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Tomorrow, ACIP—the advisory committee that guides U.S. vaccine policy—meets again for two days. This group has enormous influence on your access to vaccines: its decisions shape vaccine supply, insurance coverage (including Medicaid), clinicians’ understanding of what to offer you, how many doses hospitals and pharmacies stock, and the public’s confidence in what, where, when, and how to get your vaccines.

This meeting will focus on two things:

1. Hepatitis B vaccine, including a vote that could meaningfully affect infant access in the U.S.
2. The entire childhood immunization schedule, including its history, the number of doses, ingredients like aluminum, and whatever else they may pull out of their hat.

It’s going to be a ride. Mainly because a few months ago, RFK Jr. overhauled the committee, replacing long-standing experts with individuals ranging from longtime vaccine skeptics to Covid-19 contrarians.

So, here’s your guide to what to expect, including a proactive heads-up on the misleading claims likely to surface and a breakdown of the fallacies behind them. Whether you’re a clinician answering questions, a parent scrolling social media, or simply someone trying to find clarity in the chaos, I hope this is helpful.

Note: As I shared with paid subscribers yesterday, together with The Evidence Collective (TEC), we wrote a much deeper pre-bunk HERE that includes key background on all anticipated ACIP topics, practical communication guidance, a fallacy playbook, and a rundown of the falsehoods and rumors likely to surface. Below is a high-level summary.

What to expect

Credible sources suggest none—or very few—of the ACIP presentations will be delivered by CDC scientists or experts. Instead, external groups, including some with clear anti-vaccine track records, are slated to take the lead. This is highly unusual, and I’m incredibly concerned that data will be misinterpreted and misleading, and false claims will be presented as expert testimony.

Reviewing the timing, spacing, and risks of each vaccine requires scientific expertise because the stakes are high: get the evidence or timing wrong—or lose sight of the historical reasons behind these recommendations—and preventable diseases can come roaring back. And once falsehoods are aired in this forum, they can spread quickly, potentially amplified by one of the nation’s highest offices.

But there is good news.

1. There is no vote for the childhood vaccination schedule as a whole. They will only discuss it. This means timing, spacing, and availability to you won’t change. The only vote is on the Hepatitis B vaccine, specifically whether to maintain the universal birth dose given within 24 hours of life.
2. We know exactly what to expect. These players have relied on the same falsehoods and logical fallacies for decades. Their playbook hasn’t changed. That means we can prepare.

Thursday’s vote

The only vote tomorrow is on whether to keep the universal Hepatitis B birth dose, given within 24 hours of life. At September’s meeting, RFK Jr.’s ACIP proposed delaying it for infants born to mothers who test negative. This decision could significantly affect vaccine availability for infants and increase the overall number of infections.

Why the universal birth dose exists:

• Babies are especially vulnerable—9 in 10 infants who catch it become chronically infected
• 12–18% of U.S. pregnant women are never tested for hepatitis B.
• Only 35% of women who test positive get recommended follow-up care.
• The birth dose catches babies who fall through those cracks.

What the evidence shows:

• No safety, efficacy, or long-term benefit to delaying.
• Delaying to 2 months: 1,400+ additional infections, 480+ deaths per birth year.
• Since 1991, the birth dose has cut pediatric hepatitis B infections by 99%.

: Reported number of acute hepatitis B cases in the United States by year, 1980-2023 and related policy milestones. Figure by CIDRAP. Annotated by Your Local Epidemiologist (red)

The birth dose exists precisely because screening isn’t perfect. The evidence doesn’t support changing that.

Then onto Friday

On Friday, the agenda is unusually broad: the entire childhood vaccination schedule. I expect it to be a waterfall of falsehoods. Here is some clarity on the topics they are likely to cover.

1. How the vaccine schedule is built—and why it exists

The childhood vaccine schedule isn’t new. The American Academy of Pediatrics (AAP) first introduced it in 1938, when just four vaccines existed: smallpox, diphtheria, pertussis, and tetanus. Those few vaccines alone prevented tens of thousands of childhood deaths each year. Over the following decades, the addition of vaccines for polio, measles, mumps, rubella, and others drastically reduced childhood illness, disability, and death.

Many diseases on today’s schedule are now rare because of vaccines. For example, once Haemophilus influenzae type b (Hib) vaccine was added in the late 1980s, cases of severe childhood meningitis and epiglottitis dropped 71% within two years. These diseases disappeared from everyday experience, not because they stopped existing, but because the schedule worked.

In 1995, AAP and ACIP created a unified national schedule, ensuring children across the country received consistent, science-based protection. Today, the schedule protects against 17 diseases. Each year, an updated version is published on CDC’s website.

2. Why vaccines are given when they are

The schedule is designed to protect children from dangerous infections as early as possible, while spacing doses to create the strongest immune response.

• If given too early, maternal antibodies can interfere with some vaccines, or the child’s immune system may be too immature to build long-lasting protection.
• If given too late, children remain vulnerable during the period when their risk of severe disease, hospitalization, or complications is highest.

Diseases like pertussis, measles, and pneumococcal infection are especially severe in infancy and early childhood. The schedule reflects decades of research into the biology of both children’s immune systems and the pathogens themselves.

Further spacing out vaccines doesn’t provide extra safety; it extends the window of vulnerability and makes families less likely to complete the schedule.

3. Do children get “too many” vaccines?

People hesitant about childhood vaccines often claim children receive 72 or 96 doses, but these numbers are misleading.

Children receiving vaccines according to the current schedule receive about 54 doses over 18 years, protecting against 17 diseases. And a third of those are yearly flu vaccines. Misleading and inflated counts might include every yearly flu and Covid-19 shot, count combination vaccines (like MMR) as separate vaccines, or count vaccines given to pregnant mothers. The exact number varies based on timing, catch-up schedules, health conditions, and available formulations.

Our immune systems can’t be overwhelmed, either. Today’s vaccine antigens represent a tiny fraction of what immune systems encounter daily from normal environmental exposures. For example, young children average up to 8 to 12 colds per year. Routine infections stimulate strong immune responses—thankfully, that’s how we recover from illness. Children’s bodies are made to respond and learn from what they’re exposed to, and are not “overwhelmed.”

It’s true that children born before the 1990s received fewer vaccines than today’s kids. But over the years, we’ve exposed children to fewer and fewer antigens (parts of microbes that stimulate the immune system) while protecting against more diseases. Because we target immune protection far more efficiently. In the mid-1980s, children were exposed to 3,000 antigens in vaccines. Now it’s 180.

Figure made by Your Local Epidemiologist

4. Has the entire vaccine schedule been studied?

Hundreds of studies have examined the safety of individual vaccines and common combinations, but few have evaluated the entire childhood immunization schedule. Studies in other countries that have similar vaccination schedules have found no red flags:

• A German study compared disease rates among kids who completed the vaccine schedule to those who didn’t. As expected, unvaccinated individuals have a much higher rate of vaccine-preventable diseases.
• A U.K. study of nearly six million childhood vaccine doses found that administering vaccines according to the schedule is safe—any increase in reactions was limited to mild, temporary effects such as fever.

Ethical and feasibility considerations constrain research to the fullest extent. Randomized trials assigning children to delayed or no vaccination would require withholding proven protection, which is unethical. We continually evaluate safety through trials of each new vaccine, during which children receive the full existing schedule, effectively testing the schedule and the new product. Regulators require additional “concomitant use” studies to assess how vaccines interact when given together, ensuring they are tested in the same combinations and at the exact timing used in real life.

5. Aluminum, ingredients, and other familiar targets

Aluminum has been used safely in vaccines for more than 90 years.

Trace amounts of aluminum in shots strengthen the immune response, helping the body develop better protection. It allows vaccines to use smaller amounts of antigen and reduce the number of doses needed.

Fortunately, we have recent and high-quality data showing this is safe. A recent Danish study examined more than 1.2 million children born between 1997 and 2018, following them for up to 24 years—one of the largest vaccine safety studies ever conducted. Researchers analyzed 50 different conditions: autoimmune, allergic, and neurodevelopmental, including autism and ADHD. They tested whether greater aluminum exposure was associated with a higher risk of disease. They found no evidence of harm, no dose-response relationship, and no increased risk for any of the 50 conditions studied.

There are other options. (Currently, five adjuvants are available on the market.) However, companies would need to develop new vaccine formulations with alternative adjuvants and conduct new clinical trials. This would be expensive and difficult on a practical level (recruiting enough participants, getting enough cases of disease to determine whether the vaccines actually work as well or better than the aluminum-adjuvanted ones, etc.). Furthermore, aluminum adjuvant is already preferred in childhood vaccines because it tends to be much better tolerated than other adjuvants.

How to recognize the playbook

It’s impossible to anticipate each potential misleading or false claim that may emerge this week. DNA fragments in vaccines will likely come up. Autism almost certainly will. Responding to vaccine falsehoods and rumors, as we’ve done here, can feel like whack-a-mole—refuting one false statement after another in a never-ending cycle. So, while we work to debunk specific claims, it’s equally important to understand the underlying tactics. Recognizing patterns will help us all be more discerning, regardless of the topic.

Watch for:

• False authority (non-experts framed as experts)
• Appeal to fear (magnifying tiny risks, minimizing bigger ones)
• Correlation ≠ causation
• Cherry-picking (one flawed study vs. dozens of high-quality ones)
• Moving goalposts (“if it’s not thimerosal, then aluminum… or DNA…”)
• Reversing the burden of proof (demanding that others disprove a claim instead of providing evidence for it)
• Anecdotes as evidence
• Naturalistic fallacy (“natural immunity is better”)
• False balance (“both sides” even when evidence is lopsided)

These tactics matter because they’re designed to confuse, overwhelm, and erode trust. Not inform.

Bottom line

These vaccine policy meetings have real-world consequences—for your access to vaccines, for how diseases show up in your community, and for the rumors and falsehoods that will inevitably flood social media, podcasts, and other information spaces.

We’ll be back with Cliff notes from the meeting and, most importantly, what it all means for you.

Love, YLE, Unbiased Science, and The Evidence Collective

Your Local Epidemiologist (YLE) is founded and operated by Dr. Katelyn Jetelina, MPH PhD—an epidemiologist, wife. YLE is a public health newsletter that reaches over 400,000 people in more than 132 countries, with one goal: to translate the ever-evolving public health science so that people are well-equipped to make evidence-based decisions. This newsletter is free to everyone, thanks to the generous support of fellow YLE community members.

Your Local Epidemiologist is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

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View in browser Outbreak Outlook – Northeast – Dec 2 Dec 2 READ IN APP Welcome to the Northeast edition of Outbreak Outlook! It is only available to paid subscribers. If you wish to become a paid subscriber and access region-specific information, please click the Subscribe now button below. Thanks for reading! -Caitlin Subscribed Respiratory Diseases Influenza Flu remains low, but is increasing, particularly in New York. In New York, influenza-like illness is at 2.3% of all outpatient visits, and emergency department visits have risen sharply to 1.2%, more than doubling from 0.5%. Hospitalizations for flu have increased as well, to 0.8 hospitalizations per 100,000 people, from 0.5. In New York City, flu ED visits increased 142% last week, jumping from 0.6% of ED visits to 1.6% of ED visits. Hospitalizations show a similar spike, more than doubling to 0.7% of hospitalizations. Northeast: Outpatient influenza-like illness (%) % of visits to the doctor that are for fever and cough or sore throat Pennsylvania reports 1.5% of outpatient visits for ILI, essentially unchanged from the week prior. ED visits climbed to 0.5% from 0.3%. New Jersey and Connecticut are also showing clear increases: ED visits increased substantially over the past week, to 0.9% and 0.8%, respectively. Hospitalizations more than doubled in Connecticut, but remain low overall (at 0.5). Several more states are showing slow and steady increases: ED visits are hovering around 0.4% in Massachusetts, Rhode Island, and New Hampshire. Things are still really quiet in Maine, which had a stable outpatient ILI of 0.9%, and ED visits at a low 0.2%. Similarly, Vermont is in good shape, with ED visits down to 0.1%, from 0.4% a week ago. Northeast: ED visits for influenza (%) % of visits to the emergency department that are for influenza Note: Data on outpatient ILI was not available for Vermont, New Hampshire, Connecticut, Rhode Island, Massachusetts, and New Jersey. COVID-19 Things are still in pretty good shape across the Northeast, though Covid-19 is starting to pick up in a few places. Wastewater activity is low and increasing at the regional level. In Vermont, wastewater activity is high, with viral concentrations more than doubling in the past week, and ED visits rising from 0.5 to 0.8%. Wastewater activity is low and increasing in Massachusetts, Pennsylvania, and Maine. ED visits have crept up as well in Massachusetts and Pennsylvania to 0.5% and 0.4%, respectively. In Maine, ED visits held steady at 0.3%. Northeast: ED visits for Covid-19 (%) % of visits to the emergency department that are for Covid-19 Wastewater activity is low but decreasing in New Hampshire; ED visits in the state also held roughly steady (at 0.5%). In the rest of the region (Connecticut, New York, Rhode Island, and New Jersey) wastewater activity is very low, and ED visits range from 0.2-0.4%, mostly stable or declining. Severe illness (hospitalization) is improving in both Connecticut (at 1.6 per 100,000, down from 2.0) and New York (at 1.2, down from 1.4). Northeast: Covid-19 wastewater concentration Wastewater concentration of SARS-CoV-2 RSV RSV remains very low across the region. ED visits range from 0% in Maine to 0.2% in Rhode Island. In Rhode Island, New Jersey, and New Hampshire, ED visits increased this past week. Massachusetts, New York, Pennsylvania, Connecticut, Vermont, and Maine report fairly stable and very low rates of ED visits (<0.1%). Nevertheless, hospitalizations are increasing in both New York and Connecticut (though they remain low at 0.3 and 0.2 per 100,000 people). Northeast: ED visits for RSV (%) % of visits to the emergency department that are for RSV Other Bugs Many other causes of cold- and flu-like illnesses are spreading widely right now. Sniffles abound. Adenovirus has increased rapidly in the past week, and is now higher than it has been in the past year. Parainfluenza is nearing its second peak of the year. Rhinoviruses/enteroviruses are still quite elevated, but are gently declining from their peak in September. Human coronaviruses are low, but increasing. Stomach Bugs Norovirus test positivity decreased slightly this past week, but is an overall increasing trend. Test positivity is currently at 12% nationally. The Northeast is doing quite well: norovirus held roughly stable at 6.4%. Norovirus weekly percent positive tests (%) Data reported to NREVSS Food recalls The following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items: New: Grated Pecorino Romano cheese, sold under various labels, including Boar’s Head, Locatelli, Member’s Mark, Ambriola, and Pinna at major retailers, including Wegman’s (more info) Prairie Farms Gallon Fat Free Milk (more info) Dried Whole Smelts Salted (Korushka) (more info) Previously Reported: Vampire Slayer Garlic Cheddar, sold by Face Rock Creamery exclusively at the Face Rock Flagship store in Oregon (more info) Organic Supergreens Powder Mix and Organic Moringa Leaf Powder sold under Food to Live label (more info) Organic Moringa Leaf Powder sold under Africa Imports label (more info) ByHeart Infant Formula recall reported last week has expanded to include more batches due to potential botulism contamination (more info). Peach salsa sold under the Snowfruit label (more info) First and Last tomato sauces, distributed in Connecticut and Massachusetts (more info) Oven Dried Fish distributed to customers of African Food on Wheels in the Bronx, NY only (more info) In other news Suspected botulism cases following DIY injections. According to a note published in the CDC’s MMWR journal, over the summer, 3 individuals in the U.S. (in New York, Texas, and Wisconsin) experienced severe illness from suspected botulism, after self-injecting botulinum toxin purchased online (for cosmetic purposes). The New York State Department of Health and the NYC Health Department have issued a joint statement warning healthcare providers about these cases, and also stating that the number of affected people is 10. It is not clear if the discrepancy in totals is an accident or if additional cases have been identified by the Health Department. Botulinum toxin should only be purchased from a licensed seller, and injected by a licensed and trained medical professional. My Northeast subscribers received the Southern edition by accident last week. My mistake!

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SOLD FOR $50 MILLION

MAYOR TOM ROACH, COUNCILMAN JOHN MARTIN AND COUNCILWOMAN JEN PUJA SAY FAIRWELLS. 

WPCNR COMMON COUNCIL CHRONICLE EXAMINER. By John F. Bailey. December 2, 2025:

The Common Council enabled the Galleria City rebuild of the former Galleria Mall to go forward last night with all Councilmembers lauding the project as necessary for the city to grow in the future.

The council approved selling the city-owned garages to LCOR the developer for a sum of $50 Million to be financed, and leased back for a 3 year period.

 Councilman  (and Mayor Elect) Justin Brasch  said the demolition of the garages would cost the city 25 to 30 Million dollars, which the developer will  now pay. Brasch remarked the city was assured of more affordable housing units than first provided by previous plans, and 40% more open space and that now it was time to “move on to the site plan.”

Councilman John Martin said the approval of the sale of the garages , in addition the city was offering the developer a density bonus, providing the new project with incentives for proving more affordable housing and allowing higher occupancy  buildings in return for more affordable housing units.

Councilwoman  Jen Puja noted the developer has agreed to a Project Labor Agreement that would include union and local contractors on the project.

Council President Victor Presser noted it had taken 2 years to get to this compromise, but emphasized there is “more to do” to decide what should be on that site. She said “without this rezoning, the project is dead.”

Councilman Jeremiah Frie-Pearson stressed the new Galleria would be a $2 billion project and would greatly benefit the residents of the city.

Councilman Richard Payne said the go-ahead on the project was “in the best interests of the city,” but cautioned this agreement was a “Memorandum of Understanding, and “there was  more to be negotiated.

At the beginning of the Council Meeting, John Martin Jen Puja and Mayor Roach announced they were leaving the Common Council, Mr. Martin after 14 years,Ms.. Puja to move into higher office as County Legislator for District 5 and the Mayor as newly elected County Clerk. You can hear their final addresses in the first  15 minutes of the video of last night’s council meeting at

https://whiteplainsny.new.swagit.com/videos/362255

In a public hearing on the new garage for White Plains Hospital, after several townspeople expressed concern that there was not adequate public parking on Post Road for the residences along East Post Road,  and hoped the public would be able to park in the new 8-story garage planned, William Null the Chairman of the Board of White Plains Hospital  said there would be no public parking allowed in the new garage. He said 180 spaces would be reserved for residents of Brookfield Commons, a White Plains Housing Authority site, (now about to begin its third rebuild at 159 Lexington, with two more to go).

The Council closed the public hearing of the Hospital garage and approved the project.

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GOVERNOR HOCHUL URGES CAUTION AS NOR’EASTER IS FORECAST TO DELIVER FIRST MAJOR SNOWFALL FOR MAJORITY OF NEW YORK

Winter Storm Watches, Winter Storm Warnings and Winter Weather Advisories in Effect for Many Areas North of New York City

Storm Will Cause Difficult and Potentially Dangerous Commutes Tuesday; Avoid Unnecessary Travel if Possible

New Yorkers Can Sign Up for Weather and Emergency Alerts by Texting 333111

Governor Kathy Hochul urged New Yorkers to exercise caution ahead of a Nor’easter system forecast to bring the first major snowfall for much of the state beginning early Tuesday morning. Winter Storm Watches and Warnings are in effect for parts of the Southern Tier, Mohawk Valley, North Country, Mid-Hudson and Capital Regions where snow totals could surpass 7 inches.

Winter Weather Advisories are in effect for parts of the Western New York, Central New York, Finger Lakes and Mid-Hudson regions which are expected to receive less than 6 inches of snow. The storm is expected to create difficult driving conditions during the Tuesday morning and evening commutes. New Yorkers should do their best to avoid unnecessary travel on roadways, however if unable to, it will be important to leave extra time for traveling and always remember to avoid crowding plows when they are servicing roadways.

“While New Yorkers are no strangers to snow, and preparedness is key to staying safe on the roads and at home,” Governor Hochul said. “Ahead of this snowfall, I’m encouraging New Yorkers to make a plan – stock your car with safety essentials and leave extra time when traveling. State agencies stand ready to assist New Yorkers throughout the storm and our plow crews will be out keeping our roadways safe, but we encourage everyone to be weather aware and closely monitor the forecast.”

Snow is possible statewide, with the highest totals across the Mid-Hudson and Capital Regions. Accumulations of four to eight inches of snow are expected, with isolated totals of up to one foot possible in the higher elevations of the Catskills. Snowfall totals will depend on elevation and daytime temperatures will be near freezing.

In addition to preparing for snow, New Yorkers should also prepare to protect against the dangers that can result from colder weather and winter activities. Under state regulation, a Code Blue is automatically in effect whenever the temperature and wind chill equal less than 32 degrees.

Local social services districts are legally required to take necessary steps to ensure those experiencing homelessness have access to shelter and that shelter hours are extended. Cold Weather tips from the Department of Health can be found here; additional tips for preventing frostbite and hypothermia can be found here; information on Carbon Monoxide poisoning can be found here; information on the proper use of generators can be found here; safe winter driving tips can be found here.

The New York State Department of Labor advises workers and employers to engage in extreme cold weather best practices such as:

• Limit outdoor work, provide frequent breaks in warm areas and schedule outdoor work during the warmest times of the day.
• Ensure access to clean drinking water.
• Stay hydrated with warm beverages and avoid drinking caffeine.
• Wear proper PPE, including at least three layers of clothing, gloves or mittens, thick socks, insulated footwear and a hat, hood or hard hat liner.

More Information on best practices for working in cold weather can be found here.

Winter Storm Watches, Winter Storm Warnings and Winter Weather Advisories have been issued, and New Yorkers should closely monitor their local forecasts and look for updates issued by the National Weather Service. For a complete listing of weather alerts, visit the National Weather Service website at alerts.weather.gov.

New Yorkers should also ensure that government emergency alerts are enabled on their mobile phones. They should also sign up for real-time weather and emergency alerts that will be texted to their phones by texting their county or borough name to 333111.

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