The Brief

A key federal vaccine advisory panel whose members were recently replaced by Health Secretary Robert F. Kennedy Jr. is expected to vote to recommend delaying, until age 4, the hepatitis B vaccine that's currently given to newborns, according to two former senior officials at the Centers for Disease Control and Prevention.

"There is going to likely be a discussion about hepatitis B vaccine, very specifically trying to dislodge the birth dose of hepatitis B vaccine and to push it later in life," said Demetre Daskalakis, the former director for the National Center for Immunization and Respiratory Diseases. "Apparently this is a priority of the Secretary's."

The vote is expected to take place Thursday during the next meeting of the CDC's Advisory Committee on Immunization Practices, or ACIP. The meeting is scheduled for September 18-19 at a CDC office in Atlanta, Georgia.

For more than 30 years, the CDC has advised that infants get the first of three shots of the hepatitis B vaccine at birth. In that time, the potentially fatal disease has been virtually eradicated among American children. Between 1990 and 2022, case rates plummeted 99 percent among people age 19 and younger.

Pediatricians warn that waiting until age 4 to begin vaccination opens the door to more children contracting the virus.

"Age four makes zero sense," said pediatrician Eric Ball, who practices in Orange County, California. "We recommend a universal approach to prevent those cases where a test might be incorrect or a mother might have unknowingly contracted hepatitis. It's really the best way to keep our entire population healthy."

In addition to the hepatitis B vaccine, the panel will also discuss and vote on recommendations for the combined measles, mumps, rubella, and varicella vaccine, and COVID vaccines.

Pediatricians worry changes to the schedules of these vaccines will limit access for many families, because ACIP's recommendations generally determine whether insurance plans and federal programs pay for the vaccines.

Typically, ACIP would undertake an analysis of the data before recommending a change to vaccine guidelines. As of the end of August, this process had not begun for the hepatitis B vaccines, Daskalakis and another former official said.

"This is an atypical situation. There's been no work group to discuss it," Daskalakis said.

The second former official spoke to NPR and KFF Health News on condition of anonymity.

In an email, a Health and Human Services spokesman, Andrew Nixon, wrote, "ACIP exists to ensure that vaccine policy is guided by the best available evidence and open scientific deliberation. Any updates to recommendations will be made transparently with gold standard science."

The draft agenda for the upcoming ACIP meeting was released to the public Sunday, only a few days before the meetings are scheduled to begin.

At the last ACIP meeting in June, chairman Martin Kulldorff, one of the new members handpicked by Kennedy, questioned the need to vaccinate every newborn, citing only two of the many ways the virus can spread.

Dr. Martin Kulldorff speaks during a June 25 meeting of the Advisory Committee in Immunization Practices at the CDC in Atlanta.

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Kulldorff is a former Harvard Medical School professor who became known for opposing some public health measures during the COVID-19 pandemic.

"Unless the mother is hepatitis B positive, an argument could be made to delay the vaccine for this infection, which is primarily spread by sexual activity and intravenous drug use," Kulldorff said.

The infection requires direct exposure to infected bodily fluids like blood and semen. The disease has no cure and can lead to serious conditions like cirrhosis and liver cancer later in life. The CDC advisory panel may maintain the recommendation to inoculate newborns whose mothers are considered at high risk of the disease, the former officials said.

Protection from birth

In 1991, federal health officials determined it was advisable for newborns to receive their first dose of the hepatitis B vaccine within 24 hours of birth, which blocks the virus from taking hold if transmitted during delivery.

While parents may opt out of the shots, many daycare centers and school districts require proof of hepatitis B vaccination for enrollment.

The prospect of altering the recommendation has left some people living with the virus deeply unsettled.

"I am goddamn frustrated," said Wendy Lo, 52, who lives in the San Francisco Bay area. Lo says she has probably had hepatitis B since birth. Years of navigating the psychological, monetary, medical and social aspects of chronic hepatitis B has impacted almost every aspect of her life.

"I would not want anyone to have to experience that if it can be prevented," she said.

Lo only learned she had the disease due to a routine screening in order to study abroad in college as a young adult.

Lo credits the vaccines with protecting all the members of her close family from infection.

"I shared with my partner, 'if you get vaccinated, we can be together,'" she said. He got the vaccine, which protects him from infection, "so I'm grateful for that," she said.

The CDC estimates half of people with hepatitis B do not know they are infected. It can range from an acute, mild infection to a chronic infection, often with few or no symptoms.

Most people with chronic hepatitis B were born outside of the U.S. Asians and Pacific Islanders, followed by Black people, have the highest rates of newly reported chronic infections.

When her children were born, Lo was adamant that they receive the newborn dose, a decision she says prevented them from contracting the virus.

The earlier an infection occurs, the worse the lifetime consequences, according to the CDC. When contracted in infancy or early childhood, hepatitis B is far more likely to become a chronic infection, silently damaging the liver over decades.

Those who become chronic carriers can also unknowingly spread the virus to others and face an increased risk of long-term complications including cirrhosis and liver cancer, which may not become evident until much later in life.

Treatments like the antivirals Lo now takes weren't available until the 1990s. Decades of the virus replicating unchecked damaged her liver. Every six months she gets scared of what her blood tests may reveal.

"Now I'm in my 50s, one of my big concerns is liver cancer. The vaccine is safe and effective, it's life-saving, and it protects you against cancer. How many vaccines do that?" Lo said.

Thirty years of universal vaccination

After a vaccine was approved in the 1980s, public health officials initially focused vaccination efforts on so-called "high-risk" adults.

"I, and every other doctor, had been trained in medical school to think of hepatitis B as an infection you acquired as an adult. It was the pimps, the prostitutes, the prisoners, and the healthcare practitioners who got hepatitis B infection. But we've learned so much more," said William Schaffner, professor of infectious diseases at the Vanderbilt University School of Medicine and a former voting member of ACIP.

As hepatitis B rates remained stubbornly high in the 1980s, scientists realized an entire vulnerable group was missing from the vaccination regime – newborns. The virus is often spread from an infected mother to baby in late pregnancy or during birth.

"We may soon hear 'let's just do a blood test on all pregnant women.' We tried that. That doesn't work perfectly either," Shaffner said.

Some doctors didn't test, he said, and some pregnant women falsely tested negative, while others acquired hepatitis B later in pregnancy, after they had already been tested. In 1991, Schaffner was a liaison member to the ACIP group that voted to recommend universal vaccination for hepatitis B before an infant leaves the hospital.

"We want no babies infected. Therefore, we'll just vaccinate every mom and every baby at birth. Problem solved. It has been brilliantly successful in virtually eliminating hepatitis B in children," he said.

In 1990, there were 3.03 cases of hepatitis B per 100,000 in those 19 years old and under in the U.S., according to the CDC.

Since the federal recommendation to vaccinate all infants, cases have dramatically decreased. CDC data shows that in 2022, the rate of cases among those ages 19 was less than 0.1 per 100,000.

While hepatitis B is often associated with high-risk behaviors such as injected drug use or multiple sexual partners, health experts caution that it is possible for the virus to be transmitted in ordinary situations, especially among young children.

The virus can survive for up to seven days outside the body. During that time, even microscopic traces of infected blood on a school desk or playground equipment can pose a risk.

If the virus comes into contact with an open wound or the mucous membranes of the eyes, an infection can occur. This means that unvaccinated children who are not considered "high risk" can still be exposed in everyday environments.

Future access uncertain

If the CDC significantly alters its recommendation, health insurers would no longer be required to cover the cost of the shot if given before the new recommended age. That could leave parents to pay out of pocket for a vaccine that has long been provided at no charge.

Children who get immunizations through the federal Vaccines for Children program would lose free access to the shot as soon as any new ACIP recommendations get approved by the acting CDC director.

The two former CDC officials said that plans were underway to push back the official recommendation for the vaccine as of August, when they both left the agency, but may have changed.

Schaffner is still a liaison member of ACIP, and hopes to express his support for universal newborn vaccination at the next meeting.

"The liaisons have now been excluded from the vaccine work groups. They are still permitted to attend the full meetings," he said.

He intends to speak up if he can, because he's worried about the next generation of babies and the doctors who care for them.

"We'll see cases of hepatitis B once again occur. We'll see transmission into the next generation," he said. "And the next generation of people who wear white coats will have to deal with hepatitis B, when we could have cut it off at the pass."

This story was produced in partnership with KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs of KFF.

NPR Health Correspondent Will Stone contributed to this story. Copyright 2025 KFF Health News

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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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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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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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