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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Mike Stewart

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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

Every January, the open-air downtown food fair reopens after its winter break and announces new additions to its carefully selected group of regular vendors.

This year’s new vendor class demonstrates the resilience of L.A.'s independent food scene, ranging from a Grammy-nominated producer's Persian-influenced pizza to Southern fried fish celebrating Black American culinary traditions, to an LAist 2025 Tournament of Cheeseburger heavyweight contender.

The reopening also marks the start of Smorgasburg LA's 10th anniversary year, and will feature 41 returning vendors, who've helped build the regular event into a fun, family-friendly opportunity to try new, often cutting-edge food you may not be familiar with.

Doors open from 10 a.m. to 4 p.m. at DTLA’s The Row, with free entry and free parking for the first two hours.

A new year

General manager Zach Brooks said this is his favorite time of year. "We add the new vendors at the beginning of the new year, everyone's excited."

Vendors apply through Smorgasburg's website, and the team meets with every applicant to taste their food before acceptance. Brooks said it's not a vetting process like "Shark Tank" but rather a matter of seeing if it's a good fit. Competition remains fierce, with many more applicants than available spots.

"I think it's just a testament to L.A. and the resilience of people who love this business and have a passion for it, and are going to continue to persevere and start their businesses and want to be out there selling food," Brooks said.

Here are a few highlights:

Viral orange chicken sandwich 

Long Beach-based Terrible Burger becomes Smorgasburg's new permanent burger vendor after standout appearances at LAist's Tournament of Cheeseburgers and the market's rotating Smorgasburger Stand. The smashburger pop-up, run by husband-and-wife team Nicole and Ryan Ramirez, specializes in burgers that draw from pop culture and global influences. They've made waves with a Korean barbecue burger topped with bulgogi barbecue sauce and a viral orange chicken sandwich, previously available only at their Tuesday night residency at Long Beach's Midnight Oil, making its L.A. debut Sunday.

Terrible Burger's viral orange chicken sandwich makes its LA debut at Smorgasburg after being available only in Long Beach.

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Courtesy Terrible Burger

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"We have been big Smorgasburg fans for a really long time before we even started Terrible Burger. We would go to Smorgasburg on dates, just eat and hang out. And it was just always a little dream of, "oh, what if we ever sold food here?" Nicole Ramirez said.

Crispy fried snapper and thick-cut fries 

Orange County-based Hot Grease, run by Asha Starks, is among four vendors graduating from residencies to permanent status. The Southern fried fish pop-up celebrates Black American history through food that honors Starks' family heritage.

"Folks often forget that there are Black folks in Orange County. My family came to Orange County during the second wave of the Great Migration, and they settled in Santa Ana... my food is very cultural. And the story, I feel like, is just as important to highlight," Starks said.

Hot Grease's crispy buttermilk fried snapper with thick-cut fries and "Ill Dill" tartar sauce.

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Courtesy Hot Grease

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Hot Grease serves crispy buttermilk fried snapper with thick-cut fries and small-batch sauces like "Ill Dill" tartar. Honoring the fish fry's history as a site of mutual aid, Starks directs 3% of sales to the Potlikker Line, Hot Grease's reproductive justice mutual aid fund. For January, she's added fish and grits, black-eyed peas and collard greens.

Pizza with a Persian twist

Mamani Pizza brings studio-born energy to Smorgasburg LA with pies featuring Persian-inspired creativity.

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Courtesy Mamani Pizza

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Mamani Pizza, from the Grammy-nominated producer Farsi, part of the music production team Wallis Lane, started making Neapolitan-style pizzas at his West L.A. recording studio a year ago. What began as late-night pies for friends and artists became an underground hit. Most pizzas are traditional, but Farsi adds Persian touches like The Mamani, topped with ground wagyu koobideh, roasted Anaheim chilis, Persian herbs and pomegranate molasses.

Other new vendors

Banana Mama - Asian-inspired pudding
Barranco's Yogurt - Oaxacan fruit yogurt
Franzl's Franks - Austrian sausages
Melnificent Wingz - Gourmet chicken wings
Piruchi - Peruvian street food
RuRu's Golden Tea - Karak chai
Stick Talk - vegan corn dogs
SouuLA - Taiwanese breakfast concept
Unreal Poke - Hawaiian poke
Zindrew Dumpling Shop - Spicy wontons

In halting childcare and welfare benefits to hundreds of thousands of low-income Californians, the Trump administration says it’s “concerned by the potential for extensive and systemic fraud.”

“These concerns have been heightened by recent federal prosecutions,” states the funding freeze letters to California from Trump-appointed officials at the U.S. Department of Health and Human Services (HHS).

When pressed for details about what specific prosecutions justify the freeze in California, administration officials have offered few specifics. Confirmed fraud concerning the targeted programs appears to be a tiny fraction of the total spending.

The letters don’t mention any prosecutions here in California, as the administration cites it as justification for cutting off billions of dollars in support for food, housing and childcare.

A spokesperson for the federal agency declined to comment when asked what prosecutions the letter refers to, and for the basis for the broader fraud concerns cited as the reason for cutting off funds.

Prosecutions that have been brought around child care benefits amount to a small fraction of 1% of the federal childcare funding California has received, according to a search of all case announcements on federal prosecutors’ websites covering the whole state. The U.S. Department of Justice, which oversees such prosecutions, has not responded to a request asking if additional cases exist.

At a news conference Friday, LAist asked Bill Essayli, the top federal prosecutor for the region, if he knew of any federal prosecutions of childcare benefit fraud besides a single 2023 case previously cited by federal officials. Essayli did not point to any other federal prosecutions. The region he oversees includes over half of California’s population, including the counties of L.A., Orange, Riverside and San Bernardino.

In a separate emailed response to questions from an NPR reporter, the White House pointed to an article about a separate case in San Francisco that did not indicate it involves the federal funds being frozen.

What’s not known is the scale of complaints federal authorities have received about California’s spending with these three programs, and to what extent cases will be brought in the future. It’s also unclear how problems with California’s spending on these programs compare with other states that are not being targeted with funding freezes.

Last year, a federal Government Accountability Office review found about three-quarters of states — 37 of 50 — had negative findings in audits about their oversight of the largest program the administration is freezing funding to in five blue states.

That federal program is called Temporary Assistance for Needy Families, or TANF.

Mississippi has an ongoing fraud scandal over misuse of $77 million in TANF and other welfare dollars — much of which was used to benefit wealthy athletes like former NFL quarterback Brett Favre.

Former pro wrestler Ted DiBiase Jr. is currently on trial in a federal case alleging he conspired to fraudulently get millions in TANF welfare dollars through sham contracts for services that were never provided, as part of Mississippi's fraud scandal.

Mississippi is not among the five states the Trump administration is freezing TANF funds to, all of which are run by Democrats.

One known federal case in California

In order to determine what federal prosecutions the administration is using to justify cutting California off from federal safety net programs, LAist ran searches through all announced cases over the past decade-plus by all four federal prosecutor offices in the state. It shows a total of one case mentioning childcare benefits fraud, brought in San Diego in 2023 over $3.7 million in alleged stolen funds.

The amount alleged to be stolen was equivalent to less than $1 out of every $10,000 California received from the funding the administration is freezing over the timeframe of the announcement search.

The federal agency that distributes the funds, HHS, has a nationwide watchdog office that investigates fraud in the programs being frozen. It’s known as the Office of Inspector General, or OIG.

The inspector general’s office has thousands of reports online about fraud and misspending across HHS’ vast programs nationwide.

But a search found no reports around problems with spending in California among the three programs impacted by the spending freeze.

“As your search confirms, there aren’t public OIG-released materials on fraud in these programs occurring in California,” said a spokesperson for the inspector general’s office.

That contrasts with Minnesota, where large-scale fraud cases have been brought in recent years over theft of federal dollars meant for food and other social services. An OIG report last year found Minnesota did not comply with requirements around documenting attendance and payment to childcare providers.

In an apparent error, one of the administration’s funding freeze letters to California asks for documents about Minnesota’s processes.

Criticism that Minnesota officials failed to prevent fraud in their state drove the state’s Democrat governor, Tim Walz — who ran for vice president against Donald Trump’s ticket in 2024 — to announce Monday he was dropping out of running for reelection.

That same day, the administration announced it was expanding the funding freeze to include California and three other Democrat-led states, in addition to Minnesota.

The following morning, President Trump alleged — without giving specifics — that corruption in California is worse than Minnesota.

“California, under Governor Gavin Newscum, is more corrupt than Minnesota, if that’s possible??? The Fraud Investigation of California has begun. Thank you for your attention to this matter! PRESIDENT DONALD J. TRUMP,” the president wrote on his social media platform Truth Social.

The White House has not responded to LAist requests for an interview with President Trump.

Governor Newsom has drawn criticism in recent years for vetoing a bill to more closely track spending and outcomes for tens of billions of state homelessness dollars, which had passed unanimously in the state Legislature.

CalWORKS

In response to NPR’s questions about the basis for the funding freeze, the White House’s Office of Management and Budget pointed to the San Diego case and a local prosecution by the San Francisco DA last year involving up to $400,000 in childcare funds.

It’s unclear if the San Francisco childcare case involved the same funding streams that are being frozen. The DA’s office and White House have not responded to a request for clarification.

The other, and by far largest, issue pointed to by the White House was described as $108 million lost from California’s welfare program, CalWORKS.

“CalWorks, a TANF recipient, had lost more than $108 million in cash benefits due to welfare fraud," the White House statement said with a link to a news release from the Orange County DA's Office.

LAist looked into it, and the situation is more complex. The DA’s news release says the losses are related to a scam called EBT card skimming.

That’s when scammers steal benefit card money from welfare recipients’ benefit cards. When that happens, the state covers the losses out of state funds, according to CalMatters.

The CalWORKS EBT cards are mostly funded by state and local dollars, according to state figures. About a third of the funding for those cards comes from TANF, the largest federal program being frozen.

The White House has not responded to follow-up questions.

EBT card skimming is an issue nationwide, not just the states where funds are being frozen, according to news reports.

Legal challenge

Trump has pardoned or commuted the sentences of several people convicted of large-scale frauds, including commuting the 20-year prison sentence of a man convicted in a case alleging $1.3 billion in fraudulent health claims to the federal government. The Justice Department called it the largest health care fraud scheme ever prosecuted up to that point.

At a news conference Thursday, Vice President J.D. Vance said the Justice Department would be creating a new high-level position to oversee fraud prosecutions. That official will be directly overseen by Trump and Vance, according to the vice president.

Later in the day, California Attorney General Rob Bonta announced a lawsuit seeking to stop the funding freeze, filed by California and the other blue states targeted by the freeze.

The next day — Friday — a federal judge granted a temporary restraining order preventing the freeze for now. Further arguments and decisions in the case are expected in the coming weeks.

NPR correspondent Jennifer Ludden contributed reporting to this story.

Hiring remained anemic in December, closing out the weakest year for job growth since the beginning of the pandemic.

U.S. employers added just 50,000 jobs last month, according to a report Friday from the Labor Department. Meanwhile, the unemployment rate dipped to 4.4%, from 4.5% in November, while job gains for October and November were also revised down by a total of 76,000 jobs.

For all of 2025, employers added 584,000 jobs — compared to 2 million new jobs in 2024. That meant that last year was the worst for employment growth since 2020.

Health care and hospitality were among the few industries adding jobs in December. Health care employment is generally immune from ups and downs in the business cycle.

Manufacturing continues to lose workers, cutting 8,000 jobs in December. Factories have been in a slump for the last 10 months, according to an index of manufacturing activity compiled by the Institute for Supply Management. The sector has been hit hard by President Trump's tariffs, since many domestic manufacturers rely on some foreign components.

"Morale is very low across manufacturing in general," said an unnamed factory manager quoted in this week's ISM report. "The cost of living is very high, and component costs are increasing with folks citing tariffs and other price increases."

The federal government added 2,000 jobs in December, but is still down 277,000 jobs from the beginning of the year. The government recorded big job losses earlier in the fall, when workers who accepted buyouts officially dropped off the government's payroll.

While unemployment remains low by historical standards, workers are increasingly nervous about job security. A survey last month by the Federal Reserve Bank of New York found workers slightly more worried about losing their job in the coming year, and less confident about finding a new job if they are laid off.

The slowdown in hiring makes people who already have jobs reluctant to give them up. The resulting lack of turnover means fewer job openings for young people and others trying to get a foot in the door.

Concern about the weakening job market prompted the Federal Reserve to cut its benchmark interest rate in December for the third time since September.
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