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."
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Los Angeles County District Attorney Nathan Hochman promised at a Tuesday night town hall that MacArthur Park will see “amazing progress” in public safety before the 2028 Olympic Games.

Several community members told LAist they have seen crime return to the Los Angeles park after months of joint drug enforcement operations by the Los Angeles Police Department and federal agencies. Those efforts led to dozens of arrests for alleged drug sales in the area.

An LAPD captain attending the town hall confirmed to LAist that the department is aware of renewed safety problems.

Hochman acknowledged those concerns and said the recent operations made progress and created an opportunity for lasting change.

“If we keep this focus and the energy on this area, MacArthur Park, Skid Row and everything in between,” Hochman said, “then we will see amazing progress before the Olympics, and that is actually a promise.”

Hochman previously promised, during a drug enforcement operation on June 4, to have a picnic at the park on Labor Day. Hochman told attendees he kept that promise when he held an event at the park on Sept. 5 with other local and federal law enforcement officials.

As district attorney, Hochman works with law enforcement agencies to prosecute criminal cases in L.A. County. He said that it will take more work from policymakers and community members to remove the open-air drug market that has been entrenched there for decades.

The area is represented by L.A. City Councilmember Eunisses Hernandez, County Supervisor Hilda Solis, state Assemblymember Mark González and state Sen. María Elena Durazo. Staff members from some of those offices, and the mayor’s office, sat in on the town hall organized by the local nonprofit California Rising.

“Feel free to put the fire under the feet of our politicians,” Hochman told about two dozen residents who attended. “All too often it is easy to spend some effort on something and then get distracted and spend some effort somewhere else.”

'Temporary' relief

Some residents and business owners agreed with Hochman that the large-scale drug enforcement operations from March through June made the area feel safer, at least for a while.

“It was temporary, but we got to see, actually, families at the bus stops with their kids — before it wasn't like that,” Elaine Alaniz told LAist Tuesday. “I think it does help us, but on the other hand I still think that we need more help. It's not just a one, two, three-day thing.”

Alaniz lives nearby and is the president of the Westlake North Neighborhood Council, which begins a block northeast of MacArthur Park.

She said she has seen some crime move away from the park and into the surrounding neighborhoods.

Capt. Ben Fernandes, who leads LAPD’s Rampart Division, said the earlier operations were successful, but there have been some setbacks.

“We made a lot of headway in the beginning,” he said. “There are some issues that we've had some repopulation, especially with addicts.”

Fernandes said that the department will continue to arrest people suspected of selling drugs near the park, while connecting people who are addicted with services to help them get sober and off the streets.

A call for community involvement

Hochman and Fernandes each emphasized that making MacArthur Park a safe and welcoming place can’t be done by law enforcement alone.

“My advice: take the park back — it's your park,” Hochman said at the town hall, calling for community organizations to plan regular outings there. “That starts to send a message that the community really cares about this park.”

He asked that performers like Justin Bieber, who played an impromptu set in the park last month, have more events there as well.

Fernandes said people can get involved to change perceptions about MacArthur Park so it's no longer thought of as a place to go to score drugs.

“What we need to do is — we as a community — come together and show [people using drugs] that it's not their place to go,” he said. “That you're going to be there with your children, with your parishioners, with your friends, with your family.”

Inglewood city officials are launching an audit of their financial relationship with SoFi Stadium and claiming the stadium could owe years of ticket taxes, one month after a judge voided the 2015 contract that brought the stadium to Inglewood. 

The Inglewood City Council voted unanimously Tuesday to commission the audit. Mayor James Butts said the move is a necessary next step after the court ruling, which threw the terms of the financial relationship between the city and Hollywood Park stadium development into question. 

Millions of dollars are at stake for both the city and the stadium businesses. City officials say that the ruling means a cap that limited the amount of admissions tax that Inglewood could collect no longer applies. They also plan to investigate the authenticity of $376 million worth of infrastructure bills Hollywood Park claims the city owes. The findings of the audit could also factor into discussions of how the city will address its current $30.8 million deficit.

The City Council motion — put forward by Butts and co-sponsored by Councilmember Dionne Faulk — requires the city attorney to retain an accounting firm to conduct the audit and report back to the public on its findings within 30 days. It set aside $325,000 from the city’s General Fund to pay for the audit. You can read the city’s full explanation of the audit here.

Butts, who was at the city’s helm a decade ago when developer Stan Kroenke brought his Hollywood Park pitch to Inglewood, said city officials built what they thought was a partnership with their stadium counterparts.

But that partnership has crumbled. Since last summer, the city and stadiums have been slugging it out in a complex series of court cases over the stadium’s contract and Inglewood’s network of video billboards. The conflict has spilled over into the Nov. 3 election via ballot measures that would change the city’s commercial advertising and ticket tax rules. 

The audit approved by the City Council on Tuesday will dig into the entire financial relationship between the stadium and city since 2015, unpacking what is owed and what was received from taxes on everything from tickets to parking. City officials plan to continue auditing the taxes on a quarterly basis into the future.

Still, it’s not guaranteed the city would be able to force the stadium development to pay any debt the audit does claim. Hollywood Park could still appeal the court ruling that voided its contract with Inglewood, while Butts said the city wants to negotiate a new contract to replace it. 

A Hollywood Park spokesperson said the stadium development has lived up to its financial obligations, including paying all of its taxes.

“This is yet another thinly veiled attempt to distract from scrutiny surrounding the City’s own fiscal mismanagement and the questionable actions of its Mayor,” the spokesperson wrote in a statement.

Some locals at Tuesday’s meeting said during public comments they were baffled why the city hadn’t set up an audit process earlier.

“We have needed an audit from day one. We can’t sit here and claim we didn’t know or have an inkling what we were doing with Hollywood Park,” Diane Sambrano said. 

Exterior of Sofi Stadium in Inglewood

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Gary Coronado

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The LA Local

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Speaking during the meeting, Butts said the audit was triggered because of the void left by the development agreement and because major events including the 2027 Super Bowl and 2028 Olympics are about to hit Inglewood.

The mayor first claimed the development agreement was illegal in a letter written directly to Stan Kroenke last year, saying the city’s lawyers made the determination while researching billboard litigation.

Millions in tax revenue at stake

After the judge ruled in agreement with the city, Butts told The LA Local that city officials were still researching the specific implications of the court’s ruling. In Tuesday’s council motion, city staff highlighted what they say is one major change they’ve discovered: There’s no longer a limit on how much admissions tax the city can collect.  

Inglewood collects a 10% tax on tickets sold at SoFi Stadium, but the 2015 initiative that brought the stadium to the city put a cap on that revenue, starting at $15 million a year and increasing annually with inflation. 

The admissions tax cap also happens to be the subject of the current ballot Measure AT. WOW Media, the billboard operator allied with the city in its dispute with the stadium, is funding a campaign in favor of the initiative.

Admissions tax has been a sizable revenue stream for the city — bringing in an average $20 million a year since SoFi Stadium opened — but city officials have said it could be significantly bigger. A city analysis of Measure AT estimated that getting rid of the cap could bring in as much as an extra $50 million in future years. The city did not estimate how much admissions tax revenue it has missed out on while the development agreement was in effect.

The Inglewood audit seeks to clarify basic questions about how taxes are assessed on ticket sales and whether those taxes are actually forwarded to the city. Officials say it will provide transparency about ticket sales, pricing and fees, which have been heavily scrutinized in recent years across the state. 

Gray gets support on proposal for future billboard revenue audit

Councilmember Gloria Gray attempted to amend the audit motion Tuesday, asking the city manager to also audit the revenue the city gets from billboard fees.

“I believe the same standard of financial transparency should apply to every city agreement,” Gray said.

Though her motion didn’t receive a second, Councilmember Eloy Morales said he’d support putting a billboard revenue audit on the council’s agenda in the future. 

“I think we all support all those audits,” Morales said. 

Gray’s move was a rarity for a council that seldom debates motions during public meetings and almost always votes unanimously. The councilmember is currently running for mayor against Butts.

Inglewood pulls in as much as $8 million a year from billboards, according to budget records. Much of that comes from a series of deals the city cut with WOW Media, allowing the billboard company to construct and operate the billboards on public medians and sidewalks. In return, WOW gives the city a cut of ad revenue along with other concessions.

The post Inglewood is investigating if SoFi Stadium owes years’ worth of ticket taxes appeared first on LA Local.