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

Flies, rodents and other pests have been a persistent problem in Boyle Heights and nearby communities as millions of pounds of food rot in a nearby burned-out warehouse. It’s gotten bad enough that L.A. Mayor Karen Bass is asking for action from the L.A. County Department of Public Health.

In a letter sent Tuesday to county Public Health Director Barbara Ferrer, Bass said she’s “concerned with County DPH’s pace in addressing this disaster” and the risks it posed to health and quality of life.

“Possibly the worst manifestation of these risks is the severe infestation of flies in Boyle Heights and neighboring communities,” Bass wrote.

LAist has asked the Department of Public Health for comment and will update this article when they respond.

The back-and-forth between jurisdictions

Bass wrote that the city of L.A., which does not have its own health department, is largely dependent on L.A. County for control of potentially disease-carrying vectors. The city has said elsewhere that its Sanitation Department did set about 250 rat traps in surrounding areas.

Bass’ letter says the county took its first steps to hold warehouse operator Lineage accountable for a fly infestation on July 17, ordering the company to remove flies and mosquitoes from the property.

“Although I appreciate that County DPH has taken this first step, the County’s report only directs Lineage to eliminate flies from Lineage’s own property,” Bass’ letter to Ferrer states.

Bass urged the county to compel Lineage to address pests at neighboring properties “with aggressive measures to eliminate the flies and any other vectors.”

As for L.A. County’s Department of Public Health, a spokesperson told LAist on July 17 that it had itself directed the city and Lineage to address the pest situation.

“Los Angeles County Department of Public Health requested that both Lineage Logistics and the City of Los Angeles develop and implement a vector/insect control plan,” the statement reads.

Lineage’s part

According to Councilmember Ysabel Jurado, who represents Boyle Heights on the L.A. City Council and met with Lineage representatives on Monday, an inspector contracted by the company confirmed that the rotting food at the warehouse is serving as a breeding ground for flies. The infestation won’t go away without addressing the root cause, Jurado reported the contractor as saying.

“Removing waste, adding odor-control equipment, and conducting a pest inspection are important,” Jurado said in a statement. “But residents are asking a more fundamental question: Are conditions actually improving? They deserve evidence, timelines and accountability — not just a list of activities.”

Lineage has not yet presented its pest control plan to the public.

A ticking clock

The first day of instruction for L.A. Unified schools is Aug. 12, three days before the city’s current deadline to clear the warehouse — a deadline Lineage does not appear to be on track to meet.

That’s led many teachers and parents to raise the alarm about smells and pests that may very well still be around when school starts. An LAUSD spokesperson told Boyle Heights Beat that it is prepared to temporarily relocate nearby schools, as they did with summer programs during the warehouse fire.

Lineage meets deadline at last minute

Meanwhile, Lineage also faced a deadline of Tuesday to present a plan to air quality officials on how to address smells of spoiled food, which have been reported from miles away. A South Coast Air Quality Management District spokesperson said that the agency received a response from Lineage at 5 p.m. and is evaluating it.

L.A.’s homeless services agency has not completed any internal audits in years — and one that was started two years ago is still incomplete because management is taking months to provide responses, officials said Monday.

The delayed audit has been looking into why the L.A. Homeless Services Authority, known as LAHSA, failed to spend $7 million in federal dollars it was granted to house and serve people in need. The roughly six-page audit report hasn’t been released because it’s missing LAHSA management responses that were requested over two months ago, officials said.

Internal audits are considered critically important to protecting taxpayer dollars at every level of government. L.A. County auditors, for example, issued about 100 reports in a recent fiscal year.

“ We haven’t gotten anything,” said Erum Shahnawaz, LAHSA’s chief internal auditor, referring to the lack of response from LAHSA management at a meeting of the agency’s audit committee on Monday.

“That’s the only thing that's holding us from issuing the final report,” Shahnawaz said of the underspending audit.

That audit is examining a repeat problem. A previous, external audit in January 2022 found LAHSA had left $3.5 million in federal grants on the table by not using them.

Shahnawaz flagged management’s delays to the LAHSA Commissioner Justin Szlasa, Szlasa said. He chairs the commission’s audit committee, and has repeatedly called out LAHSA executives’ delays in providing information about taxpayer spending over the past year.

“ I've been trying to intervene and use whatever I can to try to help provide support,” said Szlasa as he described his attempts to get the auditor the answers needed to complete the report.

Szlasa was appointed to the commission by L.A. County Supervisor Kathryn Barger.

 “It shouldn't take us two months to receive a…management response to an internal audit,” Szlasa said at Monday’s meeting. He said the industry standard for internal audits is eight or nine weeks from start to finish. That compares to the two years — and counting — for LAHSA’s federal underspend audit.

“We haven't had a single internal audit completed here in the last couple of years, which is nuts,” Szlasa added. He called for internal audits to happen much more frequently.

Long delays to LAHSA audits also are not new. In November 2024, the county issued a widely-seen audit that included findings that LAHSA was failing to complete internal audits.

Half of LAHSA’s governing commission is appointed by L.A. Mayor Karen Bass and half appointed by each of the five county supervisors. Bass is also the only elected official on the commission. She served on the audit committee for several months last fall. Records show she was absent for all of the meetings during that time.

Janine Lim, LAHSA’s deputy chief financial officer, said management’s responses to the audit on underspending haven’t been provided yet because LAHSA leadership did not have clearly defined roles for who is supposed to coordinate responses to internal audits.

“ We need to work on clarifying that role internally,” Lim said.

 “The last two months have been probably some of the most stress-filled two months that we've had at LAHSA,” said Paul Rubenstein, chief of staff to LAHSA CEO Gita O’Neil, pointing to mass layoffs.

Szlasa said there’s not that much in the audit for management to respond to.

“It's like, six pages or less,” he said.

Szlasa said  another option is to “just say we've asked management for responses and we're awaiting management response. We can publish the results.”

In response, Shahnawaz said that if management doesn't have an updated timeline for a response, then she’ll go ahead and issue the report without the response.

Once they floated that idea, Lim committed to providing the responses by next Tuesday.

LAHSA’s leadership has downsized the internal audit team — dropping from a staff of three to just one in the agency’s proposed budget up for approval Friday.

Delays in getting access to financial records

The delayed responses from management are not the only thing that’s been slowing down audits, Szlasa said at the meeting.

LAHSA policy, approved by its governing commission, says internal auditors are “ authorized to access all organizational records, personnel, and systems necessary for conducting audits,” he said.

But the auditor has faced challenges in actually getting that access, Szlasa said — including delays in being allowed to view LAHSA’s databases that show contracts and financial payments.

 ”We finally were granted access, but it wasn't, it wasn't easy, it wasn't immediate. It was slow,” Szlasa said.

Many failed outside audits

The delays on the internal audit come even after LAHSA failed multiple external audits in recent years, which have found the agency — overseen by city and county elected officials — has neglected to properly track billions of dollars in spending.

Largely in response to earlier audits, L.A. County supervisors pulled funding from LAHSA and are having the county instead oversee it directly. L.A.’s mayor and City Council have continued to have LAHSA manage the city’s homeless spending while the council delays plans to start studying a possible plan to transition away city tax dollars.

Signatures under scrutiny

LAHSA is also in the midst of a different internal audit — expected to finish in late August or early September — examining whether top officials followed requirements when signing contracts and letting others sign. It was launched in the wake of LAist reporting that found LAHSA’s then-CEO Va Lecia Adams Kellum’s signature finalized a $2.1 million contract with her husband’s employer.

LAist also discovered Adams Kellum’s signature, as LAHSA’s CEO at the time, finalized a quarter-million-dollar contract between LAHSA and a longtime service provider she led up until two months earlier.

That contract was signed so soon after she left the service provider — St. Joseph Center — that the contract paperwork still listed her as one of St. Joseph Center’s points of contact and authorized signers.

She is currently under a state ethics investigation into whether her actions were an illegal conflict of interest.

When Bengara opened in Los Angeles' Arts District earlier this year, its owner and head chef had something special lined up in their kitchen arsenal.

It was genshiyaki, a rare traditional Japanese grilling method that dates back 1,500 years.

Chef and co-owner Tyler Burges had only encountered it once while traveling in Japan at a robatayaki spot in Fukuoka, a port city on the island of Kyushu.

Robatayaki, a style of slow, ember-cooked grilling rooted in Japan's rural coastal kitchens, usually centers on an open charcoal hearth. But the restaurant Burges visited had something even more noteworthy: a genshiyaki pit, a gentler, ambient method of cooking that uses radiant heat instead of direct flame.

Loving the unusually subtle, delicate flavor and texture it produced, he and head chef Phil Mireles decided to bring genshiyaki back to the U.S. and build their Arts District restaurant around it. The genshiyaki pit is a rare enough technique that Burges had to work with fabricator Phil Roxworthy for six months just to get the grill built to spec.

It's Burges' and Mireles' first L.A. project. The pair are also behind Smoke Door, their acclaimed Lake Tahoe restaurant, and Bengara brings a more casual, day-to-day take on the same fire-driven cooking.

All roads lead to the Arts District

Chef/owner Tyler Burges (left) and head chef Phil Mireles at Bengara.

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Wonho Frank Lee

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Courtesy Bengara

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Burges and Mireles both got their start at San Francisco's Saison and Angler under chef Joshua Skenes — who's now just down the street in L.A. at LYNX with fellow alum Brandyn Tepper.

Burges traces Bengara's DNA back to two mentors: Ron Siegel, who introduced him to Japanese ingredients and technique in his mid-20s, and Skenes, who taught him to cook with live fire. It was Skenes, Burges said, who showed him that fire didn't have to mean char and bravado.

"The one thing I loved about wood-fire cooking is you get this subtle, sweet barbecue flavor when you cook correctly over embers, and you don't cook directly over the fire," Burges said. "Most places, when you think about grilling something, you think of char, bold flavors, masculine flavors. But Chef Josh — it's like a master art, getting really delicate, subtle flavor using that grill method."

The uni kiritampo, Bengara's take on a traditional Akita-prefecture rice skewer, finished with scallion.

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Wono Frank Lee

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Courtesy Bengara

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What sets the food apart

Take their luscious miso cod. On a normal grill, the marinade's sugars would blacken before the fish cooked through. On the genshiyaki pit, the cod sits at a distance from the embers, cooking gently until the very end, when it's given one last pass directly over the coals — what Burges describes as a final "kiss" of heat before it hits the plate.

To fuel genshiyaki's slower, ambient style, ordinary charcoal or wood is replaced with binchotan, an ultra-dense, pure-carbon hardwood charcoal traditionally made in Japan, which burns hotter and cleaner.

The signature dish

A perfect example of how this cooking style comes together is the uni kiritampo, the Akita prefecture rice skewer, reimagined with uni and cooked via genshiyaki — born of an offhand kitchen conversation with one of the restaurant's Japanese chefs about regional dishes cooked over fire.

Once they realized genshiyaki was the dish's original, historic cooking method, the rest fell into place.

"It's like the most delicious thing," Burges said. "I don't know why it never made it over to the United States earlier."

Bengara's Arts District dining room pairs industrial bones with warm, low lighting and long communal tables.

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Wonho Frank Lee

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Courtesy Bengara

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The chewy exterior, with just a hint of smoke, gives way to a creamy inside, like a caramelized custard, that’s topped with a decadent amount of uni, providing a semi-sweet finish — one memorable bite.

Tasting menu option

Bengara recently added a daily eight-course tasting menu ($98) that doubles as a greatest-hits tour of the kitchen — Toyosu carpaccio with chili coffee oil, pork belly "tacos" wrapped in mochi crepes, miso cod, Mary's half chicken, and handmade citrus soba, with optional wagyu and uni add-ons.

The price includes a beverage pairing, with a full non-alcoholic option alongside the boozy version. Walk-ins are welcome, and reservations can be booked via OpenTable.

Topline:

Why it matters: Museum officials said you will “likely experience high demand and long wait times in the queue" and thanked people for their patience.

LAist saw estimated wait times up to 6 hours, and it took a little more than 4.5 hours for this reporter to get through. On the bright side, there were still plenty of tickets left, including for the first day. Do not refresh the page or you may lose your spot.

The details: All tickets are timed entry. Tickets are $25 for adults and $21 for those 65 and older. Children, members, active-duty military, personal aides or attendants and EBT cardholders have free entry. Museum neighbors in the LM37 program will also be free, with that pass opening in August.

But how do I buy: Each person is limited to nine tickets, and you’ll have 20 minutes to check out once they’re added to your cart, according to the museum. You can find the link here.

What's next: The grand opening is Sept. 22.

Go deeper: How to secure Lucas Museum of Narrative Art tickets ahead of the fall opening