The Brief

U.S. Health Secretary Robert F. Kennedy Jr. is pursuing federal government access to most Americans’ medical records, in a quest to research a link between vaccines and autism — a connection the medical establishment studied for decades and flatly rejects.

The Department of Health and Human Services is seeking data from little-known state systems that allow hospitals and clinics to exchange detailed, identifiable patient information, KFF Health News has learned.

In private meetings, some public health leaders have objected to giving Kennedy’s team access to such data, raising doubts that it’s legal or that the information would even be useful.

They have also expressed concerns about allowing the federal government to peer into the minutiae of Americans’ medical records, which could mean viewing anything from doctors’ notes to prescription history. HHS has offered no insight into how it will protect or handle the personal health information it obtains.

But Kennedy told KFF Health News that medical records are key to investigating the cause of autism, vaccine safety, and chronic diseases. And millions of dollars in grant money has poured into a Nebraska nonprofit that has assisted Kennedy’s effort, according to state records.

He and his advisers have been frustrated that federal access to Americans’ medical records has been limited.

“We need a good health record system, and one of the things that really surprised me most when I came into office is that there is — that the systems are broken,” Kennedy said in a May interview. “We’ve had to go to the states and, luckily, we’ve got a lot of cooperation from the states, but we now have databases together that we can actually do the studies on. Those studies are in motion.”

HHS has not publicly announced any new projects involving medical records and autism or vaccine research. Kennedy faced blowback last year when he proposed compiling the medical records of people with autism to create a federal disease registry — which health department officials later disputed was underway.

But Kennedy said in May, “We have a whole pipeline of studies that will be done over the next year.”

Though the White House has steered Kennedy away from further changes to U.S. vaccine policy ahead of November’s crucial midterm elections, President Donald Trump has regularly echoed Kennedy’s doubts about vaccine safety and last week signed an executive order calling for the U.S. to reduce the number of vaccines recommended for children.

Kennedy’s political appointees and allies — including William “Reyn” Archer III, a former Texas health official and vaccine critic whom Kennedy hired as a senior adviser — have led the initiative for the health department to collect and examine medical records.

Federal officials met with leaders of the state-run health information exchange systems several times over the past year and asked how the personal medical records they maintain could be used for vaccine research, according to seven people who participated in the discussions or were familiar with them.

Craig Behm, who runs the Maryland health information exchange, said Kennedy’s team asked about how the vast trove of medical records they store from hospitals and health systems could be used to study vaccines.

“If this administration wants to conduct research on the effectiveness of vaccines, are you saying you all can help us conduct that research?” Behm recalled being asked by a top official at HHS’ health information technology office.

Last June, Behm and leaders of other state exchanges met with Kennedy’s top advisers to discuss sharing more medical data with federal agencies. The state organizations followed up with a pitch in October for a new surveillance system that would give the federal health department “real-time, 24-hour data feeds on opioid and chronic disease trends” within a year, according to a presentation reviewed by KFF Health News. Under the proposal, HHS would get data from 90% of the population’s medical records by 2028.

Administration officials regularly asked during the meetings how the records could be used to monitor vaccine safety. Kennedy has rejected the federal government’s current vaccine-monitoring systems; decades of research has shown immunizations are safe and effective for most people.

“Vaccine safety, or whatever words you want to use, has come up pretty consistently in those conversations,” said John Kansky, CEO of the Indiana Health Information Exchange.

Kansky sees the potential value of sharing information from the exchanges for public health but is worried about the focus on vaccines: “It’s like, oh man, I wish you would have picked something that pushed fewer buttons for people.”

A system to monitor chronic disease

Nearly every state has at least one health information exchange — often regulated by state laws and run by private companies or nonprofits — that enables hospitals and health systems to immediately share patients’ medical records with one another. The systems allow doctors and nurses to quickly pull up nearly anyone’s medical history and records at emergency rooms or share after-visit summaries and notes with patients’ primary care providers, for example.

In certain circumstances — most often dealing with cases of infectious diseases such as measles or flu — the exchanges notify public health authorities, like the state health department or the Centers for Disease Control and Prevention. Using the exchanges for broader public health purposes is not an unusual idea in itself. But it can present privacy, legal, and ethical complications, health officials say.

In the end, Behm said his organization in Maryland declined to share more data with the federal government for vaccine research, noting that sharing medical records for that purpose would require a rash of approvals from hospitals, state political leaders, and research boards. Any new data-sharing agreement should also have a clear, detailed framework outlining what would be shared and with whom, he added.

“A number of us said, ‘We can’t do anything our agreements don’t allow us to do, so no,’” Behm said. Indeed, most health information exchanges have contractual restrictions on who can access clinical data.

Kansky said Indiana is still weighing whether to provide additional data for Kennedy’s project, and that nothing has yet been shared.

HHS spokesperson Emily Hilliard did not answer questions about how many states are participating in Kennedy’s project, what new data the agency is collecting, how much the federal government is spending on the initiative, how it is protecting patient privacy, or who has access to the data.

“HHS is strengthening public health surveillance and modernizing data systems to better understand and combat the childhood chronic disease epidemic as part of Secretary Kennedy’s Make America Healthy Again agenda,” Hilliard said in an emailed statement. “Americans deserve robust systems to monitor the drivers of chronic illness.”

Kennedy has asserted, without evidence, that vaccines can cause chronic illness.

A Kennedy partner in Nebraska

At least one state has been cooperative.

The former leader of Nebraska’s state health information exchange has led the effort to share data from medical records with the federal government.

Jaime Bland, former CEO of CyncHealth — the Nebraska health information exchange used by most hospitals and health systems in the state — said several states are looking to “open up channels” to provide more analysis to Kennedy’s team.

“They’re looking at the data differently and providing some insights back to the CDC,” Bland told KFF Health News.

Bland was among a group who proposed that CyncHealth would help kick off the initiative, according to a 43-slide PowerPoint presented to federal officials during an October meeting.

CyncHealth and other state health information exchanges would “ingest data from hospitals, clinics, laboratories, pharmacies, payers, and social services agencies,” then “link claims and clinical records through a master patient index.”

Data from the exchanges “will be deidentified where appropriate,” according to one slide.

The federal government would pay the exchanges for furnishing the records, according to the proposal: $3 a person, annually.

Officials would “frame publicly that this is not a new database, but a federated trust model that delivers real-time data for all HHS missions,” the presentation reads.

After the meeting, Nebraska’s health department was awarded a large grant from the CDC, and CyncHealth in turn got millions of dollars from the state.

On Dec. 19, the CDC announced new funding under its Epidemiology and Laboratory Capacity program, which sends money to state and local health departments for lab work, health information enhancements, and solutions for outbreaks.

Nebraska’s state health department was awarded $18.7 million — the most of any state last year, though Nebraska is the 38th most populous state. By comparison, Texas received $9.2 million, and California got $10.8 million.

CyncHealth was then awarded three contracts totaling $13.6 million from the state health department just weeks later, on Jan. 9 and Jan. 16, according to a publicly accessible database of state contracts.

Grace McNamara, a spokesperson for CyncHealth, said it retained $2.4 million of the funding for Kennedy’s project; the remaining money was distributed to “other participating states and various vendor organizations for implementation support.”

A former CDC official who was aware of the transaction, but not authorized to speak publicly about it, confirmed the money was intended for CyncHealth to supply data for Kennedy’s initiative to look at vaccines and autism. McNamara said that the “work is focused on improving outcomes related to acute and chronic illnesses.”

“The referenced project is not research, but rather a proof-of-concept project on how health information exchange and public health can work together to improve health outcomes and is not specific to autism,” she said in an emailed statement.

McNamara did not answer questions about what type of medical data is being provided to the federal health department or whether patients’ identifying information is removed.

Bland left her post at CyncHealth — where she was paid nearly $420,000 a year — in December. She was named in April as the chief data strategist for the MAHA Institute — a think tank founded by allies of Kennedy and Trump to advance their Make America Healthy Again movement.

Bland agreed with Kennedy that data from state health information exchanges could provide more insight into autism’s causes or vaccine injuries.

"The data is so fragmented, so modeled when it comes to population health and public health, that we lose sight of the individual stories,” Bland said. She told a story she had heard about a woman who had a seizure after receiving the HPV vaccine.

“You know, the vaccine is safe — it absolutely is — but it wasn’t safe for her,” Bland said. “As public health officials, we say the vaccine is safe. But there are cases where it is not.”

Daniel Jernigan, a former top CDC official who left the agency last summer, said he tried to point Kennedy to data that would help the health secretary study vaccine safety and autism.

After 31 years at the CDC overseeing public health surveillance, emerging infectious diseases, and the influenza divisions, Jernigan thought the solution was simple. The secretary could work with researchers to obtain huge databases pulled from health systems nationwide and maintained by major electronic health records companies.

Those databases are deidentified, meaning they don’t include patient names or other information that can identify individuals. Jernigan said Kennedy didn’t seem interested.

Instead, as The New York Times first reported, the health secretary dispatched two top advisers — Archer and Hannah Anderson, his former deputy chief of staff — to the CDC’s headquarters in Atlanta last July to download millions of identifiable patient records directly from the Vaccine Safety Datalink, the system the health agency uses to investigate complications from vaccines. The records, though, were decades old.

Jernigan said the federal government has limited legal authority to access medical records from state health information exchanges. In any case, examining those records may provide a view of a person’s medical history that will not necessarily produce answers to Kennedy’s questions about vaccines and autism.

“If they’re just using the electronic health record data, there are limits to that,” Jernigan said. “If they’re only looking at electronic health record data, all you’re going to get is what was captured in the encounter. It’s not going to be very satisfying.”

KFF Health News data reporter Maia Rosenfeld contributed to this article.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

The Japanese American National Museum announced today it will reopen in January after a two-year, $25 million overhaul of the country’s largest museum dedicated to the Japanese American experience.

The museum in L.A.’s Little Tokyo is reshaping its galleries and expanding its signature exhibition to include more perspectives and connections between Japanese American history and current debates over race, immigration and democracy.

The new exhibition at JANM features A.I.-assisted avatars of Japanese American survivors of incarceration.

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Courtesy of Japanese American National Museum

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“We want to tell the story in a way that is more expansive and that other immigrants, communities can see their own story reflected,” said Ann Burroughs, the museum’s president and CEO.

That effort to tie history to the present comes as JANM itself has faced political pressure, with the museum losing federal funding amid Trump administration cuts.

From the outside, visitors returning to the museum, which has been closed since January 2024, will recognize its modern, minimalist exterior. Once they step through the doors, though, the experience will be vastly different.

The biggest change will be the installation of a 9,200-square-foot permanent exhibition occupying nearly all of the museum’s first floor — more than twice the space of the exhibition it replaces.

"Common Ground," which opened in 1999, covered Japanese American history from migration to the U.S. in the 1800s to the passage of a federal law — the Civil Liberties Act of 1988 — that formally apologized for the incarceration of Japanese Americans during World War II and provided $20,000 in reparations to surviving detainees.

The new exhibition, called "In the Future We Call Now: Realities of Racism, Forging Democracy," will include more recent history, such as Japanese American support for reparations for Black Americans and vocal opposition to the Islamophobia that swelled after 9/11. It will also cover the Japanese American response to ICE detention and incarceration of migrant children, drawing parallels to World War II camps.

Galleries have been reconfigured to include more recent history and more objects from the past, including kimonos owned by women from Japan, who immigrated to the U.S. in larger numbers starting in the turn of the 20th century.

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Courtesy of Japanese American National Museum

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It will also bring lesser-known perspectives to familiar history through telling the story of incarceration from “women and mothers” and those incarcerated at Tule Lake, the camp in Northern California where Japanese Americans labeled as disloyal by the U.S. government were isolated during World War II.

“JANM hadn’t told that story before,” Burroughs said. “You can’t draw those parallels of what’s happening now if you don’t talk about the camps and if you don’t talk about Tule Lake.”

The new exhibition will also lean more heavily into audiovisual storytelling, using technology and archival media to make the history feel more immediate.

The interactive “StoryFiles” incorporate AI so visitors can pose questions to digital avatars of incarceration survivors like the actor George Takei.

Burroughs stressed that the museum is not using generative AI, but drawing upon hours and hours of interviews in which subjects answered hundreds of questions.

The new exhibition will also draw deeply from JANM’s extensive collection of Japanese American home movies, including footage dating to the 1930s, and give visitors a window into everyday life before World War II.

Some of JANM’s best-known objects will be included in the new exhibition, like barracks from the Heart Mountain incarceration camp in Wyoming and a model of Manzanar in California’s remote Owens Valley, the first of the camps to be built.

The museum is also emphasizing everyday culture, with displays ranging from kimonos brought by Japanese immigrant women at the turn of the 20th century to rice cookers, and the worldwide reach of Hello Kitty.

The Hirasaki National Resource Center has been relocated to the second floor and will showcase work from artists like Ruth Asawa and Isamu Noguchi.

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Courtesy of Japanese American National Museum

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The larger new exhibition was created without growing the museum's footprint through reconfiguring the building. For example, the museum’s Aratani Central Hall will take on a new role as the museum’s main entrance, with visitors entering through its sweeping curved glass wall and moving directly into the exhibition galleries. But Burroughs said the redesign will not come at the expense of the hall’s longtime function as a community space available to local nonprofits.

Upstairs, visitors will find reconfigured spaces including a new reading room filled with works and furnishings by Ruth Asawa and Isamu Noguchi. Behind the scenes, JANM has upgraded decades-old building systems such as its HVAC and elevators.

The museum overhaul was funded as part of a much larger $135 million fundraising campaign, Burroughs said. The rest of the campaign supports JANM’s operations and long-term financial stability, including about $56 million in endowment and board-designated reserves.

"You know, life is never secure in the nonprofit world or in the museum world," Burroughs said. "We have to do a lot more to build up our endowments. We just will keep going."

Public health officials are urging people to be wary of flea-borne typhus after a recent outbreak of the illness.

The outbreak in late July was centered in the Pico-Union neighborhood of Los Angeles. The L.A. County Department of Public Health said five people were hospitalized; all recovered.

The outbreak comes as typhus cases continue to tick up in L.A. County.

Cases have been increasing fairly steadily for more than a decade, but they nearly doubled over the last three years. The Public Health Department logged a record 220 cases in 2025, and officials say this year is on track to exceed that.

Public health officials say the increase is likely because human-animal interactions are also increasing. That could be due to human population expansions into areas with more animals, available food sources for wildlife in populated areas or more people owning pets.

The bacteria that causes typhus is transmitted from animals to humans through fleas.

Typhus can’t be passed from one human to another, and public health experts say the illness is completely treatable, especially if it’s caught early.

Outbreaks and how to prevent them

Most of the time, typhus cases are spread out across L.A. County. But sometimes, there’s a localized spread over a short period of time that turns into an outbreak.

Public health officials respond to a few of them in L.A. County each year.

Generally, outbreaks are triggered by high concentrations of host animals.

“Wherever these animals may be present or wherever they may be congregating, in those areas we can see an increase in the number of human infections,” said Dr. Aiman Halai with the L.A. County Department of Public Health.

The most common hosts for typhus are rats, opossums and free-roaming cats. When people or pets come in contact with host animals, they can pick up the infected fleas and bring them into homes, spreading them to other people and animals in the process.

Halai says a variety of factors can attract animals and lead to an outbreak, including overflowing dumpsters, overgrown vegetation or a well-meaning neighbor feeding local critters.

You can help prevent outbreaks by securing trash in bins, making sure food isn’t left outside, and ensuring pets are on up-to-date flea control medication. Cutting back overgrown vegetation and blocking off crawl spaces can eliminate places where animals can shelter in and around homes.

Halai also says it’s important not to feed wildlife.

Should you be worried?

Although public health experts are wary of the typhus uptick in L.A. County, the 220 cases recorded in 2025 in L.A. County are not overly concerning.

"That’s a very  low rate at the population level,” said Dr. Jeffrey Klausner, a professor of infectious diseases at USC’s Keck School of Medicine.

Typhus is an acute infection caused by bacteria known as Rickettsia typhi. Variations of the bacteria also cause other illnesses transmitted by fleas, ticks, lice and mites, including tick-borne Rocky Mountain Spotted Fever.

Doctors can test for typhus fairly easily, and it is treatable with antibiotics. Symptoms are similar to the flu, and can include fever, headaches, muscle aches and nausea. It can also cause rashes in some cases.

Most infections are mild, but they can cause hospitalization and, in rare cases, can be fatal.

Klausner said the concern is that testing for typhus is not always routine.

“The most important thing is that when patients come in to their doctor — and they have fever, they may have a rash, they may have headache, may have muscle or joint aches — that the doctor's thinking about potentially flea-borne infectious diseases because the treatment can be different,” Klausner said.

The best treatment for typhus is the antibiotic doxycycline. If a patient with typhus gets another type of antibiotic like penicillin or amoxicillin, the treatment may not be as successful.

According to Klausner, when presented with flu-like symptoms, it’s also a good idea for patients to tell their doctors if they’ve been around animals, spent time in an encampment or even just gone on a hike.

Topline:

Why it matters: The small amphibian is found in the grasslands of Southern California and the Central Valley. But habitat loss, urban sprawl and longer droughts have been threatening the species’ population in recent decades.

What the protections do: Now that the Western spadefoot is a candidate for permanent protections, any development project planned for Western spadefoot habitats will have to take the amphibians into account.

Some exceptions may apply: The commission did carve out exceptions for solar projects in the Central Valley. To take advantage of federal tax credit deadlines, some projects can continue to be built, as long as they protect breeding pools and curtail construction during the season when spadefoots are most active.

What conservationists say: Brendan Cummings, conservation director with the Center for Biological Diversity, said in Southern California the biggest threat to the Western spadefoot is not solar development: “It’s warehouses or data centers and road widenings and all manner of construction activities.”

What happens next: The California Department of Fish and Wildlife will conduct a year-long review to determine if the Western spadefoot should be permanently protected.