Wall-to-wall public health news this week. Susan Monarez testified to Congress about her dramatic firing, ACIP voted to change something related to vaccines, plus lots of product recalls… and, of course, RFK Jr. I’ve got a measles outbreak update for you, too. Buckle up, the ACIP news toward the end is a ride.

Real quick, do you know about the DermaRite recall? DermaRite voluntarily recalled many of its products in August due a concern of bacterial contamination that could cause sepsis. Check out their full list of recalled products and throw away any that you have that match this list.

Several new recalls were announced this week, too, ranging from a Paris Hilton mini fridge to lead-contaminated cinnamon to exploding sparkling wine. I looked at my spice cabinet and found three different cinnamons hiding in there. Thankfully, none are on the recall list. Go check yours really quick, just in case!

For future recalls, it’s a great idea to follow agencies like the CPSC, but you can also make a habit of checking their aggregate of several different recall lists. The website is……….. old. Maybe retro is a more polite way to put it. They clearly need more funding at the agency to clean up and modernize their websites and streamline delivering recall notices. Either way, the information is still good, so check this retro site out to make sure you’re not hanging onto anything dangerous!

Dr. Susan Monarez testified to Congress on Wednesday. She was the CDC director for all of a month before RFK Jr fired her, despite him working to land her the job in the first place. She confirms in her testimony that RFK Jr wanted her to pre-approve changes to vaccine recommendations a month before changes would be announced by the ACIP meetings in September. She claims she saw no data to support changing anything regarding vaccine recommendations. It sounds like she and RFK Jr really fought it out over her refusal to pre-approve changes. Here’s a short clip of this testimony (2.5 minutes):

In her testimony Wednesday, Monarez said the following about the Thursday and Friday ACIP meetings:

Maybe the new ACIP panel members… won’t be able to understand the data. Not to spoil what’s ahead in the newsletter, but I was certainly feeling that way when I was watching the meeting.

She also said this, which spoke to me:

Speaking of diseases we fought hard to defeat… Here’s a quick update on the current measles outbreak in the US.

There’s been a confirmed measles exposure in the O’Hare Airport on September 11th. If you were in the O’Hare Airport on the 11th, watch this video for details on when and where in the airport the exposure occurred. Measles is extremely contagious and you could get sick up to 21 days after the day of exposure!

The number of new cases has trended downward in the United States, but new cases are still being diagnosed. Here’s the trend of cases diagnosed per week, from the CDC (updated September 17th):

In the last week of data from the CDC, only one new case of measles was diagnosed. That’s the lowest we’ve seen in months. That doesn’t mean we’re out of the woods, as we aren’t vaccinating kids at the rate needed for herd immunity in a majority of states. Here’s the CDC’s graphic on kindergartner vaccination rates from 2023-2024 (the latest data we have). States in orange aren’t at the level of vaccination needed for herd immunity:

Hepatitis B Vaccines were on the ACIP agenda this Thursday. This vaccine hasn’t really been noteworthy outside of the public health field, where the vaccine is championed for astronomically reducing yearly infections of Hep B. But it can’t be that simple, with antivaxxers, can it?

Anyone can be an asymptomatic carrier of Hep B and transmit it to others without knowing. It’s recommended that pregnant people get a Hepatitis B test at their first prenatal visit to their doctor. This screen should be completed every single time a person gets pregnant, in case they contract Hep B between pregnancies.

Newborns receive a Hepatitis B vaccine within 24 hours of being born. This is called a birth dose. The birth dose, combined with a completion of the vaccine series in infancy and childhood, significantly protects children from contracting Hep B in their lives. If the pregnant parent is positive for Hep B, the birth dose also protects the infant from developing Hep B. Parents can refuse this birth dose, if they choose, according to someone I know that just gave birth a couple months ago.

Hep B infections can become chronic, with lifelong complications and damage to the liver. That includes possibly developing liver cancer. Chronic infections are more likely to develop in children than adults. The American Academy of Pediatrics points out that 25% of children that get a chronic Hep B infection will die from Hep B. A quarter!!!

Antivaxxers are a known political force after the COVID-19 vaccine was developed and hit the market. Antivaxxers as a group, however, face a tremendous barrier in their cause to remove vaccine mandates (and forgo vaccines altogether): the overwhelming amount of data that proves vaccines are effective. It would take too long to get into exploring the depth and breadth of this data in totality, there is so much of it. Vaccinations are also generally really popular in the United States.

So what does an antivaxxer do if they want to wrestle control over this narrative despite the evidence that they’re wrong? The move in 2025 is to say “I’m not an antivaxxer, I just have concerns about some of our vaccines. Some are effective, but who gets them and when is ~concerning~.” This is an attempted dodge of the data by conceding that vaccines do work while simultaneously trying to sow doubt and create more barriers to getting vaccinated.

How do I know this? I read forums where antivaxxers talk with each other about how reasonable they are for their belief that the Hep B vaccine works BUT that newborns shouldn’t get it. The argument is as follows: pregnant people are routinely screened for Hep B, and if that result is negative, then it’s needless suffering for a newborn to get a shot. The implication is that big pharma is taking advantage of parents during the vulnerability of birth to profit off the Hep B vaccination while it’s basically “impossible” for the newborn to get Hep B. Reader, it is possible for a newborn to get Hep B even if routine screens of the pregnant parent is negative!!!! I have to tell you that ASAP in case you read that argument and think they have some good points.

Hepatitis B is spread through blood or bodily fluids, not including saliva or nasal mucous. Childbirth is the most common way that newborns are exposed to Hep B in the United States. But just because the birthing parent tested negative at the start of pregnancy doesn’t mean they didn’t contract it after testing and before giving birth! The tests themselves aren’t perfect either, it’s possible to get false negative or false positive results.

Even if we assumed screening tests worked as well as the birth dose, we don’t screen every single person the infant will interact with. Children also can contract Hep B from asymptomatic caregivers or family members. From the perspective of costs, it is actually cheaper to give the birth dose than it would be to force anyone interacting with children to complete regular mandatory screening. Big pharma would make more money from those tests and subsequent treatments than they do with the preventative medicine.

Alright, the moment we’ve all been anticipating has hit the fan. On Thursday, I had time before a call to tune into the livestreamed ACIP meeting on the Hep B vaccine and the MMRV (combined MMR and chickenpox, or Varicella) vaccine. I went from placid listening to nuclear rage in approximately 45 seconds upon tuning in. Thankfully, my scheduled call saved me from completely losing the rest of my afternoon to rage watching the rest of the meeting.

To catch you up on this event: RFK Jr has cleared house at the ACIP and installed people the New York Times labels as… “activists.” To say I disagree with this phrasing is an understatement, they largely are antivaxx for all intents and purposes. In normal times, the ACIP meets annually to discuss and potentially change government guidance regarding vaccines, including changes to the recommended vaccine schedule for children and adults. Hence their full name: Advisory Committee on Immunization Practices.

These are certainly not normal times.

The small moment I watched was regarding the Hep B vaccine. Data was shown and the person speaking quite unprofessionally and unscientifically extrapolated from the data, implying that serious risks were being overlooked. What was the data? The data showed around 20% of babies had symptoms of crying and being fussy after the Hep B vaccine was given. Her extrapolation? This is indicative of serious possible neurological issues that may need future treatment. Cue my gasket blowing.

Apparently, this wasn’t a wildly convincing argument, as they pushed making any decision on Hep B to Friday’s session, where they were scheduled to only discuss the COVID vaccine. On Friday, they then voted to delay making any changes to the Hep B vaccine recommendations. It’s unusual that the Hep B birth dose would get so much focus only to delay a vote, especially since there isn’t anything new in the scientific literature surrounding this shot. My concern is this was brought up just to broadcast the idea that this is a controversial procedure and sow doubt in the minds of a bigger audience than antivaxxer groups and internet forums. If the family group chat I’m privy to is an indication, more people are suddenly becoming wary of the Hep B vaccines.

It’s not a good sign that Friday evening my Bluesky timeline had several PhDs trying to hash out what the ACIP actually changed in the vaccine landscape with the votes they held. Personally, I think the antivaxxer play here is to create confusion and sow doubt and division about the effectiveness of these vaccines. Fiercely enacting obvious barriers would likely rally wider vaccine support that could shut them down. But confusion in the healthcare ecosystem doesn’t rally the public, it just makes healthcare providers frustrated. This write-up on CNN is pretty comprehensive, if you want a deep dive into the results of their votes. Here’s the main takeaways:

These votes aren’t a final decree—they still need approval by the CDC head. That would have been Dr. Monarez before she was fired for not pre-approving these votes. Now they’ll go to the acting head, Jim O’Neill (another RFK Jr goon).

I have to stress this point: this is really odd and confusing. Again, I’m assuming this is by design, though I’m sure some of it is due to incompetence. Dr. Monarez’s testimony really clued me in to RFK Jr’s understanding of public health. It sounds like he despises it, quite frankly, and I anticipate further confusion in the future regarding recommendations like these. The more confusing it is, the harder it is to fight. And the harder it is for Americans to get the preventative care we’ve had for decades! Bleak.

If you haven’t gotten your fall vaccines yet, I’d encourage you to do so (or at least try, depending on if you can get the shots in your state)!

There’s so much I followed this week, but I can’t write about it all. Take a look at these stories yourself, if you’re hungry for more:

Public health has historically ebbed and flowed. We eradicated measles in the US once before, and we can do it again. Keep that in mind, if the news has you down this week. You can listen to this as a pick-me-up, too. Whatever you do, don’t succumb to doom scrolling, ya hear!

See y’all next week,

Professor Batty