PBS ran an important segment on Health Secretary Robert F. Kennedy’s decision to cancel $500 million in grants to study mNRA vaccine grants. These are the vaccines that broke the COVID pandemic.
PBS interviewed scientists about this surprise decision. If you would like to see the interviews, open the link.
Health Secretary Robert F. Kennedy Jr.’s decision to cancel nearly half a billion dollars in federal funding for mRNA vaccine development has left many public health experts and scientists stunned.
mRNA technology was central in the battle against COVID and can be developed more quickly than traditional vaccines. But anti-vaccine communities and skeptics don’t trust its safety.
Geoff Bennett spoke with Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, about the latest in mRNA vaccine research and the implications of Kennedy’s move.
“I can say unequivocally that this was the most dangerous public health decision I have ever seen made by a government body,” Osterholm said.
U.S. children’s health in decline
As the Trump administration works to reimagine public health through its “Make America Healthy Again” initiative, a new study paints a stark picture of the challenges facing the nation’s kids.
The health of American children has significantly worsened across several key indicators since 2007, according to a recent study published in JAMA.
Kids get a chance to stretch their legs and skills during physical exercise in Los Angeles in 2023.
Courtesy LA84 Foundation
Millions of young people across the nation have returned to school, yet students are still struggling to navigate the return to normal. Research shows us that educators and policymakers can bring back joy in schools by prioritizing sport and play to build a supportive learning environment. One where we all win.
The role of sports and play extends far beyond physical fitness. It profoundly impacts student social and emotional health and school connectedness. By instilling valuable life skills, fostering social bonds and promoting emotional well-being, sport and play contribute to a holistic educational experience that nurtures well-rounded individuals capable of transcending life’s challenges and thriving in diverse circumstances.
With parents, educators and administrators now back in school, let’s not forget the Covid-19 pandemic ushered in a new set of challenges for youth, leading to a mental health crisis as declared by the U.S. Surgeon General in late 2021.
While issues concerning the mental health of our kids had arisen long before the pandemic, nearly three years of isolation and increased screen time, death and uncertainty only magnified students’ stress, anxiety and depression. We warned this was a mounting mental health emergency in schools last year, but today it is in clearer focus. Results released in February from the Centers for Disease Control and Prevention’s Youth Risk Behavior Survey indicated startling trends. Nearly 3 in 5 teen girls (57%) said they felt “persistently sad or hopeless.” More than 40% of boys and girls responded they had felt so sad or hopeless within the past year they were unable to perform regular activities.
According to a 2022 State of Youth Mental Health report which surveyed 2,000 parents, 68% have seen their children face significant mental and emotional challenges. Yet, recent studies have also found 60% of youth with major depression do not receive mental health treatment, many of them youth of color.
These findings require us to not rush into school with a singular focus on closing the learning loss. Let’s instead look to accelerate opportunities through sport and play to help our kids reconnect to themselves, to their friends and to their schoolwork.
Sport and play hold a profound significance in fostering social and emotional well-being and enhancing school connectedness for students. Beyond mere physical activity, engagement in sport and play cultivates essential life skills and nurtures interpersonal relationships.
Policymakers across the country have recognized the value of sport and play in schools and are advancing this framework. California state Sen. Josh Newman authored Daily Recess for All, Senate Bill 291, which ensures students have access to a 30-minute recess for unstructured play and that it cannot be withheld as a form of punishment.
The joy and spontaneity inherent in play promote emotional release and stress reduction. Engaging in recreational activities allows students to unwind, alleviate anxiety and recharge their mental faculties. This, in turn, equips them to navigate academic pressures and personal trials more effectively. One study found that 6-to-8-year-olds who exercised frequently had fewer symptoms of major depressive disorders two years later.
This same study found 73% of parents believe that sport benefits their child’s mental health. Participating in sports teaches invaluable lessons in teamwork, communication and perseverance. Through wins and losses, individuals learn to handle success and setbacks, building resilience and boosting self-esteem. These experiences translate into the ability to cope with challenges outside the sports arena, contributing to a balanced social and emotional state.
Sports and play serve as powerful catalysts for building social bonds. Students develop a sense of camaraderie and shared purpose in collaborative activities, breaking down barriers and forming connections that transcend differences. This inclusivity enhances the feeling of belonging, which is vital for a positive school environment.
In a world increasingly driven by digital interactions, the physicality of sports and play offers a refreshing counterbalance. Face-to-face interactions during games and playtime nurture emotional intelligence and empathy, enriching interpersonal skills that are essential for healthy relationships in school — and later in life.
Although it’s never been more needed in the educational environment, many public schools have defunded sports programs and offer physical education far less than they once did. That reinforces the pay-to-play model and leaves out the kids who have the least.
Our data shows that as household income increases in LA County, so does activity levels for the children in the home. Children from homes with income under $35,000 a year play far less than kids from affluent households, and they are unable to access the resources they need to be active.
These children are our future engineers, musicians, teachers, caregivers and leaders. Talent is universal, but opportunity is not. We can mend the kids’ lives who are suffering by providing access to the transformative power of sport and play, and help change a significant number of their destinies.
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Renata Simril is president & CEO of the LA84 Foundation, the legacy of the 1984 Summer Olympics in Los Angeles, and a national leader advocating for the role of sport and play in positive youth development.
The opinions expressed in this commentary represent those of the author. EdSource welcomes commentaries representing diverse points of view. If you would like to submit a commentary, please review our guidelines and contact us.
Students spend time at the turtle pond on the campus of San Diego State University.
Credit: Noah Lyons/EdSource
According to a 2018 study published by Frontiers of Public Health, spending time outdoors can aid people in a variety of categories: “attention and cognition, memory, stress and anxiety, sleep, emotional stability and self-perceived welfare or quality of life.”
Monicka Fosnocht, an associate therapist at San Diego State University with a background in natural public medicine agrees. “For a lot of students that are struggling with mental health, or even students who don’t and are just stressed, it’s really helpful to get a nice, big dose of vitamin D and get outside so that we can get our brains functioning optimally.”
SDSU has its own outdoor resources. One space in particular, the turtle pond, has become a popular destination for students seeking solace from their academic lives.
The origins of the turtle pond date back to 1973. The campus community asked for more green spaces, and the school delivered. Koi fish dominated the scene at first, but red-eared slider turtles eventually became the pond’s informal namesake.
Within this area, there are hammocks, slacklines, trees, ample seating and, of course, the pond itself, all providing students with a mental health boost.
The therapeutic effect of being in outdoor spaces is increasingly being noted by mental health professionals, including SDSU counseling and psychological services faculty member Tri Nguyễn.
“Therapists are moving a lot more outdoors.” Nguyễn said. “There are providers who do therapy outdoors, by hiking or going on a walk. It’s no longer just within the confines of an office space.”
While individuals between 15 and 21 years old are significantly more stressed than older generations, they are more likely to report their struggles and seek help. Fosnocht is optimistic that young people can normalize conversations surrounding mental health and find unique ways to address it.
“I’m really hopeful for Gen Z and the generations to come that are decreasing the stigma around mental health and also connecting it to very accessible things like being in nature, hanging out with the turtles, talking to other people and taking the time to connect with people in person.”
A frequent turtle pond visitor is Natale Canepa, a fifth-year journalism and media studies major. While he isn’t a musician by nature, he’s added to the character of the turtle pond with his music. He said that to express his excitement about returning to classes after the pandemic, he started whistling.
Nicknamed “The Turtle Pond Whistler,” Canepa posts videos on Instagram, which has, in turn, attracted others to the turtle pond.
In addition to being an outlet for his self-expression, he views the pond as a place for truly living in the moment.
“I see the turtle pond as a place of magic; I come here and I’m mesmerized by the sights, sounds and smells,” Canepa said. “I think the best moments in life are the quiet, slow moments when you can hear the rustling of the leaves in the wind, hear the splashing of the water and look at the little turtles swimming around in the pond.”
Canepa is not alone in that sentiment. Lauren DuBose, a fourth-year business administration major, visits the turtle pond on a near-daily basis to unplug from her academic life.
Even if she only has a 15-minute gap between classes, DuBose spends time at the pond connecting with friends, listening to music and practicing mindfulness.
“Being in San Diego, you have so many sunny days,” DuBose said. “If you can get 10 minutes of sunlight a day just sitting there and closing your eyes a little bit, that’s definitely beneficial to your mental health.”
Another outdoor amenity that SDSU’s counseling and psychological services provides involves a pair of four-legged friends. Baxter and Luna, the school’s therapy dogs, make frequent appearances at school events, including “Lunch with Luna,” which takes place at the turtle pond.
College campuses across California are embracing the outdoors, too.
Students, staff and faculty at University of California, Irvine are encouraged to participate in “Wednesday Wellness Walks” across parks and marshes across the city, while Chico State University has its own guided forest therapy program, based on “forest bathing,” a popular Japanese practice.
And in the spring of 2022, the University of California, Davis created an initiative called Healthy Outside.” This was part of a campuswide effort to get students outdoors and spend more time in natural settings. The program also rewarded students with prizes for participating.
Fosnocht said that practicing mindfulness should go beyond the school, and into the local community.
“We don’t have to limit it to campus alone. When I work with students, I encourage them to use all the outdoor spaces throughout San Diego,” Fosnocht said. “We’re very close to Mission Trails as well as Cowles Mountain and the beaches.”
The lobby at UC Riverside’s new Student Health Center.
Credit: Stan Lim / UC Riverside
A newly built $36 million student health clinic at UC Riverside aims to provide a wide array of medical and mental health services in an attractive building that showcases views of nearby mountains. The two-story Student Health and Counseling Center includes a food pantry, a pharmacy, an outdoor balcony for meditation and waiting rooms that look like hip hotel lobbies.
And beyond serving Riverside students, it may become a national model of how campuses are investing more resources to keep their students physically and emotionally well in the post-pandemic era, experts say.
The 40,000-square-foot clinic will provide “one-stop shopping for wellness” that integrates physical and mental health services, said Denise Woods, UC Riverside’s associate vice chancellor of health, well-being and safety. During a recent tour, she said she expects that the building will make it easier for a student to tap into multiple types of services.
The new UC facility replaces a 60-year-old building that is half its size and was built when the student population, now about 27,000, was much smaller. Paid for by UC bonds and other funds, the clinic centralizes services that had been scattered around campus and moves them closer to dormitories for students’ convenience.
Credit: Stan Lim / UC Riverside
The new Student Health Center at UC Riverside.
Nadia Colón, a fourth-year psychology and law and society double major who is a student senator, said many students have been looking forward to the new building, which opened last month. “I think it will be perfect for students who need medical or counseling help,” she said. The old, smaller building has some good services, but “the new building, from what I have seen, is updated and has more resources.”
The medical health clinic and pharmacy are on the first floor along with a satellite food pantry for students who need food or household supplies to get through the week. Mental health counseling rooms are on the second floor, with extra soundproofing so passersby cannot hear therapy sessions.
Helps with recruiting
Experts say the new health center is an example of how colleges and universities are emphasizing students’ medical and psychological wellness much more than in the past, particularly after the challenges posed by the pandemic and the emergence from it. In the long run, they say, such attention pays off for the schools, helping to recruit new students and improving graduation rates and alumni relations.
“For a long time, we’ve known that physical and mental health and well-being are an important part of academic success, retention and graduation. It’s been shown that when students are physically and emotionally well, they perform better,” said physician Michael Huey, former interim chief executive officer of the American College Health Association and former executive director of Emory University’s health and counseling services.
More universities are renovating or replacing old health facilities and grouping services under one roof, he said. For students seeking medical or counseling assistance for the first time without their parents’ guidance, encountering a “modern, spacious, clean and professional-appearing center” helps them get past initial fears, Huey added. And ensuring privacy in counseling rooms helps to ease the stigma some young people might feel about reaching out for emotional help, he said.
New health centers can also bolster new enrollment, according to Richard Shadick, who is a board member of the Association for University and College Counseling Center Directors and director of the counseling center at Pace University in New York City. “I think having a new building that addresses the needs of students, the physical and psychological needs of students, is a great idea. More and more families are looking at the wellness services provided by schools when making a decision about where the students go to college. It’s become rather common for that being a selling point for a college or university,” he said.
Credit: Stan Lim / UC Riverside
The pharmacy at the Student Health and Counseling Center.
National surveys by the American College Health Association show a significant drop this past spring in the rate of undergraduates who rated their health as very good or excellent compared with 2020: 47% compared with 55%. However, it shows that the most common health ailments are not life-threatening at their age, such as allergies, back pain, sinus infections and colds.
On the psychological side, more students are coming to college already having experience with mental health counseling or medication. Research by the Center for Collegiate Mental Health, which is located at Penn State, showed that about 60% of students who use college counseling services had been in prior mental health treatment, compared with 48% about a decade ago. Social anxiety among students is on the rise, fueled by social media and concerns about coming back to in-person classes after isolation during the pandemic, according to the center.
Credit: Larry Gordon / EdSource
Dr. Kenneth Han, UC Riverside’s chief medical officer in the new clinic.
At UC Riverside, the new center’s layout placing counseling on a separate floor provides privacy, but the easy proximity to the medical floor also can help physicians and counselors to work closely together and with patients if need be, said Kenneth Han, UC Riverside’s chief medical officer.
“It’s not just about a specific ailment. It’s so much more than that for (a student) to be successful. How are things going in with your classes? With your friends? With your professors? I can see you for your diabetes, your cough, your cold. And we will talk about all those things,” he said.
Last year, about 1,840 students a month came for medical visits and about 590 for counseling and psychological care, the campus reports.
The center handles mainly routine illnesses and injuries like flu, urinary tract infections, stomach pain and sprains and offers vaccinations and birth control. It sends students to local hospitals for emergencies and surgeries.
Credit: Stan Lim / UC Riverside
The Student Health and Counseling Center has 25 exam rooms, more than twice that of the old building.
For example, the center’s doctors will not reset bones and will stitch wounds only if away from the face or hands, officials said. It is open weekday daytime hours, although a nursing phone line is available around the clock, seven days a week, and students may be referred to off-campus urgent care centers on nights and weekends.
Fourth-year student Allison Escobar, a psychology major from Redwood City, said she thinks the new building will attract more students. Recently she worked there as part of a team preparing the center for its opening. It is a big improvement over the old one, which she said “had a lot of things wrong with it.” Here, she said, students especially appreciate the improved and soundproofed counseling rooms. “Students care about their privacy during what they are going through. A lot of consideration for privacy is a huge thing,” she said.
Counselors respond to mental health emergencies
Set to launch within months, a new emergency response team of mental health professionals — rather than campus police — will be first responders to most mental health emergencies such as a suicide threat or depression. In response to systemwide UC policies enacted two years ago, all UC campuses have formed or are starting similar teams.
Credit: Larry Gordon/EdSource
The van of the new crisis response team at UC Riverside.
That is now the preferred alternative to dispatching uniformed police in patrol cars whose presence sometimes escalates a situation, although police are available to counter any violence, officials say. The Riverside campus experiences about four such emergency episodes a month on average.
The new emergency intervention team will have offices in the health center, and its blue van is parked just outside, painted with a rainbow logo declaring “UCR Health, Well-Being & Safety, Supporting Student Success Holistically.”
“We want the right people to address the right issues,” Han said. “If there is an underlying mental health issue, we don’t necessarily need to have security get involved.”
Bringing in the outdoors
The clinic was designed by the HGA architectural firm, which has several offices around California, and was built by Turner Construction. Kevin Day, the project’s design principal architect at HGA, said it was important to provide views of the Box Springs Mountain Reserve, a large park next to campus, through the lobby’s glass walls and big windows as well as to have an outdoor courtyard and balcony with shade. Appointment windows on both floors look like contemporary theater box offices, and the interiors are painted in cool pastel shades.
Connecting the clinic to the natural landscape “becomes a part of the healing process. It is really about creating a welcoming environment,” Day said. Knowing that coming to a medical appointment can be stressful, his team’s goal was to design a building that would help “lower the blood pressure.”
The building takes into account the recent pandemic. The 28 counseling rooms are much larger than usual to provide safe distances between therapist and patient. Several of the 25 urgent care and primary care exam rooms have special ventilation systems to limit the spread of air-borne illnesses.
Credit: Stan Lim / UC Riverside
A Student Health and Counseling Center exam room.
The soundproofing for counseling rooms is a switch from the old building, where therapists sometimes had to use noise machines to block conversations from the public. All those rooms have windows, for a brighter atmosphere. Plus, the center is developing a mobile check-in system so students who do not want to wait in a public lobby can go directly to their appointments when notified via text.
Online counseling became more popular during the pandemic, and that will still be offered as an option. However, many colleges and universities across the nation reported overall declines in demand for all counseling services during the pandemic even as mental health problems increased. Numbers have rebounded at many schools but not to the pre-pandemic level. UC Riverside hopes to build up those visit numbers as students get familiar with the new building.
Unless they opt out and use family or other coverage, UC Riverside students pay about $2,100 a year for campus health insurance as part of their registration fees and receive most medical services without any additional costs. All students, regardless of insurance status, can get free, unlimited counseling sessions, although most usually need only four to six visits; that is funded through the mandatory $410 annual student services fee.
To create an education system that has stable funds for mental health, California educators and leaders are turning to the health system and launching a statewide behavioral health initiative to fill funding gaps in fluctuating, sometimes unpredictable school budgets.
“The health systems and the education systems are not bound together successfully enough to make sure we engage in both prevention and treatment,” said David Gordon, a commissioner at the Mental Health Services Oversight and Accountability Commission. “That’s particularly true for the most underserved communities.”
Funding for mental health in California public schools typically has come from general education budgets, a reason funds have never been stable. As the need for more mental health services and specialists skyrockets, administrators and experts are turning to the health system to better serve needs that existing education budgets just can’t cover.
Schools bridge some gaps by placing nurses, social workers, school counselors and psychologists on campuses, but there’s never enough money to fully meet student mental health needs. Without a built-in, statewide system to fund mental health in schools, districts are left to figure it out themselves.
“We’re so used to trying to provide external funding to fund us to some sort of equitable level for every student,” said Loretta Whitson, executive director of the California Association of School Counselors. “It’s never been the general fund will cover us — it’s just sort of baked into the cake.”
It’s been that way since at least the late 1980s, when Whitson began her education career, she said.
The Local Control Funding Formula, legislation that changed the way education was funded in California, created more funds for mental health and “a more holistic view and review of schools,” Whitson said. “But if there’s not enough money to go around, then school district administrators need to make very hard decisions.”
If districts have to rely on general fund money for mental health providers, it creates competition with funding for teachers and education programs, Whitson said. If budgets had more funds specifically for mental health, it would mean more money for education.
If we piecemeal it like it’s been, then we’re always trying to find money through categorical programs or grant funding.
Loretta Whitson, executive director of the California Association of School Counselors
California doesn’t mandate districts to provide school counselors, social workers, nurses or psychologists, but it is encouraged. Some experts say mandates could ensure there would be mental health specialists at every school. But that goes against the idea of local control, Whitson said, which allows districts to make decisions based on their community’s needs and resources.
Grants for mental health have helped, but it’s not sustainable, Gordon said. School districts will receive grants for a few years or even less, and when those dollars run out, the services or mental health specialists do too if districts don’t have money to keep them going.
Similarly, districts turned to pandemic relief dollars to boost staffing for school counselors, social workers, psychologists and nurses, but those funds expired in September.
Nonprofits and community organizations have stepped in to help fill needs at lower costs, put therapists on school campuses, and taken over doing burdensome paperwork. But if the services aren’t free to school districts, then most money for mental health has to come out of the education budget.
Blending two systems
Gordon credits Gov. Gavin Newsom’s Children Youth and Behavioral Health Initiative for beginning to merge the health and education system. The goal for two major systems to come together is reachable, Gordon said, “but it will take a lot of coordination and collaboration.”
A key component of the behavioral health initiative is to support partnerships between Medi-Cal managed care plans and schools to increase access for children receiving Medi-Cal — nearly 5.7 million kids in 2022. Another goal is to increase access to early interventions and preventative mental and behavioral health care.
The behavioral health initiative was part of the Budget Act of 2021 and the governor’s Master Plan for Kids’ Mental Health. The California Department of Health Care Services will invest $4.7 billion over multiple years in youth behavioral services.
According to the master plan, more than 240,000 children cope with depression, and 66% don’t receive treatment. Suicide rates among 10-18-year-olds increased by 20% in 2019-2020.
Efforts to implement the behavioral health initiative started in January 2022. So far, hundreds of millions of dollars in funding have been disbursed to dozens of organizations for training and retention of providers, loan repayments and scholarships to increase providers in underserved areas.
But some of the funding is distributed as grants and won’t last long, Whitson said.
“I think it’s important to consider: How do we sustain this? A lot of programs come in as temporary programs, so seed money,” Whitson said. “We look at sustainable money as Medi-Cal a lot of times.”
The amount of money school districts can bill to Medi-Cal recently increased, thanks to new legislation. The California Education Code was updated in January after AB-2058 passed, allowing districts to bill Medi-Cal for mental health services provided by school counselors.
A 2018 statewide count of school counselors tallied about 11,000, Whitson said. She estimates there are about 14,000 now.
“School counselors are one of the biggest billing forces in the state. It should be bringing in quite a bit of money,” Whitson said. “It could be used to lower the caseloads on all levels — social workers, psychologists, school counselors.”
However, the process for school districts to bill Medi-Cal can be long and cumbersome.
Sometimes districts won’t get a full refund, and it could take a few years before the money is returned, said Marlon Morgan, founder and CEO of Wellness Together, a nonprofit that brings mental health providers to school campuses in California and New York.
“Schools are pretty reticent to use that billing option because they could end up spending $1 million but only get $500,000 back,” Morgan said. “If you’re on a school board and looking at ways to stabilize your budget and to know what to expect, that’s a huge wild card, and frankly one that doesn’t get used very often.”
In Sacramento County, schools are partnering with the Sacramento County Health Department to have one mental health provider at every school, said Gordon, who is also the superintendent of the Sacramento County Office of Education. The partnership works well because the county health departments already manage Medi-Cal and Medicaid plans — which insure more than 60% of people in the county, he added.
The purpose isn’t only to provide direct services at schools, but to have someone from the health system stationed at schools interacting with staff, students, and families every day, Gordon said. The goal is to have “centers of wellness and prevention, rather than a center of let’s go out and seek treatment for a problem that should’ve been caught many years ago,” he said.
Some organizations are combining billing insurance and grant funding to bring providers to schools. Campus Clinic, which aims to remove barriers to health care access by putting providers at schools, has brought mental health providers and other physicians to 14 districts and more than 600 schools in California, said Thomas Shaffer, the organization’s founder and president.
Most districts haven’t had to foot the bill. Campus Clinic started paying for all the costs, Shaffer said, and was able to sustain its offerings through billing insurance, including Medi-Cal, and applying for grants. One burden Campus Clinic and other similar organizations lift from districts is handling the paperwork and billing.
“We aim to complete, not compete, with existing resources,” Shaffer said.
Still, the need for mental health services and providers is too great to catch up with demand. Campus Clinic is contracted with 28 more districts that are still in the planning stages, Shaffer said.
Campus Clinic also offers universal health screenings that allow schools to quickly identify which students are showing signs of anxiety, depression and risk of self-harm, Shaffer said. Schools can see responses through a dashboard that includes real-time notifications for students who are at risk of self-harm. Campus Clinic has teams that start reaching out to families to offer services.
But it doesn’t come without challenges. Building trusting relationships with families so they feel comfortable accepting services can be an uphill battle.
‘The cultural and trust piece’
Officials at Feaster Charter School in Chula Vista saw immediate results after Campus Clinic gave universal mental health screenings to students in grades six through eight in May.
Out of the 350 students, roughly 40% were identified as having some level of anxiety and depression, said Karen Haro-Esparza, community school coordinator.
Teams at Campus Clinic started contacting families right away, Haro-Esparza said. Although it’s a huge help, it also created challenges — “the cultural and trust piece.”
“Because they are not a regular part of our staff, when Campus Clinic communicates with families, they have a lot of questions,” Haro-Esparza said. “Our challenge has been, ‘How do we educate families further to destigmatize and normalize the partnerships?’”
The stigma around mental health — especially among people of color and different cultures — is one reason families or guardians don’t seek or access resources for students. Something most mental health experts working in education can agree on is the importance of maintaining trust among schools, providers and families.
“It’s not just putting money out to buy services. It’s working to try to put the systems together so that they’re relating and families will come to know and trust the medical system even though they aren’t located in their community.”
David Gordon
Campus Clinic providers aim to become part of the school community, Shaffer said. One strategy Campus Clinic providers use is to rotate through different classrooms to speak with students about health and wellness for 15 minutes to become more familiar and create connections.
Wellness Together is investing in interns to diversify the workforce and build trusting relationships between communities and mental health providers, Morgan said. Before mental health professionals receive their licenses, they need to complete hundreds of hours that typically are unpaid — some programs won’t even allow future providers to have paid internships.
Morgan, who started his career as a school counselor, said he’s seen dozens of people never get their licenses because they can’t afford to work for free. It contributes to the lack of diversity in the behavioral health workforce, he said. Now, the nonprofit has more than 30 partnerships with universities in California to ensure interns are paid liveable wages and receive benefits.
Wellness Together pays interns working toward their licenses to be social workers, clinical and mental health counselors, licensed marriage and family therapists, and a pupil personnel services credential.
“The biggest challenge is finding staff and making sure the staff reflects the communities they’re serving,” Morgan said. “By paying interns and paying associates, we now have an option and an opportunity to really hire the best person for the job and often hire a person who is local and from the community.”
The federal government has not fully funded special education in decades, leaving the bulk of the costs to school districts and the state.
Alison Yin/EdSource
When Erica Mazariegos heard that a shocking number of special education teaching positions remain vacant, she was not surprised. With over 27 years as a special educator, Mazariegos is dedicated and passionate, yet says “the stress of recent years has led me to question my ability to carry on. There will come a point when I must prioritize my health over my career.”
Like Erica, special education teachers throughout U.S. public schools have been vocal about their concerns regarding working conditions after the pandemic, particularly the shortage of resources and staff support. The attrition rates among special education teachers soared following Covid-19, and educators have endured heightened levels of job-related stress, prompting an increasing number of them to exit the profession.
This exodus has left schools grappling with severe teacher shortages. According to the National Center for Educational Statistics, 45% of schools reported unfilled positions in special education roles, with 78% citing difficulties in hiring special education staff for the current school year. The situation in California closely mirrors the national shortages, with the Learning Policy Institute describing the teacher shortage in California as a “five-alarm fire.”
The stress experienced by special educators is not only deeply ingrained in the inherent nature of their roles but also in the perceptions surrounding them. A key contributing factor is the idealization of special education teachers by schools, often portraying them as extraordinary individuals who are characterized as nurturing and self-sacrificing, willing to prioritize their students’ well-being over their own. It’s commonplace to hear general education teachers express sentiments like, “I could never do what you do.” This portrayal creates unrealistic expectations for special educators, adding to the systemic sources of stress, which include unequal resource allocation and a shortage of adequately trained support staff.
Padma Vajhala, an early-career special education teacher with two years of experience, highlights many stressors in her job, such as individualized education program meetings, conducting paperwork checks, navigating uncertainties about parental consent, encountering subtle racism in schools, and adhering to the core mission of special education — differentiated teaching for each student. But, she underscores that these stressors are overshadowed by the primary source of stress: daily management of challenging behavior exhibited by her students in class without enough staff support. She points out that her stress affects students by hindering effective instruction, classroom management and the modeling of social-emotional skills. Stressed teachers are more likely to react unpredictably and employ ineffective behavior management strategies.
While it remains crucial to address such systemic causes of stress as lack of staff support in the classroom, schools must simultaneously implement programs dedicated to teaching self-care strategies and allocate resources to support these educators’ mental health and overall well-being. These initiatives should involve professional development programs that prioritize physical wellness, encompassing exercise, dietary choices, and sleep, to sustain energy levels and enhance emotional resilience.
Additionally, it is imperative to equip special educators with training in social-emotional learning skills. This training should cover the establishment of clear boundaries between their professional and personal lives, mindfulness practices, participation in yoga, and learning relaxation techniques. Acquiring these skills can significantly reduce stress levels among special educators while providing positive role models for students concurrently learning these skills in their classes.
Most importantly, special education teachers can create communities of practice informally with their colleagues based on shared interests, facilitating connections with colleagues, mentors, and therapists to seek guidance and share their experiences. Moreover, these communities of practice can leverage self-reflection practices to recognize and manage stressors effectively.
A notable approach is reflexive visual journaling, a creative process that intertwines written reflection with images, drawings, and other visual elements. This practice has demonstrated considerable effectiveness in early detection of burnout indicators, pinpointing triggers, and aiding individuals in navigating and coping with stress. Zachary McNiece, assistant professor of counselor education at San Jose State University, emphasizes the importance of visual journaling, stating, “In today’s post-Covid world, while teachers act as front-line mental health advocates, they can experience the after-effects of trauma their students have faced over the last few years; visual journaling creates a means for teachers to slow down, allow space for their feelings and reactions, and let go of the emotional residue of secondary trauma exposure, so they can improve their wellness and support their students.” These self-reflective practices can also be embedded into teacher preparation programs to support new special education teachers.
Preventing burnout in special education cannot be solely an individual responsibility; it requires collaboration from schools, districts and policymakers. Special educators are pivotal in fostering an inclusive and equitable education system.
It is essential that schools prioritize special educators’ well-being by supporting and implementing targeted self-care strategies to sustain their passion and dedication. This approach not only safeguards the mental and emotional health of educators but also enriches the educational experience for students with disabilities, ultimately contributing to the development of a stronger and more compassionate society.
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Sudha Krishnan is an assistant professor at San Jose State University’s special education department, Lurie College of Education,and a Public Voice Fellow with the OpEd Project.
The opinions in this commentary are those of the author. If you would like to submit a commentary, please review our guidelines and contact us.
During the week leading up to Dec. 28 and with Covid-19 strain JN. 1 having become dominant, the LA County Department of Public Health reported an average of 621 cases each day, marking a 25% increase from the previous week.
The Department of Public Health also said the figures are an “undercount” since most tests are done at home and not reported to medical staff. Meanwhile, for the first time this season, the county has entered the CDC’s “medium” category for Covid hospitalizations. Mask mandates have been reinstated in health care facilities.
“There have been notable, yet not unexpected, increases in COVID-19 reported cases, hospitalizations and deaths,” according to a news release from the LA County Department of Public health.
“While recent increases are significant, they remain considerably below last winter’s peak and common-sense protections are strongly recommended to help curb transmission and severe illness as the new year begins.”
Earlier this season, 23% of LA County residents participating in a text message survey said they had experienced a cough or shortness of breath within a week of Dec. 10, according to the Los Angeles Times.
More specifically, they reported that about 18% of specimens tested at Sentinel Surveillance Labs in LA County came back positive for the flu — marking a 4% increase from the previous week. And, in the week leading up to Dec. 16, more than 12% of specimens came back positive for RSV.
“Respiratory infections among children and adults are increasing this winter season. These infections are not limited to Flu and COVID-19,” read a message from LAUSD. “We are also seeing a rise in Respiratory Syncytial Virus, also known as RSV.”
Before going on winter break, between Dec. 6 and Dec. 12, LAUSD also reported 528 Covid cases, according to the district dashboard.
LAUSD and the LA County Department of Public Health suggest parents follow these guidelines for determining when a child should be home, come to school and how to stay healthy.
What should I do if my child tests positive for Covid?
Whether symptomatic or not, students with Covid should stay home for five days, following either testing positive or experiencing symptoms.
Those who are immunocompromised, however, may isolate for longer periods, according to the district.
If my child tests positive for Covid, when is it safe for them to return to the classroom? Do they need to provide a negative test result before coming back?
Students do not need to provide a negative antigen test to return to class between days six and 10. And following day five, if your child has been without a fever for 24 hours without taking fever-reducing medicines, and their symptoms are improving, they can return to the classroom.
If, however, the symptoms come back after the isolation period, the student should test again, according to the district.
What does it mean if my child is a “close contact?” What do I do then?
If your child is in the same indoor space for Covid for 15 minutes within 24 hours with someone positive, they are a “close contact.”
In that case, the district asks that your child’s health be monitored for 10 days following the exposure. They also recommend masking and testing between the third and fifth days.
What about other illnesses like the flu or RSV? Do the same rules apply?
If your child has a fever of 100.4 degrees or higher — or if they are vomiting or have diarrhea — they should stay home, according to the district.
What should I communicate to the school? How do I ensure my child’s absence is excused?
If your child has Covid, upload the result onto the Daily Pass.
And regardless of the sickness, absences due to illness are excused. To excuse an absence, provide the school with documentation within 10 days of your child’s return to class.
If the school does not receive documentation, the absence will count as uncleared or unexcused, meaning it can count toward truancy.
Where do I find free Covid tests, vaccinations and treatments to keep my child healthy?
LAUSD provides Covid-19 home test kits at each school site. Libraries and other community centers may also supply tests.
Additionally, as of Nov. 20, the federal government provides each household with four home tests for free, according to the LA County Department of Public Health.
How do we stay healthy?
The LA County Department of Public Health suggests testing, not only if you have been exposed or have symptoms, but also if you have attended larger gatherings or have visited individuals who are more susceptible to illness.
They also recommend washing hands frequently and masking in crowded indoor areas as well as in spaces that are poorly ventilated to prevent Covid, RSV and the flu.
Teaching artists lead students through improv exercises during a Laughing Together workshop at San Joaquin County Office of Education’s Peer-to-Peer Summit in September 2024.
Top Takeaways
Many school districts are using comedy and improv workshops to teach students social-emotional skills, encourage self-expression and foster social connection.
Through the comedy program Laughing Together, professional comedians and mental health clinicians develop workshops based on exercises that can improve student mental health.
Game-based learning and interactive play can engage students who might have fallen behind academically or socially during the pandemic.
“If you were an object, what object would you be?”
Chris Gethard, a veteran comedian and improv teacher, posed this question to a group of high school students in Northern California at a Laughing Together workshop he was leading. He remembered one who identified as a fruit.
“When I was a kid, I convinced myself that I hated avocados,” Gethard remembered the student saying. “And then I tried one, and I actually love ’em. And that’s been my experience the past few years as I’m learning to love and embrace myself.”
It quickly became obvious to Gethard that the improv wasn’t about avocado or any fruit for that matter. It was a big moment, and the student was taking a big risk to figure out something about themselves — their gender identity in real time.
“Young people right now are living in a world where those experiences are often held up in the spotlight and politicized,” Gethard said. “So to see a kid being able to take a comedy exercise, which feels light and accessible and not too heavy, they can let their guard down and take a big swing like that.”
Many school districts are turning to comedy as a way of supporting student mental health. In 2023, Gethard co-founded Laughing Together, a program based on research that comedy can be an effective tool for students’ social-emotional learning and social connection with their peers.
Nearly 6,500 students and educators across 26 different schools, districts, or youth organizations, have taken part in their workshops since Gethard co-founded the program with Marlon Morgan, CEO of parent nonprofit Wellness Together.
“One of the reasons that we [partnered with Gethard] is that he had already shared about his own mental health through his comedy special on HBO,” said Morgan, who is also a former school counselor. “He can make dark and scary things funny, which really helps students gain insight into their own emotions and become better at connecting with each other.”
‘Taking chances in the spotlight’
Research shows that students who practice social-emotional skills in safe environments with well-defined goals have improved social behavior, emotional regulation and academic performance.
“We have clinical psychologists who go through all the improv exercises,” Gethard said. “They get to say — ‘these ones are about making people funny, and they also prioritize nonverbal communication, strengthening eye contact, being comfortable with failure and taking some chances in the spotlight.’”
Christina Patterson, a senior and peer counselor at Lincoln High School in Stockton, said pandemic shutdowns forced her to spend nearly entire days scrolling through social media, hoping for something new to interact with (“But, there never is anything new,” she added).
For the first time since her school implemented a cellphone ban, Patterson said taking part in the Laughing Together workshop, even for an hour, met the level of engagement she had always been looking for on her phone. Like Patterson, students in recent years report better cognitive, social and academic outcomes through game-basedlearning and interactive play, compared to lecture-based instruction.
“I feel engaged with people who are interactive — they’re not trying to teach at you, but they’re trying to teach with you together,” Patterson said.
Laughing Together workshops are led by one of the program’s teaching artists, including professional comedians, actors and performers, alongside children’s psychologists, drawing on art, play and game therapy research, to develop social-emotional learning and communication skill-building into each exercise. For Gethard, a workshop is successful if he can teach students something without them realizing it.
“We want kids to leave feeling more connected and comfortable with each other, not like they just watched a slide show or that they were just spoon-fed these lessons,” he said. “We want them to feel that they’re allowed to at least throw an idea out there, and no one’s going to judge them, pick them apart, or criticize them.”
Sofia Stewart-Lopez, a senior and peer counselor at Lincoln High School, helped set up a peer-to-peer summit, where she and other student mentors took part in a Laughing Together workshop. She remembered starting the day anxious about a big presentation about mental health resources she had later in the day, but after a few skits and improv games, she felt more confident, relaxed and connected to the people around her.
“I learned that a big part of balancing heavy topics of mental health, like anxiety, depression or substance abuse, is learning how to combat them with things that can help you with those feelings,” Stewart-Lopez said.
Markus Alcantar, a senior and a peer counselor at Lincoln High School, said his favorite part of the workshop was one in which he got to become an apple. He had to think on his feet about why he felt like one, and then he improvised a skit with someone who had decided they were a tree. In another exercise, he said a volunteer started with juggling a ball, after which students added another ball, followed by another, and then another — until they couldn’t keep up anymore.
“It was a fun representation of how you can have a lot of things going on in your head mentally, and that you can learn to unravel those thoughts and organize them for yourself and other people,” Alcantar said.
About 1 in 5 teenagers, and most of Stewart-Lopez’s friends at school, she said, have experienced symptoms of anxiety or depression. So the workshop, she said, was particularly helpful in understanding how laughter exactly works in the brain — like how endorphins and serotonin receptors can alleviate some feelings of sadness or anxiety — to be able to have fun and build healthy coping skills with friends at school.
“The [improv exercises] also taught us that thinking on our feet better prepares us to be able to respond in different types of situations,” Stewart-Lopez said. “We learned that different people need different types of support, which betters us as mentors.”
Middle school students attend a Laughing Together workshop at San Joaquin County Office of Education’s Peer-to-Peer Summit in September 2024.
Most recently, Gethard completed nine workshops at a high school where over half of the student body are on Individualized Education Plans (IEP), or accommodations for students with learning, developmental, or behavioral disabilities. During the first workshop, he noticed most students reaching for their phones in the middle of an exercise or while on stage. To ease students into the experience, he’d tell them to simply take a breath and try to be present.
“After the first few workshops, a teacher came up to me and said, ‘their ability to lock in and focus on that is leaps and bounds compared to week one,” Gethard said. “She said, ‘they just never got their ability to focus back after Covid, but if we can keep going with this, it’s going to change the game for these kids in the room.’”
Rates of anxiety and depression — which shot up by 70% among California children between 2017 and 2022 — are the top health-related drivers of absenteeism since the onset of the pandemic. Research indicates that reduced social interaction, coupled with overreliance on screen time, also worsened students’ social cognition skills, such as cooperation and communication, and executive functions, such as attention and memory.
Alcantar was in seventh grade when schools shut down, and when he returned to in-person instruction as a high school freshman, he said he found it difficult for him to initiate conversations with people around him. Stewart-Lopez said that after schools lifted mask mandates, she kept hers on for a while because she was worried about meeting social expectations about what she should look like.
“The pandemic had added to my sense of anxiety about, ‘What if I don’t fit in? What if I’m different from everybody else?” she said.
For Stewart-Lopez, laughter feels like home. It’s how she and her sisters got through their parents’ separation and also how she plans to take new risks with new people at college this year.
“We’re creating that safe place for students to get real-time responses to the risks they’re taking — and everyone’s taking risks — which makes it okay,” said Morgan, the CEO of nonprofit Wellness Together.
Californians remain anxious about the mental health of public school students four years after the Covid virus closed down schools, according to a new survey released Wednesday. They also indicated they’re lukewarm toward passing a statewide school construction bond.
In the Public Policy Institute of California’s survey of 1,605 California adult residents, 81% of all adults and public school parents said they were strongly or somewhat concerned about students’ mental health and well-being – a view that, for most part, cut across race, political party affiliation and family income. The number reflects a continuing worry about the persistent impact of the pandemic two years after students returned to the classroom following school closures of more than a year.
SOURCE: PPIC Statewide Survey, April 2024. Survey was fielded from March 19-25, 2024 (n=1,605 adults, n=1,089 likely voters, and n=252 public school parents).PPIC
Advocates for a statewide bond to build and repair TK-12 school facilities may face an uphill battle to pass it – assuming Gov. Gavin Newsom and legislators put the issue before voters in November.
Only 53% of likely voters said they would vote for a state bond, while 44% said they’d vote no, with only 3% undecided, according to the Public Policy Institute of California, which on Wednesday released its annual survey of voters’ view on TK-12 education issues. The number is well below 60%, the standard level of favorability that comforts backers of an initiative heading into a campaign.
The mid-March survey also found mixed views on how Newsom and the Legislature are handling the state education system; 51% of all Californians and 60% of public school parents said they liked how he had managed education. That’s the lowest number since his election in 2018, and consistent with PPIC’s most recent survey on his overall job performance. The survey had a margin of error of 3.3% plus or minus.
Newsom’s highest rating was in April 2020, when 73% of likely voters approved and 26% disapproved of his performance on TK-12 education. That coincided with the emergence of the coronavirus, and his decision to close schools. “Newsom got a bump in the early days of the crisis for responding decisively amid the shock of the pandemic,” said Mark Baldassare, survey director and chair of public policy for PPIC.
The Legislature and State Superintendent of Public Instruction Tony Thurmond also received roughly 50% approval in the latest survey; however, the poll also showed that most Californians agreed with their positions on social and political issues that captured headlines in the past year.
69% of all adults said they strongly (43%) or somewhat (26%) oppose individual school boards passing laws to ban and remove certain books from classrooms and school libraries; a smaller majority of public school parents (30% strongly, 25% somewhat) agreed. Last year, Newsom threatened to fine Temecula Valley Unified and replace a social studies textbook that the board rejected because it included a reference to the late gay activist Harvey Milk; the board reversed its position.
58% of all adults and 55% of public school parents oppose individual school boards creating policies to restrict what subjects teachers and students can discuss in the classroom.
More than 80% of adults and public school parents strongly or somewhat favor teaching about the history of slavery, racism, and segregation in public schools; more than 50% of all respondents strongly held that view.
Local schools got good marks for preparing students for college, but less so the workforce. 60% of all adults and 72% of public school parents said their schools did well preparing students for college, while 51% of all adults and 65% said they did a good job preparing students for jobs and the workforce. Only 45% of African American respondents said the schools did a good job for college, compared with 64% of Asian Americans, 61% of Latinos and 61% of Whites.
As with these and many of the issues surveyed, there was a sharp partisan division, with most Democrats supporting Newsom’s positions and most Republicans opposing them.
California adults were about evenly split (50% support, 49% oppose), however, on whether to allow books with stories about transgender youth in public schools. Three in four Democrats support this, while eight in 10 Republicans oppose it, and independents are divided (51% support, 48% oppose). Only 42% of public school parents support the idea, and 57% said they oppose it; they also opposed including lessons on transgender issues by the same breakdown.
Newsom and the Legislature have committed billions of dollars to phase in voluntary transitional kindergarten for all 4-year-olds. Two-thirds of all adults, including 77% of public school parents, 80% of Democrats, 41% of Republicans, 84% of Blacks, and 57% of Whites, said that’s a good idea.
Uncertainty about bond issue
Newsom said in January that he supports placing a school construction bond on the November statewide ballot; voters last passed a state bond in 2016, and the state has run out of money to contribute to districts’ share of new construction and renovations.
However, Newsom and legislative leaders have not negotiated the specifics. School consultant Kevin Gordon, president of Capitol Advisors, said that polling results could affect the size and scope of a bond. Instead of a $15 billion bond that legislative leaders have discussed, it could be much less; instead of including money for the University of California and California State University, which polls less favorably than TK-12, it could include money only for TK-12 and community colleges, he said.
Gordon and Baldassare disagreed on how much to read into the 53% support of the bond eight months before the election.
“All of the not-so-good news about the state budget, with billions of dollars in red ink, has had an impact on voters’ attitude that affects the bond issue now,” Gordon said. “But after this summer, with a balanced budget adopted, and with economists optimistic about the latter part of 2024, voters’ attitude could change.”
Credit: Public Policy Institute of California, April 2024 survey
Four years ago, voters rejected a state bond 46% to 54% in the March 2020 primary election. But, Gordon said, voters have never defeated a state bond initiative in a November election, which attracts more people to the polls.
Baldassare said the bare majority support in the survey shows “there is a lot of economic anxiety among voters over inflation and anxiety over taking on more debt.” That showed in the bare passage last month, with 50.2% of the vote, of Proposition 1. It will determine how to spend money on housing for unhoused people suffering from mental illness.
The survey also produced mixed, and perhaps puzzling results to the same questions asked in previous surveys:
Asked “how concerned are you that California’s K-12 public school students in lower-income areas are less likely than other students to be ready for college,” 39% this year said “very concerned.” That’s the lowest percentage since the question was introduced in 2010, when 59% said they were very concerned.
Asked, “How would you rate the quality of public schools in your neighborhood today,” 49% of likely voters gave their schools an A or B. That’s nine percentage points higher than last year and in pre-pandemic 2019.
Asked whether the quality of education has gotten worse over the past few years, 52% of adults said it was worse, 11% said it had improved, and 34% said about the same. That was an improvement from last year, when 62% said education had gotten worse and only 5% said it had improved – and far better than in 2011. That was during the depths of the Great Recession, when school districts were slashing budgets following cuts in state revenue: that year, 62% said schools had gotten worse.
Michael Hiltzik, columnist for The Los Angeles Times, explains why Robert F. Kennedy Jr. is himself a danger to public health. Why did Trump pick him? RFK Jr. is neither a medical nor a scientific researcher. He has made his mark in public as a conspiracy theorist and a publicist for the idea that vaccines cause autism and other illnesses.
Hiltzik writes:
Americans have become woefully familiar with Health and Human Services Secretary Robert F. Kennedy Jr., the purveyor of flagrant misinformation about medical treatments. And with Robert F. Kennedy Jr., the minimizer of health crises such as the spreading measles outbreak. And with Robert F. Kennedy Jr., the antivaccine crusader.
Now let’s meet Robert F. Kennedy Jr., the promoter of a costly, time-consuming and distinctly unethical order for testing vaccines. “All new vaccines will undergo safety testing in placebo-controlled trials prior to licensure — a radical departure from past practices,” HHS announced in a May 1 statement. What it didn’t say was that the “departure” is “radical” because it’s shunned by medical authorities as a bad thing.
Just this week, Kennedy’s agency doubled down on this order with the appointment of Vinay Prasad, an oncologist at UC San Francisco, as head of the Center for Biologics Evaluation and Research, the division at the Food and Drug Administration that oversees vaccine testing.
Prasad was a strident critic of the Biden administration’s approach to the COVID-19 pandemic, including the COVID vaccines. In a blog post in late April, he called for clinical testing of COVID boosters, along the lines of Kennedy’s order. Prasad succeeds Peter Marks, a widely respected expert who resigned from the FDA in March after clashing with Kennedy.
“I was willing to work to address [Kennedy’s] concerns regarding vaccine safety and transparency,” Marks wrote in his resignation letter. “However, it has become clear that truth and transparency are not desired by the Secretary, but rather he wishes subservient confirmation of his misinformation and lies.”
The HHS announcement about Kennedy’s demand for placebo-controlled trials was unclear about how it defined “new vaccines.” But his previous claims about vaccine safety have made clear that he’s referring not only to first-generation vaccines for diseases, but also boosters and expanded formulations. That’s an important point, as I’ll cover in a moment.
The antivaccine camp, of which Kennedy has long been a leader, has pushed the claim that most childhood vaccines haven’t been adequately tested for safety because they haven’t been subjected to placebo-controlled trials — and therefore may be unsafe.
“Except for the COVID vaccine, none of the vaccines on the CDC’s childhood recommended schedule was tested against an inert placebo, meaning we know very little about the actual risk profiles of these products,” Kennedy’s spokesman at HHS, Andrew Nixon, asserted in connection with the order.
Both components of that claim are misrepresentations.
Let’s take a closer look, starting with some rudimentary points.
The testing that Kennedy and Prasad advocate are randomized control trials. They’re correct in asserting that so-called RCTs are the gold standard in clinical testing of drugs and vaccines.
RCTs typically involve at least two groups of subjects: One receives the medicine in question and another — a control group — receives something else, such as a placebo, a concoction that’s designed to resemble the medicine but is essentially inert, with no evident effect on the disease. The placebo may be an injectable saline solution, or water, or a sugar pill.
Kennedy, like other antivaxxers, is deceptive in saying that the safety of vaccines should be questioned if it hasn’t been tested against an “inert placebo.”
That brings us to the ethics of clinical testing, and why Kennedy’s policy is so dangerous.
Testing a vaccine against a true placebo is ethical and proper when it’s the first treatment for a disease for which no other safe and effective treatment exists. That’s not the case, however, when a known treatment does exist — say after a vaccine has been shown to be safe and effective and has become the standard of care.
As vaccine specialist Paul Offit of Children’s Hospital of Philadelphia has explained, subjecting new versions of those vaccines to placebo-controlled testing — giving some subjects the new vaccine and the control subjects no treatment, would be unethical, because it would require depriving the placebo group access to a known treatment. That was the conclusion of an expert panel assembled by the World Health Organization in 2014.
Offit, in a 2023 rejoinder to Kennedy’s appearance on a Joe Rogan podcast, in which he claimed that drug companies “never do placebo-controlled trials,” pointed to what may be the most famous vaccine trial to illustrate this point. That was the nationwide trial of Jonas Salk’s polio vaccine. In 1954, 420,000 first- and second-graders were given the Salk shot, and 200,000 got a shot of salt water. Salk objected to the trial’s design. Smaller trials had established the safety and efficacy of his vaccine, so the plan meant depriving 200,000 children of immunity to a disease that was paralyzing 50,000 children a year and killing 1,500.
As Offit noted, in the full trial 16 children died from polio; all were in the placebo group. So were 34 of the 36 children paralyzed in the course of the trial. “These are the gentle heroes we leave behind,” Offit wrote.
Now let’s examine Kennedy’s order as it applies to modern vaccines. As the veteran pseudoscience debunker David Gorski has pointed out, contrary to the assertion by Kennedy’s spokesman, almost none of the vaccines on the current childhood vaccination list is a first-generation vaccine warranting placebo testing. (An exception is Gardasil, which safeguards against human papilloma virus.)
They’re upgraded preparations of vaccines that themselves underwent placebo-controlled trials, or formulations aimed at new variants of the targeted disease, or shots that inoculate against several diseases all at once.
To demand that every new formulation be tested against an inert placebo would mean turning back the clock to reproduce trials that may have taken place decades ago, but resulted in the licensing of the original vaccine after safety and efficacy were established.
That means it would have been unethical to test the new version against a saline control, because the control group would be deprived of any effective treatment. “The bottom line,” Gorski writes, “is that, if you trace back the history of the vaccines developed for a disease like, say, measles, you will eventually find the RCT testing the first effective vaccine against it and that vaccine will have had a placebo control.” He’s right. In a tweet thread, vaccinologist Peter Hotez traced back the history of several vaccines to their initial RCTs.
What makes Kennedy’s order especially cynical is that designing and implementing a clinical trial is an extraordinarily complex, costly and time-consuming process. As a team of Canadian researchers observed in a 2018 Nature article, a full-scale Phase 3 clinical trial — the level at which drugs and vaccines are studied for safety, efficacy and dosing — requires as many as 3,000 participants and can take as long as four years.
In an online posting last month, Prasad ridiculed “the mainstream media” for being upset about the idea that COVID boosters should in effect receive full randomized clinical trials before approval. He took particular issue with an article by Helen Braswell of STAT asserting that such a requirement might well delay approval of a vaccine targeting a new COVID variant until it was too late to protect users from that variant. Prasad called the argument false because “the virus spreads year round.”
Is that so? At the height of the pandemic, new COVID variants sometimes appeared within months of one another. The virulent Delta variant, for example, appeared in the spring of 2021 and was overtaken by the Omicron variant, which also caused severe disease, that November.
Delays in rolling out vaccines to combat newly emergent disease strains and variants could cost millions of lives. Under existing vaccine approval protocols, the COVID vaccines prevented as many as 20 million deaths globally within a year after they were introduced early in 2021.
Prasad’s new job will put him in charge of developing vaccine testing policies and overseeing the design and approval of clinical trials. I asked him via email what policies he would pursue, whether he was in alignment with Kennedy’s approach, and how he expected vaccine developers to reconcile the costs and time constraints of undertaking clinical trials on the scale he advocates with the imperatives of public health. I didn’t receive a reply.
So far, the Kennedy regime at HHS has lived down to the worst expectations of his critics. His devotion to unnecessary testing of vaccines that have already shown their safety and efficacy is only one aspect of a comprehensive assault on public confidence in science-based medicine.
In a recent appearance on Sean Hannity’s Fox News program, Kennedy dismissed the severity of the current measles outbreak and denigrated the effectiveness of the measles vaccine. The current outbreak of 935 cases is by far the worst in the U.S. since 2019, when 1,274 cases were recorded; at the current rate, we are on the path to nearly 3,000 this year.
Kennedy has promoted almost useless nostrums against measles, such as vitamin A, while describing vaccination as a personal choice. That’s devastatingly wrongheaded. Kennedy confuses “medicine” and “public health.” The former concerns itself with the individual; the latter with the community. Vaccine policy belongs in the latter category because vaccines are most effective when the effort is communitywide.
Measles is among the most contagious diseases known to humankind, which means that communal vaccination is crucial. Professionals have concluded that a 95% vaccination rate is the minimum required to protect the most vulnerable, such as infants, from infection; as of 2024, the U.S. vaccination rate among kindergartners had fallen from 95.2% in 2019-20 to 92.7%.
The Centers for Disease Control and Prevention, which falls within Kennedy’s jurisdiction, says the decline in measles vaccinations leaves 280,000 kindergartners at risk. Two children in the U.S. already have died from a disease that was thought to have been eradicated in the U.S. in 2020; Kennedy doesn’t seem concerned that the toll on his watch is poised to get much worse.
Within this area, there are hammocks, slacklines, trees, ample seating and, of course, the pond itself, all providing students with a mental health boost. 
