The Brief

The CDC on Monday accepted controversial new guidelines for the updated COVID-19 vaccines that could make it harder for many people to protect themselves this winter compared with previous years.

Acting CDC Director Jim O'Neill agreed to the recommendations for the COVID shots from Health Secretary Robert F. Kennedy Jr.'s handpicked Advisory Committee on Immunization Practices, which met in September.

Unlike in earlier years, the new guidelines call for people to talk to a doctor, pharmacist or some other health care provider about the risks and benefits of getting vaccinated before they get a shot. This extra step is called "shared decision-making,"or "individual-based decision-making," according to the language in the news release.

The move is the final action necessary for implementing the new guidelines, which affect who can get and give the COVID shot, and whether vaccination will be covered by private and government insurance without copayments.

Final recommendations were delayed

The step came after an unusual, unexplained two-week lag between when CDC advisers issued the recommendations and the agency accepted them. The official decision allows the CDC to finally start shipping vaccines to doctors, clinics and other providers through the Vaccines for Children Program, which provides vaccines free to about 40% of all U.S. children.

"Informed consent is back," O'Neill said in a statement announcing the step. "CDC's 2022 blanket recommendation for perpetual COVID-19 boosters deterred health care providers from talking about the risks and benefits of vaccination for the individual patient or parent. That changes today."

Independent vaccine experts challenged that claim.

"There is no basis to claim that routine recommendations prevent doctors from discussing risks and benefits with patients," said Dorit Reiss, who studies vaccine policies at the University of California, San Francisco. "Doctors [have always been] required to get informed consent. Shared clinical decision-making simply signals the vaccine is not routinely recommended and decreases uptake."

Others agree O'Neill's claim is false and could undermine public confidence in the vaccines.

"The claim that the past recommendations deterred health care professionals from talking to patients about risks is completely untrue and is another example of the misinformation and made up information that this administration continues to release to the public and further creates confusion and distrust in healthcare providers and vaccines," wrote Dr. Tina Tan, the president of the Infectious Diseases Society of America, in an email. "This is extremely unfortunate and critically increases the American public's risk for serious vaccine preventable diseases."

The CDC also formalized a recommendation that makes it more complicated for some parents to get their babies vaccinated against measles, mumps, rubella and chickenpox.

"If that's his approach, I am concerned about [additional] childhood vaccines recommended for routine use," Reiss added in an email. "If he thinks a routine recommendation undermines informed consent — which it doesn't — that could further reduce uptake and may make the Trump-Kennedy outbreaks of measles and pertussis we are seeing even larger."

The moves guarantee continued insurance coverage for the COVID shots and allows pharmacists nationwide to keep administering the vaccines. But the changes withdraw some government coverage for the combination shot that protects against measles, mumps, rubella and chickenpox and that some parents prefer.

In previous years, the COVID-19 vaccines have been easily available for free to anyone 6 months and older by simply walking into a pharmacy, doctor's office or clinic and asking for a shot.

Barriers to vaccination

But the vaccines became harder to get in August, when the Food and Drug Administration approved updated versions of the Moderna, Pfizer/BioNTech and Novavax vaccines only for people at increased risk for serious disease because they are age 65 or older or had some other health issue.

The change occurred because top Trump administration health officials say they have concerns about the safety and effectiveness of the vaccines, even though there is overwhelming evidence the vaccines are very safe and highly effective. Federal health officials also argue that most people have so much immunity now that they don't necessarily need annual boosters anymore.

Many public health experts agree that COVID no longer poses the serious risk it once did to many people, especially those who are younger and otherwise healthy. Other countries have also shifted to a more "risk-based" COVID vaccination strategy.

But some healthy people still want to get vaccinated to reduce their risk of getting sick at all, missing work or school, developing long COVID or spreading the virus to vulnerable people, such as older family members and friends with other health issues.

Over the past month, the change caused anger, frustration and confusion. In states like Georgia and Utah, people had to get a prescription to get a shot and some couldn't get vaccinated at all.

The situation was further complicated because Kennedy, who has a long history of criticizing vaccines, said the government was no longer recommending the vaccines for pregnant women and healthy children, even though pregnancy is listed as a risk factor by the CDC and FDA, and COVID can still make some kids very sick.

Earlier this month, the vaccine panel, which gives influential advice to the CDC, voted to recommend the shots for anyone 6 months and older, provided they consult with a health care provider about the risks and benefits.

Confusion still reigns 

The requirement for shared clinical decision-making creates a new hurdle to getting vaccinated compared with previous years, by explicitly requiring a conversation with a provider on an individual's risks and benefits before they get one.

The new guidelines continue to ensure coverage by private and public insurers, including Medicaid, Medicare, the Vaccines for Children Program and the Children's Health Insurance Program.

The recommendation should also clarify that anyone age 6 months and older is eligible for the COVID vaccine, including healthy children, pregnant women and younger adults. (The only way to protect younger babies, who are among those who face the greatest risk from COVID, is by immunizing their mothers during pregnancy.)

But some providers may remain confused or hesitant to administer the shots because of lingering uncertainty and mixed messages, for instance, speculative safety risks presented during the CDC's advisory committee meeting that are not backed by solid evidence.

Some states and major medical groups like the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists and the Infectious Diseases Society of America have issued separate guidelines recommending the shots to most everyone ages 6 months and up, to protect themselves and their communities this upcoming respiratory virus season.

In addition, more doctor's offices may opt against stocking the new vaccines because of concerns the debate may further dampen demand, requiring people to go elsewhere, such as a pharmacy.

Some pharmacies may require patients to read and fill out a form that discusses the potential risks and benefits of the vaccines. But CVS, the nation's largest pharmacy chain, says people will be able to get a COVID vaccines simply by asking for one. Pharmacists won't have to require anything, including even a conversation, unless patients have questions, CVS says.

A separate shot for chickenpox is now recommended 

O'Neill also accepted the panel's vote to ban the MMRV combination shot, which protects against measles, mumps, rubella and varicella, or chickenpox, for children under 4.

Young children can gain the same protection by getting separate shots for MMR and varicella, and most of them – some 85% – already do, according to CDC data shared and discussed at the advisory committee's September meeting.

That's because the combination shot is associated with a slightly higher risk of fevers that can lead to seizures in kids under 4. Because of the risk the CDC has, for more than 15 years, preferred that children under 4 receive the shots separately. Still, some parents were choosing to get the combo shot, because it was easier or more available, and the risk associated with the potentially frightening but temporary side effect is low.

Because of the recommendation, the MMRV vaccine will no longer be covered by federal programs that offer subsidized vaccines. "This panel has made a recommendation for a practice that's essentially in place anyway, but removed the option of having those vaccines financed for those who may think this is a better option," says Dr. Katrina Kretsinger, a medical epidemiologist who worked on vaccine policy for more than a decade at CDC, before retiring from the agency in 2023, "This is effectively removing a choice from parents."

Making different policies from the same safety information that was thoroughly examined years ago will also raise mistrust among parents, Kretsinger says. "There is confusion about how to proceed, and also doubts raised by the fact that this is being re-examined," she says, "It furthers the chilling effect on vaccine uptake."

The change may also cause shortages of the separate vaccines, at least initially, until manufacturers can adjust their production to meet the new demand.

A fresh call to break up the MMR vaccine

A few hours after issuing the new vaccine guidelines, Acting CDC Director O'Neill also called on makers of the combined MMR vaccine to break it up into three separate shots for measles, mumps and rubella in a post on X.com. The post praised President Trump for his leadership and reposted his call in September that the MMR vaccine be administered as "THREE TOTALLY SEPARATE SHOTS."

The combination shot for measles, mumps and rubella has been used in the U.S. for decades.

"This really is absolutely completely ridiculous and really sets us back over 50 years in time given that the MMR vaccine was licensed here in the US in 1971," said Tan, president of the Infectious Diseases Society of America, in an email. "It was made as a combination vaccine to ensure that persons would receive all the vaccines that they would need as a single shot as opposed to 3 separate injections. This is crazy and continues to erode the public health system and the public trust in vaccines."

"There is no published scientific evidence that shows any benefit in separating the combination MMR vaccine into three individual shots," said a statement from Merck, which makes an MMR vaccine. "Use of the individual components of combination vaccines increases the number of injections for the individual and may result in delayed or missed immunizations."

The statement also said that evidence suggests combination vaccines improve outcomes for kids by increasing completion of recommended vaccines and getting them at the right ages. Merck also said there are no single-shot vaccines approved for use in the U.S. for measles, mumps or rubella.

"Combination vaccines play a crucial role in improving vaccination coverage rates; their safety and efficacy have been demonstrated by decades of research," said a statement from GSK, maker of the other MMR vaccine available in the U.S. "By reducing the number of separate injections required, combination vaccines allow for a simpler and more efficient immunization process, which is essential for timely protection against disease."
Copyright 2025 NPR

Every January, the open-air downtown food fair reopens after its winter break and announces new additions to its carefully selected group of regular vendors.

This year’s new vendor class demonstrates the resilience of L.A.'s independent food scene, ranging from a Grammy-nominated producer's Persian-influenced pizza to Southern fried fish celebrating Black American culinary traditions, to an LAist 2025 Tournament of Cheeseburger heavyweight contender.

The reopening also marks the start of Smorgasburg LA's 10th anniversary year, and will feature 41 returning vendors, who've helped build the regular event into a fun, family-friendly opportunity to try new, often cutting-edge food you may not be familiar with.

Doors open from 10 a.m. to 4 p.m. at DTLA’s The Row, with free entry and free parking for the first two hours.

A new year

General manager Zach Brooks said this is his favorite time of year. "We add the new vendors at the beginning of the new year, everyone's excited."

Vendors apply through Smorgasburg's website, and the team meets with every applicant to taste their food before acceptance. Brooks said it's not a vetting process like "Shark Tank" but rather a matter of seeing if it's a good fit. Competition remains fierce, with many more applicants than available spots.

"I think it's just a testament to L.A. and the resilience of people who love this business and have a passion for it, and are going to continue to persevere and start their businesses and want to be out there selling food," Brooks said.

Here are a few highlights:

Viral orange chicken sandwich 

Long Beach-based Terrible Burger becomes Smorgasburg's new permanent burger vendor after standout appearances at LAist's Tournament of Cheeseburgers and the market's rotating Smorgasburger Stand. The smashburger pop-up, run by husband-and-wife team Nicole and Ryan Ramirez, specializes in burgers that draw from pop culture and global influences. They've made waves with a Korean barbecue burger topped with bulgogi barbecue sauce and a viral orange chicken sandwich, previously available only at their Tuesday night residency at Long Beach's Midnight Oil, making its L.A. debut Sunday.

Terrible Burger's viral orange chicken sandwich makes its LA debut at Smorgasburg after being available only in Long Beach.

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Courtesy Terrible Burger

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"We have been big Smorgasburg fans for a really long time before we even started Terrible Burger. We would go to Smorgasburg on dates, just eat and hang out. And it was just always a little dream of, "oh, what if we ever sold food here?" Nicole Ramirez said.

Crispy fried snapper and thick-cut fries 

Orange County-based Hot Grease, run by Asha Starks, is among four vendors graduating from residencies to permanent status. The Southern fried fish pop-up celebrates Black American history through food that honors Starks' family heritage.

"Folks often forget that there are Black folks in Orange County. My family came to Orange County during the second wave of the Great Migration, and they settled in Santa Ana... my food is very cultural. And the story, I feel like, is just as important to highlight," Starks said.

Hot Grease's crispy buttermilk fried snapper with thick-cut fries and "Ill Dill" tartar sauce.

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Courtesy Hot Grease

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Hot Grease serves crispy buttermilk fried snapper with thick-cut fries and small-batch sauces like "Ill Dill" tartar. Honoring the fish fry's history as a site of mutual aid, Starks directs 3% of sales to the Potlikker Line, Hot Grease's reproductive justice mutual aid fund. For January, she's added fish and grits, black-eyed peas and collard greens.

Pizza with a Persian twist

Mamani Pizza brings studio-born energy to Smorgasburg LA with pies featuring Persian-inspired creativity.

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Courtesy Mamani Pizza

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Mamani Pizza, from the Grammy-nominated producer Farsi, part of the music production team Wallis Lane, started making Neapolitan-style pizzas at his West L.A. recording studio a year ago. What began as late-night pies for friends and artists became an underground hit. Most pizzas are traditional, but Farsi adds Persian touches like The Mamani, topped with ground wagyu koobideh, roasted Anaheim chilis, Persian herbs and pomegranate molasses.

Other new vendors

Banana Mama - Asian-inspired pudding
Barranco's Yogurt - Oaxacan fruit yogurt
Franzl's Franks - Austrian sausages
Melnificent Wingz - Gourmet chicken wings
Piruchi - Peruvian street food
RuRu's Golden Tea - Karak chai
Stick Talk - vegan corn dogs
SouuLA - Taiwanese breakfast concept
Unreal Poke - Hawaiian poke
Zindrew Dumpling Shop - Spicy wontons

In halting childcare and welfare benefits to hundreds of thousands of low-income Californians, the Trump administration says it’s “concerned by the potential for extensive and systemic fraud.”

“These concerns have been heightened by recent federal prosecutions,” states the funding freeze letters to California from Trump-appointed officials at the U.S. Department of Health and Human Services (HHS).

When pressed for details about what specific prosecutions justify the freeze in California, administration officials have offered few specifics. Confirmed fraud concerning the targeted programs appears to be a tiny fraction of the total spending.

The letters don’t mention any prosecutions here in California, as the administration cites it as justification for cutting off billions of dollars in support for food, housing and childcare.

A spokesperson for the federal agency declined to comment when asked what prosecutions the letter refers to, and for the basis for the broader fraud concerns cited as the reason for cutting off funds.

Prosecutions that have been brought around child care benefits amount to a small fraction of 1% of the federal childcare funding California has received, according to a search of all case announcements on federal prosecutors’ websites covering the whole state. The U.S. Department of Justice, which oversees such prosecutions, has not responded to a request asking if additional cases exist.

At a news conference Friday, LAist asked Bill Essayli, the top federal prosecutor for the region, if he knew of any federal prosecutions of childcare benefit fraud besides a single 2023 case previously cited by federal officials. Essayli did not point to any other federal prosecutions. The region he oversees includes over half of California’s population, including the counties of L.A., Orange, Riverside and San Bernardino.

In a separate emailed response to questions from an NPR reporter, the White House pointed to an article about a separate case in San Francisco that did not indicate it involves the federal funds being frozen.

What’s not known is the scale of complaints federal authorities have received about California’s spending with these three programs, and to what extent cases will be brought in the future. It’s also unclear how problems with California’s spending on these programs compare with other states that are not being targeted with funding freezes.

Last year, a federal Government Accountability Office review found about three-quarters of states — 37 of 50 — had negative findings in audits about their oversight of the largest program the administration is freezing funding to in five blue states.

That federal program is called Temporary Assistance for Needy Families, or TANF.

Mississippi has an ongoing fraud scandal over misuse of $77 million in TANF and other welfare dollars — much of which was used to benefit wealthy athletes like former NFL quarterback Brett Favre.

Former pro wrestler Ted DiBiase Jr. is currently on trial in a federal case alleging he conspired to fraudulently get millions in TANF welfare dollars through sham contracts for services that were never provided, as part of Mississippi's fraud scandal.

Mississippi is not among the five states the Trump administration is freezing TANF funds to, all of which are run by Democrats.

One known federal case in California

In order to determine what federal prosecutions the administration is using to justify cutting California off from federal safety net programs, LAist ran searches through all announced cases over the past decade-plus by all four federal prosecutor offices in the state. It shows a total of one case mentioning childcare benefits fraud, brought in San Diego in 2023 over $3.7 million in alleged stolen funds.

The amount alleged to be stolen was equivalent to less than $1 out of every $10,000 California received from the funding the administration is freezing over the timeframe of the announcement search.

The federal agency that distributes the funds, HHS, has a nationwide watchdog office that investigates fraud in the programs being frozen. It’s known as the Office of Inspector General, or OIG.

The inspector general’s office has thousands of reports online about fraud and misspending across HHS’ vast programs nationwide.

But a search found no reports around problems with spending in California among the three programs impacted by the spending freeze.

“As your search confirms, there aren’t public OIG-released materials on fraud in these programs occurring in California,” said a spokesperson for the inspector general’s office.

That contrasts with Minnesota, where large-scale fraud cases have been brought in recent years over theft of federal dollars meant for food and other social services. An OIG report last year found Minnesota did not comply with requirements around documenting attendance and payment to childcare providers.

In an apparent error, one of the administration’s funding freeze letters to California asks for documents about Minnesota’s processes.

Criticism that Minnesota officials failed to prevent fraud in their state drove the state’s Democrat governor, Tim Walz — who ran for vice president against Donald Trump’s ticket in 2024 — to announce Monday he was dropping out of running for reelection.

That same day, the administration announced it was expanding the funding freeze to include California and three other Democrat-led states, in addition to Minnesota.

The following morning, President Trump alleged — without giving specifics — that corruption in California is worse than Minnesota.

“California, under Governor Gavin Newscum, is more corrupt than Minnesota, if that’s possible??? The Fraud Investigation of California has begun. Thank you for your attention to this matter! PRESIDENT DONALD J. TRUMP,” the president wrote on his social media platform Truth Social.

The White House has not responded to LAist requests for an interview with President Trump.

Governor Newsom has drawn criticism in recent years for vetoing a bill to more closely track spending and outcomes for tens of billions of state homelessness dollars, which had passed unanimously in the state Legislature.

CalWORKS

In response to NPR’s questions about the basis for the funding freeze, the White House’s Office of Management and Budget pointed to the San Diego case and a local prosecution by the San Francisco DA last year involving up to $400,000 in childcare funds.

It’s unclear if the San Francisco childcare case involved the same funding streams that are being frozen. The DA’s office and White House have not responded to a request for clarification.

The other, and by far largest, issue pointed to by the White House was described as $108 million lost from California’s welfare program, CalWORKS.

“CalWorks, a TANF recipient, had lost more than $108 million in cash benefits due to welfare fraud," the White House statement said with a link to a news release from the Orange County DA's Office.

LAist looked into it, and the situation is more complex. The DA’s news release says the losses are related to a scam called EBT card skimming.

That’s when scammers steal benefit card money from welfare recipients’ benefit cards. When that happens, the state covers the losses out of state funds, according to CalMatters.

The CalWORKS EBT cards are mostly funded by state and local dollars, according to state figures. About a third of the funding for those cards comes from TANF, the largest federal program being frozen.

The White House has not responded to follow-up questions.

EBT card skimming is an issue nationwide, not just the states where funds are being frozen, according to news reports.

Legal challenge

Trump has pardoned or commuted the sentences of several people convicted of large-scale frauds, including commuting the 20-year prison sentence of a man convicted in a case alleging $1.3 billion in fraudulent health claims to the federal government. The Justice Department called it the largest health care fraud scheme ever prosecuted up to that point.

At a news conference Thursday, Vice President J.D. Vance said the Justice Department would be creating a new high-level position to oversee fraud prosecutions. That official will be directly overseen by Trump and Vance, according to the vice president.

Later in the day, California Attorney General Rob Bonta announced a lawsuit seeking to stop the funding freeze, filed by California and the other blue states targeted by the freeze.

The next day — Friday — a federal judge granted a temporary restraining order preventing the freeze for now. Further arguments and decisions in the case are expected in the coming weeks.

NPR correspondent Jennifer Ludden contributed reporting to this story.

Hiring remained anemic in December, closing out the weakest year for job growth since the beginning of the pandemic.

U.S. employers added just 50,000 jobs last month, according to a report Friday from the Labor Department. Meanwhile, the unemployment rate dipped to 4.4%, from 4.5% in November, while job gains for October and November were also revised down by a total of 76,000 jobs.

For all of 2025, employers added 584,000 jobs — compared to 2 million new jobs in 2024. That meant that last year was the worst for employment growth since 2020.

Health care and hospitality were among the few industries adding jobs in December. Health care employment is generally immune from ups and downs in the business cycle.

Manufacturing continues to lose workers, cutting 8,000 jobs in December. Factories have been in a slump for the last 10 months, according to an index of manufacturing activity compiled by the Institute for Supply Management. The sector has been hit hard by President Trump's tariffs, since many domestic manufacturers rely on some foreign components.

"Morale is very low across manufacturing in general," said an unnamed factory manager quoted in this week's ISM report. "The cost of living is very high, and component costs are increasing with folks citing tariffs and other price increases."

The federal government added 2,000 jobs in December, but is still down 277,000 jobs from the beginning of the year. The government recorded big job losses earlier in the fall, when workers who accepted buyouts officially dropped off the government's payroll.

While unemployment remains low by historical standards, workers are increasingly nervous about job security. A survey last month by the Federal Reserve Bank of New York found workers slightly more worried about losing their job in the coming year, and less confident about finding a new job if they are laid off.

The slowdown in hiring makes people who already have jobs reluctant to give them up. The resulting lack of turnover means fewer job openings for young people and others trying to get a foot in the door.

Concern about the weakening job market prompted the Federal Reserve to cut its benchmark interest rate in December for the third time since September.
Copyright 2026 NPR