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(NEW YORK) — Four Western U.S. states have come together to issue unified vaccine recommendations for the upcoming respiratory illness season, and California has enacted a new law to base the state’s immunization guidance on independent medical organizations, rather than the U.S. Centers for Disease Control and Prevention.
The West Coast states including California, Washington, Oregon, and Hawaii — all led by Democratic governors — banded together earlier this month to create the West Coast Health Alliance (WCHA), citing what they called an erosion of trust in the CDC.
“The alliance represents a unified regional response to the Trump Administration’s destruction of the U.S. CDC’s credibility and scientific integrity,” stated a press release Wednesday from California Gov. Gavin Newsom.
Also on Wednesday, Newsom signed a new law, which will shift the immunization recommendations the state will recommend from the CDC to independent medical organizations that include the American Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG).
The recommendations issued by the West Coast states on Wednesday include guidance for receiving the COVID-19, flu and RSV vaccines.
“Science matters. We will ensure our policies are based on rigorous science. We stand united with our partner states and medical experts to put public health and safety before politics. I will continue to do everything in my power to protect Washingtonians,” said Washington Gov. Bob Ferguson.
The announcement came the day ahead of a two-day meeting of the CDC’s the Advisory Committee on Immunization Practices (ACIP), during which the panel of advisers recently picked by HHS Secretary Robert F. Kennedy is expected to vote Thursday on some vaccines on the CDC childhood immunization schedule and Friday on recommendations for COVID-19 vaccines.
The FDA has approved the new COVID-19 vaccines only for those at high risk for severe illness including those 65 and older. Anyone who falls out of those categories is allowed to get a prescription for the vaccine after discussing it with their doctor.
The association that represents many insurance companies (AHIP) pledged to cover the cost for any vaccine that is part of the current guidelines before the new ACIP makes their recommendations this week. The current guidelines suggest anyone older than 6 months should consider getting the COVID-19 and annual flu shot until at least the end of 2026.
Several states have also made rules that allow anyone who wants a vaccine to get one at their pharmacy.
In a statement earlier this month, a spokesperson for the U.S. Department of Health and Human Services blasted the West Coast states’ plans for a health alliance, criticizing COVID-era policies in “Democrat-run states.”
The statement added, “ACIP remains the scientific body guiding immunization recommendations in this country, and HHS will ensure policy is based on rigorous evidence and Gold Standard Science, not the failed politics of the pandemic.
(NEW YORK) — Ahead of a key meeting amongst the Centers for Disease Control and Prevention (CDC) vaccine advisors — now with 12 members hand-picked by health secretary Robert F Kennedy Jr. — doctors, health officials and advocates are raising alarms that the panel could reverse a decadeslong guideline of vaccinating infants against hepatitis B at birth.
On camera on Wednesday, Republican Sen. Bill Cassidy, a doctor specialized in treating liver diseases and chair of the Senate committee that oversees the Department of Health and Human Services (HHS), said the American people should not have confidence in the advisory panel’s decision if they recommend against the birth dose of the hepatitis B vaccine.
The Advisory Committee on Immunization Practices (ACIP) is scheduled to meet Thursday to discuss the hepatitis B vaccine recommended at birth, a shot that decades of research has shown is safe and has virtually eliminated hepatitis B among babies in the United States.
At the last ACIP meeting in June, the advisory panel casted doubt about the necessity of the hepatitis B shot recommended at birth to all babies, comments that sparked concern among physicians.
In testimony on Wednesday, ousted CDC Director Susan Monarez said she was fired because she refused to rubber-stamp future changes Kennedy wished to make to the childhood vaccine recommendations, without a careful review of the evidence herself.
On Thursday, ACIP plans to discuss the hepatitis B birth dose and is expected to vote on a new recommendation, according to a draft of the meeting agenda.
Doctors and advocates told ABC News that the hepatitis B birth dose is still an essential recommendation and delaying it may lead to gaps in insurance coverage, growing health disparities, confusion and an increase in preventable hepatitis B infections.
Doctors call the hepatitis B vaccine ‘one of the cornerstones’ of prevention In a Senate hearing on Wednesday, Republican Sen. Bill Cassidy praised the success of the recommendation to give babies a hepatitis B vaccine at birth.
“Before 1991, as many as 20,000 babies, babies, were infected with hepatitis B in the United States of America, and that changed when the hepatitis B vaccine was approved for newborns,” Cassidy said.
“Now fewer than 20 babies per year get hepatitis B from their mother. That is an accomplishment to make America healthy again, and we should stand up and salute the people that made that decision, because there’s people who would otherwise be dead if those mothers were not given that option to have their child vaccinated.”
“The hepatitis B birth dose is one of the cornerstones of our hepatitis B prevention policy,” Dr. Sean O’Leary, an infectious disease specialist and chair of the American Academy of Pediatrics committee on infectious diseases, said in a press briefing following the last ACIP meeting in June.
The CDC currently says a timely administration of a hepatitis B vaccine is essential to help prevent transmission of the virus from mother to child at birth. While efforts to test for this virus during pregnancy have improved detection, cases can still be missed, or documentation may be inaccurate or incomplete.
Doctors and public health experts said that the hepatitis B shot is currently recommended for all babies at birth because the risk if a baby is missed is too high.
“A child that is infected at birth has a 90% chance of going on to develop chronic active hepatitis B. Of those children, of those 90%, 25% of them will then go on to die of the disease,” O’Leary said.
The first hepatitis B vaccine was licensed in 1981, and the ACIP recommended a vaccine dose universally for all babies in 1991. The hepatitis B birth dose “acts as a safety net, reducing the risk for perinatal transmission when the [hepatitis B] status of the parent is either unknown or incorrectly documented at delivery,” the CDC said.
“Because the stakes were so high, because you’re so much more likely to get cirrhosis or liver cancer if you get this virus as a young child, that’s why [there’s a] birth dose,” Dr. Paul Offit, director of the Vaccine Education Center and professor of pediatrics in the Division of Infectious Diseases at Children’s Hospital of Philadelphia, told ABC News. “We did a dramatic job of virtually eliminating the disease in young kids.”
Doctors say a risk-based hepatitis B vaccine strategy didn’t work in the past Before 1991, hepatitis B shots were only given to infants considered high risk; however, this strategy missed many cases.
“Four to five decades of implementation science shows us that risk-based vaccine recommendations in this case, don’t work,” Chari Cohen, DrPH, MPH, president of the Hepatitis B Foundation, told ABC News.
“We were not very good at identifying all kids at high risk as there were other factors for which we were not accounting and because of imperfections in the system,” Dr. Gary Freed, a professor of pediatrics, health management and policy at the University of Michigan, told ABC News.
“To make sure no high-risk infants were missed, a universal hepatitis B vaccine strategy was adopted,” Freed told ABC News.
In 1999, there was a temporary pause in the universal recommendation, in favor of a risk-based recommendation for a brief period that year. At least one child in Michigan died of hepatitis B infection that year, who was missed, according to a CDC MMWR report, due to improper documentation.
Cohen said the birth dose doesn’t just protect babies from getting the virus from their mother but protects babies from getting it through close contacts who may not know they are infected.
“You only have 24 hours to save a baby from getting Hepatitis B if they’re born to a positive mom. However, you’re also trying, trying to prevent early childhood exposure, especially among families who don’t know that there’s a family member or a caregiver that has hepatitis B,” Cohen said.
Dr. Su Wang, a primary care doctor and person living with chronic hepatitis B who is a spokesperson for the Hepatitis B Foundation, knows how easily people can get missed from both sides of the healthcare system.
“We certainly cannot count on our system in the U.S., the way it is, our broken healthcare system to actually even identify those who are at risk, much less those who don’t have an identified risk. You just couldn’t imagine all the different ways that people can fall through the cracks,” Wang said.
“It’s a huge burden on somebody to have to have [hepatitis B] for the rest of their life, especially if it starts in childhood,” Wang said. “You could prevent all that with a simple vaccine.”
Wang learned she was living with hepatitis B when she tried to donate blood in college and later found out that she likely contracted the virus from a family member when she was a baby.
“This does happen, household transmission,” Wang said. “When I think about my case, I think the birth dose is something that would have helped me.”
Ending the recommendation may also worsen health disparities On Tuesday, American health insurers pledged to cover the cost of all vaccines based on previous recommendations by the ACIP that were in place as of Sept. 1. While this may protect access for many kids with private health insurance, it may leave a critical gap for kids who rely on no-cost vaccines through the Vaccines for Children Program (VFC), if the recommendation is reversed.
The CDC said over half of all American kids were eligible for shots through the VFC program in 2023. If ACIP no longer recommends a hepatitis B shot at birth, a majority of these kids may lose access.
“Fifty percent of newborns who are going to be eligible for Vaccines for Children may not have the vaccine any longer available to them,” Michaela Jackson, MS, program director of prevention policy for the Hepatitis B Foundation, told ABC News. “Policy changes can seem very, very small on the surface, but they have long-reaching impacts on the ground.”
Hepatitis B rates have improved but remain a ‘silent epidemic’ The recommendation for all babies to get the hepatitis B shot at birth has virtually eliminated this disease in young kids, but the virus still remains a “silent epidemic” in the U.S., Offit said.
Before universal vaccination at birth, it was estimated that 200,000-300,000 new hepatitis B infections occurred annually in the U.S. from 1980-1991 and over 1 million people were living with chronic hepatitis B infection, who were potentially infectious to others.
CDC data shows that there were at least 2,214 reports of acute hepatitis B cases in the U.S. in 2023, which corresponds to an estimated 14,400 acute infections with the virus, after adjusting for unrecognized or underreported infections. There were over 17,000 newly reported chronic hepatitis B cases and nearly 1,800 hepatitis B-related deaths that year.
It’s estimated that up to 2.4 million people are living with chronic hepatitis B in the U.S., many asymptomatic and unaware of their diagnosis.
“There’s a lot more hepatitis B in this country than we people realize. Risk is much higher than people know it is,” Cohen said.
The virus is contagious and spreads through contact with blood or body fluids from a person infected with the virus, according to the CDC. A person can be asymptomatic for many years and spread the infection.
There are medications people can take to slow down the virus, but there’s no cure.
“Until we have a cure for Hepatitis B, it is critically important to prevent it,” Cohen said.
The Hepatitis B Foundation has voiced grave concern that the recommendation for universal hepatitis B vaccination at birth will be reversed by the current ACIP.
“For decades, the birth dose recommendation has prevented thousands of Americans from a devastating and life-threatening illness. It is a critical part of our nation’s strategy to eliminate hepatitis B and protect the health of future generations,” the foundation said in a statement in June.
The organization called for a “zero-tolerance policy for perinatal hepatitis B transmission in the U.S.”
“We cannot allow a preventable, cancer-causing virus to destroy more lives. The health of our children and the integrity of our public health system deserve better,” the statement said.
In a letter to the ACIP ahead of Thursday’s meeting, the pharmaceutical company Merck, which makes one of the FDA-approved hepatitis B vaccines that can be given at birth, said 330 million doses of its shot have been distributed worldwide since its approval in 1986 and “have been evaluated in over 30 clinical studies enrolling approximately 13,000 participants.
Among these studies, 12 post-approval studies included 3,646 neonates, newborns, infants and children.”
“The safety profile of RECOMBIVAX HB has been well established and closely monitored for more than 35 years. Merck remains vigilant in monitoring scientific literature, healthcare reports and other data sources to ensure the continued safety of RECOMBIVAX HB,” Merck said.
Wang said $0.20 per shot could prevent a lifetime of suffering. “It’s not just a liver disease, you know, it affects your life completely.”
(NEW YORK) — The United States death rate decreased by 3.8% in 2024 as COVID fell out of the top 10 leading causes of death for the first time in four years, new provisional federal data shows.
The overall rate declined from 750.5 per 100,000 people in 2023 to 722 per 100,000, according to the report from the Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS).
This marks the lowest death rate recorded since 2020, during the first full year of the COVID-19 pandemic, and follows declines that began in 2022.
The report also found that overall deaths fell from 3.09 million in 2023 to 3.07 million in 2024.
Additionally, the report showed the three leading causes of death stayed the same from 2023 to 2024, with heart disease as the leading cause, followed by cancer and unintentional injury, respectively.
Suicide replaced COVID-19 as the 10th leading underlying cause of death, knocking the disease off the top 10 list for the first time since 2020.
“‘It’s pretty noteworthy that COVID-19 fell off the top 10 and suicide, which had been had fallen off in recent years, is … ranked again,” Farida Ahmad, corresponding author of the report and health scientist at NCHS, told ABC News. “I think that’s a pretty interesting finding given where we spent the last five years.”
Ahmad said fewer deaths from COVID in 2024 compared to 2023 may be a reason behind the 3.8% decline.
“Ever since it came onto the scene in 2020, COVID was one of the top 10 leading causes of death,” Ahmad said. “It started off as a third-leading cause and, in 2024, we see that it’s not ranked at all, actually. So, it’s still among the 15 leading causes, but not in the top 10.”
Dr. Sharonne Hayes, a professor of cardiovascular medicine at Mayo Clinic in Rochester, Minnesota, agreed that fewer cases of COVID-19 are likely driving the reduction in mortality.
“I think there’s a little less COVID, right? I mean, that’s part of it,” she told ABC News. “I think that the pandemic was such a time of both COVID-related deaths, but also just rising risk factors, particularly around cardiovascular disease, people’s lifestyles were less healthy. And maybe we are coming back to more of where we are before.”
Ahmad said another driver for the drop in deaths could be the decline in drug overdose deaths.
A CDC report published in May found that U.S. drug overdose deaths fell by nearly 27% in 2024 to the lowest levels seen in five years.
Dr. Katie Schmitz, a visiting professor of medicine in the department of medicine and cancer epidemiologist at the University of Pittsburgh, told ABC News that leading causes of death continue to be cardiac disease and cancer-related deaths due to an aging population, as well as underlying factors such as obesity.
Schmitz noted that we have an increase in proportion of the population with these co-morbidities and it’s important to highlight that access to health care can be limited, particularly for rural populations.
Other leading causes of death in the report included stroke, chronic lower respiratory disease, Alzheimer’s disease, diabetes, kidney disease and chronic liver disease and cirrhosis.
The report also found that death rates decreased from 2023 to 2024 among all racial/ethnic groups. Rates in 2024 were lowest for multiracial people at 332.3 per 100,000 and highest for the Black population at 884 per 100,000.
Death rates decreased from 2023 to 2024 for all age groups except infants younger than one year old, according to the report. Death rates in 2024 were lowest for children between ages 5 and 14 at 14.4 per 100,000 and highest for people age 85 and older at 13,835.5 per 100,000.
Schmitz said investments should be made that focus on prevention — such as addressing rising obesity rates — and early screenings, which can vary with socioeconomic status and geography.
Hayes said making lifestyle changes is hard, but it is one of the best ways to lower the risk of some of the leading causes of death, including heart disease and cancer.
“Whether it’s eating more vegetables, [decreasing] saturated fat, maintaining a healthy weight is going to help stroke, cancer, and heart disease risk as well as liver disease, kidney disease, and diabetes,” she said. “Aside from unintentional injury and suicide, virtually every other thing of that list would be impacted by lifestyle.”
Dr. Lisa Gwynn says Florida’s vaccine decision will create ‘perfect storm’ for diseases. ABC News.
(FLORIDA) — A top Florida pediatrician warned Thursday that the state’s plan to eliminate all vaccine mandates could lead to outbreaks of preventable diseases and put vulnerable populations at risk.
Dr. Lisa Gwynn, a former president of the American Academy of Pediatrics’ Florida chapter, told ABC News that removing vaccine requirements for public school children could endanger not just students, but also “newborn infants, elderly populations, and people with compromised immune systems, including those undergoing chemotherapy.”
The warning came a day after Florida Surgeon General Joseph Ladapo announced the state would become the first in the nation to remove all vaccine mandates, including those for common childhood diseases like polio, measles, chickenpox, and tetanus. Currently, all 50 states and Washington, D.C., require certain vaccinations for school attendance.
“It’s not just about parental choice,” Gwynn explained to ABC News. “When children are in close contact in classrooms, that’s a perfect storm for these types of diseases to spread.”
Gwynn argued that existing exemption policies already provide options for parents who oppose vaccination.
“There are other ways parents can achieve choice for their children,” she said. “As pediatricians, we work together with parents so they can make informed decisions.”
She also raised concerns about health equity, noting that removing mandates could create a “case of the haves and have-nots.” Children from under-resourced communities who lack access to regular medical care might enter school unvaccinated not by choice, but due to healthcare barriers, she explained.
School entry vaccination mandates are determined by each state. All states allow medical vaccine exemptions, and most states already have exemption policies in place for people with strong religious objections, in an effort to balance the need for public health with the ideal of individual freedom of choice. Some states allow exemption based on personal belief alone.
Florida’s decision to end vaccine mandates comes amid broader changes in national health policy. Health and Human Services Secretary Robert F. Kennedy Jr. appeared before the Senate Finance Committee Thursday to discuss the administration’s healthcare agenda, following recent shake-ups at both the FDA and CDC.
“These changes were absolutely necessary adjustments to restore the agency to its role as the world’s gold standard public health agency with the central mission of protecting Americans from infectious disease,” Kennedy said.
Ladapo defended the decision to end mandates on Wednesday, calling them “an immoral intrusion on people’s rights” during his announcement at Grace Christian School in Valrico, Florida.
Gwynn countered this view, pointing to decades of research supporting vaccination programs.
“Public health measures have saved millions of lives,” she told ABC News. “School vaccination requirements have been the best public health achievement of this century.”
A spokesperson for the Florida Surgeon General’s Office did not immediately respond to ABC News’ request for comment.
(NEW YORK) — People who use their smartphones while sitting on the toilet face are at higher risk for painful, itchy hemorrhoids, according to new research published in the journal PLOS One.
Researchers investigated the bathroom habits of 125 adults undergoing screening colonoscopies at Beth Israel Deaconess Medical Center in Boston. About two-thirds of participants reported scrolling through their smartphones while sitting on the toilet.
Those who were glued to their phone while using the bathroom were 46% more likely to have hemorrhoids compared to those who left their device in another room.
“The likely explanation is that prolonged sitting increases pressure in the veins around the rectum, which can contribute to hemorrhoids,” Dr. Ernesto Gonzaga, a gastroenterologist from the Hospital of the University of Pennsylvania and who did not contribute to the study, told ABC News.
Scrollers spent a longer time on the toilet, the researchers found — about five times as many smartphone users logged over five minutes of toilet time per visit. When researchers asked what they were doing on their phones while doing their business, people confessed to catching up on the news, cruising through their social media feeds, or sending emails and texts.
Gonzaga pointed out that phone users also reported getting less exercise than non-users, suggesting that their broader lifestyle patterns could also contribute to their risk of hemorrhoids.
Hemorrhoids are swollen blood vessels around the anus and rectum, according to the National Institutes of Health. They can cause itching, pain and discomfort, and in many cases, they can also lead to rectal bleeding. Studies show that they are common in both men and women and affect about 1 in 20 Americans and about half of adults over 50 years old have hemorrhoids.
They are mainly treated with more fiber and fluids, soothing creams or sitz baths, and in tougher cases, they may require surgery.
“In clinical practice, we still recognize the more classical risk factors for hemorrhoids, including constipation, straining, low fiber intake, prolonged toilet sitting, pregnancy, obesity, and sedentary lifestyle. Constipation and abnormal bowel habits are particularly strong risk factors, while high fiber intake is protective,” Gonzaga said.
Gonzaga noted that the study does have some limitations. It looked at a small number of subjects and relied on self-reporting, so it doesn’t necessarily prove that phone use on the toilet is a direct cause of hemorrhoids, he said. He called for more research to get to the bottom of it.
“Given that hemorrhoids already account for millions of outpatient visits and substantial healthcare costs, these findings raise a broader public health concern about a growing burden of disease, potentially extending into younger populations as smartphone use,” he added.
Noor Shaik, MD, PhD, is a neurology resident physician and a member of the ABC News Medical Unit.
Florida Surgeon General Dr. Joseph Ladapo. (Paul Hennessy/SOPA Images/LightRocket via Getty Images)
(TALLAHASSEE, Fla.) — Florida is moving to “end all vaccine mandates” in the state, Florida Surgeon General Joseph Ladapo announced at a press conference on Wednesday.
This is a developing story. Please check back for updates.
Health and Human Services Secretary Robert F. Kennedy Jr. speaks during a cabinet meeting with U.S. President Donald Trump in the Cabinet Room of the White House on August 26, 2025 in Washington, DC. (Photo by Chip Somodevilla/Getty Images)
(WASHINGTON) — More than 1,000 current and former employees across the Department of Health and Human Services (HHS) signed a letter on Wednesday morning calling for Health Secretary Robert F. Kennedy Jr.’s resignation.
Addressed to Kennedy and members of Congress, the signatories accused the secretary of endangering the health of Americans. Save HHS, the group behind the letter, told ABC News it’s been sent to the Senate Committee on Health, Education, Labor and Pensions; Senate Committee on Finance and the House Committee on Energy and Commerce as well as Majority and Minority leadership.
“We swore an oath to support and defend the United States Constitution and to serve the American people. Our oath requires us to speak out when the Constitution is violated and the American people are put at risk,” the letter reads, in part.
It continues, “Thus, we warn the President, Congress, and the Public that Secretary Kennedy’s actions are compromising the health of this nation, and we demand Secretary Kennedy’s resignation.”
In a statement to ABC News, HHS communications director Andrew Nixon said the CDC “has been broken for a long time” and it will take “sustained reform and more personnel changes” to restore trust in the institution.
“From his first day in office, [Kennedy] pledged to check his assumptions at the door — and he asked every HHS colleague to do the same,” the statement read, in part. “That commitment to evidence-based science is why, in just seven months, he and the HHS team have accomplished more than any health secretary in history in the fight to end the chronic disease epidemic and Make America Healthy Again.”
Employees from almost every agency signed the letter, including the Centers for Disease Control and Prevention, the Food and Drug Administration and the National Institutes of Health. The letter states the employees did so in their personal capacity, on their personal time and without the use of government equipment.
In the letter, HHS employees said Kennedy continues “to endanger the nation’s health” with examples such as the ousting of newly-installed CDC director Susan Monarez, followed by the resignations of four top CDC leaders.
The letter also referenced an interview Kennedy gave to Scripps News last month in which he said trusting experts “is not a feature of either a science or democracy,” which staffers referred to as “ongoing verbal attacks” of the HHS workforce.
Employees also expressed dismay over Kennedy’s June move to remove all 17 members of the CDC’s vaccine advisory panel, the Advisory Committee for Immunization Practices (ACIP) — which makes recommendations on the safety, efficacy and clinical need of vaccines — and replaced them with eight of his own hand-selected members, many of whom have expressed vaccine-skeptic views.
The letter calls out two new members by name, Dr. Robert Malone and Retsef Levi.
Malone — who made some early contributions to mRNA vaccine technology — discussed an unfounded theory, disputed by experts, on a podcast during the COVID-19 pandemic, claiming people were “hypnotized” into believing mainstream ideas about COVID-19, such as vaccination.
Meanwhile, Levi previously said in a post on X that there was “indisputable evidence” that mRNA vaccines cause “serious harm including death, especially among young people,” a claim that has not held up in dozens of research studies.
The letter calls on Trump and Congress to appoint a new health secretary if Kennedy refuses to resign.
“We expect those in leadership to act when the health of Americans is at stake,” the letter states. “We ask other partner organizations to join us in our call for Secretary Kennedy’s resignation and stand in solidarity with those who have already.”
The employees said the petition is in response to a letter sent last month to Kennedy — signed by more than 750 current and former staffers — beseeching him to “stop spreading inaccurate health information.”
Staffers stated the deadly shooting that occurred at the Atlanta headquarters of the CDC on Aug. 8 was “not random” and was driven by “politicized rhetoric.”
The earlier letter called on Kennedy to take a number of actions by Tuesday, Sept. 2, including not spreading inaccurate health information, affirming the scientific integrity of the CDC and guaranteeing the safety of the HHS workforce.
The new letter comes just two days after nine former directors and acting directors of CDC published an op-ed in The New York Times, also accusing Kennedy of endangering the health of Americans.
Additionally, on Tuesday, Kennedy published an op-ed in The Wall Street Journal, saying the CDC has “squandered public trust” and that Trump has asked him to “restore that trust and return the CDC to its core mission.”
(WASHINGTON) — Dr. Richard Besser explains why he and other former directors of the CDC wrote an op-ed criticizing Health Secretary Robert F. Kennedy Jr.’s handling of the CDC and public health. Nine former directors of the Centers for Disease Control and Prevention (CDC) are speaking out, saying Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. is endangering the health of Americans.
Seven former directors and two former acting directors — whose tenures stretch back to the administration of former President Jimmy Carter — published an op-ed in The New York Times on Monday, just days after the ousting of the CDC’s new director Dr. Susan Monarez.
Sources told ABC News that Kennedy and Stefanie Spear, his principal deputy chief of staff, called on Monarez to support changes to COVID vaccine policy and the firings of high-level staff, which Monarez would not commit to.
The directors said Monarez’s removal is the latest in a series of actions that could have a “wide-ranging impact” on “America’s health security.”
One of the co-authors, Dr. Richard Besser, president and CEO of the Robert Wood Johnson Foundation and acting director of the CDC during the administration of former President Barack Obama, said he and his colleagues are stunned at what they’ve seen.
“What we are seeing taking place in the Department of Health and Human Services, and at CDC in particular, is not businesses as usual,” he told ABC News. “There are always changes, different policy priorities when administration changes. But what we’re seeing under the leadership of Secretary Robert F. Kennedy [Jr.] is something different altogether.”
“He has come into his role as Secretary of Health and Human Services with a strong agenda that is centered on dismantling our vaccine system in America and limiting people’s access to these life-saving, health-preserving interventions,” Besser added.
HHS did not immediately reply to ABC News’ request for comment.
In the op-ed, the former directors point to several decisions made by Kennedy including the firing of thousands of federal health workers, touting unproven treatments as measles was spreading in the U.S., and canceling $500 million in federally funded mRNA vaccine research.
The directors also referenced Kennedy’s removal of all 17 members of the CDC’s vaccine advisory committee and replacing them with his own hand-selected members, many of whom have shared vaccine-skeptic views.
Besser said the ousting of Monarez, along with the resignation of at least four top leaders, compelled him and his colleagues to speak out.
He told ABC News that their departures leave the U.S. vulnerable to every day health challenges as well as public health threats.
“We can’t predict when the next pandemic will be here, but we know there will be future pandemics,” Besser said. “There will be other infectious threats. There will be other public health challenges, and with this Secretary performing in the way that he is, it puts us all at risk.”
He said he and the co-authors “don’t agree on everything, but we agree that our federal public health system is in major jeopardy. The CDC, which had been looked to as the world’s leading public health institution, is on life support and needs our attention immediately.”
The op-ed called on Congress to oversee HHS, which it has authority to do. It echoes a social media post from Sen. Bill Cassidy (R-Louisiana), who said the departure of CDC leaders require oversight from the Senate committee he chairs.
The former directors also called on state and local governments to fill funding gaps left behind by some of Kennedy’s actions.
“We represent individuals who served in every administration from Jimmy Carter through Donald Trump, Republicans and Democrats, and we were unified in our feeling that what we’re seeing is extremely alarming and that Congress needs to step up and perform its oversight function,” Besser told ABC News. “And so, we’re hoping that our voices will add to some of the other voices that have been calling this out and that Congress will do its part.”
(NEW YORK) — A large new study conducted in Spain and Italy found that beta blockers, drugs often used to slow the heart rate and lower blood pressure, did not provide clear benefits for heart attack patients whose hearts were still functioning well.
The results of the study, known as REBOOT, were published in the New England Journal of Medicine on Saturday and presented during the European Society of Cardiology Congress 2025 in Madrid, Spain.
The REBOOT trial enrolled more than 8,400 patients recovering from a heart attack whose heart function was above 40% and assigned them to either take a beta blocker or no beta blocker within two weeks of leaving the hospital.
Over the course of approximately 3.7 years, there was no significant difference when it came to rates of death from any cause, repeat heart attacks or hospitalization for heart failure between the two groups, according to the study.
In a “subanalysis” of the study, published in the European Heart Journal, researchers specifically looked at outcomes involving the approximately 1,600 women from the original REBOOT trial and isolated their results.
In this case, beta blockers were associated with an increased risk of death from all causes for these women, compared to women who were not taking beta blockers. In contrast, no excess risk was associated with beta blocker use in men.
However, the authors advised that the results should be interpreted with caution as the women enrolled in REBOOT trial were generally older, sicker, and received less treatment for heart attacks than men.
Second study points to benefits of beta blockers Results from another clinical trial called BETAMI-DANBLOCK — also published Saturday in the New England Journal of Medicine — appeared to yield yet another finding about beta-blocker use after a heart attack.
Results from this trial of more than 5,000 adults diagnosed with a heart attack and either mildly decreased or intact heart function demonstrated that those treated with beta blockers had fewer new heart attacks in the 3 and 1/2-year study period compared to those who did not take beta blockers after their initial heart attack.
Notably, there was no difference in rates of death, heart failure, stroke or other major heart issues between the two groups.
“The major driver was a reduction in non-fatal heart attack at follow-up,” said Dr. Gregg Fonarow, professor of cardiovascular medicine at the University of California, Los Angeles, in an interview with ABC News.
While it is important to acknowledge that the BETAMI-DANBLOCK study found a potential benefit in beta blocker use, it had some limitations. This was a smaller-scale study that combined two clinical trials into one because separately they were not able to enroll enough patients. Different rules for who could join each of the studies in each country may have skewed the results, as well.
“REBOOT was a cleaner study in terms of protocol and inclusion criteria,” said Dr. Steven Pfau, professor of cardiovascular medicine and interventional cardiologist at Yale School of Medicine in New Haven, Connecticut.
Notably, REBOOT challenges over 40 years of standardized practice, which calls for patients admitted to the hospital for a heart attack to be started on beta blockers before or shortly after they are discharged.
Cardiologists’ methods for treating heart attacks and opening blockages in the coronary arteries in a timely fashion have improved drastically over the past 10-20 years, experts say. That’s why, in an age of improved medical therapies and procedural interventions for heart attacks, such as better-performing coronary artery stents, it may be time to rethink the long-standing guidance on beta-blocker use, according to some experts.
“Beta blockers were developed at a time before routine reperfusion therapy for acute heart attacks and the evolution of more potent medications, and care has really evolved,” said Fonarow.
Pfau said that neither study makes a compelling case for beta blockers versus no beta blockers for this select group of patients.
“If beta blockers do have an effect, it is probably small, given the other therapies we have,” he said. “It fits the discussion for both studies that, with the way we currently practice, beta blockers potentially add very little to outcomes after a heart attack for patients with preserved heart function and no other pre-existing reason to be on a beta blocker.”
If patients can take beta blockers safely, they should keep using them for now, Fonarow advised. But he also called for more studies to understand which patients benefit the most from this type of medication.
Additionally, for the week ending Aug. 23, 11.2% of weekly tests came back positive for COVID, up from 3.3% the prior two months, CDC data shows.
Despite the increases, metrics remain much lower than in previous years.
Hospitalization rates are about three times lower than at the same time last year and the percentage of weekly tests coming pack positive is about two times lower compared to the same period last year.
Additionally, over the past two months, roughly 200 Americans have been dying from COVID every week, according to CDC data.
There has been confusion over who may be able to receive a COVID vaccine after the Food and Drug Administration approved updated versions of those shots for those over age 65 and younger Americans who are at high risk for severe disease. Federal health officials have insisted that anyone who wants the shot can receive it.
CDC data shows test positivity has increased above 10% in much of the southwest and western U.S. as kids head to class.
“When the dust settles, I expect it to not be as bad as last year … but that still means that some people are getting sick,” Dr. Peter Chin-Hong, a professor of medicine and an infectious diseases specialist at the University of California, San Francisco, told ABC News. “Fewer people are getting hospitalized, proportionately speaking, but some people are still being hospitalized.”
“The reason why we’re seeing the increase is because of the usual factors of more than six months since a lot of people got COVID [and] new variants,” he continued.
As of the week ending August 30, XFG, an offshoot of the omicron variant, is the dominant variant in the U.S., accounting for an estimated 78% of new COVID cases.
Meanwhile, NB.1.8.1 and LP.8.1, also omicron variant offshoots, make up 14% and 3% of estimated new COVID cases in the U.S., CDC data shows.
Dr. William Schaffner, a professor of preventive medicine and of medicine at Vanderbilt University School of Medicine, told ABC News that because the currently circulating variants are all members of this omicron family, there are no major mutations that make the virus more transmissible or more infectious.
“You can think of them all as cousins,” he said. “Now these cousins do share a couple of characteristics, one is that they appear to be fairly contagious and are quite capable of producing a great deal of mild disease. By mild, I mean not serious enough to get you into the hospital.”
Schaffner continued, “Fortunately, the vaccines that will become available this fall … should provide reasonable protection against serious disease caused by these variants.”
In a press release, Pfizer-BioNTech said its 2025-2026 COVID vaccine will target the LP.8.1 sublineage in line with FDA guidance to more closely match circulating strains.
It remains unclear how COVID vaccinations will be rolled out in the U.S. Recently, CVS said how it offers the shots will vary by state due to “the current regulatory environment.”
In 34 states, Americans can receive the COVID vaccine at a CVS pharmacy. In 13 states and in Washington, D.C., Americans can be vaccinated, depending on age, with a prescription. In three states – Massachusetts, Nevada and New Mexico – the COVID vaccine isn’t being offered.
Chin-Hong said he is worried about low vaccination rates as the country heads into respiratory virus season during the fall and winter months.
“As vaccination rates decline, from both people’s desire as well as structural barriers that are being put up by the federal government, it means that fewer people are going to get vaccines, even if people wanted to,” he said. “I’m worried that … it may mean that we would have some hospitalizations and deaths that we wouldn’t have seen normally if there was a simpler rule around vaccines.”
Schaffner said those who can receive the COVID vaccine should do so, along with the annual influenza vaccine, and advised those with risk factors for severe disease to be more cautious.
“You can get out your mask and put that on when you’re going indoors in crowded environments,” he said. “And if you’re really concerned, as I like to say, do some social distancing. Stream the movie rather than going to the movie.”
ABC News’ Youri Benadjaoud and Cheyenne Haslett contributed to this report.
