The Brief

The federal government has drastically scaled back the number of recommended childhood immunizations, sidelining six routine vaccines that have safeguarded millions from serious diseases, long-term disability and death.

Just three of the six immunizations the Centers for Disease Control and Prevention says it will no longer routinely recommend — against hepatitis A, hepatitis B and rotavirus — have prevented nearly 2 million hospitalizations and more than 90,000 deaths in the past 30 years, according to the CDC's own publications.

Vaccines against the three diseases, as well as those against respiratory syncytial virus, meningococcal disease, flu, and COVID, are now recommended only for children at high risk of serious illness or after "shared clinical decision-making," or consultation between doctors and parents.

The CDC maintained its recommendations for 11 childhood vaccines: measles, mumps, and rubella; whooping cough, tetanus, and diphtheria; the bacterial disease known as Hib; pneumonia; polio; chickenpox; and human papillomavirus, or HPV.

Federal and private insurance will still cover vaccines for the diseases the CDC no longer recommends universally, according to a Department of Health and Human Services fact sheet; parents who want to vaccinate their children against those diseases will not have to pay out-of-pocket.

Experts on childhood disease were baffled by the change in guidance. HHS said the changes followed "a scientific review of the underlying science" and were in line with vaccination programs in other developed nations.

HHS Secretary Robert F. Kennedy Jr., an anti-vaccine activist, pointed to Denmark as a model. But the schedules of most European countries are closer to the U.S. standard upended by the new guidance.

For example, Denmark, which does not vaccinate against rotavirus, registers around 1,200 infant and toddler rotavirus hospitalizations a year. That rate, in a country of 6 million, is about the same as it was in the United States before vaccination.

"They're OK with having 1,200 or 1,300 hospitalized kids, which is the tip of the iceberg in terms of childhood suffering," said Paul Offit, the director of the Vaccine Education Center at the Children's Hospital of Philadelphia and a co-inventor of a licensed rotavirus vaccine. "We weren't. They should be trying to emulate us, not the other way around."

Public health officials say the new guidance puts the onus on parents to research and understand each childhood vaccine and why it is important.

Here's a rundown of the diseases the sidelined vaccines prevent:

RSV. Respiratory syncytial virus is the most common cause of hospitalization for infants in the U.S.

The respiratory virus usually spreads in fall and winter and produces cold-like symptoms, though it can be deadly for young children, causing tens of thousands of hospitalizations and hundreds of deaths a year. According to the National Foundation for Infectious Diseases, roughly 80% of children younger than 2 who are hospitalized with RSV have no identifiable risk factors. Long-awaited vaccines against the disease were introduced in 2023.

Hepatitis A. Hepatitis A vaccination, which was phased in beginning in the late 1990s and recommended for all toddlers starting in 2006, has led to a more than 90% drop in the disease since 1996. The foodborne virus, which causes a wretched illness, continues to plague adults, particularly people who are homeless or who abuse drugs or alcohol, with a total of 1,648 cases and 85 deaths reported in 2023.

Hepatitis B. The disease causes liver cancer, cirrhosis, and other serious illnesses and is particularly dangerous when contracted by babies and young children. The hepatitis B virus is transmitted through blood and other bodily fluids, even in microscopic amounts, and can survive on surfaces for a week. From 1990 to 2019, vaccination resulted in a 99% decline in reported cases of acute hepatitis B among children and teens. Liver cancer among American children has also plummeted as a result of universal childhood vaccination. But the hepatitis B virus is still around, with 2,000-3,000 acute cases reported annually among unvaccinated adults. More than 17,000 chronic hepatitis B diagnoses were reported in 2023. The CDC estimates about half of people infected don't know they have it.

Rotavirus. Before routine administration of the current rotavirus vaccines began in 2006, about 70,000 young children were hospitalized and 50 died every year from the virus. It was known as "winter vomiting syndrome," said Sean O'Leary, a pediatrician at the University of Colorado. "It was a miserable disease that we hardly see anymore."

The virus is still common on surfaces that babies touch, however, and "if you lower immunization rates it will once again hospitalize children," Offit said.

Meningococcal vaccines. These have been required mainly for teenagers and college students, who are notably vulnerable to critical illness caused by the bacteria. About 600 to 1,000 cases of meningococcal disease are reported in the U.S. each year, but it kills more than 10% of those it sickens, and 1 in 5 survivors have permanent disabilities.

Flu and covid. The two respiratory viruses have each killed hundreds of children in recent years — though both tend to be much more severe in older adults. Flu is currently on the upswing in the United States, and last flu season the virus killed 289 children.

What is shared clinical decision-making?

Under the changes, decisions about vaccinating children against influenza, covid, rotavirus, meningococcal disease, and hepatitis A and B will now rely on what officials call "shared clinical decision-making," meaning families will have to consult with a health care provider to determine whether a vaccine is appropriate.

"It means a provider should have a conversation with the patient to lay out the risks and the benefits and make a decision for that individual person," said Lori Handy, a pediatric infectious disease specialist at the Children's Hospital of Philadelphia.

In the past, the CDC used that term only in reference to narrow circumstances, like whether a person in a monogamous relationship needed the HPV vaccine, which prevents a sexually transmitted infection and certain cancers.

The CDC's new approach doesn't line up with the science because of the proven protective benefit the vaccines have for the vast majority of the population, Handy said.

In their report justifying the changes, HHS officials Tracy Beth Høeg and Martin Kulldorff said the U.S. vaccination system requires more safety research and more parental choice. Eroding trust in public health caused in part by an overly large vaccine schedule had led more parents to shun vaccination against major threats like measles, they said.

The vaccines on the schedule that the CDC has altered were backed up by extensive safety research when they were evaluated and approved by the FDA.

"They're held to a safety standard higher than any other medical intervention that we have," Handy said. "The value of routine recommendations is that it really helps the public understand that this has been vetted upside down and backwards in every which way."

Eric Ball, a pediatrician in Orange County, Calif., said the change in guidance will cause more confusion among parents who think it means a vaccine's safety is in question.

"It is critical for public health that recommendations for vaccines are very clear and concise," Ball said. "Anything to muddy the water is just going to lead to more children getting sick."

Ball said that instead of focusing on a child's individual health needs, he often has to spend limited clinic time reassuring parents that vaccines are safe. A "shared clinical decision-making" status for a vaccine has no relationship to safety concerns, but parents may think it does.

HHS' changes do not affect state vaccination laws and therefore should allow prudent medical practitioners to carry on as before, said Richard Hughes IV, an attorney and a George Washington University lecturer who is leading litigation against Kennedy over vaccine changes.

"You could expect that any pediatrician is going to follow sound evidence and recommend that their patients be vaccinated," he said. The law protects providers who follow professional care guidelines, he said, and "RSV, meningococcal, and hepatitis remain serious health threats for children in this country."

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

The National Park Service has updated its policy to discourage visitors from defacing a picture of President Donald Trump on this year's pass.

The use of an image of Trump on the 2026 pass — rather than the usual picture of nature — has sparked a backlash, sticker protests, and a lawsuit from a conservation group.

The $80 annual America the Beautiful pass gives visitors access to more than 2,000 federal recreation sites. Since 2004, the pass has typically showcased sweeping landscapes or iconic wildlife, selected through a public photo contest. Past winners have featured places like Arches National Park in Utah and images of bison roaming the plains.

Instead, of a picture of nature, this year's design shows side-by-side portraits of Presidents George Washington and Trump. The new design has drawn criticism from parkgoers and ignited a wave of "do-it-yourself" resistance.

Photos circulating online show that many national park cardholders have covered the image of Trump's face with stickers of wildlife, landscapes, and yellow smiley faces, while some have completely blocked out the whole card. The backlash has also inspired a growing sticker campaign.

Jenny McCarty, a longtime park volunteer and graphic designer, began selling custom stickers meant to fit directly over Trump's face — with 100% of proceeds going to conservation nonprofits.

"We made our first donation of $16,000 in December," McCarty said. "The power of community is incredible."

McCarty says the sticker movement is less about politics and more about preserving the neutrality of public lands. "The Interior's new guidance only shows they continue to disregard how strongly people feel about keeping politics out of national parks," she said.

The National Park Service card policy was updated this week to say that passes may no longer be valid if they've been "defaced or altered." The change, which was revealed in an internal email to National Park Service staff obtained by SFGATE, comes just as the sticker movement has gained traction across social media.

In a statement to NPR, the Interior Department said there was no new policy. Interagency passes have always been void if altered, as stated on the card itself. The agency said the recent update was meant to clarify that rule and help staff deal with confusion from visitors.

The Park Service has long said passes can be voided if the signature strip is altered, but the updated guidance now explicitly includes stickers or markings on the front of the card.

It will be left to the discretion of park service officials to determine whether a pass has been "defaced" or not. The update means park officials now have the leeway to reject a pass if a sticker leaves behind residue, even if the image underneath is intact.

In December, conservation group the Center for Biological Diversity filed a lawsuit in Washington, D.C., opposing the new pass design.

The group argues that the image violates a federal requirement that the annual America the Beautiful pass display a winning photograph from a national parks photo contest. The 2026 winning image was a picture of Glacier National Park.

"This is part of a larger pattern of Trump branding government materials with his name and image," Kierán Suckling, the executive director of the Center for Biological Diversity, told NPR. "But this kind of cartoonish authoritarianism won't fly in the United States."

The lawsuit asks a federal court to pull the current pass design and replace it with the original contest winner — the Glacier National Park image. It also seeks to block the government from featuring a president's face on future passes.

Not everyone sees a problem with the new design. Vince Vanata, the GOP chairman of Park County, Wyoming, told the Cowboy State Daily that Trump detractors should "suck it up" and accept the park passes, saying they are a fitting tribute to America's 250th birthday this July 4.

"The 250th anniversary of our country only comes once. This pass is showing the first president of the United States and the current president of the United States," Vanata said.

But for many longtime visitors, the backlash goes beyond design.

Erin Quinn Gery, who buys an annual pass each year, compared the image to "a mug shot slapped onto natural beauty."

She also likened the decision to self-glorification.

"It's akin to throwing yourself a parade or putting yourself on currency," she said. "Let someone else tell you you're great — or worth celebrating and commemorating."

When asked if she plans to remove her protest sticker, Gery replied: "I'll take the sticker off my pass after Trump takes his name off the Kennedy Center."

The 83rd annual Golden Globe Awards take place Sunday evening beginning at 5 p.m. at the Beverly Hilton Hotel, and that means parking restrictions and street closures in the city.

Here are places to avoid, as well as some alternative routes:

North Santa Monica Boulevard:

• Westbound lane closures: Complete lane closures, from Wilshire Boulevard to Century Park East through 6 a.m. Monday.
  
• Eastbound lane closures: Complete lane closures, from Century Park East to Wilshire Boulevard from 2 p.m. Saturday through 6 a.m. Monday. 

The city suggests using South Santa Monica Boulevard, which will remain open in both directions. There also are alternative east-west routes such as Olympic, Sunset and Pico boulevards.

Wilshire Boulevard:

• Eastbound/Westbound lane reduction: Lane reductions are in effect and will last through 9 p.m. Wednesday.
  
• Eastbound/Westbound full closure: All of Wilshire Boulevard between Comstock Avenue and North Santa Monica Boulevard will be closed from 10 p.m. Saturday through 6 a.m. Monday.
  
• Eastbound lanes of Wilshire Boulevard: An eastbound closure from Comstock to North Santa Monica Boulevard will occur between 10 p.m. Monday through 6 a.m. Tuesday.

Other streets:

Several other streets like Whittier Drive, Carmelita Avenue, Elevado Avenue and Lomitas Avenue, as well as Trenton Drive and adjacent alleys will have limited closures with local access available only to residents. Closures begin at 10 p.m. Saturday and last through 6 a.m. Monday.

Parking notices:

Residential streets surrounding the venue will be completely restricted, no exceptions made, from 6 a.m. Sunday until 6 a.m. Monday on the following streets:

• Whittier Drive — from Wilshire Boulevard to Elevado Avenue
• Carmelita Avenue — from Wilshire Boulevard to Walden Drive
• Elevado Avenue — from Wilshire Boulevard to Walden Drive
• Trenton Drive — from Whittier Drive to Wilshire Boulevard
• Walden Drive — from Santa Monica Boulevard to Elevado Avenue
• Lomitas Avenue — from Wilshire Boulevard to Walden Drive

Residents without permit parking can obtain parking exemptions by contacting the city of Beverly Hills’ parking exemption line at (310) 285-2548 or online at beverlyhills.org/parkingexemptions.

Demonstrations against this week’s deadly ICE shooting in Minneapolis are planned this weekend across Los Angeles. The protests are being organized by the “ICE Out For Good Coalition” — a network of several groups including the ACLU and 50501.

Here are a some of the planned actions across the city:

Saturday

• Pasadena: Noon to 2 p.m. at Garfield and Colorado Boulevard, across from the Paseo Mall
• Eagle Rock: 1 to 2 p.m. at Colorado and Eagle Rock boulevards
• City of Los Angeles: 2 to 4:30 p.m. in Pershing Square

Sunday

• West Hollywood: 11 a.m. to 1 p.m. at 647 N. San Vicente Blvd., across from the Pacific Design Center.
• City of Los Angeles: Noon to 2 p.m. at The Home Depot on 2055 N. Figueroa St.
• Beverly Hills: 2 and 4 p.m. at 9439 Santa Monica Blvd., between Beverly and Canon drives

Jennifer Cacicio didn’t set out to move across the country.

Like thousands of others who fled the L.A. fires a year ago this week, Cacicio and her family left their Altadena home thinking they would be gone a night, maybe two.

But in the year since the Eaton Fire erased their house and neighborhood overnight, home has become somewhere entirely new.

Cacicio, a television writer, and her husband and 8-year-old daughter now live nearly 3,000 miles from L.A. — in Cold Spring, a village in New York’s Hudson Valley they’d never visited until this year.

Starting over somewhere completely new, Cacicio said, felt easier than rebuilding their lives in high-cost L.A. with the foothills of Altadena casting a long shadow.

“What we had in Altadena was so wonderful that anywhere else but Altadena feels like you're settling for less,” Cacicio said.

Jennifer Cacicio poses for a photo with her husband Matt Shallenberger and their daughter, Bruna.

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Matt Shallenberger

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Cacicio is part of a growing fire diaspora — Altadenans scattered across the country and the world, searching for versions of the natural beauty and close-knit and artistic community they enjoyed in the San Gabriels.

Cacicio said she knows of three other Altadena families who’ve relocated to the Hudson Valley. Neighborhoods still edge up against the wilderness, but wooded slopes and river cliffs now define the landscape for them where canyons and ridgelines once did.

I also spoke with two other Altadena households who left post-fire, one for the Netherlands and the other for Asheville, North Carolina. Each family described decisions shaped by financial realities and the wrenching calculus of raising young children after a fire.

From Altadena to the Netherlands

The Sporcks left the Netherlands for L.A. over seven years ago, setting off on their American adventure.

Joep, a film composer, saw career opportunities in L.A, and his wife Sarah, was eager to try life in a new country.

Friends in Altadena introduced them to the San Gabriels, and eventually they found their own house in the west part of Altadena near the Jet Propulsion Laboratory.

Joep composed film scores and trailer music in a converted garage and Sarah commuted to her job as an education specialist at a school in Lincoln Heights. Three years ago, they welcomed their first child.

In the back yard, they planted fruit trees and raised chickens, and hiked along trails to favorite spots like Millard Falls.

“We loved it, and we never meant to leave,” Joep said.

This time last year, Sarah was pregnant with their second son and had just finished her first trimester when on Jan. 7 the couple saw flames shooting from the foothills.

The fire came within several blocks, but their house was ultimately spared.

In the month after the fire, Joep worked to remediate their home alongside professional crews, as Sarah looked after their toddler, whose daycare, Altadena Children’s Center, had burned down.

“With Sarah pregnant, it was really scary, even afterwards,” Joep said.

Added Sarah: “And with a toddler that wants to play outside.”

As they prepared for their second child, the fire forced questions: How long would it take for Altadena to recover and what would that look like?

“I'm sure there will be a new Altadena in a couple of years,” Joep said. “But it felt like it wasn't going to be the same ever again.”

Once-vague thoughts moved to the foreground. In the Netherlands, they would have more family support and a stronger social safety net, like lower-cost childcare.

And Joep had reached a point in his career that he could work remotely.

This past summer, after their baby was born, a listing landed in Joep’s inbox for a three-story brick villa in the southern part of the Netherlands where Joep is from — hilly just like Altadena. The couple made an offer for the house in Epen without seeing it in person.

The Sporcks have moved back to the Netherlands, to the village of Epen in the southern part of the country.

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Gerlach Delissen

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“We made some lists like pros and cons of staying or leaving, and it was just we couldn't deny it anymore,” Joep said.

They put their house on the market — and after some price cuts — sold it to another Altadena family that had lost their home in the fire.

In November, the Sporcks moved to their Epen home, where they are still unpacking — and grieving.

“I’m really sad to be leaving America and Los Angeles,” Joep said. “It feels a little bit like giving up this dream.”

But he said the ties to the area are strong. Their children are dual-citizens. Joep will return to L.A. regularly for work.

“Part of us is now like American, Altadenan forever, I guess,” Joep said.

It's something, he said, that will always set them apart from their friends and family in the Netherlands.

From Eaton Canyon to the Blue Ridge Mountains

Altadena wasn’t their first stop in Southern California. There was Sherman Oaks and Highland Park.

But for Carson Dougherty and Chris Gower, their Altadena cottage rental within walking distance of Eaton Canyon was the first place that felt like home in L.A.

Pushing their daughters in strollers to Altadena Beverage and Market and Prime Pizza, they would stop to speak with neighbors along the way.

“I would walk around and just be like, ‘Oh my God, I can’t believe we live here,'" Carson said. “I've just never loved a place more or felt more welcome.”

Carson, a spiritual coach, had moved from New York to L.A. about nine years ago when she was an actor, accompanied by Chris who works in tech sales.

Carson is originally from northern Virginia, while Chris grew up in Surrey, England. The call of family always beckoned, but the allure of life in Altadena kept it at bay.

Carson Dougherty and her family moved to Asheville, North Carolina.

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Courtesy Carson Dougherty

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They had months earlier re-upped their lease for another two years, when the Eaton Fire happened.

The next day, they returned to find their rental standing — but coated in soot.

With no clear remediation plan being offered by the landlord and worried about their children’s health, the couple broke their lease and forfeited their full deposit.

As they planned their next move, Carson and Chris began rethinking what it meant to raise a family in California — from pre-school to housing.

“Life here is very hard,” Carson said. “We're obsessed with it, but it's not easy.”

Carson flew with the girls out to Virginia, and stayed with her parents. When Chris rejoined them, they discussed where they could live.

Using A.I., they researched cities within 500 miles of Carson’s parents that met their criteria for schools and property taxes. Starting with more than 50 places, Carson winnowed down the list by watching online walking tours of cities and asking for advice on social media.

Asheville, North Carolina — where she had once attended a wedding — kept coming up.

“But we were like, ‘We're not going to move to a place that just had a hurricane,” Carson said, recalling the devastation of Hurricane Helene in 2024.

After taking road trips to Pennsylvania, New York and New Jersey and feeling nothing was clicking, the couple traveled to Asheville. They were drawn to the Blue Ridge Mountains that ring the city and the artistic community that reminded them of Altadena’s.

“I was like, ‘OK, this is it,’” Carson said. “I don't know. It was just a feeling.”

Two months into living in their current spot in Asheville, they’re still adjusting.

“I can see this was the right move for us,” Carson said. “But it doesn't feel like home yet.”

“It still feels like a consolation prize,” Chris said. “Whereas Altadena was the one that we were like ‘Holy crap, we found it.'"

Giving her daughter home

In Cold Spring, New York, Jennifer Cacicio is also going through a range of emotions.

“I love Altadena so much, and there's so much grief in letting go of it,” she said.

She mourns her street of identical mid-century homes designed by the architect Gregory Ain. When neighborhood kids visited each other, they knew the exact layout of each others’ homes.

Jennifer estimates of the 28 houses in the neighborhood, about three-quarters are gone.

After struggling with the cost of renting or buying in L.A., she and her husband — a landscape photographer — began thinking about moving East, where she’s from.

During their daughter’s spring break, the family flew out for an expedition.

“We tried to frame it with my daughter, like, ‘You know what this terrible thing happened, and we're going to try to turn it into a family adventure and live closer to cousins and explore a new part of the world,'" Jennifer said.

Jennifer Cacicio's 8-year-old daughter surveys her new environs in Cold Spring, N.Y.

They looked at towns within an hour or so of New York City, located in the suburbs of New York and Connecticut. In New York’s Hudson Valley, they visited an open house for a school that their daughter instantly took a shine to.

“We were like, ‘Great, let's just build it around that — like one thing felt right,’” Cacicio said.

Another sign came when Jennifer, who was the showrunner for this year’s Paramount+ drama Happy Face, got an offer to work on a show based in New York.

“It kind of felt like the universe confirming the decision in a way,” Jennifer said.

In September, they moved into their new home in Cold Spring. Cacicio puts aside her sadness when she thinks about her daughter.

After an event as traumatic as a fire, she wants her childhood to feel stable again. Altadena will recover over the next decade, Cacicio said, but later than she would hope for her daughter.

Being in a new place has brought unknowns, but also a sense of excitement.

"That was kind of what it came down to," Cacicio said. "It didn't feel like settling. It just felt different."