By Nada Hassanein, Stateline.org

Heading into the respiratory illness season, states and clinicians are working to encourage pregnant patients to get COVID-19 vaccinations, even though the U.S. Department of Health and Human Services no longer recommends that they should.

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Along with being older and having an underlying health condition, pregnancy itself is a risk factor. Pregnant women are more vulnerable to developing severe illness from COVID-19. They’re also at high risk for complications, including preterm labor and stillbirth. The vast majority of medical experts say getting the shot is safe and effective — much safer than having the illness.

But HHS Secretary Robert F. Kennedy Jr. announced in May that the agency would no longer recommend that pregnant women get the vaccine. Before testifying before Congress in June, Kennedy circulated a document on Capitol Hill claiming higher rates of fetal loss after vaccination. But the authors of those studies told Politico that their work had been misinterpreted.

Experts say the federal shift puts the onus on state health agencies to ramp up vaccine guidance and outreach. Clinicians and public health organizations are trying to dispel misinformation and make sure information reaches low-income people and people of color, who had higher maternal death rates during the pandemic. During the first two years of the pandemic, the virus contributed to a quarter of maternal deaths, according to federal data.

“We are severely disappointed,” said Dr. Neil Silverman, a professor of clinical obstetrics and gynecology at the University of California, Los Angeles David Geffen School of Medicine. He has studied vaccines and pregnancy for the past 15 years and specializes in high-risk pregnancies.

Silverman called the federal shift a “public health tragedy on a grand scale.”

Vaccinations against COVID-19 help prevent severe illness in pregnant people as well as their newborns, who are too young to get vaccinated, Silverman said. In what’s called passive immunity, vaccinated mothers pass on antibodies to their babies through the placenta and through breast milk.

“State public health agencies are probably going to have to implement vaccine guidance that differs from the federal recommendations. And that’s going to be an interesting can of worms,” said OB-GYN Dr. Mark Turrentine, a professor of obstetrics and gynecology at the Baylor College of Medicine in Texas.

Turrentine serves on a board of the American College of Obstetricians and Gynecologists that focuses on immunization and infectious diseases. He said his recent pregnant patients who had COVID-19 hadn’t gotten the vaccine.

“The change in guidance on the federal level just really makes a lot of confusion, and it makes it very challenging to try to explain to individuals why all of a sudden the difference,” Turrentine said.

A slew of public health organizations have been making a concerted effort to dispel vaccine myths. They include the Society for Maternal-Fetal Medicine, a Washington, D.C.-based nonprofit organization of maternal-fetal experts. At a news briefing the society held this month, clinicians stressed the safety and long-standing science behind COVID-19 vaccines, as well as the shots for RSV and the flu. Cases of RSV and the flu tend to peak in the winter months, while in recent years COVID-19 cases have spiked in the summer and the winter.

Dr. Brenna Hughes, an OB-GYN who chairs the organization’s infectious diseases and emerging threats committee, pointed to survey data from the federal Centers for Disease Control and Prevention showing that less than a third of eligible pregnant patients received COVID-19 shots, and only 38% received RSV shots for the 2023 to 2024 season. Less than half — 47% — received flu shots, and 59% received TDAP (whooping cough) vaccines.

CDC data shows that for last year’s and this year’s season, only between 12% and 14% of pregnant patients got the COVID-19 vaccine.

“The complications from the infection are so much greater than the complications and the very few and typically minor adverse events that might occur from the vaccine,” said microbiologist Sabra Klein, a professor of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health.

In June, the American College of Obstetricians and Gynecologists and 30 other professional health organizations signed a letter urging insurers to continue covering the COVID-19 shot for pregnant women, and have continued to urge coverage since then.

CVS Caremark, one of the nation’s three major pharmacy benefit managers, told Stateline it will continue covering the vaccine for pregnant women. The Arizona, California and North Carolina state Medicaid agencies also told Stateline they are still currently covering COVID-19 vaccines for pregnant women.

Dr. Kimberly Fortner, president-elect of the Infectious Diseases Society for Obstetrics and Gynecology, said during the maternal-fetal medicine briefing that she hopes medical groups’ joint messaging will bolster insurers.

“Hopefully by us linking arms, that can then help develop consistency so that insurers will continue to pay for the vaccine,” she said.

Exacerbating disparities

Dr. Ayanna Bennett, director of the District of Columbia Department of Health, said the federal government’s new stance has upended “a system that’s been stable for a very long time.”

Bennett said her agency used federal pandemic aid to shore up vaccine outreach efforts to communities of color. Now that flow of money is ending.

The changes in federal guidance and funding will “almost certainly exacerbate” maternal health disparities, said Marie Thoma, a perinatal epidemiologist and an associate professor in the University of Maryland Department of Family Science who researches pregnancy and COVID-19.

Black and Indigenous women died at higher rates. The virus exacerbated existing racial disparities in maternal health — and created new ones: Latina mothers, who generally see low rates of maternal mortality, saw deaths surge to 28 per 100,000 in 2021. Their rate was about 12 per 100,000 in 2018, according to federal data.

“We are going in with some exposure already that we didn’t have during the start of the pandemic. So, there will be some protection, but now that will erode,” said Thoma. “If we’re not getting vaccines, or if people are hesitant to take them, we could see some increase.”

Silverman said the administration’s efforts to strip mentions of race from government policies makes it difficult for institutions to reach populations at greatest risk. He called the dismissal of decades of data “saddening and infuriating.”

“The politicization of the vaccine process, or access to it, is what concerns me the most,” said Dr. Yvette Martas, a Connecticut OB-GYN who chairs the board of directors of the Hispanic Health Council.

Many women “are trying to navigate an economic system that’s not always in their favor in terms of also providing access to the kind of educational material that they need,” she said.

Not just COVID-19

In June, Kennedy ousted all 17 members of the CDC’s vaccine advisory committee, replacing them with some members who are vaccine skeptics.

The change is creating chaos. Some states have vaccine laws, such as mandates for kids and coverage statutes, that are specifically tied to the committee’s decisions.

The Vaccine Integrity Project at the University of Minnesota called on frontline health workers, health officials and professional societies to “counter the spread of inaccurate and confusing vaccine information.”

At a news briefing this month held by the Association of State and Territorial Health Officials, representatives from Alabama, Connecticut and Washington, D.C., said they will continue to recommend vaccines.

Alabama’s state health officer, Dr. Scott Harris, said clinicians will be instrumental in getting correct vaccination information to patients.

“We don’t think that we necessarily have the same authoritative voice that we might have had a decade ago in trying to guide people in what to do, but we do believe that people trust their health care providers in most cases and are certainly willing to listen to them,” he said at the briefing.

Bennett said she is hopeful that strong, consistent messaging from respected medical organizations will help combat confusion.

“Having established groups like the American Academy of Pediatrics or the American College of Obstetrics and Gynecology make very firm recommendations that keep us essentially not changed from where we have been, I think, should reassure families,” she said.

Stateline reporter Nada Hassanein can be reached at nhassanein@stateline.org.

©2025 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

By HOLLY RAMER, Associated Press

CONCORD, N.H. (AP) — President Donald Trump’s administration is faltering in its aggressive pursuit of the death penalty as it revisits cases in which predecessors explicitly decided against seeking capital punishment.

Since taking office in February, U.S. Attorney General Pam Bondi has authorized prosecutors to seek the death penalty against 19 people, including nine defendants in cases in which President Joe Biden’s administration had sought lesser sentences. But judges have blocked those reversal attempts for all but two defendants, most recently on Monday in a pair of cases in the U.S. Virgin Islands, showing the limits of the Trump administration’s power to undo decisions in cases already well underway.

FILE – Attorney General Pam Bondi, speaks during a news conference at the White House, Aug. 11, 2025, in Washington. (AP Photo/Alex Brandon, File)

In pursuing capital punishment, the Justice Department is seeking to follow through on a Trump campaign promise to resume federal executions after they were halted by Biden’s Attorney General Merrick Garland. The Republican president’s Justice Department has accused the previous Democratic administration of supplanting “the will of the people with their own personal beliefs” in failing to seek death sentences in many cases involving horrific crimes.

Detailed opinions haven’t been issued in the most recent two cases, which involve a man accused of killing a police officer in 2022 and two men accused of armed robbery and murder in 2018. But other judges who have rejected reversal attempts on constitutional and procedural grounds were blunt in their assessment of the Trump administration’s approach.

“The government has proceeded hastily in this case, and in doing so has leapfrogged important constitutional and statutory rights,” Trump appointee U.S. Judge Stephanie Gallagher in Maryland wrote in June, striking the notice of intent to seek the death penalty against three alleged MS-13 gang members accused of killing two teenage girls in 2020. “That is unacceptable.”

‘Willful blindness’ vs. ‘basic management’

Authorization of capital prosecution typically occurs years before trial, but in the Maryland case, prosecutors filed the death penalty notice less than four months before the trial was scheduled to start. None of the defendants were represented by attorneys who specialize in death penalty litigation, which they would have been entitled to under federal law due to the complexity of capital cases and the potential consequences.

FILE – Gloria Rubac, left, an anti-death penalty activist, speaks during a protest outside the prison where Robert Roberson is scheduled for execution at the Huntsville Unit of the Texas State Penitentiary, Oct. 17, 2024, in Huntsville, Texas. (AP Photo/Michael Wyke)

“The government does not hide the ball here — the only reason for its flip-flop on the death penalty was the change in administration,” wrote Gallagher, who called the government’s “willful blindness” to the differences between capital and non-capital trials “startling.”

“This court will not cast aside decades of law, professional standards, and norms to accommodate the government’s pursuit of its agenda,” she wrote. “Of course, elections have consequences, and this administration is entitled to pursue the death penalty in cases where it can do so in accordance with constitutional and statutory requirements. But this is not one of them.”

Prosecutors in Maryland and in a Nevada case declined to comment, but in court documents they argued that the Justice Department has an “inherent power” to reconsider previous decisions and that the timing of the death notice was “objectively reasonable” given that the defendants had years to prepare for trial.

“The Attorney General has simply reconsidered an earlier decision, which it is her prerogative to do so, and exercising that inherent authority is not misconduct but basic management and governance,” wrote Maryland’s U.S. Attorney Kelly Hayes. “At no point did the Government make an enforceable promise. Deciding not to seek certain charges is not a promise not to do so.”

Status of Bondi-ordered review of past cases

Trump, whose first administration carried out a record-setting 13 federal executions, signed an order on his first day back in the White House compelling the Justice Department to seek the death penalty in appropriate federal cases and support capital punishment in states. Bondi, who has said she will seek the death penalty “whenever possible,” quickly lifted a Biden-era moratorium on federal executions and ordered a review of decisions made by the previous administration.

The 120-day deadline for that review has passed with no official word on the results, but a senior Justice Department official told The Associated Press that all but about 30 cases have been examined. The official, who spoke on the condition of anonymity under terms set by the department, said roughly 1,400 decisions not to seek the death penalty were issued by Garland, with all but 459 having already been fully adjudicated by the time Trump took office.

Bondi isn’t the first attorney general to review past cases: Not only did Garland authorize just one death penalty case during his tenure, he also withdrew 35 notices of intent to seek the death penalty issued by his predecessors. The Justice Department says the Bondi-ordered review was essentially “the flip side” of Garland’s action and was the right thing to do to ensure consistency and achieve justice for victims and their families.

A national expert weighs in

But Robin Maher, executive of the Death Penalty Information Center, said while the Biden administration’s actions reflected declining public support for the death penalty, Trump has brushed that aside.

“So his enthusiasm for use of the death penalty is different not only from President Biden’s more cautious approach, it’s different from every other president’s approach in history,” said Maher, whose organization doesn’t take a position on capital punishment but is critical of how it is used.

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Whether the reversals will stand remains a question in two of the cases. In the others, courts have sided with defendants who said they reasonably relied on assurances made by the previous administration. In court documents, lawyers for some of the defendants said they would have pursued plea bargains or objected to postponing trial dates had they known the death penalty decision would be reversed.

“In some of these cases, very different paths were taken when those assurances were given,” Maher said.

In Nevada, prosecutors notified Cory Spurlock of their intention to seek the death penalty just 12 days before he was set to go on trial for the 2021 deaths of a California couple. Striking down that notice in May, Judge Miranda Du said the government fell far short of justifying its “wholesale reversal at the eleventh hour.” The trial began this week after prosecutors withdrew their appeal of her ruling.

“The government decided — certainly not by inadvertence or accident — to reverse course on an issue of critical importance, involving Spurlock’s life, less than two weeks before trial, with full knowledge that the reversal would have a chaotic impact on the progression of this case and would make it impossible to proceed to trial on the scheduled date,” wrote Du, who was nominated by President Barack Obama, a Democrat. “Under the circumstances, this is certainly tantamount to playing ‘fast and loose’ with the Court’s orders in particular and the judicial process in general.”

Associated Press writer Alanna Durkin Richer in Washington contributed to this report.

By BILL BARROW and ADRIANA GOMEZ LICON, Associated Press

ATLANTA (AP) — Florida conservative Joe Gruters, a Donald Trump cheerleader dating back to the president’s days as a reality TV star, is now the Republican National Committee chairman.

Having no opposition after being tapped by the president, Gruters was elected Friday at the Republicans’ summer meeting in Atlanta.

For Gruters, the vote completes a steady climb from county party leader into the top ranks of Trump’s second presidency. For Trump, Gruters’ ratification reflects his penchant for loyal lieutenants and evolution from a new president disinterested in party machinery to an Oval Office veteran intent on gripping all levers of power.

After the vote Friday, Gruters thanked Trump for choosing him and promised RNC members he would focus on “election integrity,” expanding Republican voter registration and preventing internal party discord. Elections, Gruters said, are won by “whatever party does a better job of uniting the factions and bringing everybody together.”

Here is a look at Gruters’ history with Trump and Republicans and what that means as he becomes chairman.

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Gruters was with his ‘Statesman of the Year’ from the start

Trump’s decade of domination over Republican politics is replete with rivals and critics who melted into the fold. Vice President JD Vance once compared Trump to Adolf Hitler, and Secretary of State Marco Rubio labeled Trump a “con artist” and mocked his manhood.

But Gruters was a true believer years before Trump launched his first campaign in 2015.

“Joe bet on the horse before the track was even built,” said Christian Ziegler, a former Florida Republican chair and friend of Gruters.

In 2012, Gruters led the Sarasota County GOP, and Republicans were nominating Mitt Romney for president at their convention in nearby Tampa, Florida.

Romney, then the kind of moderate Republican that is now almost extinct in public office, had embraced Trump even as the businessman falsely questioned then-President Barack Obama’s birthplace and citizenship. Still, Trump was widely considered a liability for Romney against Obama, and Romney’s team was circumspect about whether Trump would have a convention role. While Trump was eventually confirmed as a speaker, an approaching tropical storm shortened the convention schedule, and his slot was among the casualties.

Enter Gruters.

The eager Sarasotan had already picked Trump as his county party’s “Statesman of the Year,” slotting a dinner gala at Sarasota’s Ritz-Carlton hotel on convention eve with 1,000 guests. It cemented an enduring friendship.

Gruters climbed the Florida ladder alongside Trump

Gruters’ support for Trump’s first presidential bid in 2015 stood out in Florida, given that Rubio and former Gov. Jeb Bush also were running.

In October, Gruters became co-chairman of Trump’s Florida campaign. His fellow chair was Susie Wiles, who is now Trump’s White House chief of staff. Bush didn’t make it to the Florida primary, and Trump trounced Rubio, ending the senator’s campaign.

Gruters was elected to the Florida House of Representatives in 2016 at the same time Trump won Florida’s electoral votes and the presidency. And Wiles, Gruters’ old Trump campaign partner, was the mastermind behind Florida Gov. DeSantis’ narrow 2018 victory.

So when it mattered, Gruters was well-positioned with a friend in the Oval Office and the governor’s office — buoyed by Wiles, who had distinguished herself as a Florida kingmaker.

Gruters navigated nasty party splits and Trump’s election lies

All those powerful allies backed Gruters’ successful bid for Florida GOP chairman in 2019.

Gruters and the party increased GOP registration across the state and helped push battleground Florida to a clearer conservative advantage. In 2020, as Democratic presidential nominee Joe Biden flipped Sun Belt battlegrounds Arizona and Georgia, Trump won Florida comfortably.

That helped Gruters navigate Trump’s falsehoods that Biden’s national victory was rigged. Gruters chose his words carefully, stopping short of Trump’s election denialism yet ensuring he never drew the defeated president’s ire. Leaning on local results, Gruters called Florida the “gold standard.” He said there were “questions” about “shenanigans” in other states.

“Florida has been the center of everything,” said current state Chairman Evan Power. “Joe knows the successes and the lessons from Florida — he can bring that to the national level.”

Florida’s rightward shift yielded dominating reelection victories for DeSantis and Rubio in 2022. The win made DeSantis a presumed front-runner for the Republican presidential nomination in 2024.

A certain Palm Beach resident, however, was not finished.

As Trump built his third campaign, Wiles stuck with him — not DeSantis. The governor ultimately broke with Wiles and Gruters. Then Trump buried DeSantis, just as he’d crushed Bush and Rubio. DeSantis made peace with Trump, but not with Gruters, describing him as recently as last month as having a “linguine spine.”

Gruters reaffirms Trump’s hold on the Republican Party

Trump has cycled through multiple national GOP chairs. Reince Priebus in 2016 was the reluctant Trump backer who became the president’s chief of staff in 2017, only to be fired via social media post. Trump then turned to Ronna Romney McDaniel, Mitt’s niece. He eventually pushed out McDaniel and tapped North Carolina’s Michael Whatley as chairman, with daughter-in-law Lara Trump as family stand-in at party headquarters.

As chairman, Gruters will be a fundraising partner with the White House. The RNC is a key cog in joint party fundraising efforts that the president headlines.

Trump has always been his own primary messenger, but Gruters will be another notable face as the president approaches the 2026 midterms. That doesn’t just mean policy and branding but also the mechanics of elections. Gruters sidestepped Trump’s election denialism, but he’ll now be partly responsible for building teams of lawyers and poll watchers for a president who openly questions the efficacy of U.S. elections.

Beyond the midterms, Gruters will help set the presidential primary calendar, debate rules and other nuts and bolts of the 2028 campaign. While Trump is term-limited by the Constitution, he’s made clear that he will not stay in the shadows as voters choose his successor. With Gruters, he has a direct line into that process.

Gomez Licon reported from Fort Lauderdale, Fla.

By COLLEEN SLEVIN, MATTHEW BROWN and JESSE BEDAYN, Associated Press

COLORADO SPRINGS, Colo. (AP) — It’s been two years since nearly 200 decaying bodies were discovered throughout a fetid, room temperature building in rural Colorado. On Friday, the man responsible, a funeral home owner, is set to be sentenced in state court for 191 counts of corpse abuse.

Jon Hallford and his wife, Carie, ran a morbid racket for four years out of their Return to Nature Funeral Home in Colorado Springs: assuring people they were handling loved ones’ cremations only to stash the bodies in a bug-infested building and give them dry concrete resembling ashes.

Jon Hallford is already headed to prison after pleading guilty to federal fraud charges. Friday’s sentencing hearing will focus on state charges related to mistreatment of the bodies. Family members will have the chance to describe the anguish of learning a loved one slowly decayed among piles of others.

FILE – This image provided by the Muskogee County, Okla., Sheriff’s Office shows Jon Hallford, who was arrested, along with Carie Hallford, the owners of a Colorado funeral home Wednesday, Nov. 8, 2023, in Oklahoma, on charges linked to the discovery of multiple sets of decaying remains at one of their facilities. (Muskogee County Sheriff’s Office via AP, File)

“To me it’s the heart of the case. It’s the worst part of the crime,” said Tanya Wilson, who is traveling from Georgia to speak at the sentencing. She hired the funeral home to cremate her mother and later discovered the supposed ashes the family spread in Hawaii weren’t from her mother’s body, which had been wasting away in the building in Penrose, a small town 35 miles from Colorado Springs.

A plea agreement calls for Hallford to receive a 20-year prison sentence for the corpse abuse charges.

Some families who were victims in the case want Judge Eric Bentley to reject the agreement because Hallford’s state sentence is expected to run concurrently with his 20-year federal sentence, meaning he could be freed many years earlier than if the sentences ran consecutively.

“The scale of this is staggering. Why does the state believe they deserve a plea deal?” Wilson asked. “There needs to be accountability.”

FILE – A hearse and van sit outside the Return to Nature Funeral Home in Penrose, Colo., on Oct. 6, 2023. (AP Photo/David Zalubowski, File)

If the court rejects the agreement, Hallford could withdraw his plea agreement and go to trial, Bentley said to a packed courtroom as Friday’s hearing got underway. The judge cautioned family members objecting to a plea deal that they could be “opening Pandora’s box” since a trial would drag out the case for many months and extend their grief.

Colorado has struggled to effectively oversee funeral homes and for many years had some of the weakest regulations in the nation. It’s had a slew of abuse cases, including an estimated 20 decomposing corpses discovered this week at a funeral home in Pueblo.

Carie Hallford is accused of the same crimes as her husband and also pleaded guilty. Her sentencing on the corpse abuse charges has not been scheduled.

The couple was accused of letting 189 bodies decay. In two other instances the wrong bodies were buried. Four remains were yet to be identified, the district attorney’s office said this week.

The Hallfords got a license for their funeral home in 2017, and authorities said the bodies started piling up by 2019. Many languished for years in states of decay, some decomposed beyond recognition, some unclothed or on the floor in inches of fluid from the bodies.

As the gruesome count grew, Jon and Carie Hallford were also defrauding the federal government out of nearly $900,000 in COVID-19 era aid.

With the money from families and the federal government, the Hallfords bought ritzy items from stores like Tiffany & Co., a GMC Yukon and Infiniti worth $120,000 combined, laser body sculpting and $31,000 in cryptocurrency.

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In 2023, a putrid smell poured from the building and the police turned up. Investigators swarmed the building, donning hazmat suits and painstakingly extracting the bodies. Hallford and his wife were arrested in Oklahoma, where Jon Hallford had family, more than a month later.

Families learned that their cathartic moments of grief — spreading a mother’s ashes in Hawaii or cradling a son’s urn in a rocking chair — were tainted by a deception. It was as if those signposts of the grieving process had been torn away, unraveling months and years of working through their loved ones’ deaths.

Some had nightmares of what their relatives’ decayed bodies must have looked like. Others were anguished by the fear their family members’ souls were trapped, unable to go free.

A mother, Crystina Page, demanded to watch as her son’s body, rescued from the Return to Nature building, was cremated for real. Wilson, who had thought she already spread her mother’s ashes in Hawaii, said the family cremated her mother’s remains after they were recovered by authorities. She is waiting for the court cases to conclude before returning to Hawaii again to spread the ashes.

Brown reported from Billings, Montana.