Minnesota defies feds with COVID vaccine guidance Pharmacists may give shots to anyone 12 and older seeking protection from the virus. By JEREMY OLSON The Minnesota Star Tribune ​ "HEY BUDDY, LET'S GET VACCINATED!"

Minnesota's top doctor has issued a standing order allowing pharmacists to give COVID-19 vaccines without prescriptions to a broader group of patients than federally recommended.

The state Department of Health announced the order and that it was aligning with national medical organizations in encouraging broader use of the vaccines.

"Vaccines are one of the greatest public health achievements in modern medicine," said state epidemiologist Dr. Ruth Lynfield, adding that people should consider the protection they offer against influenza, COVID and the virus RSV at the start of respiratory disease season.

The state vaccine policy actions this week represent an unprecedented break from federal recommendations. Historically, Minnesota has parroted guidance from the Food and Drug Administration and the Centers for Disease Control and Prevention. That changed after President Donald Trump appointed a high-profile vaccine skeptic, Robert F. Kennedy Jr., as his Health and Human Services (HHS) secretary.

Kennedy, in turn, appointed skeptics to the CDC's Advisory Committee on Immunization Practices (ACIP), which decided last week against recommending the COVID-19 vaccine to anyone and instead encouraged people to make their own medical decisions.

Kennedy has raised concerns about the possibility of complications from multiple vaccines and whether the risks to individual health outweigh the benefits.  However, the American societies representing pediatricians, family doctors and obstetricians have all recommended unrestricted access to the latest COVID-19 shots for people 6 months and older.
​
The state on Monday agreed with those recommendations.
AHIP, the trade group for the nation's health plans, also recently announced it was advising its members to maintain insurance coverage for the shots.

Until now, pharmacists in Minnesota could only give the latest COVID-19 vaccines without prescriptions to people who met FDA approval criteria — namely, those 65 and older and anyone with underlying health conditions.

Lynfield's standing order acts as a blanket prescription for Minnesota, allowing pharmacists to give the shots to anyone 12 and older seeking protection from COVID-19, a contagious disease that has persisted even though the country offi cially left a state of pandemic two years ago.

Her order highlights the need for shots among people who have never been vaccinated, residents of long-term care facilities and people living with others at elevated risk of complications if they get COVID-19. A second order also allows pharmacists to give pediatric versions of COVID- 19 vaccine to children ages 3 to 11 if their parents want them to have protection.

Lynfield said it was unusual to issue guidance that deviated from federal policy, but "we wanted to make it easy for Minnesotans to go to a pharmacy" for their vaccines.

Recent data showed that about 46% of COVID-19 vaccinations in Minnesota are administered at pharmacies. Public interest in the vaccine has waned since the pandemic. At the end of the last respiratory disease season in May, only 22% of Minnesotans were fully vaccinated against COVID-19 compared to 34% who were protected against influenza.

COVID-19 is nowhere near the lethal threat it was during the pandemic, when at the worst it was causing more than 70 deaths among Minnesotans each day.

Still, the state has tallied more than 3,500 hospitalizations and 320 deaths this year from the now-endemic disease.

Even with the diminished risk, studies are showing a protective benefit from COVID-19 vaccines.

Bloomington-based HealthPartners is part of a national VISION research group which earlier this year reported that vaccination was 33% effective in preventing COVID-related emergency room visits among adults and more than 40% effective at preventing COVID-related hospitalizations among seniors.

Monday's actions came at the prompting of an executive order by Gov. Tim Walz, who expressed concern that federal health authorities are ignoring scientific research. Other states have taken similar steps; Wisconsin's state epidemiologist issued a standing order last week as well to hasten COVID-19 vaccinations by pharmacists.

HHS spokesman Andrew Nixon chided Minnesota and Democratic-led states for challenging the scientific basis for the federal vaccine policies. During the pandemic, these same states imposed mask mandates and other efforts to reduce the spread of COVID-19 with limited evidence that they worked, he said. "HHS will ensure policy is based on rigorous evidence."

Complications from COVID-19 vaccinations are considered rare.
Some Minnesotans reported disabling conditions after vaccinations they sought amid the pandemic.

Mayo Clinic's Dr. Gregory Poland, a widely known vaccine advocate, reported ear-ringing known as tinnitus after his shot.

A University of Minnesota-led research group conducted an exhaustive review this summer of the latest vaccine safety data and verified rare and mostly mild cases of myocarditis (a swelling of the heart muscle) among vaccine recipients. One study included in the analysis found up to three cases per 100,000 recipients, mostly males, in those who received the Pfizer version of the COVID-19 vaccine.

In that analysis, COVID-19 vaccines still presented far greater benefits than risks, protecting recipients against severe or disabling levels of COVID-19.

Michael Osterholm, director of the U's Center for Infectious Disease Research and Policy, was critical of federal advisers last week for overlooking these clear scientific findings.

"Sadly," he said, "the ACIP we knew has been hijacked and is today an ideological body and no longer a scientific one."

[email protected]

U.S. loses its role as leader on vaccines Nations turn elsewhere for ways to protect the health of their citizens. By DAMIEN CAVE The New York Times

​When Vietnam considered making COVID-19 vaccines mandatory for children deep into the pandemic, many parents resisted, fearing side effects and rumors of expired doses.

Their skepticism helped shape policy — the COVID vaccine mandate never happened.  And it led to greater caution.  More parents started scrutinizing packaging to ensure that every vaccine jabbed into an arm came from a reputable company.

What Vietnam's COVID concerns did not do was metastasize into a broader anti-vaccine movement like what the world is now watching in the United States. Instead, COVID revived gratitude for routine vaccination.

Coverage for the first dose of the measles vaccine in Vietnam reached 98% in 2024, and the vaccine for polio reached 99%.

"There was a scare, and that's why there was an almost global commitment to say, 'We will now work toward making a more robust system,' " said Basil Rodrigues, UNICEF's Regional Health Adviser for East Asia and the Pacific. "Countries are trying to ensure that they strengthen their vaccine systems."

Brazil, Nigeria, Hungary and Samoa are just a few of the nations investing more in vaccination to try to catch up after COVID, during a global rise in outbreaks of measles and yellow fever.
​
That makes the United States an obvious outlier, though not because of public opinion, which still favors vaccination. Rather, experts say, it is because of the government. Health Secretary Robert F. Kennedy Jr. and other vaccine critics are now in charge of public health and — under a banner of MAHA or "make America healthy again" — they are stripping away support for vaccine development, promotion and distribution.

Florida recently became the first U.S. state to announce an end to mandates for vaccines.
​
Experts say that weakens a policy devised to ensure that — in a decentralized and unequal health care system — nearly every child could be protected from horrific infections.

Kennedy has defunded vaccine research.
He has replaced vaccine experts with critics on a key advisory panel, limited access to COVID-19 shots and muddied official guidance on many others, worrying experts who see confusion eroding vaccine confidence worldwide.

As Heidi J. Larson, who leads the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine, recently put it in an essay for the Lancet:

​"The USA, long a cornerstone of global health leadership, has become an unexpected source of global instability in vaccination confidence."
Scientists see facts being cast aside, with effects that could last for years.

"The threat is this:
that the U.S. style anti-vax movement linked to MAHA wellness-influencer grifting and authoritarianism is now globalizing," said Peter J. Hotez, a vaccine expert at Baylor College of Medicine and the author of a new book, "The Deadly Rise of Anti-Science."

Mandates, usually focused on entry to school, have also been common for decades.

In a recent study of 194 countries by international academics, 106 nations had policies requiring vaccination for at least one disease. Vaccines against diphtheria, measles, and tetanus were the most mandated, while COVID vaccines were among the least.

Governments often harden childhood mandates when threats intensify. For example, Italy and France added measles to their mandatory schedules after outbreaks in 2017 and 2018. Within two years, vaccination rates had risen nearly 6 percentage points in Italy, and around 4 in France.

That is usually how it goes, though less so with Americans.

After a measles outbreak in 2015 led California to stop letting parents opt out of vaccines for nonmedical reasons, such as "personal belief," fewer kindergartners showed up at school without their shots. But studies later found that medical exemptions had quadrupled.

The medical exemption rate at private schools was 10 times higher than the median nationwide.

America did not start out determined to avoid vaccines.
In 1806, President Thomas Jefferson wrote a letter to Edward Jenner, an English scientist, thanking him for developing the world's first vaccine, against smallpox. Jefferson wrote that he "took an early part in recommending it to my countrymen."

In 1855, after a rash of smallpox deaths, Massachusetts became the first state to require that children be vaccinated for school. In 1905, the Supreme Court upheld the right to mandate vaccination for public safety.

None of that history earned a mention when Joseph Ladapo, the Florida surgeon general, announced last week that Florida would end vaccine mandates. "Who am I to tell you what to put in your body?" he said to loud applause, at an event near Tampa. "Your body is a gift from God."

Ladapo and others — including Kennedy — have celebrated a "your research, your choice" approach that, according to various studies, bolsters false claims of vaccine danger.
​
Worldwide, the U.S. is a major exporter of vaccine misinformation.
That global exchange of vaccine-preventable diseases will become more common, experts argue, because worldwide vaccination levels are still below those from before COVID — the pandemic disrupted the supply chain for many vaccines and kept people from scheduled vaccination. It is also, many add, because the U.S. government is backing away from the country's role as a champion of immunization.
"It's a clichea cute; that infectious diseases know no borders, but it is true that our global preparedness and response to infectious diseases relies on a strong U.S. presence and U.S. commitment to vaccination, from research to development to deployment," said Jason L. Schwartz, a public health professor at Yale.

"So the steady weakening of U.S. government support for all aspects of vaccination will invariably weaken our response to vaccine preventable diseases around the world."

​AI is an unused tool in curbing mass shootings By STEPHEN CONTAG ​ As a physician, I believe in prevention. As a parent, I believe in protection. And as a citizen, I believe we must use every tool available to safeguard our communities. ​

As both a physician and a parent, I think every day about how to prevent harm before it occurs. Medicine has taught me that prevention is the most powerful tool we have. Yet nothing in my training prepared me for the epidemic that now claims the lives of more children and teens in America than any other preventable cause:

gun violence.
When 21 people were injured and two children were killed while attending church in Minneapolis, the sense of safety in a familiar space was shattered again. Mayor Jacob Frey asked the question that should trouble us all:

If people are not safe in church, where are they safe?
​It is a question that extends far beyond houses of worship. The same uncertainty now shadows schools, shopping malls, concerts, grocery stores, movie theaters and hospitals. In short, the very places where communities gather.

If we want to change that reality, we must start treating gun violence like the public health crisis it is. Prevention in medicine works through layers. Primary prevention aims to stop illness before it begins. Secondary prevention detects problems early. Tertiary prevention uses advanced measures when the risk is imminent. For heart disease, tertiary prevention might mean a defibrillator. For cancer, it might mean a transplant or advanced chemotherapy. For gun violence, it must mean technology that interrupts a weapon before it can be used against a crowd.

Artificial intelligence can provide this protection.
AI already operates quietly in many areas of life. It flags suspicious financial transactions before accounts are drained. It helps physicians detect strokes and sepsis minutes earlier than human judgment alone. It allows airports to identify security threats in real time. The same ability to scan, recognize and trigger an immediate response could be applied to firearms.

The concept is simple.
Firearms, whether newly manufactured or retrofitted, could contain embedded chips that communicate with perimeter sensors. Schools, churches, malls, hospitals, concert venues and other gathering places could install sensors that continuously and discreetly scan for unauthorized weapons. If a firearm crossed into a protected zone, the system would trigger an automatic alert to staff, law enforcement and first responders.

Instead of chaos erupting after the first shot, there would be a window of time to intervene before lives are lost. This is not speculative technology. It exists today.

Yes, building such a system would require resources and political will. But we have made similar choices before.
Cars once lacked seat belts and air bags, until we decided that preventable deaths on the road were unacceptable. Air travel once involved little screening, until 9/11 made us recognize the need for layered security. None of those measures eliminated accidents or attacks, but all of them reduced the risks. The same principle applies here: Prevention, not perfection, should be our standard.

The strength of AI lies in its speed and impartiality.
It does not depend on a teacher noticing a warning sign or a mall security guard spotting a hidden weapon. It does not pause to argue politics or wait for paperwork to be processed. It responds instantly. No system will prevent every tragedy, but when firearms are among the leading causes of death in this country, incremental progress must be embraced.

Critics may argue that such technology infringes on the Second Amendment.
Yet this approach does not ban firearms.
It sets clear boundaries between weapons and the spaces where communities gather. Just as responsible driving means wearing a seat belt and obeying traffic laws, responsible gun ownership should mean respecting digital safeguards in schools, malls, churches and hospitals. Carrying a firearm into a protected space would no longer be left to chance. It would be a violation with consequences.

Public health has always shown that layered strategies work. Vaccines reduce risks, screenings detect problems early and advanced therapies save lives when prevention fails. Gun violence demands the same approach. Artificial intelligence can provide that final layer of defense, the one that prevents a firearm from turning into another vigil, another headline, another community in mourning.

As a physician, I believe in prevention. As a parent, I believe in protection. And as a citizen, I believe we must use every tool available to safeguard our communities.

AI is not a cure for gun violence, but it can be a shield. It can restore a measure of safety in schools, churches, malls, hospitals and all the places where people come together.

We already have the technology.
What remains is the will to act. The choice is whether we continue to accept preventable loss, or whether we draw digital boundaries that protect lives.

Communities deserve to gather without fear. We owe them that much.
​
Stephen Contag, MD, is a physician specializing in Obstetrics and Gynecology at the University of Minnesota. The views expressed here are his own and are not intended to reflect those of his employer.

Kennedy defiant on COVID vaccine curbs

He had tense exchanges with Senate panel over health policies, chaos at agencies.

By MATT BROWN and MIKE STOBBE • The Associated Press

Secretary of Health and Human Services Robert F Kennedy appears before the Senate finance commitee in Washington on Thursday where he sparred with senators on both sides of the isle.

WASHINGTON - U.S. Health Secretary Robert F. Kennedy Jr., facing pointed bipartisan questioning at a rancorous threehour Senate committee hearing on Thursday, tried to defend his efforts to pull back COVID-19 vaccine recommendations and explain the turmoil he has created at federal health agencies.

Kennedy said the fired CDC director was untrustworthy, stood by his past anti-vaccine rhetoric and disputed reports of people saying they have had difficulty getting COVID-19 shots.

A longtime leader in the antivaccine movement, Kennedy has made sweeping changes to agencies tasked with public health policy and scientific research by laying off thousands of workers, firing science advisers and remaking vaccine guidelines. The moves — some of which contradict assurances he made during his confirmation hearings — have rattled medical groups and officials in several Democratic-led states, which have responded with their own vaccine advice.

Medical groups and several Democrats in Congress have called for Kennedy to be fired, and his exchanges with Democratic senators on the panel repeatedly devolved into shouting, from both sides.

But some Republican senators also expressed unease with his changes to COVID-19 policies.
The GOP senators noted that Kennedy said President Donald Trump deserved a Nobel Prize for the 2020 Operation Warp Speed initiative to quickly develop mRNA COVID-19 vaccines — and that he also had attacked the safety and continued use of those very shots.

"I can't tell where you are on Operation Warp Speed," said Sen. Thom Tillis, R-N.C.

Tillis and others asked him why the director of the Centers for Disease Control and Prevention was fired last week, less than a month into her tenure.

Kennedy said she was dishonest, and that CDC leaders who left the agency last week in support of her deserved to be fired.

He also criticized CDC recommendations during the COVID-19 pandemic tied to lockdowns and masking policies, and claimed — wrongly — that they "failed to do anything about the disease itself."

"The people at CDC who oversaw that process, who put masks on our children, who closed our schools, are the people who will be leaving,"
Kennedy said. He later said they deserved to be fired for not doing enough to control chronic disease.

Trump was asked at a White House dinner with tech leaders on Thursday night if he has full confidence in what Kennedy is doing.
Trump said he didn't watch the hearings but Kennedy "means very well." Trump said Kennedy has "a different take, and we want to listen to all those takes."

Democrats express hostility from the start
The Senate Finance Committee had called Kennedy to a hearing about his plans to "Make America Healthy Again," but Democratic senators pressed Kennedy on his actions around vaccines.

Sen. Ron Wyden of Oregon said Kennedy had "stacked the deck" of a vaccines advisory committee by replacing scientists with "skeptics and conspiracy theorists."

Last week, the Trump administration fired the CDC's director — a Trump appointee who was confirmed by the Senate — less than a month into her tenure. Several top CDC leaders resigned in protest, leaving the agency in turmoil.

The ousted director, Susan Monarez, wrote in the Wall Street Journal on Thursday that Kennedy was trying to weaken public health protections.

"I was told to preapprove the recommendations of a vaccine advisory panel newly filled with people who have publicly expressed antivaccine rhetoric," Monarez wrote.

"It is imperative that the panel's recommendations aren't rubber-stamped but instead are rigorously and scientifically reviewed before being accepted or rejected."

Kennedy told senators he didn't make such an ultimatum, though he did concede that he had ordered Monarez to fire career CDC scientists.

Kennedy pushed back on concerns raised by multiple Republican senators, including Tillis and John Barrasso of Wyoming and Bill Cassidy of Louisiana. Barrasso and Cassidy are physicians.

Shouting matches and hot comebacks
The health secretary had animated comebacks as Democratic senators pressed him on the effects of his words and actions.

When Sen. Raphael Warnock of Georgia questioned Kennedy about his disparaging rhetoric about CDC employees before a deadly shooting at the agency this summer, Kennedy shot back: "Are you complicit in the assassination attempts on President Trump?"

Kennedy called Sen. Ben Ray Lujan of New Mexico "ridiculous," said he was "talking gibberish" and accused him of "not understanding how the world works" when Lujan asked Kennedy to pledge to share protocols of any research Kennedy was commissioning into autism and vaccines.

He also engaged in a heated, loud exchanges with Sens. Elizabeth Warren of Massachusetts and Tina Smith of Minnesota.

He told Sen. Bernie Sanders that the Vermont independent was not "making any sense."

Some senators had their own choice words.

"You're interrupting me, and sir, you're a charlatan.

That's what you are, " said Sen. Maria Cantwell, a Washington Democrat. "The history on vaccines is very clear."

As the hearing neared its end, Kennedy pulled his cellphone from his pocket and then tapped and scrolled as Wyden asked about mifepristone, a drug used for medication abortion.

Kennedy disputes data
In May, Kennedy announced COVID-19 vaccines would no longer be recommended for healthy children and pregnant women, a move opposed by medical and public health groups.

In June, he abruptly fired a panel of experts that had been advising the government on vaccine policy. He replaced them with a hand-picked group that included several vaccine skeptics, and then shut the door to several doctors groups that had long helped form the committee's recommendations.

Kennedy has voiced distrust of research that showed the COVID-19 vaccines saved lives, and at Thursday's hearing he even cast doubt on statistics about how people died during the pandemic and on estimates about how many deaths were averted — statistics produced by the agencies he oversees.

He said federal health policy would be based on gold-standard science but confessed that he wouldn't necessarily wait for studies to be completed before taking action against, for example, potential causes of chronic illness.

"We are not waiting for everything to come in. We are starting now," he said.

Many of the nation's leading public health and medical societies, including the American Medical Association, American Public Health Association and the American Academy of Pediatrics have decried Kennedy's policies and warn they will drive up rates of vaccinepreventable diseases.

I DON'T MEAN TO JUMP IN ON OUR CLUB PUBLICATION BUT THIS IS IMPORTANT ENOUGH TO DO SO. The Critical Case of FEMA For a critical agency like the Federal Emergency Management Agency (FEMA), appointing qualified individuals is not just beneficial—it's essential. The best outcomes are achieved when leadership positions are filled by professionals who possess the right combination of specialized education and practical experience in emergency management.

While these leadership changes may occur quietly, their true impact will become tragically clear during the next major disaster. When a catastrophe strikes and the nation's resources are needed for a large-scale rescue and safety mission, the competence—or incompetence—of FEMA's leadership will be on full display, directly affecting the lives of the impacted population. ​​
Harv

​FEMA staff letter warns of disaster
They say Trump officials risk Katrina-level crisis.
By BRIANNA SACKS The Washington Post

​More than 180 Federal Emergency Management Agency employees sent a letter Monday to members of Congress and other officials, arguing that the agency's direction and current leaders' inexperience harm the agency's mission and could result in a disaster on the level of Hurricane Katrina.

The letter, on which three dozen employees signed their full names, says that since January, staffers have been operating under leaders — Department of Homeland Security Secretary Kristi Noem, acting FEMA administrator David Richardson and former leader Cameron Hamilton — who lack the legal qualifications and authority to manage FEMA's operations.

This has eroded and hindered the agency's ability to effectively manage emergencies and other operations, including national security work, the letter says.

After Hurricane Katrina became one of the worst disasters in the nation's history, in part because of failures of local, state and federal governments, Congress passed the Post- Katrina Emergency Reform Act to give FEMA more power and responsibility. That hurricane made landfall in Louisiana in August 2005, leading to at least 1,800 deaths and $100 billion in damage. The resulting legislation let FEMA better prepare communities for and help them recover from disasters.

But the letter warns that the Trump administration is sending the agency and country back to a pre-Katrina era by not having a Senate-confirmed and qualified emergency manger at the helm; by slashing mitigation, disaster recovery, training and community programs; and by thwarting officials' ability to make decisions because of a restrictive new expense policy.

The letter demands that federal lawmakers defend FEMA from DHS interference, protect the agency's employees from "politically motivated firings," conduct more oversight and ultimately take FEMA out of DHS and establish it as an independent Cabinet-level agency in the executive branch.

"Our shared commitment to our country, our oaths of office, and our mission of helping people before, during, and after disasters compel us to warn Congress and the American people of the cascading effects of decisions made by the current administration," the employees wrote, adding that they are sounding the alarm "so that we can continue to lawfully uphold our individual oaths of office and serve our country as our mission dictates."

During Katrina, the DHS secretary "had difficulty coordinating the disparate activities of Federal departments" and "lacked real-time, accurate situational awareness of both the facts from the disaster area as well as the on-going response activities of the Federal, State, and local players," a federal review found.

Some of the same issues played out during the deadly Texas floods in July because Noem's budget restrictions kept teams from moving quickly. In their letter, the employees said that disaster "proved the inefficiencies, ineffectiveness, and dangers of the processes and decisions put forth by the current administration."

As of Sunday evening, 36 employees had signed their full name and about 150 others had signed anonymously.

In a statement, DHS said it is "committed to ensuring FEMA delivers" for Americans.

"The Trump Administration has made accountability and reform a priority so that taxpayer dollars actually reach the people and communities they are meant to help," acting press secretary Daniel Llargues said in a statement.

The statement referred to actions the agency had already undertaken during Noem's tenure, including awarding more than $6 billion in individual assistance for disaster recovery and more than $17 billion in public assistance.

The show of resistance from FEMA employees is the latest example of federal employees speaking out against the Trump administration's actions and policies, in many cases putting their jobs and safety at risk. It began in June when National Institutes of Health employees issued a letter modeled after Director Jay Bhattacharya's dissent against the government's COVID-19 policies in 2020. Employees at the Environmental Protection Agency, NASA and the National Science Foundation followed suit.

Nearly 140 EPA employees were put on leave after their letter of dissent last month.

There are a number of other agencies coalescing and mapping out similar declarations to push back against the dismantling of their institutions, said Jeremy Berg, a board member for Stand up for Science, which has been helping advise federal workers on the declarations.

Berg served as director of the NIH's National Institute of General Medical Sciences from 2003 to 2011.

"Some people are risking everything but can't live with themselves if they don't do it and are ready to struggle on unemployment if they get fired," Berg said. "It's a real profile in courage to watch."

FEMA has faced drastic institutional changes in recent months, from the loss of a third of its workforce to programs that help communities prepare for disasters and rebuild after they've been hit.

Over the past six months, the administration has cut funding or frozen major programs that FEMA employees said save lives and can reduce future devastation from climate change. Trump officials have also not given out hazard mitigation grants, which fund resilience projects, since February despite many states having applied for them after floods and winter storms. Administration officials have also scaled back or scrapped several programs related to climate and science, arguing they are cutting costs and preventing fraud.
​
"This administration's decision to ignore and disregard the facts pertaining to climate science in disasters shows a blatant disregard for the safety and security of our Nation's people and all American communities regardless of their geographic, economic or ethnic diversity," the FEMA employees said in their letter.