NEW YORK (AP) — The Trump administration is appealing a judge’s order as it tries to cut the number of vaccines recommended for every child in the United States.

The appeal filed Wednesday was a response to a March 16 court order that blocked the decision by President Donald Trump’s health secretary, Robert F. Kennedy Jr, to end broad recommendations for all children to be vaccinated against flurotavirus, hepatitis A, hepatitis B, some forms of meningitis and RSV, a respiratory virus.

U.S. District Judge Brian Murphy’s order also stopped a meeting of a Kennedy-appointed vaccine advisory committee.

The judge’s order remains in effect while the appeal is considered.

The government’s one-sentence filing did not say why the block should be lifted. U.S. health officials did not immediately comment on the filing, or respond to a question about why they waited six weeks to file an appeal.

The appeal is the latest development in a lawsuit filed in July by the American Academy of Pediatrics and some other medical groups. The lawsuit in federal court in Boston originally focused on Kennedy’s decision to stop recommending COVID-19 vaccinations for most children and pregnant women.

The lawsuit was updated as Kennedy took more steps that alarmed medical societies, causing the plaintiffs to ask Murphy to take steps to address those policy changes too.

For example, the plaintiffs amended the lawsuit to stop the scaling back of the nation’s childhood vaccination schedule. They also asked the court to look at Kennedy’s actions concerning the Advisory Committee on Immunization Practices, which advises public health officials on what vaccines to recommend to doctors and patients.

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

Murphy, who was nominated to the bench by Democratic President Joe Biden, said Kennedy’s reconstitution of ACIP likely violated federal law. The judge ordered the appointments — and all decisions made by the reformulated committee — put on hold.

Earlier this month, the Republican administration updated the committee’s charter to broadens qualifications for panel members in ways that would allow the inclusion of Kennedy allies. That move did not resolve the legal challenge, according to Richard Hughes IV, a lawyer representing the pediatrics group.

Hughes this week said he was disappointed that the government decided to appeal but said he expected to prevail. He pledged to bring an end to Kennedy’s “steady destruction of vaccine policy and public health.”

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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.

WASHINGTON (AP) — President Donald Trump said Thursday he’s nominating radiologist and former Fox News Channel contributor Dr. Nicole Saphier for surgeon general after Dr. Casey Means’ path forward stalled in the Senate over questions about her experience and her stance on vaccines.

In a social media post, Trump said he would nominate Saphier, whom he called “a STAR physician who has spent her career guiding women facing breast cancer through their diagnosis and treatment.” Health Secretary Robert F. Kennedy Jr. complimented the nomination, calling Saphier “a long-time warrior for the MAHA movement.”

But at least in one instance, she hasn’t been in lockstep with Trump’s thoughts on health policy, telling The Associated Press in September that his cautions about pregnant women taking Tylenol were oversimplistic and “patronizing.”

Means’ withdrawal came after her tense exchanges with lawmakers of both parties threw into question whether she could secure enough votes to advance out of the Senate health committee.

In an interview Thursday, Means said her nomination fell apart after a “yearlong smear campaign against me,” which she said was a larger effort to impugn the MAHA movement and its focus on reforming food and healthcare.

She said she will continue to “help with progress on this movement how I can.”

Means pitched ideas popular with MAHA

In nominating Means last May, Trump sought to hire a close Kennedy ally as the nation’s doctor. The 38-year-old Means, a Stanford-educated physician who became disillusioned with the health care system and pivoted to a career as an author and entrepreneur, promotes ideas popular with the MAHA movement, including that Americans are overmedicalized and that diet and lifestyle changes should be at the center of efforts to end widespread chronic disease.

But Means, who did not finish her surgical residency program and doesn’t currently have an active medical license, also had faced scrutiny for her lack of experience and potential conflicts. On top of those concerns, senators grilled her in February about Kennedy’s effort to pull back vaccine recommendations — leading to some contentious moments as Means toed the line between support for vaccines and calling them a decision best made by patients and their doctors.

In her confirmation hearing, Means was repeatedly asked about the birth dose of the hepatitis B vaccine, which the U.S. Centers for Disease Control and Prevention stopped recommending for all children late last year in a move criticized by scientific and medical groups nationwide and currently blocked during a lawsuit. Means has raised doubts about the birth dose, posting on social media in 2024 that giving the vaccine to a newborn whose parents don’t have hepatitis B was “absolute insanity.”

Means’ nomination had languished since the late February confirmation hearing, even as activists from the MAHA movement orchestrated a push to support her bid by surging phone calls to Republican senators Lisa Murkowski of Alaska and Susan Collins of Maine. They had both indicated reservations with the pick.

Means told The Associated Press her understanding was that Murkowski wasn’t going to vote for her, and Collins had serious reservations.

“I think there was some talking past each other,” Means said of her conversations with the senators, noting they seemed focused on vaccines when she “wasn’t coming in with any agenda to impact the vaccine conversation.”

In post Thursday, Trump called Means “a strong MAHA Warrior” and also criticized the “intransigence and political games” from GOP Sen. Bill Cassidy of Louisiana, the chair of the Senate health committee, who is facing a tough reelection this year and who interrogated Means about vaccines during the hearing.

Means’ brother, Calley Means, a health adviser to the Trump administration, blamed Cassidy in a social media post, claiming his “constant delay tactics” sank the nomination because he didn’t bring Means’ nomination to a committee vote. Kennedy later piled on with his own post claiming Cassidy “did the dirty work for entrenched interests seeking to stall the MAHA movement.” Cassidy didn’t respond to a request for comment.

Now Trump will try to fill the post a third time

Means is the second U.S. surgeon general pick whose nomination has been withdrawn in Trump’s second term. Trump withdrew his first nominee, Fox News medical contributor Janette Nesheiwat, after questions were raised about her academic credentials.

Saphier is director of breast imaging at Memorial Sloan Kettering Monmouth, according to her profile on the New York-based institution’s website. She has a doctor of medicine degree from Ross University School of Medicine in Barbados along with fellowships at the Mayo Clinic, the profile said.

Like Means, Saphier has questioned whether every child needs to get the hepatitis B vaccine at birth.

“I don’t necessarily think it’s necessary,” she said on a podcast in September. “My opinion is if a woman recently tested negative for hepatitis B and they’re living a low-risk lifestyle, no IV drug use, not a sex worker, they don’t have a hepatitis B positive person living in the home, then the newborn probably doesn’t need this vaccine and we can have a conversation about whether or not they should get the vaccine later in life.”

She also has criticized COVID vaccine booster requirements, arguing on a radio show in September that they were not always rooted in evidence.

Saphier used the phrase “Make America Healthy Again” years before Kennedy popularized it. It was the title of a book she wrote in 2020 that criticized government handling of health care and the Affordable Care Act.

In at least one case, Saphier has diverted from Trump’s medical messaging. Last year, as Trump advised pregnant women, “Don’t take Tylenol” — promoting unproven and in some cases discredited ties between the medication, vaccines and autism — Saphier said that while pregnant women generally are advised to take acetaminophen only under medical supervision, when necessary and at the lowest effective dose, equally important was that untreated fever or severe pain can also pose serious risks to mothers and babies. She noted that part was missing from Trump’s message, delivered at a press conference with top U.S. health officials.

“For decades, women have endured a paternalistic tone in medicine. We’ve moved past dismissing symptoms as ‘hysteria,’” Saphier wrote in an email to the AP at the time. “The President’s recent comments on Tylenol in pregnancy are a prime example. Advising moderation was sound; delivering it in a patronizing, simplistic way was not.”

On a podcast at the time, Saphier said the press conference was “full of hyperbole” and “really painful to watch.”

Saphier did not respond to a request for comment.

___ Kinnard reported from Columbia, S.C.

DUBAI, United Arab Emirates (AP) — Iran’s supreme leader defiantly vowed Thursday to protect the Islamic Republic’s nuclear and missile capabilities, which U.S. President Donald Trump has sought to curtail through airstrikes and as part of a wider deal to cement the war’s shaky ceasefire.

In a statement read by a state television anchor, Ayatollah Mojtaba Khamenei said the only place Americans belonged in the Persian Gulf is “at the bottom of its waters” and that a “new chapter” was being written in the region’s history. Khamenei has not been seen in public since taking over as supreme leader following the killing of his father in the war’s opening airstrikes.

His remarks come as Iran’s economy is reeling and its oil industry is being squeezed by a U.S. Navy blockade halting its tankers from getting out to sea. The world economy is also under pressure as Iran maintains its chokehold on the Strait of Hormuz, through which a fifth of all crude oil is transported. On Thursday, the global benchmark for oil, Brent crude, traded as high as $126 a barrel.

That shock to oil supplies and prices is putting pressure on Trump, who is floating a new plan to reopen the critical passageway used by the U.S.’s Gulf allies to export their oil and gas.

Under the plan, the U.S. would continue its blockade on Iranian ports, while coordinating with allies to impose higher costs on Iran’s attempts to subvert the free flow of energy, according to a senior administration official, who spoke on condition of anonymity because they were not authorized to comment publicly.

In a cable sent Tuesday, the U.S. State Department instructed American diplomats around the world — except those in Belarus, China, Cuba and Russia — to seek their host government’s support for the Trump administration’s call for assistance in establishing a “maritime freedom construct” that would ensure free and unimpeded access to shipping through the strait.

“This commitment reflects broad international consensus on the need for coordinated action to counter Iranian maritime provocations and ensure navigational rights and freedoms in the Strait of Hormuz,” said the cable, a copy of which was obtained by The Associated Press on Thursday.

The initiative, being led by the State Department and the Pentagon’s Central Command, “is a fundamentally defensive response to protect the rights of all countries to navigate international waters freely and safely and to hold Iran accountable for its aggressive and illegal actions to impede the free flow of commerce,” the cable said.

At the same time, Trump has also floated possible changes to U.S. troop presence in allied countries in Europe. The day after the president announced his administration was conducting a review on potentially reducing the U.S. troop presence in Germany, he was asked by a reporter whether he’d weigh pulling U.S. forces out of Italy and Spain — which have sparred with the United States over use of bases for Iran-related operations.

“Why shouldn’t I,” Trump answered. “Italy has not been of any help to us, and Spain has been horrible, absolutely horrible.”

Ceasefire shaken as strait remains shut

The U.S. blockade — which as of Thursday has turned back some 44 commercial vessels, according to U.S. Central Command — is designed to prevent Iran from selling its oil, depriving it of crucial revenue while also potentially creating a situation where Tehran has to shut off production because it has nowhere to store oil.

A recent Iranian proposal would push negotiations on the country’s nuclear program to a later date. Trump said one of the major reasons he went to war was to deny Iran the ability to develop nuclear weapons. Iran has long maintained its program is peaceful, though it enriched uranium at near-weapons-grade levels of 60%.

Pakistan on Thursday said it was still facilitating indirect talks between the U.S. and Iran aimed at easing tensions, but that Islamabad would also welcome direct communication between the two sides, even by phone.

“If the two parties can engage in real-time conversations, that could ease the sticking points,” said Ministry of Foreign Affairs spokesperson Tahir Andrabi at a weekly news briefing. He declined to share details of any Iranian or U.S. proposals.

Speaking to mark Persian Gulf Day in Iran, Khamenei’s remarks signaled that nuclear issues and Iran’s ballistic missile program wouldn’t be traded away.

“Ninety million proud and honorable Iranians inside and outside the country regard all of Iran’s identity-based, spiritual, human, scientific, industrial and technological capacities — from nanotechnology and biotechnology to nuclear and missile capabilities — as national,” Khamenei said.

Khamenei referred to America as the “Great Satan,” a long hurled insult by Iranian leaders toward the U.S. since the 1979 Islamic Revolution.

Khamenei signals strait will remain shut

In his remarks, Khamenei seemed to signal Iran would maintain its control over the waterway, which sits in the territorial waters of Iran and Oman. Iran had been charging some ships reportedly $2 million apiece to travel through the strait.

He said that Iran’s control of the Strait of Hormuz will make the Gulf more secure, and that Tehran’s “legal rules and new management” of the strait will benefit all the region’s nations.

However, the world considered the strait an international waterway, open to all without paying tolls. Gulf Arab nations, chief among them the United Arab Emirates, have decried Iran’s control of the strait as akin to piracy.

Crackdown intensifies in Iran

Iran announced Thursday it hanged a 21-year-old man over charges stemming from the nationwide protests in Januarythe judiciary’s Mizan news agency reported.

The agency identified the executed man as Sasan Azadvar, from Isfahan. It said he was hanged for the crime of “effectively cooperating with the enemy by attacking police officers” during the protests.

Activists and rights groups say a crackdown on dissent, including a wave of executions, has further intensified since the U.S.-Israel war with Iran.

U.N. Human Rights Chief Volker Turk said on Wednesday at least 21 people have been executed since the start of the war.

Iran routinely holds closed-door trials in which defendants are unable to challenge the accusations they face, rights groups say, warning that several other people remain at risk of execution.

Fighting continues in southern Lebanon

Despite a ceasefire between Israel and Lebanon-based, Iran-backed Hezbollah militants, the group has continued to claim attacks on Israeli troops in southern Lebanon. Israel’s military said one of its soldiers was killed in battle there Thursday, raising the troop casualties to 17 since the Iran war started.

Air raid sirens sounded multiple times in border communities in northern Israel on Thursday, too. The Israeli military said it struck military structures used by Hezbollah, and the Lebanese Health Ministry said 9 were killed in strikes, including women and children.

Late on Thursday, the foreign ministry of United Arab Emirates — which has come under attack by Iran during war — announced a travel ban for its citizens covering Iran, Lebanon and Iraq, and urged those already in those countries to return home.

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Madhani reported from Washington. Associated Press writers Matthew Lee in Washington, Munir Ahmed in Islamabad, Amir Vahdat in Tehran, Iran, Sarah El Deeb and Kareem Chehayeb in Beirut, and Giovanna Dell’Orto in Minneapolis contributed to this report.