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The Dictatorship

Changes to the US vaccine recommendations are sowing confusion and could harm kids

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Changes to the US vaccine recommendations are sowing confusion and could harm kids

Dr. Molly O’Shea has noticed growing skepticism about vaccines at both of her Michigan pediatric offices and says this week’s unprecedented and confusing changes to federal vaccine guidance will only make things worse.

One of her offices is in a Democratic area, where more of the parents she sees are opting for alternative schedules that spread out shots. The other is in a Republican area, where some parents have stopped immunizing their children altogether.

She and other doctors fear the new recommendations and the terminology around them will stoke vaccine hesitancy even more, pose challenges for pediatricians and parents that make it harder for kids to get shots, and ultimately lead to more illness and death.

The biggest change was to stop blanket recommendations for protection against six diseases and recommend those vaccines only for at-risk children or through something called “shared clinical decision-making” with a health care provider.

The phrase, experts say, is confusing and dangerous: “It sends a message to a parent that actually there’s only a rarefied group of people who really need the vaccine,” O’Shea said. “It’s creating an environment that puts a sense of uncertainty about the value and necessity or importance of the vaccines in that category.”

Health Secretary Robert F. Kennedy Jr.who helped lead the anti-vaccine movement for years, said in announcing the changes that they better align the U.S. with peer nations “while strengthening transparency and informed consent.”

But doctors say they are sowing doubt — the vaccines have been extensively studied and proven to be safe and effective at shielding kids from nasty diseases — at a time when childhood vaccination rates are already falling and some of those infectious diseases are spreading.

On Friday, the American Academy of Pediatrics and more than 200 medical, public health and patient advocacy groups sent a letter to Congress about the new childhood immunization schedule.

“We urge you to investigate why the schedule was changed, why credible scientific evidence was ignored, and why the committee charged with advising the HHS Secretary on immunizations did not discuss the schedule changes as a part of their public meeting process,” they wrote.

Many don’t know what ’shared decision-making’ means

O’Shea said she and other pediatricians discuss vaccines with parents at every visit where they are given. But that’s not necessarily “shared clinical decision-making,” which has a particular definition.

On its website, the Advisory Committee on Immunization Practices says: “Unlike routine, catch-up, and risk-based recommendations, shared clinical decision-making vaccinations are not recommended for everyone in a particular age group or everyone in an identifiable risk group. Rather, shared clinical decision-making recommendations are individually based and informed by a decision process between the health care provider and the patient or parent/guardian.”

In this context, health care providers include primary care physicians, specialists, physician assistants, nurse practitioners, registered nurses and pharmacists.

A pair of surveys conducted last year by the Annenberg Public Policy Center at the University of Pennsylvania suggested that many people don’t fully understand the concept, which came up last year when the federal government changed recommendations around COVID-19 vaccinations.

Only about 2 in 10 U.S. adults knew that one meaning behind shared decision-making is that “taking the vaccine may not be a good idea for everyone but would benefit some.” And only about one-third realized pharmacists count as health care providers to talk with during the process, even though they frequently administer vaccines.

As of this week, vaccines that protect against hepatitis A, hepatitis B, rotavirus, RSV, flu and meningococcal disease are no longer universally recommended for kids. RSV, hepatitis A, hepatitis B and meningococcal vaccines are recommended for certain high-risk populations; flu, rotavirus, hepatitis A, hepatitis B and meningococcal vaccines are recommended through shared decision-making — as is the COVID-19 vaccine, although that change was made last year.

Shortly after the federal announcement Monday, Dr. Steven Abelowitz heard from half a dozen parents. “It’s causing concern for us, but more importantly, concern for parents with kids, especially young kids, and confusion,” said Abelowitz, founder of Ocean Pediatrics in Orange County, California.

Though federal recommendations are not mandates — states have the authority to require vaccinations for schoolchildren — they can affect how easy it is for kids to get shots if doctors choose to follow them.

Under the new guidelines, O’Shea said, parents seeking shots in the shared decision-making category might no longer bring their kids in for a quick, vaccine-only appointment with staff. They’d sit down with a health care provider and discuss the vaccine. And it could be tougher to have a flu clinic, where parents drive up and kids get shots without seeing a doctor.

Staying the course as challenges mount

Still, doctors say they won’t let the changes stop them from helping children get the vaccines they need. Leading medical groups are sticking with prior vaccine recommendations. Many parents are, too.

Megan Landry, whose 4-year-old son Zackary is one of O’Shea’s patients, is among them.

“It’s my responsibility as a parent to protect my child’s health and well-being,” she said. “Vaccines are a really effective and well-studied way to do that.”

She plans to keep having the same conversations she’s always had with O’Shea before getting vaccines for Zackary.

“Relying on evidence and trusted medical guidance really helps me to make those decisions,” she said. “And for me, it’s not just a personal choice for my own son but a way to contribute to the health of everybody.”

But for other families, confidence about vaccines is waning as trust in science erodes. O’Shea lamented that parents are getting the message that they can’t trust medical experts.

“If I take my car to the mechanic, I don’t go do my own research ahead of time,” she said. “I go to a person I trust and I trust them to tell me what’s going on.”

Abelowitz, the California doctor, likened the latest federal move to pouring gasoline on a fire of mistrust that was already burning.

“We’re worried the fire’s out of control,” he said. “Already we’ve seen that with measles and pertussis, there are increased hospitalizations and even increasing deaths. So the way that I look at it — and my colleagues look at it — we’re basically regressing decades.”

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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.

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The Dictatorship

The Latest: US and Israel attack Iran as Trump says US begins ‘major combat operations’

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The Latest: US and Israel attack Iran as Trump says US begins ‘major combat operations’

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The Dictatorship

‘It’s fantastic’: Trump tells MS NOW he’s seen celebrations after Iran strikes

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President Donald Trump called the celebrations in the streets of Iran “fantastic” following the killing of the country’s supreme leaderAyatollah Ali Khamenei, during a brief phone call with MS NOW on Saturday night.

Trump told MS NOW that he’s seen the celebrations in Iran and in parts of America, after joint U.S.-Israel airstrikes killed Khamenei.

“I think it’s fantastic,” the president said of the celebrations. “I’ve seen them in Los Angeles, also — celebrations.”

“I’ve seen them in Los Angeles, celebrations, celebrations,” Trump said, accentuating the point.

The interview took place roughly 11 hours before the Pentagon announced the first U.S.military casualties of the war. U.S. Central Command said three American service members were killed in action, and five others had been seriously wounded.

Revelry broke out in Iran, the United States and across the globe on Saturday, with Iranians cheering the death of Khamenei, who led Iran with an iron fist for more than 30 years, cracking down on dissent at home and maintaining a hostile posture with the U.S. and Israel.

Asked how he was feeling after the strike on Khamenei, whose death was confirmed just a few hours earlier, Trump said it was a positive development for the United States.

“I think it was a great thing for our country,” he said.

The call — which lasted less than a minute — came after a marathon day, which began in the wee hours of the morning with strikes on Iran and continued with retaliatory ballistic missiles from Tehran targeting Israel and countries in the Middle East region that host U.S. military bases.

The day ended with few answers from the White House to increasing questions about the long-term future of Iran, how long the U.S. will continue operations there, and the metastasizing ramifications it could have on the world stage. In fact, the president has done little to convince the public to back his Iran operation, nor to explain why the country is at war without the authorization of Congress.

On perhaps the most consequential day of his second term, Trump did not give a formal address to the public, nor did he hold a press conference. Instead, he stayed out of public view at Mar-a-Lago, his private club and residence in Palm Beach, Florida, where he attended a $1 million-per-plate fundraising dinner on Saturday evening.

But throughout the day, Trump took calls from reporters at various new outlets, including from MS NOW at around 11 p.m. ET.

The strikes, known formally as “Operation Epic Fury,” came after months of talks over Iran’s nuclear program, and warnings from Trump that he would strike Tehran if they did not agree to his often shifting conditions.

At 2:30 a.m. ET on Saturday, Trump posted a video to social media announcing the operation, which he said was designed to “defend the American people by eliminating imminent threats from the Iranian regime, a vicious group of very hard, terrible people.”

“The lives of courageous American heroes may be lost and we may have casualties. That often happens in war,” Trump said when he announced the strikes on Iran.

Mychael Schnell is a reporter for MS NOW.

Laura Barrón-López covers the White House for MS NOW.

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The Dictatorship

Pentagon announces first American casualties in Iran

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Pentagon announces first American casualties in Iran

Three U.S. service members were killed and five seriously wounded as the United States and Israel launched attacks on Iran, U.S. Central Command said Sunday morning.

The three service members — the first Americans to die in the conflict — were killed in Kuwait, a U.S. official said.

Several others sustained minor injuries from shrapnel and concussions but will return to duty, the Pentagon said. The identities of the dead and wounded have not been made public.

“The situation is fluid, so out of respect for the families, we will withhold additional information, including the identities of our fallen warriors, until 24 hours after next of kin have been notified,” Central Command said in a statement.

The U.S. and Israel launched sweeping airstrikes on Iranon Saturday, killing Ayatollah Ali Khameneithe country’s supreme leader for nearly four decades. Iran has vowed retaliation and hit several U.S. military bases across the region.

According to U.S. Central Command, Iran has also attacked more than a dozen locations, including airports in Dubai, Kuwait and Iraq, and residential neighborhoods in Israel, Bahrain and Qatar.

Israel Defence Forces said Sunday that Iran fired missiles toward the neighborhood of Beit Shemesh, killing civilians. The missile hit a synagogue, killing at least nine people, according to the Associated Press.

AP reported that authorities said at least 22 people were killed and 120 others wounded when demonstrators tried to attack the U.S. Consulate in Karachi in Pakistan.

The violence came after the United States and Israel attacked Irankilling its Supreme Leader Ayatollah Ali Khamenei. Police and officials at a hospital in Karachi said that at least 50 people were also wounded in the clashes and some of them were in critical condition.

On Sunday, Israel Defence Forces said on X, “It’s official: All senior terrorist leaders of Iran’s Axis of Terror have been eliminated.”

President Donald Trump told CNBC’s Joe Kernen on Sunday that the operation in Iran is “moving along very well, very well — ahead of schedule.”

In a phone call with MS NOW late Saturday, Trump called the celebrations in the streets of Iran “fantastic” following the killing of Khamenei.

Confirming Khamenei’s death, Prime Minister Benjamin Netanyahu said Sunday: “We have eliminated the tyrant Khamenei and dozens of senior figures of the oppressive regime. Our forces are now striking at the heart of Tehran with increasing intensity, set to escalate further in the coming days.”

The exchange of hostilities comes after weeks of fragile negotiations between the U.S. and Iran over Iran’s nuclear operations.

Esmail Baghaei, a spokesperson for Iran’s foreign ministry, called the joint U.S-Israeli attack an “unprovoked, unwarranted act of aggression” in an interview with MS NOW’s Ali Velshi on Sunday. He said Iran’s nuclear program has been used a pretext for the attack.

“We have every right to defend our people because we have come under this egregious act of aggression,” Baghaei said.

Trump announced the attack early Saturday during a short video posted on his Truth Social account. He called for an end to the Iranian regime and urged Iranians to “take back the country.”

Negotiators and mediators from Oman were supposed to meet in Vienna on Monday to discuss the technical aspect of a potential nuclear deal.

Rep. Eric Swawell, D-Calif., told MS NOW’s Alex Witt on Sunday afternoon that the president’s military operation in Iran was illegal, echoing what many lawmakers have said in citing that under the U.S. Constitution only Congress can declare war.

“This is a values argument. We don’t just lob missiles into other countries when we are not provoked, attacked and have no plan for what comes next,” he said.

“We have been shown zero evidence that anything changed in Iran from last year when the president did not come to Congress and took a strike on Iran,” Swalwell said.

In June the U.S. struck three Iranian nuclear sites. Trump said the facilities had been “completely and totally obliterated.” But experts and U.S. officials said the sites were damaged but not destroyed.

Erum Salam is breaking news reporter for MS NOW, with a focus on how global events and foreign policy shape U.S. politics. She previously was a breaking news reporter for The Guardian and is a graduate of Texas A&M University and the Columbia University Graduate School of Journalism. Follow her on X, Bluesky and Instagram.

Akayla Gardner is a White House correspondent for MS NOW.

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