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

The Hollywood Burbank Airport is advising flyers to arrive at least 2 hours earlier than usual for the next 60 days because of construction slated to begin Monday.

Road closures: One lane of traffic on the southbound side of Hollywood Way next to Thornton Avenue will be closed during construction. The sidewalk and bike lane on the west side of Hollywood Way between Winona Avenue and Thornton Avenue will also be closed.

When: Construction will occur Mondays through Saturdays from 9 a.m. to 3:30 p.m. through June 6.

Why: Airport spokesperson Mike Christensen told LAist crews are building a retaining wall as part of Hollywood Burbank's passenger terminal construction project.

Alternatives: Officials recommend passengers to go through the Empire Avenue entrance, or use Thornton Avenue to get to the airport.

While living in L.A., I’d been hearing about this thing — “the desert.” Seemed a bit odd to someone who lived on the Westside next to the ocean, but OK, you can also see mountains from my house, so why not throw in an entire landscape food group?

A few years ago, I figured it was time to try it out, and my family and I headed to Joshua Tree for the weekend.

We began driving east and were soon in that vast no man’s land around the 10 Freeway. On one side, I could see a moving train, with all those boxcars. I was watching, entranced, waiting to see it go past. And it kept going. And going. It was like a vibrant desert serpent, wending its way through the landscape, each boxcar a different hue. It seemed so romantic, and then I thought “in each one, there’s a whole load of hanging car air fresheners, dental floss and Japanese waving cats” and suddenly the spell was broken. Ah well.

The eerie, alien Joshua Tree.

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As we got nearer, I said “Huh, what's that weird thing that looks like an alien?” and my husband said, “Yes, that’s a Joshua Tree.”

What? Wait, stop the car. There’s an actual Joshua Tree? First, who knew, and second, that is no tree. That, sir, is a weird misshapen cactus, with multiple crooked arms reaching into the air, each with its own spiky fur muff. Kinda like one of those waving inflatable guys if they were static. (Ah, I've been in L.A. too long).

Bougie smores

The vast desert sky.

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We finally arrived at our destination, a campsite — OK, a glamping campsite, a whole bunch of airstream trailers laid out with firepits. I knew it was bougie when I went to buy a smores kit from the shop and came back with 70% dark chocolate, artisanal graham crackers and single origin marshmallows. (I made that marshmallow one up, but it really is just a matter of time).

We made a fire, marveling at the gorgeousness of the sunset, the morphing colors and the vastness of the sky. I sat afterwards watching the flames, the cold air on my skin, under a blanket of stars. Tears pricked my eyes.

In the morning we headed to Joshua Tree National Park. When we got out of the car, the vista hit me, with that bright, bright sun, strange looking rocky outcrops, and nothing but Joshua trees as far as the eye could see. I thought: I have never seen anything like this. I couldn’t have even imagined something like this. In London, if you go on a day trip, you can go back in time, say to the thatched roofs of the Cotswolds — but not to a different planet.

What an extraordinary continent this is, I think. I am awestruck by its endless, varied landscapes — the plains, the Rockies, the oceans and the forests. And there’s something particular about the desert — its simplicity, its reduction to just three or four elements, which relaxes you, chills you out.

I remember heading back to L.A. after the weekend, happy and mellow, smiling as we drove west into the setting sun. It’s a cliche, but the desert does call you back. And I hope to get back there very soon.

We have another pip — the second egg in Big Bear’s famous bald eagle nest is showing signs of hatching.

The first pip, or crack, was confirmed in Jackie and Shadow’s egg no. 2 on Saturday morning, according to Friends of Big Bear Valley, the nonprofit that runs a popular YouTube livestream of the nest overlooking Big Bear Lake.

That’s about a day after the first egg started showing signs of hatching on Friday morning. The egg shell has continued to crack as the chick breaks through, revealing more of the eaglet’s fuzzy gray feathers as time goes on.

More than 38,000 people were watching the livestream shortly after the organization confirmed the second crack, compared with the more than 26,000 viewers who tuned in on Friday.

“The first egg is still in the process of hatching, it is not considered hatched until it is completely free of the egg shell. The chick has popped its head out of the shell to say a happy hatch day to mom and dad!” Friends of Big Bear Valley wrote on Facebook to more than a million followers on Saturday. “It also appears that the second egg has a pip. It is not well defined as of this morning, but we will likely see more progress throughout the day.”

Jackie and Shadow's usual incubation timeline is around 38 to 40 days, according to the nonprofit.

What’s next

With pips in place, it could take the chicks a day or two to complete the hatching process, as seen with last season’s trio.

Friends of Big Bear Valley won’t know for sure if any chicks are male or female, as the organization has said the only way to tell is with a blood test.

But once eaglets are around 9 or 10 weeks old, there should be signs that can help the nonprofit make an educated guess, including the chicks’ size, ankle thickness and vocal pitch.

Generally speaking, female bald eagles are larger than males. Female bald eagles also tend to have larger vocal organs — the syrinx — which leads to deeper, lower-pitched vocalizations, according to Friends of Big Bear Valley.

What do we call the chicks?

Historically, Jackie and Shadow’s chicks are given temporary nicknames initially, such as Chick 1 and Chick 2, or Bigger Chick and Smaller Chick (which some fans affectionately nicknamed Biggie and Smalls).

The final decision has then been left up to Big Bear Valley elementary school students. Previous chicks have been named Stormy, BBB (for Big Bear Baby), Simba and Cookie through that process.

Last year, Friends of Big Bear Valley crowdsourced more than 50,000 name choices in a week-long fundraiser, with the students voting from 30 finalists on official ballots delivered by the nonprofit.

The feathered parents’ eaglets were named Sunny and Gizmo last April.

One of last season’s three chicks didn’t survive a winter storm within weeks of hatching. Friends of Big Bear Valley named that chick “Misty” in honor of one of their late volunteers who is “still very missed,” the organization previously shared.

When Kekoa Gittens was 3, his preschool teacher told his mother he was a problem. He couldn’t sit still. He didn’t participate. When other kids learned the alphabet, he didn’t pay attention.

The next year, Kekoa’s classroom problems worsened. His mother, Sonia Gittens, took him to his pediatrician, who referred the boy to an eye doctor.

That doctor looked at the back of Kekoa’s eyes and diagnosed him with myopic degeneration, a dramatic form of nearsightedness.

“They are too little. They don’t know how to express themselves and say, ‘I cannot see it, teacher,’” said Sonia Gittens, who lives in the Marin County town of Corte Madera.

Today, Kekoa is a successful high schooler, but too many kids don’t get their eyes checked until they’re far behind in school.

Vision problems, particularly nearsightedness, have grown more common among American children. Roughly one in four school-age kids, or 25%, wear glasses or contacts, a proportion that increases as kids get older, according to 2019 federal survey data.

In California too few children on Medi-Cal like Kekoa are getting their eyes checked, and the problem is growing worse. Just 16% of school-age kids on Medi-Cal saw an eye doctor between 2022 and 2024 for first-time eye exams, continuing vision check ups or glasses, according to a report commissioned by the California Optometric Association. That’s down from 19% eight years earlier. The report, based on two years of Medi-Cal data, suggests that the state is moving in the wrong direction even as eye problems become more prevalent among kids.

Medi-Cal provides insurance for low-income Californians and those with disabilities.

“Every day when I see these children it is always a surprise to me that the kids are not getting the care they need,” said Ida Chung, a pediatric optometrist and an associate dean at Western University of Health Sciences in Pomona.

The trend indicated in the report is alarming, Chung said. In her clinic, where about half of children are on Medi-Cal, it’s common for kids with congenital vision problems to visit for the first time when they’re in first grade or later. That indicates to Chung that many kids don’t have enough access to eye care.

Though kids might be getting basic vision screenings at school or from a pediatrician, some eye problems are still overlooked. “It’s something the child had before they were born,” Chung said.

Eye exams decrease statewide

Colusa County, a rural farming region north of Sacramento, saw the sharpest drop in kids’ eye doctor appointments in the state from 20% between 2015-16 to just under 2% between 2022-24.

Nearly all counties — 47 out of 58 — performed worse on vision care than they did in the past, the report shows, with some, like Colusa, declining significantly.

Most of the severe declines happened in rural areas, although urban counties like San Francisco and Los Angeles also saw decreases. Only seven counties improved the rate of children receiving eye exams or glasses. Four counties were excluded for comparison in the report because the numbers were too small.

“The decline in performance here is so widespread that something really needs to happen,” said David Maxwell-Jolly, a health care consultant who authored the report and the former director of the Department of Health Care Services, which oversees Medi-Cal. “These numbers are way lower than what you would expect to be seeing if we’re doing a good job of detecting kids with treatable conditions.”

A spokesperson for the Department of Health Care Services said in an email the state could not confirm the accuracy of an external report, noting that vision services can be difficult to track because “not all encounters are captured in a single, comprehensive dataset.”

For example, many initial vision screenings take place in the pediatrician’s office during well-child visits, which include eye and hearing screenings as well as immunizations and developmental checks. State data shows about half of kids with Medi-Cal receive well-child visits.

Still, experts say the low numbers tell a real story: if children were reliably getting follow-up care from initial screenings, the share who get comprehensive eye exams and glasses would be closer to 25-30% — in line with the known prevalence of vision problems among kids — rather than the 16% found in the optometric association’s report.

Maxwell-Jolly said the analysis he conducted replicated an internal, unpublished department report tracking vision services between 2015 and 2016. His analysis, based on data obtained through a public records act request, updated the results for more recent years.

The state’s most recent Preventive Services Report, which measures how well Medi-Cal delivers preventive care to children, shows the rate of comprehensive eye exams for children and young adults ages 6-21 is similar to the optometric association’s analysis at 17%.

Contra Costa County experienced the third largest decline in children’s eye care in the state. A spokesperson for Contra Costa Health Plan said Medi-Cal health plans are not required by the state to track vision benefits and that it would take time to understand the data. The state, however, does track vision services internally, according to the health care services department.

A bill sponsored by the optometric association and authored by Assemblymember Patrick Ahrens, a Democrat from Cupertino, aims to require the state to establish vision benefit quality measures and report performance data publicly. The goal of the legislation is to track where kids do not have enough access to vision services and to ensure that Medi-Cal providers are improving services.

Rural challenges

Amy Turnipseed, chief strategy and government affairs officer for Partnership HealthPlan of California, said rural parts of the state struggle to find enough providers. The nonprofit health insurer provides Medi-Cal for 24 northern counties, including Colusa and Modoc.

In Modoc County, which borders Oregon and Nevada, one optometrist serves a 90-mile radius. Partnership has worked closely with that optometrist to ensure they continue accepting Medi-Cal patients, Turnipseed said.

“In rural counties with lower populations, losing even one provider can exponentially impact the access to services to families,” Turnipseed said. “In the past few years we’ve seen vision providers reduce or limit their Medi-Cal, which makes it harder for families to see providers.”

An assortment of glasses at Vision to Learn mobile optometry clinic at Esther Lindstrom Elementary School in Lakewood on March 20, 2026. Photo by Ariana Drehsler for CalMatters Modoc is one of just seven counties where more children have received vision care in recent years, according to the report.

Providers frequently cite low reimbursement rates from the state as a reason for not accepting Medi-Cal patients. The California Optometric Association estimates only about 10% of its members accept Medi-Cal. The reimbursement rate for a comprehensive eye exam is about $47, said Kristine Shultz, association executive director.

“Our reimbursement rates haven’t increased in 25 years. Imagine getting paid what you were paid 25 years ago,” Shultz said.

Schools check kids’ vision, but follow-up is spotty

State law requires schools to periodically check kids’ vision starting in kindergarten. Those screenings are a good bellwether for if a child is struggling to see in class, said Chung with Western University. The problem is getting the kids who fail the screening to an eye doctor.

Chung runs an academic optometry clinic that works with local schools in Pomona. Each year up to 35% of students fail the screening, meaning they likely have a vision problem. But based on conversations with school nurses, Chung said only about 7% of those children then go to an eye doctor and come back to school with glasses.

Chung, who chairs the children’s vision committee for the California Optometric Association, said colleagues who work with school districts around the state report similar experiences.

“If a high number of those children are not getting the follow up care, we may just be fooling ourselves and checking a box,” Chung said. “We’re in compliance with the law in California but are we really helping the children?”

For some families, the answer is no. That’s what happened to Kekoa when he was 3. The school checked his eyes and said he might have vision problems, but his mother, Gittens, waited. Her son was still learning his numbers and letters. How would he be able to read an eye chart, she reasoned. It wasn’t until his problems got worse that Gittens took Kekoa to an eye doctor.

Now, at 15, Kekoa wears contacts and likes athletics. He needs to see to compete in capoeira martial arts competitions and surf on the weekends, his mother said.

First: Dr. Kiyana Kavoussi shows letters on a monitor during Noah Mattison’s, 11, visual acuity test. Last: Optician Maya Ortega looks at Italia Martin’s, 6, eyes before she chooses new glasses inside the Vision to Learn mobile optometry clinic at Esther Lindstrom Elementary School in Lakewood on March 20, 2026. Photos by Ariana Drehsler for CalMatters Many parents lack the resources to take their kids to the doctor, or simply wait. Notes from school nurses flagging that a child failed a vision screening may also get lost in a backpack on the way home, educators say. The California Department of Education does not track the results of school vision screenings.

Vision To Learn, a nonprofit, created a mobile eye clinic to help bridge the gap between kids failing school vision screenings and getting glasses. The group brings an optometrist to campus, meaning kids that need an eye exam can get one the same day and go home having gotten a prescription and ordered glasses.

Damian Carroll, chief of staff and national director, said Vision to Learn’s numbers tell a similar story to Chung’s. About one-third of students screened are unable to read the eye chart, but very few of those kids have adequate glasses.

In the California schools where the program operates, around 70% of kids who have been prescribed glasses did not own a pair. Another 20% had glasses with outdated prescriptions, according to internal data, Carroll said.

And that gap can drastically affect learning outcomes or behavior in school.

“First and second graders who try on glasses the first time are blown away because they just thought that’s how the world looked,” Carroll said. “They can see the leaves on the trees and the math on the board, and it’s shocking to them.”

For the record: This story has been updated to reflect that Maxwell-Jolly’s study replicated the methodology of an earlier one by the Department of Health Care Services, but did not republish department findings.

Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.