positive for the virus in the two weeks after exposure, none appeared to transmit it to others at school, the report said.
• More via 社区黑料

Pfizer鈥檚 Low-Dose Shot Did Not Provoke an Adequate Immune Response in 2- to 5-Year-Olds:

• “In ongoing clinical trials, the companies tested 3 micrograms of the vaccine 鈥� one-tenth of the adult dose 鈥� in children 6 months to less than 5 years of age.
• “The companies said Friday they would begin testing the addition of a third dose in the children, and if successful, .”

Omicron

Biden Addresses the Nation:听 听

• “Fact Sheet: Biden to Protect Americans and Help Communities and Hospitals Battle Omicron.” . Full .听听
• “鈥�鈥� Biden said, adding that Americans have an obligation to their families and their country to get vaccinated.”
• “, and that 鈥榯hanks to the prior administration and the scientific community, America is one of the first countries to get the vaccine.鈥欌��

Dr. Ashish Jha: We have the tools to keep schools open and safe

• 鈥淲e have all the tools to keep schools open and safe: Vaccinations, testing, improvements in ventilation, tens of billions of dollars have gone to schools. 鈥� If I hear of a single school district that goes remote but keeps bars open, what that says to me is: They don鈥檛 care about kids 鈥� and they don鈥檛 care about COVID. Because bars spread COVID. Schools generally don鈥檛 鈥� not if you put in place mitigation efforts.鈥�

City & State News

Arizona: Mike McShane: “” and related

California: was already all-in on technology, which helped it weather the pandemic.

D.C.: Educator survey by Washington Teachers Union and EmpowerEd found .听

Louisiana: to children ages 5 and up, a first in the U.S.

Michigan: , and

Pennsylvania: About have received a COVID-19 vaccine more than a month after the 5-to-11 age group was approved. Percent that have received one dose:

• 8% of Black children
• 12% of Hispanic children
• 24% of white children
• 31% of Asian children

Virginia: named as his choice for state education secretary.听

Federal Updates

Education Department: Is seeking comments on its draft guidance, “.” Comments are due Jan. 16.

Institute of Education Sciences: Grant notice:

COVID-19 Research

Kids鈥� Vaccine Safety, by the Numbers:

CDC Recommends Pfizer, Moderna Vaccines Over J&J: Citing increasing evidence that the Johnson & Johnson shots trigger a rare blood clot disorder now linked to dozens of cases and at least nine deaths in the last year, .听听

• “The CDC accepted advice from a panel of experts to the use of the Moderna and Pfizer-BioNTech COVID-19 vaccines over the Johnson & Johnson jab, following growing concerns about rare blood clots.”
• Stat’s Helen Branswell has a great covering the meeting.

The CDC鈥檚 Flawed Case for Wearing Masks in School:

• “What data do exist have been interpreted into guidance in many different ways. The World Health Organization, for example, does not recommend masks for children under age 6. The European Centre for Disease Prevention and Control recommends against the use of masks for any children in primary school.”
• In September, appearing 鈥渁s a guest on CBS鈥檚 ‘Face the Nation,’ [CDC Director Rochelle Walensky] cited a study published two days earlier, which looked at data from about 1,000 public schools in Arizona. The ones that didn鈥檛 have mask mandates, she said, were 3.5 times as likely to experience COVID outbreaks as the ones that did.鈥�
• “But the Arizona study at the center of the CDC鈥檚 back-to-school blitz turns out to have been profoundly misleading. 鈥榊ou can鈥檛 learn anything about the effects of school mask mandates from this study,鈥� Jonathan Ketcham, a public health economist at Arizona State University, told me. His view echoed the assessment of eight other experts who reviewed the research, and with whom I spoke for this article.”
• 鈥淭his is not the only study cited by Walensky in support of masking students, but it鈥檚 among the most important.鈥�
• 鈥淲ith Biden in the White House, the CDC has promised to 鈥榝ollow the science鈥� in its COVID policies. Yet the circumstances around the Arizona study seem to show the opposite. Dubious research has been cited after the fact, without transparency, in support of existing agency guidance. 鈥楻esearch requires trust and the ability to verify work,鈥� Ketcham 鈥� told me. 鈥楾hat鈥檚 the heart of science. The saddest part of this is the erosion of trust.鈥欌��

Children and COVID-19:

• Nearly 170,000 child cases were added the past week, an increase of nearly 28% over the last 2 weeks.听
• For the 19th week in a row, child COVID-19 cases are above 100,000.听
• Since the first week of September, there have been more than 2.3 million additional child cases.

Long COVID in Kids:

• “ let鈥檚 stop the scaremongering and get the public messaging right. The vast majority of kids with COVID-19 will recover completely, but we do need better tools to identify (and resources to investigate and support) the small proportion of kids with persistent symptoms.”

Viewpoints

Should We Treat COVID-19 as an Emergency or as Endemic?:

• “Trust in scientific authorities has fallen during COVID, and increasingly, people are frustrated to discover that restrictions we have lived under 鈥� like requiring little kids to wear masks on the playground, something almost no other countries on the planet do 鈥� aren’t as rooted in good science as advertised. Support for things like mask mandates and requiring people to show proof of vaccination to go about their day has been slipping gradually.”
• “Most Americans 鈥� including two-thirds of Republicans and 6 in 10 Independents 鈥� say: We don’t think we are ever getting to COVID zero, so let’s learn to live with it.”
• “The idea that if we all just spent a few more weeks hunkered down, 鈥�15 days to slow the spread鈥� and all that, we can just beat this thing once and for all is increasingly viewed as nonsense.鈥�
  

Advancing Comprehensive School Mental Health Systems: A Guide for State Education Agencies: A outlines five key steps state education agencies can take to support a comprehensive approach to school mental health, alongside state examples and relevant resources.听

Getting Personal: The Future of Education Post COVID-19: . :听

• “Nearly all of the educators surveyed 鈥� 99% 鈥� said that COVID-19 accelerated their schools鈥� adoption of personalized learning, with 51% strongly agreeing with that statement. (The other 48% 鈥渟omewhat鈥� agreed.) Nearly a third 鈥� 30% 鈥� strongly agreed with the statement that the pandemic 鈥渕ade personalized learning more relevant than ever.鈥�
• “Already, 70% of schools use digital tools to deliver what they define as personalized learning, and 93% expect they will either increase or start doing so in the next two years.”

Are Schools Ready for the Next Big Surge?: Asks the

• “This time, union leaders in New York, Boston and Philadelphia said they were not asking for districtwide remote learning and were instead focused on pushing administrators to enforce virus mitigation measures.”

Zach Eckert: Unexpectedly passed away. 听

Remembering Denis Doyle: And reflects.

• He was a of “Reinventing Education: Entrepreneurship in America’s Public Schools” with then-CEO of IBM Lou Gerstner, a book that I found particularly thought-provoking when I was working at the Pennsylvania Department of Education.听
• He later launched Schoolnet with Jonathan Harber, a company that was in many ways several years ahead of its time.听听
• But more than anything, I remember his kind, gentle and encouraging mentorship when I was serving at the U.S. Department of Education. He will be missed.听

…And on a Reflective Note

As we close out 2021, let us look forward to Better Days:

• 听“Deep breath, stay calm; ,” via Ant Clemons and Justin Timberlake.
• “And you asked me what I want this year; And I try to make this kind and clear; ,” say the Goo Goo Dolls.听听
• “For last year’s words belong to last year’s language and next year’s words await another voice,” writes T.S. Eliot

Normally, this is a season marked by joy and cheer. But I know for many, this year feels a bit more heavy and exhausting. I wish you peace. May your holiday be filled with the simple gifts that matter most and a near year blessed with hope, health and happiness. 鈥擩辞丑苍

ICYMI @The74

This weekend, check out our top 21 stories of the year. Some of the highlights:

• Investigation:
• Pandemic Recovery: With Up to 9 Grade Levels Per Class, Can Schools Handle the Fallout From COVID鈥檚 K-Shaped Recession?
• Math Education: Can Right Answers Be Wrong? Latest Clash Over 鈥榃hite Supremacy Culture鈥� Unfolds in Unlikely Arena: Math Class

For even more COVID policy and education news, .

Disclosure: John Bailey is an adviser to the Walton Family Foundation, which provides financial support to .

鈥滻 don鈥檛 think we should be considering remote options,鈥� Cardona said Tuesday in an interview with 社区黑料. 鈥淥ur students deserve more, not less, and our parents have done enough to help balance school closures the first year of the pandemic.鈥�

The secretary鈥檚 comments, however, come amid a sharp increase in schools already shifting to remote learning, either because of or . According to , which tracks schools鈥� response to the pandemic, there are 646 school closures this week, up from 356 last week. Following the holiday break, 421 closures are expected, but that鈥檚 still less than a fifth of the number of closures in August, when the Delta variant postponed the return of many students to in-person learning. 

Cardona鈥檚 comments amplified those made by the president in an afternoon news conference Tuesday.

鈥淭oday, we don鈥檛 have to shut down schools because of a case of COVID-19,鈥� Biden said. He urged parents to vaccinate their children and said the best way to protect those under 5, not yet eligible for vaccines, is to ensure their family members and caregivers are fully vaccinated and have had a booster. 鈥淭he science is clear and overwhelming,鈥� he said. 鈥淲e know how to keep our kids safe.鈥�

The president announced several steps to increase COVID testing availability and expand capacity at hospitals. The administration will deliver 500,000 at-home tests to those who want them, starting in January, open more pop-up vaccination clinics, and make emergency response teams available to hospitals.

On Friday 鈥� the last day before the holiday break for many schools 鈥� the Centers for Disease Control and Prevention released two studies showing that test-to-stay procedures can prevent lost instructional days due to quarantine. Cardona said he didn鈥檛 have a hand in pushing for the announcement before the break, but that, 鈥渙ur teams talk regularly.鈥�

鈥淚 was glad they were able to communicate it early enough,鈥� he said. 鈥淎s we鈥檙e thinking about 2022, we can use test-to-stay, as we鈥檙e thinking about how to utilize the [American Rescue Plan] funds, we can use test-to-stay to limit quarantine and keep our children in school.鈥�

The secretary added that there鈥檚 room for improvement in providing up-to-date numbers on school closures. The National Center for Education Statistics produces data on the percentages of students attending school in-person or remotely, but are released monthly, compared to Burbio鈥檚 weekly update, and in the past, have frequently been months behind. The latest data, released last week, reflects in-person and remote learning as of Dec. 3.

鈥淲e鈥檙e going to continue to refine those systems, especially if there鈥檚 an increase in spread,鈥� he said.

According to the Center on Reinventing Public Education, which has tracked school closings and openings since the beginning of the pandemic, only eight states have provided schools with detailed guidance this school year on when they should consider closing. 

Cardona said it鈥檚 important to not only know what percentage of students are in school, but 鈥渨hat鈥檚 causing potential, short-term remote learning options or what they need in order to keep their schools open.”

The Los Angeles Unified Board of Education听听to delay its vaccine mandate for students 12 and up until next fall. The district was facing the possibility of transferring 34,000 unvaccinated students into an already understaffed remote learning program called City of Angels.听

Leaders of the district鈥檚 administrators union were concerned about the potential loss of staff if schools lost more students.

Los Angeles Unified students 12 and over may have until next fall to comply with the district鈥檚 vaccine mandate 鈥� roughly nine months after the original Jan. 10 deadline, officials announced Friday.

The first large school system in the nation to mandate COVID-19 vaccines for students, the district is facing roughly 34,000 students who will not be fully vaccinated by the original deadline as well as concerns from parents and administrators over the surge in enrollment in the district鈥檚 remote learning program.

The plan would push thousands more unvaccinated students into an independent study program, which is already struggling to meet at a time when the district, like many others, has major . Under the contract with the union, teachers only provide remote instruction when students are in quarantine. But teachers still have flexibility in how much they interact with students learning at home.

Board members will discuss delaying the deadline at their meeting on Tuesday, when they also plan to ratify the contract of Miami-Dade superintendent Alberto Carvalho to lead the district鈥檚 schools.

Pushing back the deadline will 鈥渉opefully lessen the stress on administrators in terms of the possible number of students they may lose,鈥� said Nery Paiz, president of the Associated Administrators of Los Angeles. 

When the nation鈥檚 second-largest school district announced its mandate three months ago, jumping out in front of vaccine requirement, some predicted it would spark a ripple effect in other districts across the country.  

With the Centers for Disease Control and Prevention lowering the age for booster shots to 16, the Biden administration and state leaders continue to strongly encourage families to get their children vaccinated. are now considering whether to add COVID-19 vaccines to the list of immunizations needed for school, and many parents and educators say more mandates are inevitable. But at the local level, officials are still up against vaccine resistance 鈥� and sometimes refusal 鈥� among parents.

On Friday morning, California Gov. Gavin Newsom said Los Angeles Unified should 鈥渇ine tune鈥� its policy to keep students in the classroom. Unvaccinated students in are facing a similar deadline.

Parent advocates suggest the Los Angeles district might have moved too quickly without a back-up plan.

鈥淲e hope the district anticipated a level of vaccine hesitancy and has drafted plans to protect every child’s right to receive a high-quality education,鈥� Katie Braude, CEO of Los Angeles parent advocacy group Speak UP, said in a statement. She added that the organization is concerned about the virtual program鈥檚 鈥渁bility to expand this quickly to meet the needs of 34,000 more students and the domino effect of teacher displacement on kids remaining in the classroom.”

October from the Kaiser Family Foundation showed that vaccination rates among 12- to 17-year-olds have slowed down, with half of parents saying their child is vaccinated or will be soon. The survey was conducted before the vaccine for 5- to 11-year olds became available , but at the time, less than a third planned to jump at the chance and another third said they would wait to see how it was working. The remaining parents said they definitely would not be getting their children vaccinated.

鈥極utside the scope鈥�

Interim Superintendent Megan Reilly said the district 鈥渁pplauds鈥� the more than 85 percent of students who are in compliance with the mandate. 鈥淭his is a major milestone, and there鈥檚 still more time to get vaccinated,鈥� she said in . 

The L.A. board鈥檚 decision could set up a confrontation with the district鈥檚 powerful teachers union. United Teachers Los Angeles 鈥渕ade the demand [for the mandate] at the bargaining table,鈥� according to its statement in support. 

But the district didn鈥檛 meet their demand. The contract ratified in early October only requires the district to 鈥渕ake every effort鈥� to test unvaccinated students and staff weekly for COVID-19. According to the district鈥檚 statement only unvaccinated students would have to continue weekly testing after January.

Student vaccine mandates are 鈥渙utside the scope of bargaining negotiations and teachers unions know this,鈥� said Bradley Marianno, an assistant education professor at the University of Nevada, Las Vegas. But with 500 Los Angeles Unified for not complying with the employee vaccine mandate, UTLA would likely want the district to 鈥渉old firm鈥� on its deadline for students, he said.

A union spokeswoman did not respond to a request for comment.

Leslie Finger, an assistant professor of political science at the University of North Texas, said unions have had to perform a delicate balancing act to satisfy their large and diverse memberships.

When it comes to adults, 鈥渢he unions have had to appease both the pro- and anti-vaccine membership, which I think has led the national unions to come out with somewhat tepid endorsements of vaccine mandates,鈥� she said. 鈥淔or students, however, I think unions can be more firmly pro-vaccine mandate because the policy doesn’t require anything of members who oppose getting vaccines themselves.鈥�

Some opponents of student vaccine mandates have launched legal challenges, that shots for younger students still don鈥檛 have full U.S. Food and Drug Administration approval. The Pfizer-BioNTech vaccine for ages 16 and up received full authorization in August. 

But on Wednesday, a Los Angeles Superior Court judge said he is leaning toward denying from parent groups to halt the district鈥檚 mandate. And in against San Diego Unified, the 9th Circuit U.S. Court of Appeals last week allowed the requirement to stand. The plaintiffs are asking for religious exemptions. 

Let Them Choose, an initiative of anti-mask mandate group Let Them Breathe, has also filed against San Diego. A hearing is set Dec. 20 in San Diego Superior Court. And the organization plans to file a lawsuit against a Los Angeles that issued its own vaccine mandate, said Sharon McKeeman, the organization鈥檚 founder. 

鈥淣o family should be coerced into making personal medical decisions, and no student should feel enticed or pressured into getting vaccinated without parental consent,鈥� she said. 鈥淭he district has created a huge logistical and legal issue for itself by unnecessarily trampling on students鈥� rights.鈥�

鈥楻elentless family engagement鈥�

Mike Magee, CEO of Chiefs for Change, said he didn鈥檛 think the challenges Los Angeles is facing would discourage other superintendents in the network from 鈥減ursuing every possible avenue to full community vaccination.鈥�

鈥淲hether districts require the vaccine or not, high vaccination rates will depend on a relentless family engagement effort along with simplicity of access to the shot,鈥� he said.

Alma Farias of Los Angeles, who has custody of her niece Cindy, an 11th grader, said she is among those who had initial reservations about the vaccine. But her concerns were outweighed by the prospect of Cindy getting sick after returning to in-person learning last spring.

She said she can sympathize with parents who are holding out. 

鈥淭here are a lot of things probably going through their minds right now,鈥� she said in Spanish through an interpreter. 鈥淧arents are still processing all the information that is out there, and they鈥檙e still processing everything that is going on with this pandemic.鈥� 

Chicago Public Schools CEO Pedro Martinez is among those who would like to see vaccine mandates for students and said he鈥檚 talked to the Chicago Teachers Union about it. But he said he鈥檚 not quite ready to issue a mandate for students because Chicago health officials advise waiting. 

Once the FDA grants full approval of the vaccine for younger students, that will 鈥渉elp our medical professionals feel more comfortable,鈥� he said.

But he also thinks the federal government should take the lead on student vaccination mandates. Leaving it up to states, he said, means variants like Omicron are likely to spread, as long as families travel to places where a smaller percentage of the population is vaccinated.

The district has been under pressure from its teachers union  to implement 鈥� across our schools鈥� and to meet vaccination targets for students. But Martinez said access to the vaccine is not the problem: Regional clinics across the city offer the vaccine and 23 schools have on-site vaccination centers. 

鈥淲e鈥檝e never had a day where we didn鈥檛 have enough supply,鈥� he said.

According to city data, two thirds of children 5 and up are vaccinated, but among 5- to 11-year-olds, less than 10 percent of Black children and about 12 percent of Latino children are vaccinated. 

鈥淧arents are either hesitant or there鈥檚 no urgency,鈥� he said. 鈥淲e still have to figure out what information our parents need.鈥�