With a flood of disturbing headlines these days, in today’s edition you’ll find some bright spots to celebrate—California Covid levels are dropping, fall vaccine access is protected (which wasn’t guaranteed), we’re getting healthier meals in schools, and the RSV vaccine continues to prevent hospitalizations. I’ll walk you through all that, plus RFK’s “autism report.”
Infectious disease “weather” report
Covid: Although virus levels remain High statewide, we’re seeing a clear decline. Statewide wastewater levels for Covid have dropped 42% in the past 21 days.
RSV and Flu remain flat:
Vaccine access
The dust is settling after a confusing few weeks of federal vaccine policy, and fall vaccine access in California looks surprisingly… normal. We now have unified vaccine recommendations among the four states (CA, WA, OR, HI) in the West Coast Health Alliance for flu, RSV, and COVID. Vaccines are available at pharmacies and clinics across the state. Here are the vaccine recommendations again:
Ultra-processed food ban for California schools
California may become the first state to ban ultra-processed foods (UPFs) from school meals. The “Real Food, Healthy Kids” Act (Assembly Bill 1264) has passed both houses and is waiting for Governor Newsom’s signature.
This legislation would accomplish two important things:
Establish the first statutory definition of ultra-processed foods in the nation. The lack of a common definition has been a major barrier to regulation.
Prohibit schools from serving ultra-processed foods, starting a phase-out on July 1, 2029.
The California Department of Public Health and the Office of Environmental Health Hazard Assessment are tasked with defining UPFs based on several factors, including:
Scientific evidence linking them to adverse health outcomes. Obesity, diabetes, heart disease, cancers, and other diseases have been associated with certain UPFs.
Alignment with FDA’s recent definitions of “healthy.”
Food product restrictions in other jurisdictions.
Concentrations of saturated fat, added sugar, or salts.
MAHA common ground:
The MAHA Report released in May called for defining and restricting consumption of ultra-processed foods, especially for children. It’s notable that California may be the first state to take action that matches these MAHA priorities.
When I became a health officer in California 12 years ago, policies to restrict junk food were mostly seen as left-leaning overreach. Today, it’s refreshing to see people from all sides coming together for childhood nutrition. The Real Food, Health Kids Act has strong bipartisan support in California.
What impact could this have?
California’s public schools serve about one billion meals to children annually. In 2022, California became the first state to provide free breakfast and lunch to all public school students, regardless of family income—no questions asked. If you want a meal, it’s yours.
Kids from lower income families, who benefit most from free school meals, are also at higher risk for chronic illness. Notably, 16.9% of California’s children are obese, and the American Diabetes Association projects that 41% of Californians will be obese by 2030. Shifting the billion-meal school food pipeline toward healthier foods could be the largest preventive medicine intervention in state history.
Our healthcare system is strained by rising rates of chronic conditions—we need a stronger focus on prevention. If it’s signed, the public health effects of AB 1264 will be gradual but profound, and could reduce chronic disease rates for decades.
Adult RSV vaccine prevents hospitalizations
RSV usually starts ramping up by mid-October in California. Ever since the RSV vaccine was approved for older adults three years ago I’ve been waiting to see how well it works in the real world—beyond the controlled clinical trials.
It’s an important question: RSV causes up to 150,000 hospitalizations and 8,000 deaths annually in people age 60 and older in the U.S.
Last month a large study was published that answers some of those questions. Researchers tracked almost 7,000 adults across 26 hospitals over two RSV seasons, and compared outcomes between vaccinated and unvaccinated people.
Here’s what they found:
RSV vaccine cut hospitalization risk: The vaccine prevented 68% of RSV hospitalizations when vaccination occurred in the same season, and 48% when vaccination occurred in the prior season.
RSV vaccine helped prevent the most serious outcomes: RSV vaccine was 72% effective against being put on a breathing machine or dying.
Effectiveness varied: Effectiveness against hospitalization was 30% in immunocompromised people and 56% in those with heart disease.
What this means for us: The RSV vaccine prevented serious illness when tested in communities, where it matters most. This reinforces the findings in the initial clinical trials.
If you’re eligible and haven’t gotten the RSV shot, getting vaccinated soon can reduce your risk of hospitalization. If your immune system is weakened or you have heart disease you still benefit, but the protection isn’t quite as strong.
This study also shows that immunity can wane over time—an important point for research going forward (and another reason we need strong scientists working on vaccines nationally). For now, it’s a one-time shot.
For adults, the California Department of Public Health recommends RSV vaccination for:
All adults 75 and older
Adults 50-74 who are at increased risk for severe RSV
There are separate RSV recommendations (on the table above) for babies and pregnant people, who were not part of this study.
Most pharmacies offer the RSV shot for eligible people along with your flu and Covid vaccine. You can find appointments in California here.
Autism “report”
On Monday, RFK Jr.’s autism “report” landed. He and the president focused mainly on Tylenol (acetaminophen) during pregnancy.
Oversimplified science
I’m far more concerned about the federal trend to oversimplify science, or frankly mislead, than I am about Tylenol. Getting to the bottom of complex issues like autism takes scientific discipline and dedicated research—there’s no good short cut. Obstetricians, pediatricians, and scientists have spent decades studying this.
When RFK Jr. promised this May to have solution for autism by September, I knew he had two options—either push back the date and take time for the right research, or fabricate a simplistic answer. We’ve seen which path he took.
In his hunt for a silver bullet, we were concerned he’d target vaccines. He chose Tylenol. In fact, decades of research show autism results from multiple factors, many of which are genetic. Hasty, simplistic answers get in the way of important and ongoing autism research— and fail to respect the natural diversity of ways children’s minds work.
Vaccines don’t cause autism. And we don’t need to blame moms who were following doctor’s advice, and taking Tylenol safely for pain during pregnancy.
For a thorough review of the research on Tylenol and pregnancy see Katelyn and Kristen’s great YLE post yesterday.
Poll results
Thank you for responding to last week’s poll—more than 1,000 of you weighed in. The top two topics of interest were microplastics and health (31%), and the Big Beautiful Bill and California (33%). So those are in the hopper! (All the topics were interesting, and we’ll try to get to them further out.)
Bottom line
That’s it for this week. I hope you’re able to unplug a bit this week, and do what you do to stay well.
Love,
Matt
Dr. Matt Willis is the author of Your Local Epidemiologist in California. A California native, he’s served as a primary care physician, CDC epidemiologist, and Public Health Officer for Marin County, where he guided the pandemic response. He lives in the Bay Area with his wife, children, and a dog named Teddy.
I really needed some good news. Thank you for providing it!! I absolutely LOVE that we are working towards healthier food for our school children in CA! My daughter was telling me how pre-covid, she actually had a whole salad bar to choose from in elementary school. After they came back from COVID, it changed to all single-serving, plastic coated packs of food that do not taste very good. We WANT kids to like going to school and food could be a part of that. I would love to see schools encouraging kids to be involved in their meals as well, either through gardening or prepping for the meals in a food-safe way. Serving large amounts of kids can be tricky and I don't want to discount that, but we can do better! Thank you, as always, for the information you provide. I look forward to it every time.
I wanted to try novavax this year but don’t see it available anywhere yet. I’m in the East Bay Area.