Last week was my first grader’s back-to-school night. I found myself sitting in those tiny chairs, scanning the classroom. As I admired the adorable drawings on the walls and watched my daughter try to spell “bestie” in her notebook, I was calculating risk: where her desk was, how close it sat to the door, and what that might mean if a mass shooter walked onto campus. I hate that my mind went there, but it did.

And as a parent, I know I’m not alone.

The very next day, news broke of another school shooting—the 100th this year— overshadowed by the separate campus shooting that killed Charlie Kirk.

This week’s Dose covers not only the waves of disease and vaccine news (and there’s a lot!), but also another public health crisis: the reality that gun violence is a public health problem in the United States, and guns are the number one killer of children. Public health is about protecting health and safety in every sense.

The reality is stark, but change is possible.

Infectious disease “weather report”

Covid-19: Wastewater levels, a key indicator of community spread, are now “high.” Encouragingly, infections appear to be slowing in Florida and Hawaii, the leaders of this wave, suggesting the national peak may be near. Other metrics, like emergency department visits for Covid-19 and the number of positive tests, have already started decreasing.

The common cold (gray line) is also experiencing a significant spike.

Everything else is quiet still:

• Flu: Outpatient visits for flu-like illness are climbing, especially among kids. We haven’t crossed the 3% threshold that defines flu season yet, but the South is seeing early growth, as it often does.
• RSV: Still quiet—nothing notable so far.

What does this mean for you? If you’re sick, it’s most likely the cold or Covid-19. It’s safest to continue to mask in indoor crowded areas. If you start to feel sick, stay home. To get ahead of the flu and RSV, plan for your vaccine (and other fall vaccines) with our 2025 guide to fall vaccines.

Another measles death: A sobering reminder

Los Angeles County reported the tragic death of a school-aged child from a complication of measles.

• The child was infected years ago, before they were eligible for vaccination.
• They later developed subacute sclerosing panencephalitis (SSPE), a rare but fatal brain disease that appears years after initial infection. About 1 in 600 infants infected with measles will develop SSPE.
• SSPE causes progressive neurologic decline; most victims die within 1–3 years of symptom onset. There is no cure.

The CDC still lists three measles deaths this year. It’s unclear whether they will add this delayed case to official counts.

Ultimately, this is a heartbreaking reminder of one reason we vaccinate: to protect those who cannot protect themselves. This type of story will be increasingly important to elevate to neighbors and communities if (and when) more states drop vaccination requirements for schools.

See more from CA YLE Matt Willis here. And, if you’re a grandparent, consider joining Grandparents for Vaccines grassroots effort. Learn more here!

Covid vaccine access: States to the rescue (mostly)

As of Friday, 16 states have acted to preserve Covid-19 vaccine access by ensuring pharmacists can keep administering shots. This matters: over 90% of Americans get vaccinated at pharmacies.

States are improvising because many laws tie access to federal guidance, and this year federal decisions are not following the best science. Some states are now exclusively relying on professional organizations, like the American Academy of Pediatrics, who continue to use transparent, evidence-informed practices.

So far, we’ve seen:

• Expanding pharmacists’ scope (CA, CO, MD)
• Executive orders or emergency declarations (MA, NY)
• Standing orders (WA, NY, DE, NC)
• Pharmacy board directives (PA, NV, KY)

What we’re hearing from you: Confusion is everywhere. More than 200 of you shared stories, from all 50 states. Many are incredibly frustrating to read:

“I’m 33 weeks pregnant and want to give my baby as much coverage going into ‘sick season’ as possible .… My provider said I couldn’t get any fall vaccines at my visit or even make a plan because they aren’t ‘in season’ and my local hospital (part of a national health care system) hasn’t stocked them yet in my small community given the confusion. What’s the point in having the power to make an informed choice if the system isn’t set up to give us access?”

With permission, we compiled these stories into a congressional brief sent to senators and professional societies last week. Keep sharing your stories here.

Expect even more vaccine headlines this week

There will be two key developments in the vaccine policy space this week:

1. The HELP committee hearing. Former CDC director Susan Monarez—removed by HHS Secretary RFK Jr.—will testify about political interference in vaccine policy. She is expected to describe the pressure she faced to “rubber-stamp” recommendations not grounded in science. This could prompt pushback from senators, including Bill Cassidy (R-LA), a physician who cast the deciding vote for RFK Jr.’s confirmation. That said, this is an oversight hearing—more investigation than action—so it won’t directly affect you.
2. The September ACIP meeting. On Thursday and Friday, the Advisory Committee on Immunization Practices (ACIP)—the external body that sets vaccine policy—will hold a special session, its second under RFK Jr.’s leadership. This committee already has a record of disregarding scientific evidence. On the agenda: three vaccines—MMRV (measles, mumps, varicella, rubella), hepatitis B for infants, and Covid-19. There’s a real possibility this group could vote against recommending some—or even all—of them. If that happens, these vaccines may be removed from many state programs or forced off-market. The consequences could be deeply disruptive for families trying to access routine, life-saving immunizations.

Why this meeting will spark confusion

Beyond the decisions themselves (and implications for access), expect a wave of rumors and falsehoods online and in conversations with your family and friends. Last time, this ACIP committee—hand-picked by RFK Jr.—flat out ignored scientific evidence or consensus. There’s little reason to think this meeting will be any different, so scientists, policymakers, and communicators are bracing for chaos.

We already have a preview. On Friday, The Washington Post reported that ACIP plans to discuss reports of 25 pediatric Covid-19 deaths using VAERS (the Vaccine Adverse Event Reporting System). VAERS is an important tool for spotting early safety signals, but it has significant limitations:

• Anyone can file a report, not just healthcare providers.
• It runs on an honor system, which means reports can be incomplete, inaccurate, or even intentionally misleading.
• Most critically: VAERS data cannot establish causality. CDC conducts investigations after reports come in, but the raw data alone does not prove that a vaccine caused an event.

This is why VAERS is often misused by vaccine skeptics to cast doubt on safe vaccines. I would not be surprised if this committee leans on VAERS in the same way—to justify pulling Covid-19 vaccines off the market for pediatric patients.

What this means for you: Until the votes are final, the exact impact is hard to predict. But you can expect a flood of headlines and social media chatter this week—much of it a mix of rumors and falsehoods, amplified by misuse of data like VAERS. I’ll be back as quickly as possible to help sort through what’s fact, what’s spin, and what it means for your health and your family.

School shootings: 100 in 2025 so far

Last week, Evergreen High School near Denver became the 100th school shooting this year. It wasn’t labeled a mass shooting (fewer than 4 injuries/deaths), but the trauma is no less real. On the same day, Charlie Kirk was shot to death on a college campus.

Gun violence is clearly a public health problem in the United States. And, like infectious diseases, it spreads in patterns:

• School shootings cluster around transitions in the school calendar (start of year, winter break, year-end). The timing of a Sept/Oct shooting follows this pattern.
• Whether it’s a mass shooting or firearm injury, these have outsized impacts on mental health and perceptions of safety.
• Firearm injuries are the number one cause of death for U.S. children. This is a distinction no other high-income country shares.

Since there are patterns in public health, it indicates that the issue’s not random but preventable. There are some things you, as an individual, can do right now to address gun violence. I’ve written about them extensively before:

• Practice gun safety.
• Hear something, say something. Among school shootings, more than 78% of shooters leaked their plans.
• Be cognizant of media.

But in the end, the thing that makes the most impact is policy. We’ve been here before with other massive challenges, like smoking and car crashes, and we’ve been able to do unimaginable things and save millions of lives when we approach problems with a public health lens.

There is bipartisan support for many common-sense gun policies, including background checks and red flag laws.

And policy change works.

For example, states with the strictest gun laws have fewer deaths than states with more permissive gun laws, as shown in a recent JAMA Pediatrics study.

This was after controlling for several other factors. My friend and colleague was one of the principal authors and wrote more commentary on this in detail here.

While policy proposals tend to fall short, they make progress and inch us forward to a safer world. Change is possible, and we need to fight for it.

Bottom line

Stay safe and brace for a noisy week of vaccine headlines. I’ll be back with more and what it means for your health and your family.

And if you find yourself at a back-to-school night, I hope your thoughts linger more on joy than mine did—on the art taped to the walls, the messy handwriting, the little sparks of hope sitting in those tiny chairs, and ultimately the future of our nation.

Love, YLE

Upcoming YLE webinar on fall vaccines

This week will be chaotic on the vaccine front (see more below). To help cut through the noise, join me and Chelsea Cipriano of the Common Health Coalition next Monday for a live webinar on fall vaccines: the who, what, when, where, and why of fall vaccination. Paid subscribers can register below.

Register here! Look forward to seeing you there!