A fourth person in Pennsylvania has died of measles, the state health department confirmed Tuesday. The latest death was in an unvaccinated 18-year-old resident of Mifflin County.

In the announcement, the state health department also confirmed a county coroner's report over the weekend of the death of an unvaccinated 40-year-old woman in Jefferson County. The state had previously reported two deaths in Lancaster County; both were infants—a newborn boy and a 6-week-old girl, both too young to be vaccinated.

According to the Mifflin County coroner, Andrea L. Alcalde, the 18-year-old's cause of death was determined to be acute disseminated encephalomyelitis (ADEM), which is a rare but known severe complication of measles. The condition is characterized by a rapidly progressing autoimmune disorder in which aberrant inflammation from an infection strips away the protective coverings of nerve cells in the brain and spinal cord. Before measles vaccines were widely used, ADEM was commonly associated with measles, though other viral infections can also spur its development.

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US Health Secretary Robert F. Kennedy Jr. will deliver a keynote address at an anti-vaccine conference being held in Washington, DC, later this week and hosted by the anti-vaccine organization he once led, Children's Health Defense (CHD). The organization announced Monday that Kennedy had signed on to the event.

Kennedy will appear alongside other high-profile figures in the anti-vaccine world, including Andrew Wakefield, the disgraced former doctor who was stripped of his medical license over a fraudulent, now-retracted study that falsely claimed a link between autism and the measles, mumps, and rubella (MMR) vaccine. An investigation by a medical board found that Wakefield had mistreated vulnerable children and that his actions amounted to serious professional misconduct.

Despite being ostracized from the medical community, Wakefield has become an enduring figure in the anti-vaccine community. His dangerous falsehood that vaccines cause autism has also endured—with significant help from CHD and Kennedy, who have embraced and widely promoted the erroneous link.

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President Trump signed an executive order Monday that makes sweeping, unilateral changes to federal vaccine recommendations. The order aims to reduce the number of lifesaving vaccines all children are recommended to get—from 18 to 11—while also splitting them up and spacing them out over more time and more medical visits.

The vaccine changes are not backed by evidence or spurred by new findings. Rather, they are based on false anti-vaccine fearmongering about harms, including the debunked claim that they cause autism, and misinformation that multiple vaccinations can "overwhelm" children's immune systems. This false claim has also been repeatedly debunked and explained.

During a signing event at the White House on Monday afternoon, Trump falsely claimed that pediatricians "have a vaccination that looks like the size of a bottle of soda," that is "poured into a little child's body, and bad things happen in too many cases. This is an explosion; this is an epidemic," Trump said.

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The White House is drafting an executive order on the disproven link between vaccines and autism, according to independent reports from The Washington Post and Bloomberg, which both cited unnamed sources with knowledge of the efforts.

Bloomberg reported that the executive order, which is still taking shape and is subject to change, could be issued as soon as next week. The Post said the order's drafting so far is aimed at the childhood vaccine schedule, autism research, and parental choice for vaccinations.

Dozens of high-quality studies encompassing data from millions of children worldwide have already been carried out on the topic and have consistently found no link between childhood vaccines and autism. The claim of a link stems from an unethical, fraudulent study that was retracted years ago, and its author was stripped of his medical license.

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Two nominees for high-profile health roles in the Trump administration faced scrutiny from the Senate health committee Wednesday—and both crashed and burned in their own special ways.

The Senate Committee on Health, Education, Labor, and Pensions (HELP) scrutinized Erica Schwartz, the nominee for director of the Centers for Disease Control and Prevention, and Sean Kaufman, up for the role of assistant secretary for preparedness and response.

Schwartz's assignment

Public health experts were "cautiously optimistic" about Schwartz's nomination. She is well-respected and holds views in line with evidence-based medicine, including being supportive of vaccinations—in contrast to anti-vaccine Health Secretary Robert F. Kennedy Jr., whom she will serve under. She is also highly qualified for the role, with a medical degree, a master's degree in public health, and a law degree. She's had a long career as a Navy Officer and previously held the roles of chief medical officer for the US Coast Guard and deputy surgeon general in the first Trump administration.

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Independent advisors for the Food and Drug Administration on Friday voted 9–0 in support of approving Moderna's seasonal mRNA flu vaccine, which a Trump appointee at the agency initially tried to block from even being reviewed.

In an all-day meeting, members of the FDA's advisory committee—known as VRBPAC for Vaccines and Related Biological Products Advisory Committee—pored over data and presentations on the vaccine, which is dubbed mRNA-1010 and branded as mFlusiva. The presentations included a review from FDA scientists, which was supportive of the vaccine.

Data from a Phase 3 trial including over 40,000 adults age 50 and older found the mRNA vaccine was around 27 percent more effective against seasonal flu than a standard flu shot. A smaller Phase 3 trial, involving data from nearly 3,000 people age 65 years and older, showed the shot produces stronger immune responses than a high-dose flu vaccine, which is recommended for this age group. The safety profile of the vaccine was also generally good.

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