The Brief

For two decades, Washington, D.C., pediatrician Lanre Falusi has counseled parents about vaccine safety, side effects and timing. But this year, she said, the conversations have changed.

"For the first time, I'm having parents of newborns ask me if their baby will still be able to get vaccines," Falusi said.

Throughout the U.S., pediatricians say anxious parents are concerned about access to routine childhood immunizations.

That's especially true for those with children covered by Medicaid, the government insurance program for low-income families and people with disabilities. Medicaid covers 4 in 10 children in the United States.

"It really became an issue when RFK Jr. stepped into the role of HHS secretary," said Deborah Greenhouse, a pediatrician in South Carolina.

The concern accelerated after the shake-up of a key Centers for Disease Control and Prevention vaccine advisory body in June, raising fears that millions of American families could soon have to pay out of pocket for shots now covered by their health insurance.

Health and Human Services Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist, removed all 17 members of the CDC's Advisory Committee on Immunization Practices (ACIP), the panel responsible for recommending which shots are included in the nation's adult and childhood immunization schedules.

Kennedy replaced the panelists with new members aligned with his views, prompting alarm among medical professionals and public health experts.

Insurance uncertainty worries parents

"People should be worried about what's going to happen to the availability of vaccines for children," said Jennifer Tolbert, deputy director of the Program on Medicaid and the Uninsured at KFF, a national health information nonprofit that includes KFF Health News.

Under the Affordable Care Act, health insurers are required to cover all ACIP-recommended vaccines.

States and other jurisdictions use the childhood vaccine schedule to set immunization requirements for schoolchildren.

ACIP's recommendations also determine which vaccines get covered by the Vaccines for Children Program, a CDC-funded initiative that provides free immunizations to low-income and uninsured children. Half of children in the U.S. are eligible for the VFC Program.

If the new ACIP members withdraw support for a particular vaccine and the CDC director agrees, Tolbert said, the consequences would be immediate.

"It would automatically affect what is covered and therefore which vaccines are available to children on Medicaid," she said.

Health insurance companies have not yet said how they would alter coverage, but Tolbert said such a move would open the door for private insurers to refuse to cover the vaccine.

Pediatricians worry about a future where parents might have to choose: pay hundreds of dollars out of pocket for shots or leave their kids unprotected.

The health insurance industry group AHIP said that health plans "continue to follow federal requirements related to coverage of ACIP-recommended vaccines and will continue to support broad access to critical preventive services, including immunizations."

Pediatricians say news about President Donald Trump's new budget law, which is expected to reduce Medicaid spending by about $1 trillion over the next decade, has also prompted questions from parents.

While parents may be worried about losing their Medicaid, the law doesn't mention vaccines or change eligibility or benefits for children's Medicaid, Tolbert said.

But less federal funding means states will have to make decisions about who is covered and which services are offered.

To raise the revenue needed to pay for Medicaid, states could raise taxes; move money earmarked for other spending, such as education or corrections; or, more likely, reduce Medicaid spending.

"And they may do that by cutting eligibility for optional populations or by cutting services that are optional, or by reducing payments to providers in the form of provider rates," Tolbert said. "It's unclear how this will play out, and it will likely look different across all states."

In May, Kennedy announced in a post on X that the CDC is no longer recommending the COVID-19 vaccine for healthy children and pregnant women. The move prompted a lawsuit by the American Academy of Pediatrics and other physician groups that seeks to freeze Kennedy's directive.

And in June, the new ACIP members appointed by Kennedy voted to recommend that adults and children no longer receive flu vaccines with thimerosal, a preservative rarely used in some flu vaccines. Anti-vaccine activists, including Kennedy, have rallied against thimerosal for decades, alleging links to autism despite no evidence of any association.

"There is no cause for concern," Department of Health and Human Services spokesperson Emily Hilliard said in a statement. "As Secretary Kennedy has stated, no one will be denied access to a licensed vaccine if they choose to receive one."

"When the ACIP committee met last month, they reaffirmed that flu vaccines will remain accessible and covered, and they emphasized safety by ensuring these vaccines are mercury-free," Hilliard wrote.

"The Vaccines for Children (VFC) program continues to provide COVID-19 vaccines at no cost for eligible children when the parent, provider, and patient decide vaccination is appropriate. Medicaid will continue to reimburse the administration fee."

But the possibility that a vaccine could be restricted or no longer covered by insurance is already changing how parents approach immunization.

In Falusi's practice, parents are scheduling appointments to coincide precisely with their child's eligibility, sometimes making appointments the same week as their birthdays.

Doctors warn that fewer kids may get shots if cost shifts to families

Melissa Mason, a pediatrician in Albuquerque, N.M., has treated some patients who got measles during the multistate outbreak that started in neighboring Texas.

She's concerned that any new limitations on access or reimbursement for childhood vaccines could lead to even more preventable illnesses and deaths.

Nationally, there have been more than 1,300 measles cases since January, including three deaths, according to the CDC. "We're seeing this outbreak because vaccination rates are too low and it allows measles to spread in the community," Mason said.

Children and teens account for 66% of national measles cases. Mason has begun offering the measles vaccine to infants as young as 6 months old, a full six months earlier than standard practice, though still within federal guidelines.

Last year, overall kindergarten vaccination rates fell in the United States. At the same time, the number of children with a school vaccination exemption continued to rise.

Pertussis, or whooping cough — another disease that can be deadly to young children — is spreading. As of July 5, more than 15,100 cases had been identified in U.S. residents this year, according to the CDC.

Mason said pertussis is especially dangerous to babies too young to receive the vaccine.

For now, pediatricians are trying to maintain a sense of urgency without inciting panic.

In Columbia, S.C., Greenhouse used to offer families a flexible age range for routine vaccinations.

"I'm not saying that anymore," the pediatrician said.

She now urges parents to get their children vaccinated as soon as they are eligible.

She described anxious parents asking whether the HPV vaccine, which helps prevent cervical cancer, can be administered to children younger than the recommended age of 9.

"I actually had two parents today ask if their 7- or 8-year-olds could get the HPV shot," Greenhouse said. "I had to tell them it's not allowed."

With the vaccine requiring multiple doses months apart, Greenhouse fears time may run out for families to get the series covered by insurance. If they have to pay out of pocket, she's afraid some families may choose not to get the second dose. A second dose could cost about $300 if no longer covered by insurance.

"I cannot be 100% sure what the future looks like for some of these vaccines," Greenhouse said. "I can tell you it's a very scary place to be."

Kennedy's newly appointed vaccine advisory committee is expected to hold its next public meeting as soon as August.

This story comes from NPR's health reporting partnership KFF Health News, a national newsroom that produces in-depth journalism about health issues. It's one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.
Copyright 2025 KFF Health News

An East Hollywood nursing home that nearly lost its license this year because of repeated state citations for deaths of residents at the facility was cited again last month after another person died.

The California Department of Public Health cited Brier Oak on Sunset after a 92-year-old resident bled to death on Sept. 27. Staff members had continued injecting her with blood thinners over a 40-hour period in violation of clinical guidelines.

It’s an AA citation, the most severe the department issues when violations of care standards are determined to be a substantial factor in someone’s death. The facility faces a $120,000 fine.

These kinds of citations are rare. The department has recently issued, on average, fewer than 20 AA citations yearly across more than 1,200 skilled nursing facilities in California.

Brier Oak has received three AA citations for patient deaths since late 2022.

State regulations require authorities to suspend or revoke the licenses of any facilities that get two AA citations within a period of 24 months.

The state Public Health Department began that process with Brier Oak in May based on resident deaths in 2022 and 2024. But officials dropped that effort later because they say they determined the two patient deaths had occurred 26 months apart — just outside of the two-year window.

A spokesperson for the company that owns Brier Oak told LAist it has appealed the first two citations and is considering whether to appeal the third.

Advocates for nursing home residents say the recent death could have been avoided if the state had taken action.

“There were red flags, and a lot of these red flags existed prior to the death of this poor resident,” said Tony Chicotel, senior staff attorney with  California Advocates for Nursing Home Reform.

The state said Brier Oak has until Dec. 19 to notify the department if it intends to appeal.

What led to the patient deaths?

In the recent death at Brier Oak cited by the state, multiple communication and technical failures by nursing staff led to the patient bleeding out over a period of 40 hours, according to the citation.

The 92-year-old patient was immobile and had been prescribed a blood thinner called heparin to help prevent blood clots from forming. But once a patient is bleeding, those injections make bleeding worse, and potentially fatal.

When nursing staff found bright red blood in the resident’s diaper the day before she died, Brier Oak failed to follow established processes for documenting the bleeding or communicating it to a nurse practitioner or medical doctor, according to the citation.

Nurses told state authorities they delayed informing physicians because they “get mad” when contacted in the middle of the night.

The facility’s staff also failed to fully assess the patient to determine the possible causes of the bleeding and or to properly monitor the issue during crucial periods, according to the citation.

She suffered four internal bleeding episodes over 40 hours and continued to receive blood thinner injections.

The citation says a nurse practitioner at Brier Oak told state licensing authorities later that if she’d been informed about the patient’s ongoing bleeding, she would have stopped the blood thinner and sent her to a hospital.

In 2022, Brier Oak received a AA citation after a 62-year-old woman died from respiratory failure in part because nurses hadn’t been trained to operate her breathing machine.

In 2024, the nursing home got another AA citation. This time, a 63-year-old woman with paraplegia and severe obesity fell from her bed and died while a nursing assistant was changing her. The assistant was alone, even though the woman’s care plan required two staff members.

Who owns Brier Oak?

Brier Oak on Sunset is primarily owned by Genesis Healthcare, a publicly-traded nursing home operator that filed for Chapter 11 bankruptcy in July.

Once the largest nursing home operator in the U.S., Genesis was facing billions in debt when it declared bankruptcy, according to court filings. That includes millions in potential damages from lawsuits related to patient care failures.

In a brief statement to LAist, a company spokesperson said it's still considering whether or not to appeal the recent citation at Brier Oak.

The citation should trigger a suspension or revocation of the facility's license, according to state regulations. The latter means it would have to close its doors. The two most recent deaths and citations at the facility occurred within the two-year window.

The California Department of Public Health confirmed it cited Brier Oak on Nov. 26.

The department said the facility submitted a required written response before a Dec. 6 deadline, showing how it will fix the problems and prevent them from happening again..

The department determined Brier Oak was back in compliance during an onsite visit last week, a representative told LAist.

Brier Oak on Sunset currently houses about 150 patients, according to state records.

A bankruptcy judge has stalled the proposed sale of Genesis Healthcare to an affiliate of one of its investors.

Experts say it’s unclear whether the state would revoke the license of an owner who is actively trying to sell and turn over operations to someone else.

It’s been a rough start to ski and snowboard season for California mountain towns. Snowfall is well below average, but Christmas could come with some of the white stuff. Here's where things stand:

Hmmm. Didn’t we just have a record storm?

Yes. That big atmospheric river that hit Southern California last month made it one of the wettest Novembers on records. But since then, it’s been unusually warm and dry, which is not good for mountain towns that depend on snow, and the outdoor enthusiasts that flock to them.

How bad is it?

California’s snowpack is about 20% of normal for this time of the year, according to the state’s snow-tracking website. Southern California isn’t quite as bad off — we’ve gotten about half our normal snowfall so far.

As for the resorts, only about 20% of the terrain at Bear Mountain in Big Bear is open. About 35% of Mammoth Mountain is open.

Can’t they just make snow?

They are, but the unusually warm temperatures have curbed resorts’ ability to make enough snow to open more terrain. “If you're blowing water into 40-degrees, it's going to stay water,” said Justin Kanton, a spokesperson for Big Bear Mountain Resort. “ So as much as people probably would want us to just crank the snow guns all day, every day up here and just get things moving, that's not really possible.”

But there’s a silver lining!

The dry weather has allowed Caltrans to make good progress toward opening Highway 38, said Evan Engle, who chairs the board of the Big Bear Chamber of Commerce. The road typically handles up to 40% of traffic up to the mountain town, Engle said. But it’s been closed since September when it got washed out by Tropical Storm Mario.

Getting it open as soon as possible is key to keeping visitor traffic manageable, and getting supplies to Big Bear.

What’s the snow outlook?

SoCal mountains are likely to see some precipitation around Christmas, said Kyle Wheeler, a meteorologist with the National Weather Service. But with temperatures not expected to drop much, it’s uncertain how much of it will be white, Wheeler said.

If you go to Big Bear: 

• If you plan to hit the slopes, get on it early, when the snow is at its best given the warm conditions. 
• No snow? There’s more to do than ski and snowboard. Check this list of winter fun events.  
• Worried about traffic? Consider going up earlier in the week. If you can’t do that, consider taking Highway 18 through Lucerne Valley. It’s a longer route if you’re coming from L.A., but less traveled, and less likely to make you car sick (fewer tight curves). 

The Los Angeles Police Department used more than 2,400 crowd control munitions in response to protests from June 6 to 14, according to a new report.

Officers used a total of 2,431 less-lethal projectile rounds and 35 canisters of tear gas over the nine days, according to LAPD reports. The department recorded 12 injuries officers caused with those weapons.

The LAPD released the missing report last week after LAist identified the use of crowd control weapons on four different days in June that had not been reported according to state law. Assembly Bill 48, which went into effect in 2022, limits when and how crowd control weapons can be used, and requires law enforcement agencies to publicly release reports on their use within 60 days.

A 30-day extension for these reports can be granted in some cases, but the LAPD released this report about three months late even if an extension was justified.

Officials acknowledged they were out of compliance on Dec. 10 before releasing the report, saying the delay “stems from the extraordinary volume and complexity of incidents” over that time.

This report is different from others

It is unusual for a crowd control report to include more than one day, and the report for June 9 through 14 covered six days and “45 sepearte [sic] non categorical use of force incidents.”

It does not describe any of those use of force incidents specifically, and the LAPD has not yet responded to LAist’s request for more detailed descriptions of those incidents.

The report also considered the entire six days to have been one continuous protest, though it included several anti-ICE protests over the week and the national “No Kings” protest on June 14.

Two reports released earlier this year for June 6 and 8 covered single days and provided more detailed descriptions of incidents where the LAPD used less-lethal munitions against protesters.