The Food and Drug Administration has reversed course and agreed to review Moderna’s application for the first mRNA-based flu vaccine under a revised approach, company and federal officials said Wednesday.
Last week, Vinay Prasad, the agency’s top vaccine regulator, declined to review the vaccine, a rare move that shocked the company and that public health experts saw as the latest example of the Trump administration’s hostility toward immunization. Federal health officials argued that Moderna lacked an “adequate and well-controlled” study and should have used a high dose flu shot for adults 65 and older in a large clinical trial.
The company met with the FDA and proposed seeking full approval for the vaccine for adults 50 to 64 years of age and accelerated approval for adults 65 and older, along with a requirement to further study the vaccine in older adults, according to Moderna.
“We appreciate the FDA’s engagement in a constructive Type A meeting and its agreement to advance our application for review,” Moderna CEO Stéphane Bancel said in a statement. “Pending FDA approval, we look forward to making our flu vaccine available later this year so that America’s seniors have access to a new option to protect themselves against flu.”
The target date for completing the review and making a decision is Aug. 5, according to Moderna. If approved, the vaccine could be on the market for the next flu season.
The Department of Health and Human Services confirmed it held a formal meeting with Moderna, and it had accepted the company’s new approach.
“FDA will maintain its high standards during review and potential licensure stages as it does with all products,” Andrew Nixon, an HHS spokesman, said in a statement.
FDA Commissioner Marty Makary personally sought a quick resolution but was not involved in the regulatory decision for the new approach, according to a person familiar with the matter who spoke on the condition of anonymity to share private details.
Katalin Karikó and her Penn colleague Drew Weissman won the 2023 Nobel Prize in medicine for their messenger RNA research, which paved the way for COVID-19 vaccines that are credited with saving millions of lives.
MRNA vaccines are faster to develop than traditional vaccines. Medical experts hope such technology could help vaccine makers respond more rapidly to changes in the flu strain.Flu vaccines are updated annually, and their effectiveness varies every season depending on the quality of the match.
But Health Secretary Robert F. Kennedy Jr. and other health officials in the Trump administration have criticized the use of the technology for respiratory virus immunization and have pulled federal funding for mRNA research, including for flu vaccines.
Vaccine experts had raised concerns over Prasad’s initial decision to refuse to review the vaccine, saying that shifting guidance from the FDA could deter future investments in pricey clinical trials. For the Moderna vaccine, Blackstone, a private equity company, invested $750 million into conducting a large-scale clinical trial and potential licensure of the vaccine.
Companies conduct clinical trials in consultation withthe FDA. According to Moderna, the FDA in April 2024 told the company that its trial design for the mRNA flu vaccine compared with a standard flu shot was “acceptable.” The FDA recommended comparing the mRNA flu vaccine against a higher-dose flu shot for those 65 and older, but the recommendation was not binding.
Moderna conducted two late-stage trials — one of the final steps before seeking approval of its mRNA flu vaccine — enrolling more than 43,000 adults ages 50 or older. In one trial, more than 40,000 participants received either a dose of the experimental mRNA flu vaccine or a standard dose of an existing flu shot. In a smaller trial, participants received a dose of the mRNA vaccine, a standard shot or a high-dose influenza shot recommended for adults 65 and older.
The administration had defended the decision to decline to review the shot. In a statement last week, Nixon said that “Moderna exposed participants aged 65 and over to increased risk of severe illness by giving them a substandard of care against the recommendation of FDA career scientists.”
In an interview last week, Moderna president Stephen Hoge said the company was “surprised” and “confused” by the refusal. He said the agency had not identified any issues around the safety or efficacy of its product.
At an event Tuesday held bythe major industry lobby organization PhRMA, Makary said the company was given “pretty clear guidance.”
“The application was reviewed, and that letter, in my mind, is part of a conversation where you’ll see a dialogue between the company and the agency,” he said.
Jay Bhattacharya, a top Trump administration health official and an outspoken critic of the Centers for Disease Control and Prevention’s response to the coronavirus pandemic, will lead the CDC on an acting basis, according to four people who spoke on the condition of anonymity to describe personnel moves.
Bhattacharya, who will continue his role as director of the National Institutes of Health, replaces Jim O’Neill, who had served as the CDC’s acting director. O’Neill, who had also served as the deputy secretary of the Department of Health and Human Services, will be nominated to run the National Science Foundation after he declined a potential ambassadorship to the Organization for Economic Cooperation and Development, two of the people said.
The installation of Bhattacharya at the CDC is the latest move by the White House and Health Secretary Robert F. Kennedy Jr. to shake up HHS’s leadership team ahead of the midterms, as the Trump administration seeks to stabilize a department rattled by internal fights and controversial messages.
The New York Times first reported that Bhattacharya would serve as the acting head of CDC, which is charged with protecting Americans from health threats and issues recommendations on vaccines and other public health matters. Trump officials have said they are planning to find a full-time CDC director, a post that requires Senate confirmation. Susan Monarez, who was confirmed as CDC director in July, was ousted less than a month later after clashing with Kennedy over his plans to change vaccine policies.
Bhattacharya, a Stanford University physician and economist, rose to prominence during the pandemic by arguing that the government’s response to the outbreak was too harsh, a stance that put him at odds with public health leaders who said his proposals would imperil the most vulnerable Americans. He co-wrote the Great Barrington Declaration, which was published in October 2020 and called for an end to coronavirus shutdowns. The declaration drew rebukes from government officials — a clash that ultimately boosted his profile and helped draw the support of Kennedy, a fellow critic of the government’s pandemic response.
“The CDC peddled pseudo science in the middle of a pandemic,” Bhattacharya wrote on X in 2024, criticizing agency leaders’ past claim that widespread masking could end the coronavirus outbreak.
As CDC’s acting head, Bhattacharya is poised to oversee the agency’s vaccine recommendations, which have emerged as a political flash point as Kennedy has worked to roll them back over the objections of public health leaders. A KFF poll published this month found that 47% of U.S. adults now trust CDC for reliable information on vaccines, down from 85% in early 2020.
Bhattacharya has said he supports vaccination for childhood diseases.
“I think the best way to address the measles epidemic in this country is by vaccinating your children for measles,” Bhattacharya said at a Senate hearing this month.
Bhattacharya and other NIH leaders in January also published a commentary in the journal Nature Medicine that criticized the public health response to the pandemic led by other agencies.
“Many of the recommended policies, including lockdowns, social distancing, school closures, masking, and vaccine mandates, lacked robust confirmatory evidence and remain the subject of debate regarding their overall benefits and unintended consequences,” they wrote. “Where enforced, vaccine mandates contributed to decreased public confidence in routine voluntary immunizations.”
Most of us have heard the adage “Feed a cold, starve a fever.”
It comes from an outdated theory that a cold makes your body cooler and eating can help warm it up, and that a fever makes your body warmer and fasting can help cool it down. The premise itself is flawed: While fevers do raise your body temperature, colds don’t make your body cold. You might even get a fever when you have a cold.
As for whether you should eat more or less, in most cases, there’s no convincing evidence thatlimiting food intake when you’re sick plays a meaningful role in recovery, experts said.
There may be a more accurate approach. “Feed a cold. Feed a fever, too,” said Roy Gulick, the chief of the infectious-disease division at Weill Cornell Medicine and an attending physician at New York-Presbyterian Hospital.
Experts recommend staying hydrated and eating healthy foods — at least when your stomach will allow it — to support your body when you’re sick. The advice holds true whether you’re dealing with a cold, which is an upper-respiratory infection that can be caused by more than 200 viruses, or a fever, which can be caused by viral and bacterial infections, autoimmune issues, and reactions to medications, among other things.
“If you are truly not feeling hungry, you don’t necessarily have to eat more than you feel like eating,” said Geeta Sood, an assistant professor in the infectious-disease division at Johns Hopkins University.However, you do want to make sure you’re getting enough calories, protein, and nutrients — and hydration — to help support your body as it heals, she said.
What does the research show?
Research in this area is limited — and mostly in animals. For example, in a 2016 study, mice were infected with either a bacterium that causes gastrointestinal illness or a virus that causes influenza. In mice with the bacterial infection, fasting was protective while nutritional supplementation was detrimental, the authors found. The pattern was reversed in mice with the flu and viral sepsis.While interesting fodder for further research, these results can’t be applied directly to humans, experts said.
In humans, researchers who conducted a 2021 review concluded that there is some evidence that nutrients such as vitamins and minerals can help support the body’s immune response and help fight infections in general. And a 2024 review that included newer studies that were conducted duringthe pandemic suggested that nutritional needs may depend on the specific pathogen you’re fighting and other variables, such as the duration and severity of your illness — not simply on whether it’s a bacterium or virus.
The reality is that most studies on how nutrition affects infections have looked at only a handful of pathogens, said David Schneider, a professor of microbiology and immunology at Stanford University. To further complicate matters, when you’re experiencing symptoms such as a runny nose or fever, you may not know whether you’re sick with a bacterium or virus, he said. Both of these things make it difficult to give generalized recommendations about what might be best for every cold or every fever, he said.
Why do I lose my appetite when I’m sick?
There is some rationale to the adage, because it’s common to lose your appetite when yourbody is fighting off an infection. As your immune system ramps up, it releases chemical messengers, known as cytokines, to rally immune cells to fight infection, and those same signals also tell the brain that eating isn’t a priority, said Sharon Bergquist, an internal medicine physician and associate professor at the Emory University School of Medicine.
While not well understood, one theory states that a drop in calorie and protein intake triggers a process called autophagy, which helps recycle damaged cell parts and may play a role in immune defense, she said.
That said, the process of fighting an infection is “metabolically really costly,” Bergquist said, explaining that although you can skip food for a day if you aren’t hungry, going longer than that may leave you without adequate nutrition. “It takes so much energy and calories that there’s a rationale for us needing to increase our food and our hydration during times of illness so that we can support our immune system,” she said.
What can I do if I have an infection?
Vaccines are the first-line defense to help prevent and lessen the severity of some viral infections, including COVIDand the flu. If you get sick, however, you can try some medications that may help you recover faster.
Antibiotics target specific kinds of bacteria such as those that cause strep throat, pneumonia, or urinary tract infections.
Antiviral medications can help treat certain viral infections, including the coronavirus and influenza. Three antivirals — Paxlovid, remdesivir, and molnupiravir — are available by prescription to treat COVID in people who are at high risk of serious complications, and four antivirals are approved to treat the flu.
There are also a few other things you can do to help support your body.
Stay hydrated. Losing water and electrolytes through sweat when you have a fever, as well as through diarrhea and vomiting, can put you at risk for dehydration, so it’s important to drink plenty of water and make sure you’re getting enough electrolytes, Gulick said. Pediatric beverages and sports drinks with added sodium and potassium can help you stay hydrated, and warm liquids such as soups, broths, and caffeine-free herbal teas can help ease symptoms such as congestion, body aches, and chills, Sood said. Avoid alcohol and caffeinated drinks because they are diuretics and can make dehydration worse.
Eat, when possible. Listen to your body, but when you have an appetite, eat healthy, whole foods rich in vitamins, minerals, and antioxidants such as fresh fruits and vegetables. One strategy is to make smoothies or soups, Bergquist said. Avoid foods high in saturated fats and processed carbohydrates.
Get rest. Take time to rest as your body does much of its repair work while you sleep, Bergquist said. “Don’t push your body because you want to dedicate that energy to your immune system,” she said.
Take hot showers or baths. The steam can help break up congestion and clear airways.
Try zinc. Zinc may help shorten a cold by a day or two. In a 2024 review, researchers found some evidence that zinc might reduce the duration of symptoms by about two days compared with a placebo, though the mineral was associated with mild side effects such as nasal and oral irritation, problems with taste, stomach pain, constipation, diarrhea, and vomiting. Most other supplements have no real advantage for colds, including vitamin C, which, when started at the onset of symptoms, doesn’t help lessen the duration or severity, research shows.
Use honey for a cough or sore throat. Adults and children older than 1 year can add honey to warm tea or water to help soothe sore throats and calm coughs.
When Kelly McBride read Elizabeth Bruenig’s essay in the Atlantic about a child’s death from measles complications, she was moved and quickly shared the story on her Facebook account. She hadn’t realized that Bruenig’s family had been ravaged by virus and the well-known journalist had lost a child.
McBride, a media ethicist and senior vice president at the Poynter Institute, also didn’t realize the story was a hypothetical scenario — and the child a composite character based on the author’s research — until a friend alerted her to an editor’s note at the bottom of the story. Then, McBride felt duped.
“I feel deceived,” McBride said. “I spent all weekend talking about this story to my friends as if the reporter had experienced it.”
Bruenig’s stirring account of a mother’s experience learning her child will die of the long-term effects of measles has remained one of the Atlantic’s most read stories since it was published Thursday, receiving more than 700 comments. Written in the second person, some readers have called the essay a visceral and gut-wrenching exposéof the human impacts of the measles epidemic.
It has also generated controversy. Readers and media experts have condemned the story as breeching journalistic ethics by informing the reader that the story is fictionalized through a short editor’s note at the end of the 3,000-word essay. Some public health experts argued the story was a dangerous writing exercise that could evoke backlash and confusion as vaccine skepticism hits an all-time high across the country.
“Grateful to @ebruenig for sharing her and her family’s ordeal,” Gabby Stern, a former World Health Organization communications director, wrote on X shortly after the story published. “Friends, please ensure that your children receive vaccinations against preventable diseases like measles.”
She followed up soon after: “I missed the disclaimer at the bottom. Others did, too. You get to the end and you’re shattered, not looking for caveats and fine print. Disappointed in the magazine. The topic is too high-stakes for such shenanigans.”
Adrienne LaFrance, executive editor at the Atlantic, told The Washington Post in a statement that the magazine was “pleased that so many people are reading and praising Liz’s remarkable essay.”
“We trust our readers to understand all different kinds of writing and writerly devices,” she said. “And while we included a note about Liz’s methods for transparency’s sake, we’re finding that most readers already understand the second-person well enough to know that the ‘you’ referenced throughout the piece is not literally ‘you,’ the reader.”
The Atlantic, one of the most popular American magazines with 1.4 million subscribers, has become a destination for health reporting in recent years. The Atlantic is among a cohort of outlets that have reported on rising measles cases across the United States, as well as the role that misinformation and shifting government guidelines have on childhood vaccinations. Once eliminated in the country, outbreaks have led to the highest count of measles cases in more than three decades. Atlantic staff writer Tom Bartlett was first to find and interview the parents of a child who died of measles in Texas, the first such death in a decade.
Bruenig, a former Post opinion writer, has twice been a finalist for the Pulitzer Prize for feature writing, one of the industry’s top honors for narrative journalism. (This reporter worked for the Atlantic from 2017 to 2019.)
Bruenig wrote the essay in the second person, detailing a scenario where two unvaccinated children attend a birthday party and catch measles from an infected-but-asymptomatic child. “Your daughter behaves normally over the next week while the virus slowly spreads inside her, infecting immune cells that carry it to the lymph nodes, where it replicates and spreads at a rapid pace.”
It includes a short disclaimer at the bottom of the 3,000-word piece: “This story is based on extensive reporting and interviews with physicians, including those who have cared directly for patients with measles.”
Reported hypotheticals have been used in other grim chronicles such as Outside Magazine’s 1997 story “Frozen Alive,” about freezing to death; a passage of Kathryn Schulz’s 2015 New Yorker essay “The Really Big One” about the risks of a large earthquake; and the 2024 Annie Jacobsen book “Nuclear War: A Scenario,” about how nuclear warfare could transpire. The first two stories also are written in second person.
Many readers, including physicians, praised the Atlantic essay, writing that its evocative writing and storytelling forced readers to grapple with the impact of vaccine hesitancy. “Read this while holding my almost-one-month-old, and it absolutely wrecked me. What a powerful and important piece,” one commenter wrote. “Tragically realistic story exquisitely described by Ms. Breunig,” wrote another. “I’m a pediatrician who has never seen a case of measles but am awaiting my first one.”
Others, however, expressed their confusion in the essay’s comments. “The fact that readers in the discussion are unsure of whether this is a true story or fiction highlights a fundamental failure on the part of the author, and the editor,” one reader wrote.
“I know the internet is full of made up stuff, but I trusted the Atlantic,” another reader wrote. “I feel foolish that I told my husband about this as if it were the truth. Glad I didn’t share it with my sisters. We are all pro vaccines, and I’m concerned this story masquerading as a first person memoir will encourage people on the edge to blow off vaccines.”
Tom Rosenstiel, a professor at University of Maryland’s Philip Merrill College of Journalism and former executive director of the American Press Institute, felt the piece did the reader a disservice by not being fully transparent about they were about to read. He said the Atlantic needed to clearly explain the unusual choices in the story upfront, avoiding deception.
“Any time you’re answering questions about why you did something in the story after you’ve published it, you’re in a bad place,” he said.
Some physicians argued the uncertainty around the essay could fan distrust of vaccines. Angela Rasmussen, a virologist at the University of Saskatchewan who edits the journal “Vaccine,” said she found the essay scientifically sound but extremely confusing. She initially believed the essay was about Bruenig’s real child and felt the essay could backfire. “We need effective communicators like this,” she said. “But if that effective communication is being presented in such a way that it actually diminishes trust further, then we’re in real trouble.”
Rachael Bedard, a physician and writer, called herself an admirer of Bruenig, but expressed similar concerns in a series of posts on X.
“One of the things that people who have actually interacted [with] anti-vaxxers know is that they often think the liberal media is lying to them about how bad measles is,” she wrote, writing that the Atlantic’s presentation of this essay as anything other than fiction “affirms all of those concerns.”
Bruenig, in an interview with the website Nieman Lab, defended the structure of her essay. “It is a hypothetical account of a very real phenomenon based on careful reporting,” she said. “I would place it somewhere on the creative nonfiction spectrum.” She said that she interviewed doctors for her piece, and based the character of the mother on herself.
“I have no doubt that there are a lot of people out there who are unhappy with the story or reject its premises, and they are entitled to their interpretations. I get it,” she said. “But my job is to report the truth about the world — and I use all kinds of literary, and narrative devices to do that. I do it because telling the truth is important in its own right, whether or not anyone finds it persuasive.”
Johnson & Johnson plans to spend more than $1 billion to build a cell therapy manufacturing facility in Montgomery County near Spring House, the New Jersey pharmaceutical and medical supplies giant said Wednesday.
The Lower Gwynedd Township plant, part of an effort by the company to invest $55 million in the U.S. by early 2029, is expected to employ 500 people when fully operational in 2031, J&J said.
The facility at 1201 Sumneytown Pike will add to J&J’s capacity to make cell therapy treatments for cancer, with a focus on multiple myeloma. That’s a type of cancer that attacks white blood cells in the bone marrow. Cell therapy is the use of engineered immune cells to treat disease.
“Pennsylvania’s proud manufacturing legacy, from steel to today’s medicines and medical technologies and Johnson & Johnson’s roots here for seven decades, are part of why we are investing here.” Joaquin Duato, J&J’s chairman and CEO, said.
Duato spoke during an event at the company’s Spring House research and development campus, where 2,500 scientists work in 70 laboratories. The Montgomery County site is J&J’s largest R&D center and it’s “where most of our discovery efforts start,” Duato said.
The company based in New Brunswick, N.J., employs 5,885 people at 10 Pennsylvania facilities, according to the office of Gov. Josh Shapiro. The Shapiro administration has offered $41.5 million in state support for the J&J project.
“With this investment, we are further cementing our place as a leader in life sciences,” Shapiro said. He said his administration’s efforts to cut red tape are among the reasons companies like J&J “are choosing to double down on their investments” in Pennsylvania.
Eli Lilly & Co. last month announced plans to build a $3.5 billion pharmaceutical plant in the Lehigh Valley to expand manufacturing capacity for next-generation injectable weight-loss medicines.
GSK said in September that it will build a biologics factory in Upper Merion Township, but did not specify how much it would spend there. That project is part of GSK’s plan to spend $1.2 billion on advanced manufacturing facilities.
Johnson & Johnson chairman and CEO Joaquin Duato (left), was joined by Gov. Josh Shapiro and Pa. Dept. of Community and Economic Development Secretary Rick Siger (right) on Wednesday when J&J announced it will spend $1 billion on a cell therapy plant on its campus in Lower Gwynedd Township.
Merck, another New Jersey-based drug giant, last year announced plans for a $1 billion factory and lab near Wilmington. Merck also has major operations in Montgomery County, which is among the top-ranked counties nationally for pharmaceutical manufacturing jobs.
J&J has a long legacy in the Philadelphia region. Among its major acquisitions here was the 1959 purchase of McNeil Laboratories, which later developed Tylenol. The pain reliever is still made at a plant in Fort Washington.
Other major Philadelphia-area J&J deals include the 1999 purchase of Centocor, one of the country’s first biotech companies, and the 2012 deal for Synthes Inc., a Swiss medical device maker with its North American headquarters and major operations here.
Separately from the new cell therapy manufacturing facility, J&J has two expansion projects planned for the Spring House R&D site.
One is a new cell engineering and analytical sciences facility. The other is focused on CAR-T testing and manufacturing during research and development, with the goal of creating personalized therapies more quickly and efficiently. The company did not disclose the cost of those projects.
A millionaire’s private island filled with luxury goods, gourmet food, and fine wine seems like a reality a million miles from yours, so what can Philadelphia-area parents learn from the Epstein files?
Plenty.
There are people like Jeffrey Epstein everywhere. He just had a bigger field.
Epstein started small. In her memoir Nobody’s Girl, the late Virginia Roberts Giuffre, abused and trafficked by Epstein starting at age 16, describes how Epstein told her that as a teacher, he traded sex for grades. Alumni of New York’s elite Dalton School have described inappropriate conduct toward girls. Yet he was dismissed from the school simply for “poor performance.”
Back in the 1970s, when Epstein taught, sex abuse prevention programs were primarily directed at kids. Teaching kids to recognize “good touch/bad touch” would have done nothing for teenage girls, likely targeted for their insecurity, for whom attention from a cute, popular new teacher felt like affection and status. Today, the most effective school-based sex abuse prevention programs involve the entire school helping faculty and staff recognize and respond to inappropriate behavior. Policies explicitly identify acceptable and unacceptable behaviors around issues from touching to communicating with students outside of school. Ongoing prevention programs empower everyone to act if they see a breach. Parents are included as partners to reinforce healthy messages at home. One great example is Safety STARS — Enough Abuse.
What are the lessons for parents? I can count at least four:
1. Learn what sexual abuse prevention program is offered in your school or district and participate in the parent component. Confirm that it follows best practices, such as requiring a code of conduct for faculty, staff, and students, and commitment from administration to continuous monitoring of adherence to the policies.
Almost 20 years ago, Epstein was convicted of trafficking children for sex but escaped serious punishment in a now widely criticized plea deal. Defense attorneys at the time used the phrase “underage women” to soften how his acts against children sounded. I urge parents and all adults to more accurately call his crimes “child rape.” This helps challenge the social norm that it is somehow acceptable to have sex with minors who may be dressed up to appear older than they truly are.
2. For decades, social scientists have distinguished a pedophile — someone primarily attracted to prepubescent children — from ephebophiles, people attracted to older adolescents and teens. Either way, acting on such attractions is a crime against children.
Adults who target older youth may be more subtle in how they approach their targets, and that’s why parents should monitor all their teens’ relationships with adults, both virtual and in real life. A 17-year-old may look grown, and may balk at this supervision. But their brain still has nearly a decade before it can consistently make mature decisions.
Adolescence is a time of deep insecurity, when teens are highly sensitive to others’ opinions. As Giuffre noted in her memoir, people like Epstein are adept at “reading a room.” They can intuit what a vulnerable teen needs, and offer it, exacting their price later.
3. Even as maturing teens pull away, parents must work harder to stay connected and know what is happening in their teens’ lives. Set special times — driving to school can be ideal — to ask questions that require more than a yes-no answer. Take the time to learn the names of their friends, teachers, and coaches, so they know you’re really interested. Leave a surprise note on their bed telling them you’re proud of something they did. Teens need steady validation of their worth — not only for achievements, but simply for who they are. Keeping their self-esteem “cup” as full as possible is an important protective factor.
Predators are master manipulators. They can patiently work their way into an adolescent’s confidence, shoring up fragile self-esteem. That’s why it’s so critical for parents to be their children’s consistent support. Predators don’t just live on private islands and roam the world in private jets; they can run the social hierarchy as the “alpha” in a high school, or orchestrate hazing in a college fraternity or sorority.
4. Use the Epstein news as a moment to remind kids what a bully really is: someone who repeatedly uses their power to hurt, scare, or control a more vulnerable person. It is also a crucial chance to talk about sexual health and safety. Explain how youth of any age can be vulnerable to exploitation, and be explicit that sex should never be traded for anything.
A colleague raising teens put it starkly when I asked how she was handling the Epstein stories: “Kids are watching how we handle this as adults, and they are not impressed.” The children of this attorney are likely not the only ones who wonder why Epstein went so lightly punished, or why our culture seems to condone sexualized images of teens.
Ask your children what they’ve read and heard, what they think it means, and listen. Then share your thoughts and values. All adults can show the young people in our lives that we can do better — by talking openly about abuse, bullying, harmful media messages and whatever else is troubling our children. We can show them that we stand behind them and will advocate for safer policies in schools and communities.
Janet Rosenzweig MS, PhD, MPA is author of the book “The Sex-Wise Parent,” a senior policy analyst at The Institute for Human Services, and a member of the board of directors of The National Coalition to Prevent Child Sexual Abuse and Exploitation.
Republicans think patients should be shopping for better healthcare prices. The party has long pushed to give patients money and let consumers do the work of reducing costs. After some GOP lawmakers closed out 2025 advocating to fund health savings accounts, President Donald Trump introduced his Great Healthcare Plan, which calls for, among other policies, requiring providers and insurers to post their prices “in their place of business.”
The idea echoes a policy implemented during his first term, when Trump suggested that requiring hospitals to post their charges online could ease one of the most common gripes about the healthcare system — the lack of upfront prices. To anyone who’s gotten a bill three months after treatment only to find mysterious charges, the idea seemed intuitive.
“You’re able to go online and compare all of the hospitals and the doctors and the prices,” Trump said in 2019 at an event unveiling the price transparency policy.
But amid low compliance and other struggles in implementing the policy since it took effect in 2021, the available price data is sparse and often confusing. And instead of patients shopping for medical services, it’s mostly health systems and insurers using the little data there is, turning it into fodder for negotiations that determine what medical professionals and facilities get paid for what services.
“We use the transparency data,” said Eric Hoag, an executive at Blue Cross Blue Shield of Minnesota, noting that the insurer wants to make sure providers aren’t being paid substantially different rates. It’s “to make sure that we are competitive, or, you know, more than competitive against other health plans.”
Not all hospitals have fallen in line with the price transparency rules, and many were slow to do so. A study conducted in the policy’s first 10 months found only about a third of facilities had complied with the regulations. The federal Centers for Medicare & Medicaid Services notified 27 hospitals from June 2022 to May 2025 that they would be fined for lack of compliance with the rules.
The struggles to make healthcare prices available have prompted more federal action since Trump’s first effort. President Joe Biden took his own thwack at the dilemma, by requiring increased data standardization and toughening compliance criteria. And in early 2025, working to fulfill his promises to lower health costs, Trump tried again, signing a new executive order urging his administration to fine hospitals and doctors for failing to post their prices. CMS followed up with a regulation intended to up the fines and increase the level of detail required within the pricing data.
So far, “there’s no evidence that patients use this information,” said Zack Cooper, a health economist at Yale University.
In 2021, Cooper co-authored a paper based on data from a large commercial insurer. The researchers found that, on average, patients who need an MRI pass six lower-priced imaging providers on the way from their homes to an appointment for a scan. That’s because they follow their physician’s advice about where to receive care, the study showed.
Executives and researchers interviewed by KFF Health News also didn’t think opening the data would change prices in a big way. Research shows that transparency policies can have mixed effects on prices, with one 2024 study of a New York initiative finding a marginal increase in billed charges.
The policy results thus far seem to put a damper on long-held hopes, particularly from the GOP, that providing more price transparency would incentivize patients to find the best deal on their imaging or knee replacements.
These aspirations have been unfulfilled for a few reasons, researchers and industry insiders say. Some patients simply don’t compare services. But unlike with apples — a Honeycrisp and a Red Delicious are easy to line up side by side — medical services are hard to compare.
For one thing, it’s not as simple as one price for one medical stay. Two babies might be delivered by the same obstetrician, for example, but the mothers could be charged very different amounts. One patient might be given medications to speed up contractions; another might not. Or one might need an emergency cesarean section — one of many cases in medicine in which obtaining the service simply isn’t a choice.
And the data often is presented in a way that’s not useful for patients, sometimes buried in spreadsheets and requiring a deep knowledge of billing codes. In computing these costs, hospitals make “detailed assumptions about how to apply complex contracting terms and assess historic data to create a reasonable value for an expected allowed amount,” the American Hospital Association told the Trump administration in July 2025 amid efforts to boost transparency.
Costs vary because hospitals’ contracts with insurers vary, said Jamie Cleverley, president of Cleverley and Associates, which works with healthcare providers to help them understand the financial impacts of changing contract terms. The cost for a patient with one health plan may be very different than the cost for the next patient with another plan.
The fact that hospital prices might be confusing for patients is a consequence of the lack of standardization in contracts and presentation, Cleverley said. “They’re not being nefarious.”
“Until we kind of align as an industry, there’s going to continue to be this variation in terms of how people look at the data and the utility of it,” he said.
Instead of aiding shoppers, the federally mandated data has become the foundation for negotiations — or sometimes lawsuits — over the proper level of compensation.
The top use for the pricing data for healthcare providers and payers, such as insurers, is “to use that in their contract negotiations,” said Marcus Dorstel, an executive at price transparency startup Turquoise Health.
Turquoise Health assembles price data by grouping codes for services together using machine learning, a type of artificial intelligence. It is just one example in a cottage industry of startups offering insights into prices. And, online, the startups’ advertisements hawking their wares often focus on hospitals and their periodic jousts with insurers. Turquoise has payers and providers as clients, Dorstel said.
“I think nine times out of 10 you will hear them say that the price transparency data is a vital piece of the contract negotiation now,” he said.
Of course, prices aren’t the only variable that negotiations hinge on. Hoag said Blue Cross Blue Shield of Minnesota also considers quality of care, rates of unnecessary treatments, and other factors. And sometimes negotiators feel as if they have to keep up with their peers — claiming a need for more revenue to match competitors’ salaries, for example.
Hoag said doctors and other providers often look at the data from comparable health systems and say, “‘I need to be paid more.’”
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The University of Pennsylvania is getting $7.8 million over the next two years to study an overlooked aspect of human health: the lymphatic system.
Often described as the body’s sewer system, its main job is to maintain the body’s balance of fluid and filter out waste. Millions of Americans live with dysfunction in the system, often unknowingly.
The time to diagnose some lymphatic disorders is at least five years, said Maxim Itkin, an interventional radiologist who directs Penn’s center specializing in lymphatic disorders.
He’s even had a patient who experienced unexplained symptoms for 50 years before getting treatment.
“Right now, most healthcare providers simply aren’t equipped — or trained — to recognize lymphatic dysfunction, and the tools they need are virtually nonexistent,” said Kimberley Steele, a program manager at the Advanced Research Projects Agency for Health (ARPA-H), the federal agency organizing the research effort.
That’s why the government, through ARPA-H, is investing $135.7 million toward research headed by 11 institutions in the U.S. and Canada, including Penn, to improve detection of issues in the lymphatic system.
With its slice of funding, the team at Penn will develop ways to image the network and identify hidden signs of disease.
An inside look
Similar to plumbing, fluids in the lymphatic system can be flowing, obstructed, or leaking.
Doctors are able to “close” these leaks and even “open” obstructed areas, but the problem is knowing when those procedures are needed.
Existing contrast agents — substances used to increase visibility of tissues during imaging — for the lymphatic system are largely considered obsolete and offer poor resolution, said Itkin, who is leading the Penn project, which started last October.
When he began researching the system 20 years ago, he “started to realize that it’s of enormous importance, and it’s forgotten primarily because nobody can image [it] and do interventions,” he said.
Maxim Itkin, an interventional radiologist at the Hospital of the University of Pennsylvania, found a way to track the flow of lymphatic fluid using X-ray imaging equipment.
Itkin and his team have come up with ways of imaging by injecting dye into lymph nodes and tissues and tracing the dye’s location. This has enabled him to diagnose hidden conditions and develop new treatment methods.
The ARPA-H funding will allow them to go even further, developing imaging agents that focus on the parts of the lymphatic system in the liver and gut — organs that generate the majority of the network’s flow in the body.
These will be used for CT (computed tomography) and MRI (magnetic resonance imaging) scans.
One of the imagingcandidates is designed to be swallowed and absorbed in the intestine, so doctors can see the lymphatic system in the gut. The second imaging agent will be administered via IV to show the system in the liver.
“It was my dream to see the lymphatic system from inside by itself,” Itkin said.
They’ll be using an approach called AI-driven multi-omics, where AI will analyze samples for unique molecules being excreted by the lymphatic system in the liver.
Penn and several other funded groups are working with the New York-based nonprofit Lymphatic Education and Research Network to help with research and patient recruitment.
Current funding is for two years, with the potential to extend for another three years.
Itkin says seeing the lymphatic system in the liver will be a thrill.
Before 1751, sick Pennsylvanians had few healthcare options other than often expensive home visits from doctors. That changed when Benjamin Franklin and physician Thomas Bond established a medical institution to treat the physically and mentally ill for free.
The result was the Pennsylvania Hospital on Spruce Street. The 275-year-old institution became home to the country’s first surgical amphitheater to teach students, the oldest medical library, and a nursing museum, among other historic firsts. It continues to advancemedical research as part of Penn Medicine.
Now the nation’s oldest charteredhospital will become Philadelphia’s newest museum.
The hospital’s Pine Building, which started construction in 1755, will be converted to the Pennsylvania Hospital Museum, Penn announced on Monday. The museum in the majestic Georgian architecture building at Eighth and Pine Streets, designed by architect Samuel Rhoads, is scheduled to open to the public on May8.
“It’s a very Philadelphia story to hear the history of the hospital because it really is about caring for other people,” said Stacey Peeples, lead archivist at Pennsylvania Hospital.
Stacey Peeples, lead archivist at Pennsylvania Hospital, described artifacts in the hospital’s new museum.
The medical library, surgical amphitheater, and apothecary have all been restored for the museum. Eight galleries will feature videos, hands-on activities, and archival objects describing the history of the hospital and the care it delivered.
The opening of the museum in the hospital’s 275th year coincides with America’s Semiquincentennial celebrations. (The University of Pennsylvania Health System, which merged with the hospital in October 1997, will run the museum.)
One of Peeples’ favorite items on display is a collection of medical cases compiled by the hospital’s doctors in the early 19th century.
Housed in the historic library, the book is flipped to a page showing a man with a seven-pound tumor in his cheek and neck area. Visitors can also find the actual preserved tumor from 1805 on display in the back of the room.
A historic medical book compiling interesting cases at Pennsylvania Hospital shows an image of Pete Colberry, a patient who fell from ship rigging and was stabilized on a bed to hold him in place, circa 1804.
A look at early medicine
Pennsylvania Hospital’s apothecary — where medicines were mixed and sold — was last used for that purpose in the early 1900s.
Most recently, it served as a conference room.
It’ll now be restored to its original layout, based on historic images from the 19th century. That includes bringing back alcoves filled with shelves of bottles, the scale used to weigh ingredients, as well as a giant counter where the apothecary could mix medications, Peeples said.
An archival image of Mildred Carlisle working in the Pennsylvania Hospital apothecary, circa 1920s.
In the historic library, the only room ready for news media to view this week, the artifacts remained scattered around.
A tonsil guillotine, designed to remove tonsils using a blade, sat next to early surgical tools and stethoscopes. Some objects, such as the scalpel, have not changed significantly in form through the years.
“But how we treat those objects certainly is very, very different. We want to make sure everything’s sanitized now,” Peeplessaid.
Surgical instruments belonging to Dr. James Wilson from the 1800s.
Other artifacts included old tools of medical education.Like three anatomical casts of women who died during childbirth in the mid-1700s that were used for anatomical study in lieu of cadavers.
The museum’s exhibits will showcase the hospital’s history of delivering care related to behavioral health and women’s health, as well as its role treating patients during times of conflicts, beginning with the Seven Years’ War, and through pandemics.
“People would always talk about us being able to do something on a larger scale like this, and I honestly wasn’t sure that was ever going to happen,” said Peeples, who has been at the hospital for 25 years.
Tickets will go on sale at the end of the month and cost $12 per person, with discounts for those 12 and under, 65 and over, and the military.
The plan is for the museum to be a permanent fixture, open Wednesdays to Sundays. The rest of the hospital will keep operating as normal.
Interior of the Historic Library of Pennsylvania Hospital, located at Eighth and Pine Streets.
The hospital, older than the nation, houses 517 licensed inpatient beds, and saw 19,759 adult admissions, 54,023 emergency department visits, and 5,163 births in fiscal year 2025, per Penn Medicine’s statement.
“Pennsylvania Hospital is a jewel in the crown that is Penn Medicine, where our staff draw energy from our rich history to shape the future of medicine,” Alicia Gresham, CEO of Pennsylvania Hospital, said in a statement.
Jefferson Health oncologist Jennifer Johnson had exhausted all the standard treatment options for her 49-year-old patient with esophageal cancer, who was likely to die within months.
Surgery, chemotherapy, radiation, and immunotherapy had kept the Northeast Philadelphia woman alive for six years after her diagnosis, but no longer were enough to stop her cancer from spreading.
Johnson knew her patient needed something novel. She recalled a presentation several years prior at a conference for head and neck cancers, where a doctor discussedan experimental treatment called T-cell receptor (TCR) therapy.
This type of cancer immunotherapy works by engineering the immune system to fight cancer, and falls into the same family of treatments as CAR-T, or chimeric antigen receptor (CAR) T cell therapy, an approach pioneered at the University of Pennsylvania that has revolutionized treatment for blood cancers.
She thought TCR therapy’s clever approach could work against solid tumors, where CAR-T had not been effective.
“I just remember sitting in the room and watching him present, thinking, I’m gonna use that one day,” the oncologist and cancer researcher recalled.
As it would happen, the approach was being tested in a phase II clinical trial at Rutgers Cancer Institute against tumors just like her patient’s: metastatic cancers driven by a virus called human papillomavirus 16. One of the most common strains, HPV16 causes roughly half of cervical cancer cases worldwide, as well as cancers of the head and neck area, anus, and genitals.
Cases that reach the metastatic stage like Johnson’s patient often run out of treatment options. Whether T-cell receptor therapy would work was unknown, but the alternatives were expected to fail.
“Anything that you might offer them would definitely not be expected to make their cancer go away completely and do it for a long time,” said Christian Hinrichs, the oncologist and scientist heading the trial whose presentation Johnson saw.
But interim results from the first half of the trial showed improvement in six out of 10 patients, whose tumors at least partially shrank. And two of them had no evidence of cancer after treatment.
Johnson’s patient, Maria Pascale, was one of thetwo whose promising early results were presented at a medical conference and highlighted in a research abstract in the Journal for ImmunoTherapy of Cancer in November.
She arrived at the health system in New Jersey in the summer of 2024 in such poor health thather lungs were starting to collapse.
The therapy has enabled her to celebrate two birthdays, start martial arts classes, reunite with old friends visiting from Argentina, and see her 23-year-old son get engaged.
“Imagine the wedding, then later the grandkids, I’m always thinking about [that],” she said.
What is a T-cell receptor therapy?
In the immune system, T cells act as frontline defenders against viruses, bacteria, and other threats.
Sometimes, these cells aren’t great at their jobs.
In the face of cancer, T cells can become exhausted over time, and fail to recognize invaders or mount attacks.
The idea behind immunotherapy is to transform these regular immune cells into cancer-fighting super-soldiers.
The Rutgers approach, an engineered TCR therapy, involves collecting T cells from a patient’s blood and genetically engineering them to better target a cancer cell for attack.
Afterward, the scientists grow more of the enhanced T cells in the lab and infuse them back into the patient.
The “prototype” for this style of therapy is CAR-T, a treatment that has saved tens of thousands of lives since the first FDA approval in 2017. Scientists have not yet been able to replicate the therapy’s success in blood cancers in solid cancers, although some early stage trials have shown potential.
TCR therapy is thought to be more promising against the latter cancer type — which is what’s being treated in the Rutgers trial — due to differences in the way the engineered T cells identify cancer cells.
CAR-T therapy uses what’s called a chimeric antigen receptor, a protein that recognizes a cell as cancer based on what’s on the outside of the cell.
It’s like knowing you’re at your friend’s house because of a specific doormat or set of house numbers on the exterior.
TCR therapy uses what’s called a T-cell receptor, which can recognize cancer cells based on what’s inside the cell.
It’s like knowing you’re at your friend’s house because you can see your friend inside.
Sometimes cancer cells have more unique identifiable elements on the outside, but other times they don’t. Imagine if multiple houses had the same doormat.
“That target would be on other cells that aren’t cancer cells and cause lots of toxicity,” said Carl June, the pioneering cancer scientist at Penn who developed the first FDA-approved CAR-T therapy and was not involved in the Rutgers trial.
That’s been the problem that’s held back CAR-T’s use in solid tumors.
The target in the Rutgers trial is a protein called HPV16 E7, found inside the cell. In tumors driven by the virus HPV16, it plays a key role in turning a cell into cancer.
“That’s like going after its Achilles’ heel,” June said.
Swarming the cancer
Pascale first arrived at Thomas Jefferson University Hospital in Center City in 2018 after suffering injuries in a car accident.
Doctors found a mass in the 43-year-old’s neck that turned out to be cancer.
Surgeons removed the mass,and she was fine until 2021 when doctors, including Johnson, found the cancer at the top of her esophagus.
They treated her with a combination of chemotherapy and radiation, which worked until March of 2022, when the cancer started appearing in Pascale’s lungs.
“All bets were off,” Johnson said.
Doctors gave Pascale chemotherapy and immunotherapy over the next couple of years, but in the spring of 2024, she developed an allergy to one of her chemotherapy drugs.
Around the same time, the cancer spread to the skin on Pascale’s back.
That’s when Johnson transferred her care to Hinrichs’ team at Rutgers.
Pascale started preparations for the treatment in July 2024, spending a couple weeks in the hospital.
The Rutgers team took T cells from her blood, gave her chemotherapy to knock her immune system down, and then transfused the engineered cells back into her body.
Within 48 hours, Pascale started feeling horrible.
“It was painful. It was my whole body, like I had pneumonia,” she said.
She had trouble breathing as the cells fought the cancer in her lungs. Hinrichs described it as “the T cells swarming the cancer,” leading to an inflammatory reaction.
The same thing occurred on her back. When Pascale’s sister came over, she saw one of the tumors in her skin was suddenly the size of a lemon.
Another one appeared red and felt like someone was burning a cigarette on her back.
The pain continued for three days, and then she felt well enough to go home. Pascale and her sister could see and feel the nodules on her back get smaller, until eventually they were gone.
Roughly five months later, Pascale’s scans showed no evidence of cancer. As of last month, a year and a half after she received the treatment, that was still true.
“What’s three days of pain compared with the opportunity that I have to live a lot of beautiful things with my family and friends?” Pascale said.
Maria Pascale walks with her sister Maria Durante and her doctor Christian Hinrichs at Rutgers.
The future of the treatment
Hinrichs said his team is working to figure out why two of the patients, including Pascale and a patient with anal cancer, responded better to the treatment.
He cautioned that it’s too early to draw sweeping conclusions since the sample size is small. (Researchers will seek to recruit another 10 patients for the ongoing trial.)
The patients who had complete responses will need follow-up scans every few months to make sure their cancers have not returned.
It will still take years to finish evaluating safety and efficacy. Treatments tested in clinical trials often do not advance to become standard practice.
June, the Penn scientist, called the trial’s early results promising and noted that there weren’t any major safety problems reported.
Adverse effects seen in the trial were mainly those caused by the chemotherapy.
However, the drawback of using TCR therapy is that patients need a certain genetic background for it to work, June said. This is similar to how not every organ donor would be a good match for a recipient.
The genetic profile chosen for the Rutgers therapy is the most common in America. However, it is less common in Black and Asian people compared to white people.
Scientists hope it could one day be possible to manufacture the therapy witha warehouse approach, where TCR therapies that work across genetic backgrounds could be mixed and matched.
“It’s a practical issue that the drug companies face,” June said.
CAR-T, in comparison, canbe used more broadly across different genetic backgrounds.
What matters most, since the treatment is expensive to make, is that the responses hold up over time, June said.
(The TCR therapy’s cost has not yet been set, Hinrichs said, since it is currently manufactured individually for each patient.)
“If they’re long lasting, then it’s really going to be a huge advance because nothing else works in the patients he’s treated,” June said.
At Jefferson, Johnson is cautiously optimistic about the treatment that has kept her patient alive.
If the therapy makes it through the rest of the trial process and proves effective, she hopes it could become “another thing in our armamentarium against this type of cancer.” (A type that doctors would hope to see less of since the introduction of the HPV vaccine in 2006.)
“I can’t tell you how wonderful it is to have a patient responding and living well when you saw things going the wrong way,” Johnson said.
Editor’s note: This story has been updated to clarify where the research has been presented and a reference to the prevalence of the genetic profile used in TCR therapy.
