Possible risk of autism in children. Dormant cancer cells awakening. Accelerating aging of the brain.

Federal officials in May 2023 declared an end to the national COVID pandemic. But more than two years later, a growing body of research continues to reveal information about the virus and its ability to cause harm long after initial infections resolve, even in some cases when symptoms were mild.

The discoveries raise fresh concerns about the Trump administration’s COVID policies, researchers say. While some studies show COVID vaccines offer protective benefits against longer-term health effects, the Department of Health and Human Services has drastically limited recommendations about who should get the shot. The administration also halted Biden-era contracts aimed at developing more protective COVID vaccines.

The federal government is curtailing such efforts just as researchers call for more funding and, in some cases, long-term monitoring of people previously infected.

“People forget, but the legacy of COVID is going to be long, and we are going to be learning about the chronic effects of the virus for some time to come,” said Michael Osterholm, an epidemiologist who directs the University of Minnesota’s Center for Infectious Disease Research and Policy.

The Trump administration said that the COVID vaccine remains available and that individuals are encouraged to talk with their health providers about what is best for them. The COVID vaccine and others on the schedule of the Centers for Disease Control and Prevention remain covered by insurance so that individuals don’t need to pay out-of-pocket, officials said.

“Updating CDC guidance and expanding shared clinical decision-making restores informed consent, centers parents and clinicians, and discourages ‘one size fits all’ policies,” said HHS spokesperson Emily Hilliard.

Although COVID has become less deadly, because of population immunization and mutations making the virus less severe, researchers say the politicization around the infection is obscuring what science is increasingly confirming: COVID’s potential to cause unexpected, possibly chronic health issues. That in turn, these scientists say, drives the need for more, rather than less, research, because over the long term, COVID could have significant economic and societal implications, such as higher health care costs and more demands on social programs and caregivers.

The annual average burden of the disease’s long-term health effects is estimated at $1 trillion globally and $9,000 per patient in the U.S., according to a report published in November in the journal NPJ Primary Care Respiratory Medicine. In this country, the annual lost earnings are estimated to be about $170 billion.

One study estimates that the flu resulted in $16 billion in direct health costs and $13 billion in productivity losses in the 2023-2024 season, according to a Dec. 30 report in medRxiv, an online platform that publishes work not yet certified by peer review.

COVID’s Growing Reach

Much has been learned about COVID since the virus emerged in 2019, unleashing a pandemic that the World Health Organization reports has killed more than 7 million people. By the spring of 2020, the term “long COVID” had been coined to describe chronic health problems that can persist post-infection.

More recent studies show that infection by the virus that causes COVID, SARS-CoV-2, can result in heightened health risks months to more than a year later.

For example, researchers following children born to mothers who contracted the virus while pregnant have discovered they may have an increased risk for autism, delayed speech and motor development, or other neurodevelopmental challenges.

Another study found babies exposed to COVID in utero experienced accelerated weight gain in their first year, a possible harbinger of metabolic issues that could later carry an increased risk for cardiovascular disease.

These studies suggest avoiding severe COVID in pregnancy may reduce risk not just during pregnancy but for future generations. That may be another good reason to get vaccinated when pregnant.

“There are other body symptoms apart from the developing fetal brain that also may be impacted,” said Andrea Edlow, an associate professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School who was involved in both studies. “We definitely need more research.”

Epidemiologists point to some specific, emerging challenges.

A U.K. study in the New England Journal of Medicine found people who fully recovered from mild COVID infections experienced a cognitive deficit equal to a three-point drop in IQ. Among the more than 100,000 participants, deficits were greater in people who had persistent symptoms and reached the equivalent of a nine-point IQ drop for individuals admitted to intensive care.

Ziyad Al-Aly, a clinical epidemiologist who has studied longer-term health effects from COVID, did the math. He estimated COVID may have increased the number of adults in the U.S. with an IQ of less than 70 from 4.7 million to 7.5 million — a jump of 2.8 million adults dealing with “a level of cognitive impairment that requires significant societal support,” he wrote.

“People get COVID-19, some people do fine and bounce back, but there are people who start experiencing problems with memory, cognition, and fuzzy brain,” he said. “Even people with mild symptoms. They might not even be aware.”

Diane Yormark, 67, of Boca Raton, Florida, can relate. She got COVID in 2022 and 2023. The second infection left her with brain fog and fatigue.

“I felt like if you had a little bit too much wine the night before and you’re out of it,” said Yormark, a retired copywriter, who said the worst of her symptoms lasted for about three months after the infection. “Some of the fog has lifted. But do I feel like myself? Not like I was.”

Data from more than a dozen studies suggests COVID vaccines can help reduce risk of severe infection as well as longer-lasting health effects, although researchers say more study is needed.

But vaccination rates remain low in the U.S., with only about 17% of the adult population reporting that they got the updated 2025-2026 shot as of Jan. 16, based on CDC data.

Trump administration officials led by Health and Human Services Secretary Robert F. Kennedy Jr. have reduced access to COVID vaccines despite the lack of any new, substantiated evidence of harm. Though the shots were a hallmark achievement of the first Trump administration, which led the effort for their development, Kennedy has said without evidence that they are “the deadliest vaccine ever made.”

In May he said on X that the CDC would stop recommending COVID shots for healthy children and pregnant women, citing a lack of clinical data. The Food and Drug Administration has since issued new guidelines limiting the vaccine to people 65 or older and individuals 6 months or older with at least one risk factor, though many states continue to make them more widely available.

The Trump administration also halted almost $500 million in funding for mRNA-based vaccines. Administration officials and a number of Republicans question the safety of the Nobel Prize-winning technology — heralded for the potential to treat many diseases beyond COVID — even though clinical trials with tens of thousands of volunteers were performed before the COVID mRNA vaccines were made available to the public.

And numerous studies, including new research in 2025, show COVID vaccine benefits include a reduction in the severity of disease, although the protective effects wane over time.

Following the Findings

Researchers say more and broader support is important because much remains unknown about COVID and its impact on the body.

The growing awareness that, even in mild COVID cases, the possibility exists for longer-term, often undetected organ damage also warrants more examination, researchers say. A study published this month in eBioMedicine found people with neurocognitive issues such as changes in smell or headaches after infection had significant levels of a protein linked to Alzheimer’s in their blood plasma. EBioMedicine is a peer-reviewed, open-access journal published by The Lancet.

In the brain, the virus leads to an immune response that triggers inflammation, can damage brain cells, and can even shrink brain volume, according to research on imaging studies that was published in March 2022 in the journal Nature.

An Australian study of advanced brain images found significant alterations even among people who had already recovered from mild infections — a possible explanation for cognitive deficits that may persist for years. Lead study author Kiran Thapaliya said the research suggests the virus “may leave a silent, lasting effect on brain health.”

Al-Alay agreed.

“We don’t know what will happen to people 10 years down the road,” he said. “Inflammation of the brain is not a good thing. It’s absolutely not a good thing.”

That inflammatory response has also been linked to blood clots, arrhythmias, and higher risk of cardiovascular issues, even following a mild infection.

A University of Southern California study published in October 2024 in the journal Arteriosclerosis, Thrombosis, and Vascular Biology found the risk for a major cardiac event remains elevated nearly three years after COVID infection. The findings held even for people who were not hospitalized.

“We were surprised to see the effects that far out” regardless of individual heart disease history, said James R. Hilser, the study’s lead author and a postdoctoral fellow at the UCLA David Geffen School of Medicine.

COVID can also reactivate cancer cells and trigger a relapse, according to research published in July in the journal Nature. Researchers found that the chance of dying from cancer among cancer survivors was higher among people who’d had COVID, especially in the year after being infected. There was nearly a twofold increase in cancer mortality in those who tested positive compared with those who tested negative.

The potential of the COVID virus to affect future generations is yielding new findings as well. Australian researchers looked at male mice and found that those who had been infected with and then recovered from COVID experienced changes to their sperm that altered their offspring’s behavior, causing them to exhibit more anxiety.

Meanwhile, many people are now living — and struggling — with the virus’ after-effects.

Dee Farrand, 57, of Marana, Arizona, could once run five miles and was excelling at her job in sales. She recovered from a COVID infection in May 2021.

Two months later, her heart began to beat irregularly. Farrand underwent a battery of tests at a hospital. Ultimately, the condition became so severe she had to go on supplemental oxygen for two years.

Her cognitive abilities declined so severely she couldn’t read, because she’d forget the first sentence after reading the second. She also had to leave herself reminders that she is allergic to shrimp or that she likes avocados. She said she lost her job and returned to her previous occupation as a social worker.

“I was the person who is like the Energizer bunny and all of a sudden I’d get so tired getting dressed that I had to go back to bed,” Farrand said.

While she is better, COVID has left a mark. She said she’s not yet able to run the five miles she used to do without any problems.

©2026 KFF Health News. Distributed by Tribune Content Agency, LLC.

More than three-quarters of American adults didn’t get a COVID shot last season, a figure that health care experts warn could rise this year amid new U.S. government recommendations.

The COVID vaccine was initially popular. About 75% of Americans had received at least one dose of the first versions of the vaccine by early 2022, Centers for Disease Control and Prevention data shows. But only about 23% of American adults got a COVID shot during the 2024-25 virus season, well below the 47% of American adults who got a flu shot. The vaccination rates for flu, measles and tetanus are also going down.

Yet COVID remains a serious, potentially deadly health risk, listed as the primary cause of death on roughly 31,400 death certificates last year. By comparison, flu killed about 6,500 people and pneumonia, a common complication of the flu, killed an additional 41,600, CDC data shows.

As millions of Americans decide whether to get a COVID shot this season, public health researchers worry vaccination rates will slide further, especially because Hispanic and Black Americans and those under 30 have lower rates, exposing them to serious complications such as long COVID. Under the Trump administration and Health and Human Services Secretary Robert F. Kennedy Jr., the federal government has narrowed its recommendations on the COVID vaccine, leading to a hodgepodge of rules on pharmacy access, with Americans living in Republican states often facing more barriers to getting a shot.

“A lot of misinformation is going around regarding COVID,” said Alein Haro-Ramos, an assistant professor of health, society, and behavior at the University of California-Irvine. “Vaccine hesitancy is going to increase.”

In August, the FDA narrowed approval for COVID vaccines to those 65 or older and to adults and children with at least one underlying condition that puts them at high risk for serious complications from COVID.

A month later, the CDC’s Advisory Committee on Immunization Practices voted to recommend “shared clinical decision-making” on the vaccine, pulling back from advising all adults to get vaccinated. The committee advised doctors to emphasize to adults under 65 and children that the benefits of the vaccine are greatest for those with underlying health conditions.

The guidance is rebutted by infectious disease experts who say most adults and children should get both the flu and COVID vaccines, which are safe, effective, and prevent serious illness. Several independent medical organizations like the American Academy of Family Physicians and the American Academy of Pediatrics have reiterated their support for broad adoption of COVID vaccines.

More than two dozen states have taken steps to ensure most people can get a COVID shot at the pharmacy without a prescription, with many states tying their policies to the advice given by medical organizations. And many of those states require insurers to cover vaccines at no cost, according to a KFF analysis. In several other states, predominantly Republican-led, pharmacy access to vaccines may require a prescription.

Among the most commonly cited reasons for COVID vaccine hesitation are fears about side effects, long-term health consequences, and the effectiveness of the vaccine, and mistrust of pharmaceutical corporations and government officials, according to a 2024 review of multiple studies, published in the journal Vaccines.

COVID vaccine hesitancy in the 2024-25 virus season was higher among Latinos, African Americans, men, uninsured people, and people living in Republican-leaning states, CDC data shows.

Latino adults were significantly less likely than adults from most other racial and ethnic groups to get a COVID shot last season, with a vaccination rate around 15%.

Some of that may be due to age: A disproportionate share of Latinos are young. But public policy actions may also be a factor. The first Trump administration, for example, tied Medicaid to “public charge,” a rule allowing the federal government to deny an immigrant a green card or visa based on their dependence on taxpayer-funded programs. Some Latinos may be afraid to sign up for social services even after the Biden administration reversed those first-term Trump actions.

Haro-Ramos co-authored a study published in 2024 that found many Latinos were hesitant to get vaccinated because of fears about their immigration status, and that experiencing health discrimination, like care denials or delays, increased their vaccine hesitancy.

“Do you trust the health care system, broadly speaking? Do you want to provide your information — your name, your address?” Haro-Ramos said. “Trust is critical.”

Haro-Ramos said the problem has likely worsened since her study was published. The Trump administration revealed this summer that it would give the personal information of Medicaid enrollees to Immigration and Customs Enforcement. Many Latinos are canceling doctor appointments to head off possible confrontation with immigration enforcement officials.

“People are avoiding leaving their homes at all costs,” Haro-Ramos said.

Janani Rajbhandari-Thapa, an associate professor at the University of Georgia College of Public Health, recently co-authored a study of COVID vaccination among nearly 1,500 African Americans living in south Georgia. The study found that participants were more likely to listen to their health care providers than faith leaders or co-workers when seeking advice on getting vaccinated.

More than 90% of those studied had received at least one dose of the vaccine, but those who were unvaccinated were more likely to agree with false statements that tied vaccines to miscarriages, to components’ remaining in the body for a long time, or even to the conspiracy that they implant a computer chip in the body.

“It’s the clinicians who can take the messages about vaccination — that these are myths,” Rajbhandari-Thapa said.

Even though COVID hospitalization and death rates have fallen dramatically since the worst days of the pandemic, fatal complications related to COVID remain most common among older people. Around 89% of U.S. COVID deaths last year were among people 65 and older, compared with about 81% of flu and pneumonia deaths.

As the pandemic falls into the rearview, young people have developed a sense of invincibility. Only 11% of Americans ages 18 to 29 received a vaccine during the 2024-25 virus season, the lowest vaccination rate among adult age groups. That’s far below the 70% of young adults who got at least one dose of the initial COVID vaccines by November 2023.

While many people get COVID after receiving a COVID shot, because the vaccine’s ability to prevent infection wears off pretty fast, some misunderstand the purpose of the shot, said Otto Yang, an infectious disease specialist at UCLA Health.

“They think, ‘Well, the vaccine didn’t prevent me from getting COVID, so the vaccine didn’t work,’” Yang said. “And what they’re not seeing is that the vaccine prevented them from getting severely ill, which is ultimately the most important thing.”

And the vaccine can help prevent long COVID, which is a problem for all ages, Yang said. A recent Northwestern University study found that younger adults suffer worse symptoms of long COVID than older adults.

Ultimately, Yang said, it is not a consistent choice to get a flu vaccine but forgo a COVID vaccine, since both are safe, effective, and prevent serious illness. It is clear, he added, that people with compromised immune systems and those at higher risk should get a COVID shot. The decision is “a little bit less clear” for others, but “probably most adults should be getting vaccinated, just like it’s recommended for the flu vaccine, as well as most children.”

Phillip Reese is a data reporting specialist and an associate professor of journalism at California State University-Sacramento.

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

A large study from Massachusetts has found that babies whose mothers had COVID-19 while pregnant were slightly more likely to have a range of neurodevelopmental diagnoses by age 3. Most of these children had speech or motor delays, and the link was strongest in boys and when the mother was infected late in pregnancy.

The increase in risk was small for any one child, but because millions of women were pregnant during the pandemic, even a small increase matters. The study doesn’t prove that COVID infection during pregnancy causes autism or other brain conditions in the fetus, but it suggests that infections and inflammation during pregnancy can affect how a baby’s brain grows, something scientists have seen before with other illnesses. It’s a reason to help pregnant women avoid COVID and to keep a close eye on children who were exposed in the womb.

What the study found

Researchers at Massachusetts General Hospital examined medical records from more than 18,000 mothers and their children born from March 2020 through May 2021, before vaccines were widely available to pregnant women. Because everyone giving birth during that period was tested for COVID, the team could clearly see which pregnancies were exposed to the virus causing it.

About 5% of those mothers had COVID while pregnant. Their children were modestly more likely to be diagnosed with a neurodevelopmental condition by age 3 than those whose mothers weren’t infected, even after accounting for differences in maternal age, race, insurance status, and preterm birth.

The link appeared strongest among boys and when infection occurred in their mother’s third trimester. Still, most children in both groups showed typical development.

“This was a very clean group to follow,” said Andrea Edlow, a maternal-fetal medicine specialist at Mass General and one of the study’s authors. “Because of universal testing early in the pandemic, we knew who had COVID and who didn’t.”

Independent authorities say COVID, which causes a powerful immune response in some people, fits the biological pattern seen with other infections in pregnancy. Alan Brown, a professor of psychiatry and epidemiology at Columbia University who studies maternal infection and brain development and was not involved in this research, explained, “COVID would be a very strong candidate for it to happen because the amount of inflammation is very extreme.”

How might infection affect brain development?

Scientists are still piecing together how various infections during pregnancy can affect fetal development. Severe illness can cause inflammation that disrupts brain growth or can trigger preterm birth, which carries its own risks.

“There’s a long history of evidence showing that maternal infection can slightly raise the risk for many neurodevelopmental disorders,” said Roy Perlis, the vice chair for research in psychiatry at Massachusetts General Hospital and co-author of the new study.

Edlow’s lab is investigating how infection and inflammation may interfere with brain development. In a healthy brain, immune cells help shape developing neural circuits by trimming away extra or unnecessary connections, a process known as “synaptic pruning,” which sculpts the brain’s wiring. When a mother’s immune system is activated by infection, inflammatory molecules can reach the fetal brain and alter the pruning process.

Animal studies support Edlow’s hypothesis. When scientists trigger inflammation in pregnant mice, their offspring often show changes in how brain cells grow and connect, changes that can alter learning and behavior.

Why late pregnancy and why boys?

In Edlow and Perlis’ study, the link between COVID and developmental delays was strongest when infection occurred late in pregnancy, during the third trimester. That’s also when the fetal brain is growing most rapidly, forming and refining millions of neural connections.

“When we think of organ development, we think earlier in pregnancy, but the brain is an exception in this regard, where there’s a massive amount of brain development in the third trimester. And that continues after birth,” Perlis said. “It is entirely plausible that the third trimester is a period of vulnerability specifically for brain development.”

But not all researchers agree that the third trimester is uniquely vulnerable. Brian Lee, a professor of epidemiology at Drexel University, cautioned that because most mothers in the study were tested at delivery, there were simply more late-pregnancy infections to analyze. “That gives the study more power to find a difference in the third trimester,” he said. “It doesn’t prove earlier infections aren’t important.”

The study also found stronger effects in boys. That pattern is familiar: Boys are generally more likely than girls to have speech or motor delays and to be diagnosed with autism. Researchers suspect that male fetuses may be more susceptible to stress and inflammation, though the biology isn’t fully understood.

What the study can and can’t show

Edlow and Perlis are careful to say the study shows an association, not proof that COVID infection in pregnancy causes developmental problems. Many other factors could explain the correlation.

Mothers who get sick with COVID may have other health issues, such as obesity, diabetes, or mental health conditions, that increase the risk of developmental delays in children. “Persons with mental disorders are much more likely to get COVID. Women with mental disorders are much more likely to have kids with neurodevelopmental problems,” Lee said. “Mothers with worse physical health are also at higher risk of having children with neurodevelopmental problems.”

Lee’s research has shown that even infections before or after pregnancy can be linked to autism, suggesting that shared genetics or environment, rather than the infection itself, could be at play. That’s why experts say much larger, longer studies are needed to understand the extent of any risk from the infection.

Edlow, Perlis, and their team plan to follow the children in their study as they grow older to see whether early differences persist or fade. They’re also studying how inflammation during pregnancy affects the placenta and fetal brain, and how to counteract these effects.

What about vaccination?

Because this study followed pregnancies from early in the pandemic, it doesn’t answer whether vaccination changes the risk. But other research offers reassurance.

A large national study in Scotland found no difference in early developmental outcomes between children whose mothers were vaccinated and those who weren’t. Another study in the U.S. found the same: no link between prenatal COVID vaccination and developmental delays through 18 months. Both align with decades of data showing that vaccination during pregnancy is safe for both the mother and the baby.

“Vaccination is a short spike … your immune system revs up, then it goes back to normal,” Edlow said. “COVID [infection] is much more prolonged, unpredictable, and people can get … a dysregulated immune phenomenon that really doesn’t exist in vaccine responses.”

What this means for parents and clinicians

Since late 2020, there’s been widespread confusion and misinformation about the safety of COVID vaccination during pregnancy. Some women have hesitated to get vaccinated out of fear it might harm their baby. But the evidence since then has been clear: COVID vaccines are safe in pregnancy. The American College of Obstetricians and Gynecologists strongly recommends COVID vaccination to protect both mother and child.

Experts say the broader lesson is that pregnancy is a period of vulnerability, and prevention matters, not only for COVID, but other infections as well.

Janet Currie, a professor of economics at Yale University, said these risks remain “underappreciated,” despite decades of evidence. “Even though the flu vaccine is recommended for pregnant women, very few pregnant women get it,” she said. “Physicians seem to be reluctant to vaccinate pregnant women.”

As Gil Mor, scientific director of the C.S. Mott Center for Human Growth and Development at Wayne State University in Detroit, put it, “Protecting the mother is protecting the long-term health of the offspring. … The best intervention is vaccination.”

A century-old echo

The idea that what happens in the womb can shape life after birth took root with studies of famine, like the Dutch “Hunger Winter” in the final months of World War II. In 1944 and 1945, as German forces blockaded the western Netherlands, rations fell to just a few hundred calories a day. Thousands died of starvation, and women pregnant during that period gave birth to babies who later faced higher risks of heart disease, diabetes, and schizophrenia. The episode became a cornerstone of the “fetal origins” idea, that deprivation or stress in pregnancy can have lifelong effects.

The 1918 flu pandemic broadened that idea to infection. Babies exposed to influenza in utero later showed small but lasting differences in education and earnings, a sign that illness during pregnancy could affect brain development. Researchers in Taiwan, Sweden, Switzerland, Brazil, and Japan found similar consequences. Some argued that those findings reflected the disruptions of World War I, not the flu itself. But later studies, including those from the United Kingdom and Finland, have strengthened the case for a biological effect, reinforcing that the infection itself, not wartime upheaval, was the key driver.

“It isn’t simply influenza that can alter fetal neurodevelopment,” Kristina Adams Waldorf, a professor of obstetrics and gynecology at the University of Washington, explained. “Many types of infections … in the mother can be transmitted as a signal to the fetus, which can alter its brain development.”

A century later, the same question has returned with COVID: Could infection during pregnancy subtly shape how children grow and learn? The new Massachusetts General Hospital study offers an early look at an answer.

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

NEW YORK (AP) — Health Secretary Robert F. Kennedy Jr.’s new vaccine advisory committee meets this week, with votes expected on whether to change recommendations on shots against COVID-19, hepatitis B and chickenpox.

The exact questions to be voted on Thursday and Friday in Atlanta are unclear. Officials at the Department of Health and Human Services did not immediately respond to questions seeking details to a newly posted agenda.

But some public health experts are worried that the votes will — at a minimum — raise unwarranted new questions about vaccines in the minds of parents.

Perhaps even more consequential would be a vote that restricts a government program from paying for vaccines for low-income families.

“I’m tightening my seat belt,” said Dr. William Schaffner, a Vanderbilt University vaccines expert.

The panel, the Advisory Committee on Immunization Practices, makes recommendations to the director of the Centers for Disease Control and Prevention on how already-approved vaccines should be used. CDC directors have almost always accepted those recommendations, which are widely heeded by doctors and guide vaccination programs.

Kennedy, a leading antivaccine activist before becoming the nation’s top health official, fired the entire 17-member panel earlier this year and replaced it with a group that includes several anti-vaccine voices.

Here’s a look at the three vaccines being discussed:

COVID-19

Before Kennedy was health secretary, ACIP would typically vote in June to reaffirm recommendations for shots against respiratory viruses that sicken millions of Americans each fall and winter.

This past June, Kennedy’s ACIP voted to recommend flu shots for Americans but was silent on COVID-19 shots.

Before that meeting, Kennedy announced he was removing COVID-19 shots from the CDC’s recommendations for healthy children and pregnant women. The move was heavily criticized by doctors’ groups and public health organizations, and prompted a lawsuit by the American Academy of Pediatrics and other groups.

Days after Kennedy’s announcement, CDC officials said families could still get the 2024-2025 version of COVID-19 shots for their kids in consultation with their doctors. That clarification meant shots would still be covered by the federal government’s Vaccines For Children program, which pays for shots for families who lack money or adequate health insurance coverage. It’s now responsible for roughly half of childhood vaccinations in the U.S. each year.

As with flu shots, however, there are new COVID-19 formulations each fall, to account for changes in which strains are circulating. The committee has not yet voted on whether to recommend this season’s COVID-19 shots or whether those shots should be covered by the VFC program.

Further complicating the picture: When the FDA last month licensed this fall’s COVID-19 shots, the agency took the unusual step of narrowing their use for healthy younger adults and children.

If the ACIP simply follows that, and if there is no additional clarifying language from the CDC, then “that would take away access for roughly half of America’s kids,” said Dr. Sean O’Leary of the American Academy of Pediatrics.

The pediatricians group urges that vaccinations continue for all children ages 6 months to 2 years.

Hepatitis B

Hepatitis B can cause serious liver infections. In adults, the virus is spread through sex or through sharing needles during use injection-drug use.

But the virus also can be passed to a baby from an infected mother, and as many as 90% of infected infants go on to have chronic infections.

A hepatitis B vaccine was first licensed in the U.S. in 1981. In 1991, the ACIP recommended a dose within 24 hours of birth for all medically stable infants who weigh at least 4.4 pounds.

Infant vaccinations are stressed for women who have hepatitis B or, crucially, who have not been tested for it. The infant shots are 85% to 95% effective in preventing chronic hepatitis B infections, studies have shown.

Newborn hepatitis B vaccinations are considered a success, and no recent peer-reviewed research shows any safety problem with giving kids the shots on their first day of life, Schaffner said.

But Kennedy’s ACIP members suggested in June they wanted to revisit the guidance.

Schaffner noted that health officials used to rely on screening mothers before birth but that many cases were missed.

“There were lots of failures,” he said. “And so there were continuing transmissions from mother to child.”

MMRV

Chickenpox was once a common childhood annoyance, causing an itchy skin rash and fever.

But the highly contagious virus can also lead to complications such as skin infections, swelling of the brain and pneumonia. Severe cases are more common among teens and adults who get it for the first time. The virus — called varicella — also can reactivate later in life and cause the painful illness called shingles.

The government first recommended that all children get a chickenpox vaccine in 1995, leading to a dramatic drop in cases and deaths.

In 2006, a combination MMRV shot — measles, mumps, rubella and varicella — was licensed. The CDC initially recommended that doctors and parents use the combo shot over separate MMR and varicella injections.

But within a few years, studies showed children who got the combo shot more often developed a rash, fever and — in rare instances — seizures after vaccination compared with children who got separate shots.

In 2009, the ACIP changed its recommendation, removing the preferential language and saying either the combination shot or separate shots were acceptable for the first dose.

Today, most pediatricians suggest separate doses for the first shot, but give the combined shot for the second dose, pediatrics experts say.

Again, there’s no new evidence about harms from MMRV shots, said O’Leary, of AAP.

Why revisit it now?

“This version of the ACIP is an orchestrated effort to sow distrust in vaccines,” O’Leary said.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

NEW YORK (AP) — Health Secretary Robert F. Kennedy Jr.’s new vaccine advisory committee meets this week, with votes expected on whether to change recommendations on shots against COVID-19, hepatitis B and chickenpox.

The exact questions to be voted on Thursday and Friday in Atlanta are unclear. Officials at the Department of Health and Human Services did not immediately respond to questions seeking details to a newly posted agenda.

But some public health experts are worried that the votes will — at a minimum — raise unwarranted new questions about vaccines in the minds of parents.

Perhaps even more consequential would be a vote that restricts a government program from paying for vaccines for low-income families.

“I’m tightening my seat belt,” said Dr. William Schaffner, a Vanderbilt University vaccines expert.

The panel, the Advisory Committee on Immunization Practices, makes recommendations to the director of the Centers for Disease Control and Prevention on how already-approved vaccines should be used. CDC directors have almost always accepted those recommendations, which are widely heeded by doctors and guide vaccination programs.

Kennedy, a leading antivaccine activist before becoming the nation’s top health official, fired the entire 17-member panel earlier this year and replaced it with a group that includes several anti-vaccine voices.

Here’s a look at the three vaccines being discussed:

COVID-19

Before Kennedy was health secretary, ACIP would typically vote in June to reaffirm recommendations for shots against respiratory viruses that sicken millions of Americans each fall and winter.

This past June, Kennedy’s ACIP voted to recommend flu shots for Americans but was silent on COVID-19 shots.

Before that meeting, Kennedy announced he was removing COVID-19 shots from the CDC’s recommendations for healthy children and pregnant women. The move was heavily criticized by doctors’ groups and public health organizations, and prompted a lawsuit by the American Academy of Pediatrics and other groups.

Days after Kennedy’s announcement, CDC officials said families could still get the 2024-2025 version of COVID-19 shots for their kids in consultation with their doctors. That clarification meant shots would still be covered by the federal government’s Vaccines For Children program, which pays for shots for families who lack money or adequate health insurance coverage. It’s now responsible for roughly half of childhood vaccinations in the U.S. each year.

As with flu shots, however, there are new COVID-19 formulations each fall, to account for changes in which strains are circulating. The committee has not yet voted on whether to recommend this season’s COVID-19 shots or whether those shots should be covered by the VFC program.

Further complicating the picture: When the FDA last month licensed this fall’s COVID-19 shots, the agency took the unusual step of narrowing their use for healthy younger adults and children.

If the ACIP simply follows that, and if there is no additional clarifying language from the CDC, then “that would take away access for roughly half of America’s kids,” said Dr. Sean O’Leary of the American Academy of Pediatrics.

The pediatricians group urges that vaccinations continue for all children ages 6 months to 2 years.

Hepatitis B

Hepatitis B can cause serious liver infections. In adults, the virus is spread through sex or through sharing needles during use injection-drug use.

But the virus also can be passed to a baby from an infected mother, and as many as 90% of infected infants go on to have chronic infections.

A hepatitis B vaccine was first licensed in the U.S. in 1981. In 1991, the ACIP recommended a dose within 24 hours of birth for all medically stable infants who weigh at least 4.4 pounds.

Infant vaccinations are stressed for women who have hepatitis B or, crucially, who have not been tested for it. The infant shots are 85% to 95% effective in preventing chronic hepatitis B infections, studies have shown.

Newborn hepatitis B vaccinations are considered a success, and no recent peer-reviewed research shows any safety problem with giving kids the shots on their first day of life, Schaffner said.

But Kennedy’s ACIP members suggested in June they wanted to revisit the guidance.

Schaffner noted that health officials used to rely on screening mothers before birth but that many cases were missed.

“There were lots of failures,” he said. “And so there were continuing transmissions from mother to child.”

MMRV

Chickenpox was once a common childhood annoyance, causing an itchy skin rash and fever.

But the highly contagious virus can also lead to complications such as skin infections, swelling of the brain and pneumonia. Severe cases are more common among teens and adults who get it for the first time. The virus — called varicella — also can reactivate later in life and cause the painful illness called shingles.

The government first recommended that all children get a chickenpox vaccine in 1995, leading to a dramatic drop in cases and deaths.

In 2006, a combination MMRV shot — measles, mumps, rubella and varicella — was licensed. The CDC initially recommended that doctors and parents use the combo shot over separate MMR and varicella injections.

But within a few years, studies showed children who got the combo shot more often developed a rash, fever and — in rare instances — seizures after vaccination compared with children who got separate shots.

In 2009, the ACIP changed its recommendation, removing the preferential language and saying either the combination shot or separate shots were acceptable for the first dose.

Today, most pediatricians suggest separate doses for the first shot, but give the combined shot for the second dose, pediatrics experts say.

Again, there’s no new evidence about harms from MMRV shots, said O’Leary, of AAP.

Why revisit it now?

“This version of the ACIP is an orchestrated effort to sow distrust in vaccines,” O’Leary said.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

The governors of Arizona and Maine on Friday joined the growing list of Democratic officials who have signed orders intended to ensure most residents can receive COVID-19 vaccines at pharmacies without individual prescriptions.

Unlike past years, access to COVID-19 vaccines has become complicated in 2025, largely because federal guidance does not recommend them for nearly everyone this year as it had in the past.

Here’s a look at where things stand.

Pharmacy chain says the shots are available in most states without individual prescriptions

CVS Health, the biggest pharmacy chain in the U.S., says its stores are offering the shots without an individual prescription in 41 states as of midday Friday.

But the remaining states — Arizona, Florida, Georgia, Louisiana, Maine, North Carolina, Oregon, Utah and West Virginia, plus the District of Columbia — require individual prescriptions under the company’s interpretation of state policies.

Arizona and Maine are likely to come off that list as the new orders take effect there.

“I will not stand idly by while the Trump Administration makes it harder for Maine people to get a vaccine that protects their health and could very well save their life,” Maine Gov. Janet Mills said in the statement. “Through this standing order, we are stepping up to knock down the barriers the Trump Administration is putting in the way of the health and welfare of Maine people.”

Democratic governors have been taking action

At least 14 states — 12 with Democratic governors, plus Virginia, where Republican Glenn Youngkin is governor — have announced policies this month to ease access.

In some of the states that have expanded access — including Delaware and New Jersey this week — at least some pharmacies were already providing the shots broadly.

But in Arizona and Maine, Friday’s orders are expected to change the policy.

While most Republican-controlled states have not changed vaccine policy this month, the inoculations are still available there under existing policies.

In addition to the round of orders from governors, boards of pharmacy and other officials, four states — California, Hawaii, Oregon and Washington — have announced an alliance to make their own vaccine recommendations. Of those, only Oregon doesn’t currently allow the shots in pharmacies without individual prescriptions.

Vaccines have become politically contentious

In past years, the federal government has recommended the vaccines to all Americans above the age of 6 months.

This year, the U.S. Food and Drug Administration approved them for people age 65 and over but said they should be used only for children and younger adults who have a risk factor such as asthma or obesity.

That change came as U.S. Health Secretary Robert F. Kennedy fired the entire Advisory Committee on Immunization Practices in June, accusing of them of being too closely aligned with the companies that make the vaccines. The replacements include vaccine skeptics.

Arizona Gov. Katie Hobbs, a Democrat, framed her order Friday as “protecting the health care freedom” of people in the state.

One state has taken another stance on vaccines

Florida’s surgeon general, Dr. Joseph Ladapo, announced this month that the state could become the first to eliminate requirements that children have a list of vaccinations.

Since then, though, the state health department said that the change likely wouldn’t take effect until December and that without legislative action, only some vaccines — including for chickenpox — would become optional. The measles and polio shots would remain mandatory.

Associated Press writer Patrick Whittle in Maine contributed to this report.

The governors of Arizona and Maine on Friday joined the growing list of Democratic officials who have signed orders intended to ensure most residents can receive COVID-19 vaccines at pharmacies without individual prescriptions.

Unlike past years, access to COVID-19 vaccines has become complicated in 2025, largely because federal guidance does not recommend them for nearly everyone this year as it had in the past.

Here’s a look at where things stand.

Pharmacy chain says the shots are available in most states without individual prescriptions

CVS Health, the biggest pharmacy chain in the U.S., says its stores are offering the shots without an individual prescription in 41 states as of midday Friday.

But the remaining states — Arizona, Florida, Georgia, Louisiana, Maine, North Carolina, Oregon, Utah and West Virginia, plus the District of Columbia — require individual prescriptions under the company’s interpretation of state policies.

Arizona and Maine are likely to come off that list as the new orders take effect there.

“I will not stand idly by while the Trump Administration makes it harder for Maine people to get a vaccine that protects their health and could very well save their life,” Maine Gov. Janet Mills said in the statement. “Through this standing order, we are stepping up to knock down the barriers the Trump Administration is putting in the way of the health and welfare of Maine people.”

Democratic governors have been taking action

At least 14 states — 12 with Democratic governors, plus Virginia, where Republican Glenn Youngkin is governor — have announced policies this month to ease access.

In some of the states that have expanded access — including Delaware and New Jersey this week — at least some pharmacies were already providing the shots broadly.

But in Arizona and Maine, Friday’s orders are expected to change the policy.

While most Republican-controlled states have not changed vaccine policy this month, the inoculations are still available there under existing policies.

In addition to the round of orders from governors, boards of pharmacy and other officials, four states — California, Hawaii, Oregon and Washington — have announced an alliance to make their own vaccine recommendations. Of those, only Oregon doesn’t currently allow the shots in pharmacies without individual prescriptions.

Vaccines have become politically contentious

In past years, the federal government has recommended the vaccines to all Americans above the age of 6 months.

This year, the U.S. Food and Drug Administration approved them for people age 65 and over but said they should be used only for children and younger adults who have a risk factor such as asthma or obesity.

That change came as U.S. Health Secretary Robert F. Kennedy fired the entire Advisory Committee on Immunization Practices in June, accusing of them of being too closely aligned with the companies that make the vaccines. The replacements include vaccine skeptics.

Arizona Gov. Katie Hobbs, a Democrat, framed her order Friday as “protecting the health care freedom” of people in the state.

One state has taken another stance on vaccines

Florida’s surgeon general, Dr. Joseph Ladapo, announced this month that the state could become the first to eliminate requirements that children have a list of vaccinations.

Since then, though, the state health department said that the change likely wouldn’t take effect until December and that without legislative action, only some vaccines — including for chickenpox — would become optional. The measles and polio shots would remain mandatory.

Associated Press writer Patrick Whittle in Maine contributed to this report.

They also provide a sense of relief for those with aging parents. Knowing that mom and dad are being fed and that someone is keeping an eye on them is comforting.

But there’s a downside. The criminal element knows exactly where to find these vulnerable seniors.

It’s common that a person’s mental sharpness declines at some point in life. For example, I have a longtime client who was a top auto executive. After retirement, he was in high demand by auto suppliers. But time began to catch up with him, and as so many retirees eventually do, he moved into a senior community.

Everything was going just fine until the day he answered a phone call from an unscrupulous individual pretending to be from his bank. Believing the impostor’s story, he was swindled out of nearly $10,000. During the conversation, he was told not to answer his phone under any circumstances unless it was from the phony banker himself.

After being unable to reach him by phone all day, his family drove to the facility. It didn’t take long for them to determine that he had been taken. He was unable to provide a good explanation to his family, to the investigating police or to me, his advisor. In short, a slick talking criminal, posing as a banker, stole from a senior. Sadly, my client is not alone.

I am well aware that stealing from seniors is becoming quite prevalent. Nonetheless, I was surprised to learn that scammers cost older people $700 million in 2024. That’s according to the FTC, which defines older people as those beyond the age of 60.

In 2024, 8,269 seniors lost more than $10,000 to impostors. Quite a jump from 2022, when it was slightly under 1,800. Total losses to scammed seniors was $122 million in 2020. Last year, it was more than $700 million.

Scammers use made-up crises to trick seniors, often pretending to be someone of authority, as in my aforementioned client’s “banker.” Or maybe it’s a law enforcement officer with a cockamamie story about a grandchild who desperately and immediately needs money to get out of a dangerous situation. Using today’s technology, a scammer can make almost anything seem real, and senior citizens with money in the bank make ideal targets.

Financial advisors go to great lengths to protect vulnerable clients. We do not act on emails requesting money. Phone calls are made to clients prior to executing any withdrawal requests. If senior financial abuse or fraud is suspected, there are steps advisors can take to make certain everything is in good order before any money is withdrawn.

When opening an account, advisors document a trusted, client-designated person to whom we have permission to contact if any concerns arise.

Nowadays, there are numerous ways investors can directly manage their own funds. That may be fine, but as they age and become more vulnerable, they may lack the time, desire or ability to oversee their finances the way a financial advisor does. Having a financial advisor provides one more set of eyes on the lookout for con artists.

Email your questions to kenmorris@lifetimeplanning.com

Securities offered through Kestra Investment Services, LLC (Kestra IS), member FINRA/SIPC. Investment Advisory services offered through Kestra Advisory Services, LLC (Kestra AS), an affiliate of Kestra IS. Society for Lifetime Planning is not affiliated with Kestra IS or Kestra AS. https://kestrafinancial.com/disclosures

The opinions expressed in this commentary are those of the author and may not necessarily reflect those held by Kestra Investment Services, LLC or Kestra Advisory Services, LLC. This is for general information only and is not intended to provide specific investment advice or recommendations for any individual. It is suggested that you consult your financial professional, attorney, or tax advisor with regard to your individual situation. Comments concerning the past performance are not intended to be forward looking and should not be viewed as an indication of future results.

Heading into the respiratory illness season, states and clinicians are working to encourage pregnant patients to get COVID-19 vaccinations, even though the U.S. Department of Health and Human Services no longer recommends that they should.

Along with being older and having an underlying health condition, pregnancy itself is a risk factor. Pregnant women are more vulnerable to developing severe illness from COVID-19. They’re also at high risk for complications, including preterm labor and stillbirth. The vast majority of medical experts say getting the shot is safe and effective — much safer than having the illness.

But HHS Secretary Robert F. Kennedy Jr. announced in May that the agency would no longer recommend that pregnant women get the vaccine. Before testifying before Congress in June, Kennedy circulated a document on Capitol Hill claiming higher rates of fetal loss after vaccination. But the authors of those studies told Politico that their work had been misinterpreted.

Experts say the federal shift puts the onus on state health agencies to ramp up vaccine guidance and outreach. Clinicians and public health organizations are trying to dispel misinformation and make sure information reaches low-income people and people of color, who had higher maternal death rates during the pandemic. During the first two years of the pandemic, the virus contributed to a quarter of maternal deaths, according to federal data.

“We are severely disappointed,” said Dr. Neil Silverman, a professor of clinical obstetrics and gynecology at the University of California, Los Angeles David Geffen School of Medicine. He has studied vaccines and pregnancy for the past 15 years and specializes in high-risk pregnancies.

Silverman called the federal shift a “public health tragedy on a grand scale.”

Vaccinations against COVID-19 help prevent severe illness in pregnant people as well as their newborns, who are too young to get vaccinated, Silverman said. In what’s called passive immunity, vaccinated mothers pass on antibodies to their babies through the placenta and through breast milk.

“State public health agencies are probably going to have to implement vaccine guidance that differs from the federal recommendations. And that’s going to be an interesting can of worms,” said OB-GYN Dr. Mark Turrentine, a professor of obstetrics and gynecology at the Baylor College of Medicine in Texas.

Turrentine serves on a board of the American College of Obstetricians and Gynecologists that focuses on immunization and infectious diseases. He said his recent pregnant patients who had COVID-19 hadn’t gotten the vaccine.

“The change in guidance on the federal level just really makes a lot of confusion, and it makes it very challenging to try to explain to individuals why all of a sudden the difference,” Turrentine said.

A slew of public health organizations have been making a concerted effort to dispel vaccine myths. They include the Society for Maternal-Fetal Medicine, a Washington, D.C.-based nonprofit organization of maternal-fetal experts. At a news briefing the society held this month, clinicians stressed the safety and long-standing science behind COVID-19 vaccines, as well as the shots for RSV and the flu. Cases of RSV and the flu tend to peak in the winter months, while in recent years COVID-19 cases have spiked in the summer and the winter.

Dr. Brenna Hughes, an OB-GYN who chairs the organization’s infectious diseases and emerging threats committee, pointed to survey data from the federal Centers for Disease Control and Prevention showing that less than a third of eligible pregnant patients received COVID-19 shots, and only 38% received RSV shots for the 2023 to 2024 season. Less than half — 47% — received flu shots, and 59% received TDAP (whooping cough) vaccines.

CDC data shows that for last year’s and this year’s season, only between 12% and 14% of pregnant patients got the COVID-19 vaccine.

“The complications from the infection are so much greater than the complications and the very few and typically minor adverse events that might occur from the vaccine,” said microbiologist Sabra Klein, a professor of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health.

In June, the American College of Obstetricians and Gynecologists and 30 other professional health organizations signed a letter urging insurers to continue covering the COVID-19 shot for pregnant women, and have continued to urge coverage since then.

CVS Caremark, one of the nation’s three major pharmacy benefit managers, told Stateline it will continue covering the vaccine for pregnant women. The Arizona, California and North Carolina state Medicaid agencies also told Stateline they are still currently covering COVID-19 vaccines for pregnant women.

Dr. Kimberly Fortner, president-elect of the Infectious Diseases Society for Obstetrics and Gynecology, said during the maternal-fetal medicine briefing that she hopes medical groups’ joint messaging will bolster insurers.

“Hopefully by us linking arms, that can then help develop consistency so that insurers will continue to pay for the vaccine,” she said.

Exacerbating disparities

Dr. Ayanna Bennett, director of the District of Columbia Department of Health, said the federal government’s new stance has upended “a system that’s been stable for a very long time.”

Bennett said her agency used federal pandemic aid to shore up vaccine outreach efforts to communities of color. Now that flow of money is ending.

The changes in federal guidance and funding will “almost certainly exacerbate” maternal health disparities, said Marie Thoma, a perinatal epidemiologist and an associate professor in the University of Maryland Department of Family Science who researches pregnancy and COVID-19.

Black and Indigenous women died at higher rates. The virus exacerbated existing racial disparities in maternal health — and created new ones: Latina mothers, who generally see low rates of maternal mortality, saw deaths surge to 28 per 100,000 in 2021. Their rate was about 12 per 100,000 in 2018, according to federal data.

“We are going in with some exposure already that we didn’t have during the start of the pandemic. So, there will be some protection, but now that will erode,” said Thoma. “If we’re not getting vaccines, or if people are hesitant to take them, we could see some increase.”

Silverman said the administration’s efforts to strip mentions of race from government policies makes it difficult for institutions to reach populations at greatest risk. He called the dismissal of decades of data “saddening and infuriating.”

“The politicization of the vaccine process, or access to it, is what concerns me the most,” said Dr. Yvette Martas, a Connecticut OB-GYN who chairs the board of directors of the Hispanic Health Council.

Many women “are trying to navigate an economic system that’s not always in their favor in terms of also providing access to the kind of educational material that they need,” she said.

Not just COVID-19

In June, Kennedy ousted all 17 members of the CDC’s vaccine advisory committee, replacing them with some members who are vaccine skeptics.

The change is creating chaos. Some states have vaccine laws, such as mandates for kids and coverage statutes, that are specifically tied to the committee’s decisions.

The Vaccine Integrity Project at the University of Minnesota called on frontline health workers, health officials and professional societies to “counter the spread of inaccurate and confusing vaccine information.”

At a news briefing this month held by the Association of State and Territorial Health Officials, representatives from Alabama, Connecticut and Washington, D.C., said they will continue to recommend vaccines.

Alabama’s state health officer, Dr. Scott Harris, said clinicians will be instrumental in getting correct vaccination information to patients.

“We don’t think that we necessarily have the same authoritative voice that we might have had a decade ago in trying to guide people in what to do, but we do believe that people trust their health care providers in most cases and are certainly willing to listen to them,” he said at the briefing.

Bennett said she is hopeful that strong, consistent messaging from respected medical organizations will help combat confusion.

“Having established groups like the American Academy of Pediatrics or the American College of Obstetrics and Gynecology make very firm recommendations that keep us essentially not changed from where we have been, I think, should reassure families,” she said.

Stateline reporter Nada Hassanein can be reached at nhassanein@stateline.org.

©2025 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

Heading into the respiratory illness season, states and clinicians are working to encourage pregnant patients to get COVID-19 vaccinations, even though the U.S. Department of Health and Human Services no longer recommends that they should.

Along with being older and having an underlying health condition, pregnancy itself is a risk factor. Pregnant women are more vulnerable to developing severe illness from COVID-19. They’re also at high risk for complications, including preterm labor and stillbirth. The vast majority of medical experts say getting the shot is safe and effective — much safer than having the illness.

But HHS Secretary Robert F. Kennedy Jr. announced in May that the agency would no longer recommend that pregnant women get the vaccine. Before testifying before Congress in June, Kennedy circulated a document on Capitol Hill claiming higher rates of fetal loss after vaccination. But the authors of those studies told Politico that their work had been misinterpreted.

Experts say the federal shift puts the onus on state health agencies to ramp up vaccine guidance and outreach. Clinicians and public health organizations are trying to dispel misinformation and make sure information reaches low-income people and people of color, who had higher maternal death rates during the pandemic. During the first two years of the pandemic, the virus contributed to a quarter of maternal deaths, according to federal data.

“We are severely disappointed,” said Dr. Neil Silverman, a professor of clinical obstetrics and gynecology at the University of California, Los Angeles David Geffen School of Medicine. He has studied vaccines and pregnancy for the past 15 years and specializes in high-risk pregnancies.

Silverman called the federal shift a “public health tragedy on a grand scale.”

Vaccinations against COVID-19 help prevent severe illness in pregnant people as well as their newborns, who are too young to get vaccinated, Silverman said. In what’s called passive immunity, vaccinated mothers pass on antibodies to their babies through the placenta and through breast milk.

“State public health agencies are probably going to have to implement vaccine guidance that differs from the federal recommendations. And that’s going to be an interesting can of worms,” said OB-GYN Dr. Mark Turrentine, a professor of obstetrics and gynecology at the Baylor College of Medicine in Texas.

Turrentine serves on a board of the American College of Obstetricians and Gynecologists that focuses on immunization and infectious diseases. He said his recent pregnant patients who had COVID-19 hadn’t gotten the vaccine.

“The change in guidance on the federal level just really makes a lot of confusion, and it makes it very challenging to try to explain to individuals why all of a sudden the difference,” Turrentine said.

A slew of public health organizations have been making a concerted effort to dispel vaccine myths. They include the Society for Maternal-Fetal Medicine, a Washington, D.C.-based nonprofit organization of maternal-fetal experts. At a news briefing the society held this month, clinicians stressed the safety and long-standing science behind COVID-19 vaccines, as well as the shots for RSV and the flu. Cases of RSV and the flu tend to peak in the winter months, while in recent years COVID-19 cases have spiked in the summer and the winter.

Dr. Brenna Hughes, an OB-GYN who chairs the organization’s infectious diseases and emerging threats committee, pointed to survey data from the federal Centers for Disease Control and Prevention showing that less than a third of eligible pregnant patients received COVID-19 shots, and only 38% received RSV shots for the 2023 to 2024 season. Less than half — 47% — received flu shots, and 59% received TDAP (whooping cough) vaccines.

CDC data shows that for last year’s and this year’s season, only between 12% and 14% of pregnant patients got the COVID-19 vaccine.

“The complications from the infection are so much greater than the complications and the very few and typically minor adverse events that might occur from the vaccine,” said microbiologist Sabra Klein, a professor of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health.

In June, the American College of Obstetricians and Gynecologists and 30 other professional health organizations signed a letter urging insurers to continue covering the COVID-19 shot for pregnant women, and have continued to urge coverage since then.

CVS Caremark, one of the nation’s three major pharmacy benefit managers, told Stateline it will continue covering the vaccine for pregnant women. The Arizona, California and North Carolina state Medicaid agencies also told Stateline they are still currently covering COVID-19 vaccines for pregnant women.

Dr. Kimberly Fortner, president-elect of the Infectious Diseases Society for Obstetrics and Gynecology, said during the maternal-fetal medicine briefing that she hopes medical groups’ joint messaging will bolster insurers.

“Hopefully by us linking arms, that can then help develop consistency so that insurers will continue to pay for the vaccine,” she said.

Exacerbating disparities

Dr. Ayanna Bennett, director of the District of Columbia Department of Health, said the federal government’s new stance has upended “a system that’s been stable for a very long time.”

Bennett said her agency used federal pandemic aid to shore up vaccine outreach efforts to communities of color. Now that flow of money is ending.

The changes in federal guidance and funding will “almost certainly exacerbate” maternal health disparities, said Marie Thoma, a perinatal epidemiologist and an associate professor in the University of Maryland Department of Family Science who researches pregnancy and COVID-19.

Black and Indigenous women died at higher rates. The virus exacerbated existing racial disparities in maternal health — and created new ones: Latina mothers, who generally see low rates of maternal mortality, saw deaths surge to 28 per 100,000 in 2021. Their rate was about 12 per 100,000 in 2018, according to federal data.

“We are going in with some exposure already that we didn’t have during the start of the pandemic. So, there will be some protection, but now that will erode,” said Thoma. “If we’re not getting vaccines, or if people are hesitant to take them, we could see some increase.”

Silverman said the administration’s efforts to strip mentions of race from government policies makes it difficult for institutions to reach populations at greatest risk. He called the dismissal of decades of data “saddening and infuriating.”

“The politicization of the vaccine process, or access to it, is what concerns me the most,” said Dr. Yvette Martas, a Connecticut OB-GYN who chairs the board of directors of the Hispanic Health Council.

Many women “are trying to navigate an economic system that’s not always in their favor in terms of also providing access to the kind of educational material that they need,” she said.

Not just COVID-19

In June, Kennedy ousted all 17 members of the CDC’s vaccine advisory committee, replacing them with some members who are vaccine skeptics.

The change is creating chaos. Some states have vaccine laws, such as mandates for kids and coverage statutes, that are specifically tied to the committee’s decisions.

The Vaccine Integrity Project at the University of Minnesota called on frontline health workers, health officials and professional societies to “counter the spread of inaccurate and confusing vaccine information.”

At a news briefing this month held by the Association of State and Territorial Health Officials, representatives from Alabama, Connecticut and Washington, D.C., said they will continue to recommend vaccines.

Alabama’s state health officer, Dr. Scott Harris, said clinicians will be instrumental in getting correct vaccination information to patients.

“We don’t think that we necessarily have the same authoritative voice that we might have had a decade ago in trying to guide people in what to do, but we do believe that people trust their health care providers in most cases and are certainly willing to listen to them,” he said at the briefing.

Bennett said she is hopeful that strong, consistent messaging from respected medical organizations will help combat confusion.

“Having established groups like the American Academy of Pediatrics or the American College of Obstetrics and Gynecology make very firm recommendations that keep us essentially not changed from where we have been, I think, should reassure families,” she said.

Stateline reporter Nada Hassanein can be reached at nhassanein@stateline.org.

©2025 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.