By Arielle Zionts, KFF Health News

RAPID CITY, S.D. — Cassandra Palmier had been meaning to get her son the second and final dose of the measles vaccine. But car problems made it difficult to get to the doctor.

So she pounced on the opportunity to get him vaccinated after learning that a mobile clinic would be visiting her neighborhood.

“I was definitely concerned about the epidemic and the measles,” Palmier, a member of the Oglala Sioux Tribe, said at the June event. “I wanted to do my part.”

So did her son, Makaito Cuny.

“I’m not going to be scared,” the 5-year-old announced as he walked onto the bus containing the clinic and hopped into an exam chair.

Makaito sat still as a nurse gave him the shot in his arm. “I did it!” he said while smiling at his mother.

The Oyate Health Center serves Native Americans in Rapid City, South Dakota, and surrounding areas. (Arielle Zionts/KFF Health News/TNS)

The vaccine clinic was hosted by the Great Plains Tribal Leaders’ Health Board, which serves tribes across Iowa, Nebraska, and the Dakotas. It’s one way Native American tribes and organizations are responding to concerns about low measles vaccination rates and patients’ difficulty accessing health care as the disease spreads across the country.

Meghan O’Connell, the board’s chief public health officer, said it is also working with tribes that want to host vaccine clinics.

Elsewhere, tribal health organizations have launched social media campaigns, are making sure health providers are vaccinated, and are reaching out to the parents of unvaccinated children.

This spring, Project ECHO at the University of New Mexico hosted an online video series about measles aimed at health care professionals and organizations that serve Native American communities. The presenters outlined the basics of measles diagnosis and treatment, discussed culturally relevant communication strategies, and shared how tribes are responding to the outbreak.

Participants also strategized about ways to improve vaccination rates, said Harry Brown, a physician and an epidemiologist for the United South and Eastern Tribes, a nonprofit that works with 33 tribes in the Atlantic Coast and Southeast regions.

“It’s a pretty hot topic right now in Indian Country and I think a lot of people are being proactive,” he said.

Makaito Cuny smiles at his mother after getting his second measles shot in a mobile clinic. (Arielle Zionts/KFF Health News/TNS)

Measles can survive for up to two hours in the air in a space where an infected person has been, sickening up to 90% of people who aren’t vaccinated, according to the Centers for Disease Control and Prevention.

The U.S. has had 1,319 confirmed cases of measles this year as of July 23, according to the CDC. It’s the largest outbreak in the U.S. since 1992. Ninety-two percent of the 2025 cases involve unvaccinated patients or people with an unknown vaccination status. Three people had died in the U.S. and 165 had been hospitalized as of July 23.

O’Connell said data on Native Americans’ vaccination rates is imperfect but that it suggests a lower percentage of them have received measles shots than the overall U.S. population.

The limited national data on measles vaccination rates for Native Americans is based on small surveys of people who self-identify as Native American. Some show that Native Americans have slightly lower measles vaccination rates, while others show significant gaps.

Data from some states, including South Dakota and Montana, shows that Native Americans are less likely than white children to be vaccinated on schedule.

The national measles vaccination rate is significantly lower for Native Americans who use the mostly rural Indian Health Service. About 76% of children 16 to 27 months old had gotten the first shot, according to data collected by the agency during recent patient visits at 156 clinics. That’s a 10-percentage-point drop from 10 years ago.

But the IHS data shows that its patients are at least as likely as other children to have received both recommended measles shots by the time they’re 17. O’Connell said it’s unclear if currently unvaccinated patients will continue the trend of eventually getting up to date on their shots or if they will remain unvaccinated.

The immunization rate is probably higher for older children since schools require students to get vaccinated unless they have an exemption, Brown said. He said it’s important that parents get their children vaccinated on time, when they’re young and more at risk of being hospitalized or dying from the disease.

Native Americans may have lower vaccination rates due to the challenges they face in accessing shots and other health care, O’Connell said. Those on rural reservations may be an hour or more from a clinic. Or, like Palmier, they may not have reliable transportation.

Another reason, O’Connell said, is that some Native Americans distrust the Indian Health Service, which is chronically underfunded and understaffed. If the only nearby health care facility is run by the agency, patients may delay or skip care.

O’Connell and Brown said vaccine skepticism and mistrust of the entire health care system are growing in Native American communities, as has occurred elsewhere nationwide.

“Prior to social media, I think our population was pretty trustful of childhood vaccination. And American Indians have a long history of being severely impacted by infectious disease,” he said.

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European colonizers’ arrival in the late 1400s brought new diseases, including measles, that killed tens of millions of Indigenous people in North and South America by the early 1600s. Native Americans have also had high mortality rates in modern pandemics, including the 1918-20 Spanish flu and covid-19.

The Great Plains Tribal Leaders’ Health Board reacted quickly when measles cases began showing up near its headquarters in South Dakota this year. Nebraska health officials announced in late May that a child had measles in a rural part of the state, close to the Pine Ridge Indian Reservation. Then, four people from the Rapid City area got sick later that month and into the middle of June.

“Our phones really rang off the hook” once that news came out, said Darren Crowe, a vice president at the board’s Oyate Health Center in Rapid City. He said parents wanted to know if their children were up to date on their measles vaccines.

Crowe said the health board ordered extra masks, created a measles command team that meets daily, and called parents when its online database showed their children needed a shot.

Brown praised that approach.

“It takes a concerted outreach effort that goes individual to individual,” he said, adding that his organization helped the Mississippi Band of Choctaw Indians and the Alabama-Coushatta Tribe of Texas with similar efforts.

Brown said reaching specific families can be a challenge in some low-income Native American communities, where many people’s phone numbers frequently change since they use temporary prepaid plans.

Once a health worker reaches a parent, Brown said, they should listen and ask questions before sharing the importance of the vaccine against measles, mumps, and rubella.

“Rather than trying to preach to somebody and beat them over the head with data or whatever to convince them that this is what they need to do, you start out by finding out where they are,” he said. “So, ‘Tell me about your experience with vaccination. Tell me what you know about vaccination.’”

Most people agree to immunize their children when presented with helpful information in a nonjudgmental way, Brown said.

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

Cancer survivors infected with COVID-19 in the early months of the pandemic had a higher risk of dying from dormant cells reawakening, Colorado researchers found, though they don’t know whether people who get the virus now face the same risk.

Experiments in mice found that genetically modified animals were more likely to have signs of metastatic cancer in their lungs if infected with flu or COVID-19 than engineered mice that researchers didn’t give a virus, said James DeGregori, deputy director of the University of Colorado Cancer Center in Aurora.

That finding launched an international partnership to determine whether the same thing happened in people, he said.

DeGregori was one of the lead investigators, alongside scientists from Utrecht University in the Netherlands, Imperial College London, University College London, University of Connecticut, Albert Einstein College of Medicine in New York City, Children’s Hospital of Philadelphia, and the COVID-19 International Research Team, based in Massachusetts.

Two datasets, from the United States and the United Kingdom, both showed a higher risk that cancer survivors with confirmed COVID-19 infections would die from metastatic cancer, compared to survivors who didn’t test positive for the virus.

The British data showed people who tested positive had about twice the risk of those who tested negative, and the American data showed about a 44% increased risk, DeGregori said. A significant number of the U.S. patients never got tested for COVID-19, however, so the risk was likely higher because of cancer deaths in people with missed infections, he said.

The American data only included breast cancer survivors, while the British data included people who were in remission from any type of cancer. The risk of death was highest in the months immediately after an infection.

COVID-19 didn’t directly cause the cancer to spread, but created an environment where dormant cells elsewhere in patients’ bodies can wake up, DeGregori said. The body responds to an infection with inflammation to kill the virus, which helps the cancer cells, he said.

“It’s kind of like collateral damage,” he said.

Drugs exist that could block one specific molecule that ramps up inflammation, but they also suppress the immune system, which is a problem when the patient has a serious infection, DeGregori said.

“You have to balance the good it does with the bad it does,” he said.

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The researchers didn’t have enough data to know whether people with more-severe cases of COVID-19 were more likely to die from their cancer, DeGregori said. They also couldn’t tell if flu infections had a similar effect, because most people who have the flu don’t seek medical care, he said.

Other questions for future studies include whether the risk is the same for infections with more recent COVID-19 variants and in vaccinated people, and whether other types of infections also can help cancer spread, DeGregori said.

Not all cancer survivors have dormant cells in their bodies, and of those who do, not everyone sees those cells wake up after an infection, DeGregori said. Still, survivors who are worried about their cancer spreading might want to get vaccinated against respiratory diseases and take steps like avoiding sick people, he said.

“We don’t want to scare people, but knowledge is power,” he said. “Anything that could limit the odds of infection should limit the odds of (cancer) awakening.”

By JOSH BOAK, Associated Press

WASHINGTON (AP) — For weeks, President Donald Trump was promising the world economy would change on Friday with his new tariffs in place. It was an ironclad deadline, administration officials assured the public.

But when Trump signed the order Thursday night imposing new tariffs, the start date of the punishing import taxes was pushed back seven days so the tariff schedule could be updated. The change in tariffs on 66 countries, the European Union, Taiwan and the Falkland Islands was potentially welcome news to countries that had not yet reached a deal with the U.S. It also injected a new dose of uncertainty for consumers and businesses still wondering what’s going to happen and when.

Trump told NBC News in a Thursday night interview the tariffs process was going “very well, very smooth.” But even as the Republican president insisted these new rates would stay in place, he added: “It doesn’t mean that somebody doesn’t come along in four weeks and say we can make some kind of a deal.”

President Donald Trump speaks with the media during a meeting with Britain’s Prime Minister Keir Starmer at the Trump Turnberry golf course in Turnberry, Scotland Monday, July 28, 2025. (AP Photo/Jacquelyn Martin)

Trump has promised that his tax hikes on the nearly $3 trillion in goods imported to the United States will usher in newfound wealth, launch a cavalcade of new factory jobs, reduce the budget deficits and, simply, get other countries to treat America with more respect.

The vast tariffs risk jeopardizing America’s global standing as allies feel forced into unfriendly deals. As taxes on the raw materials used by U.S. factories and basic goods, the tariffs also threaten to create new inflationary pressures and hamper economic growth — concerns the Trump White House has dismissed.

Questions swirl around the tariffs despite Trump’s eagerness

As the clock ticked toward Trump’s self-imposed deadline, few things seemed to be settled other than the president’s determination to levy the taxes he has talked about for decades. The very legality of the tariffs remains an open question as a U.S. appeals court on Thursday heard arguments on whether Trump had exceeded his authority by declaring an “emergency” under a 1977 law to charge the tariffs, allowing him to avoid congressional approval.

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Trump was ebullient as much of the world awaited what he would do.

“Tariffs are making America GREAT & RICH Again,” he said Thursday morning on Truth Social.

Others saw a policy carelessly constructed by the U.S. president, one that could impose harms gradually over time that would erode America’s power and prosperity.

“The only things we’ll know for sure on Friday morning are that growth-sapping U.S. import taxes will be historically high and complex, and that, because these deals are so vague and unfinished, policy uncertainty will remain very elevated,” said Scott Lincicome, a vice president of economics at the Cato Institute. “The rest is very much TBD.”

The new tariffs build off ones announced in the spring

Trump initially imposed the Friday deadline after his previous “Liberation Day” tariffs in April resulted in a stock market panic. His unusually high tariff rates unveiled then led to recession fears, prompting Trump to impose a 90-day negotiating period. When he was unable to create enough trade deals with other countries, he extended the timeline and sent out letters to world leaders that simply listed rates, prompting a slew of hasty agreements.

Swiss imports will now be taxed at a higher rate, 39%, than the 31% Trump threatened in April, while Liechtenstein saw its rate slashed from 37% to 15%. Countries not listed in the Thursday night order would be charged a baseline 10% tariff.

Vehicles for export are parked at a port in Pyeongtaek, South Korea, Thursday, July 31, 2025. (Hong Ki-won/Yonhap via AP)

Trump negotiated trade frameworks over the past few weeks with the EU, Japan, South Korea, Indonesia and the Philippines — allowing the president to claim victories as other nations sought to limit his threat of charging even higher tariff rates. He said on Thursday there were agreements with other countries, but he declined to name them.

Asked on Friday if countries were happy with the rates set by Trump, U.S. Trade Representative Jamieson Greer said: “A lot of them are.”

Thursday began with a palpable sense of tension

The EU was awaiting a written agreement on its 15% tariff deal. Switzerland and Norway were among the dozens of countries that did not know what their tariff rate would be, while Trump agreed after a Thursday morning phone call to keep Mexico’s tariffs at 25% for a 90-day negotiating period. The president separately on Thursday amended an order to raise Canada’s fentanyl-related tariffs to 35%.

European leaders face blowback for seeming to cave to Trump, even as they insist that this is merely the start of talks and stress the importance of maintaining America’s support of Ukraine’s fight against Russia. Canadian Prime Minister Mark Carney has already indicated that his country can no longer rely on the U.S. as an ally, and Trump declined to talk to him on Thursday.

India, with its 25% tariff announced Wednesday by Trump, may no longer benefit as much from efforts to pivot manufacturing out of China. While the Trump administration has sought to challenge China’s manufacturing dominance, it is separately in extended trade talks with that country, which faces a 30% tariff and is charging a 10% retaliatory rate on the U.S.

Major companies came into the week warning that tariffs would begin to squeeze them financially. Ford Motor Co. said it anticipated a net $2 billion hit to earnings this year from tariffs. French skincare company Yon-Ka is warning of job freezes, scaled-back investment and rising prices.

It’s unclear whether Trump’s new tariffs will survive a legal challenge

Federal judges sounded skeptical Thursday about Trump’s use of a 1977 law to declare the long-standing U.S. trade deficit a national emergency that justifies tariffs on almost every country on Earth.

“You’re asking for an unbounded authority,” Judge Todd Hughes of the U.S. Court of Appeals for the Federal Circuit told a Justice Department lawyer representing the administration.

The judges didn’t immediately rule, and the case is expected to eventually reach the Supreme Court.

The Trump White House has pointed to the increase in federal revenues as a sign that the tariffs will reduce the budget deficit, with $127 billion in customs and duties collected so far this year — about $70 billion more than last year.

New tariffs threaten to raise inflation rates

There are not yet signs that tariffs will lead to more domestic manufacturing jobs, and Friday’s employment report showed the U.S. economy now has 37,000 fewer manufacturing jobs than it did in April.

On Thursday, one crucial measure of inflation, known as the Personal Consumption Expenditures index, showed that prices have climbed 2.6% over the 12 months that ended in June, a sign that inflation may be accelerating as the tariffs flow through the economy.

The prospect of higher inflation from the tariffs has caused the Federal Reserve to hold off on additional cuts to its benchmark rates, a point of frustration for Trump, who on Truth Social, called Fed Chair Jerome Powell a “TOTAL LOSER.”

But ahead of Trump’s tariffs, Powell seemed to suggest that the tariffs had put the U.S. economy and much of the world into a state of unknowns.

“There are many uncertainties left to resolve,” Powell told reporters Wednesday. “So, yes, we are learning more and more. It doesn’t feel like we’re very close to the end of that process. And that’s not for us to judge, but it does — it feels like there’s much more to come.”

AP writer Paul Wiseman contributed to this report.

By Kimberly Palmer, NerdWallet

The Consumer Financial Protection Bureau, or CFPB, and other government agencies have scaled back their consumer protection work in recent months, but there are still steps people can take to keep their money safe.

In fact, consumer advocates say doing so is more important than ever.

“We as consumers are quite vulnerable right now,” says Christine Hines, senior policy director at the National Association of Consumer Advocates.

“We all need to be much more diligent about the products and services that we sign up for,” she adds.

Here are four ways to be your own advocate:

Enter new financial relationships with skepticism

Before taking out a new loan, insurance policy or any other kind of financial product, research the company, says Jeanine Skowronski, author of the “Money As If” newsletter.

Read reviews on Google, Trustpilot, Reddit, the Better Business Bureau and other sources that collect consumer feedback and complaints, she says. The CFPB complaint database is still available, too.

“You want to take everything in aggregate. Look at a lot of sources and identify themes,” Skowronski says. “Use many voices to help you decide.”

Even after you choose, keep track of how it’s going, she says. It might be worth shopping around again if you’re not happy after a few months.

Monitor accounts closely

Carefully check your financial accounts. If there is an error or extra fee tacked on, you can investigate right away, Hines says.

“I am monitoring my accounts more frequently,” she adds.

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Sometimes, an unexpected charge is the first sign of identity theft.

Bob Sullivan, an independent journalist and author of “The Red Tape Chronicles” on Substack, suggests signing up for text alerts from your financial institution with balance or deduction updates.

“I always have a good grasp of what the balance should be in all my accounts and get a text with the balance at least once a week,” Sullivan says.

Credit monitoring services can also help, especially if you get access to a free service after being involved in a data breach, he adds.

You can also consider a credit freeze to prevent new accounts from being opened in your name.

Speak up if you have concerns

“If there’s something wrong, call the company,” Hines says. Ask about why a fee was charged or why you were automatically opted into data sharing, for example.

“You can say, ‘There’s something wrong here and you can fix it right now before I make a public complaint,’” she suggests.

If you’re not sure what to say, you can follow a handy online script to talk through various concerns — like cutting cable and internet bills, trimming phone bills and saving on utilities — with a human customer service rep.

But maybe you can’t get a human. Sullivan says it can be frustrating to interact with a chatbot when you’re hoping to resolve a problem swiftly. That’s why he recommends walking into a bank branch or a store’s physical location with customer service representatives available if that’s an option.

“If you’re a good customer, a lot of these banks will waive a late fee once in a while. It’s always worth asking,” he says.

If your concerns are not addressed, Skowronski says it might be time to take your business elsewhere.

“You’re not stuck with a particular financial institution. Let your money talk,” she says.

File an official complaint if necessary

The CFPB might be scaled back, but it’s still accepting complaints on its website, and Hines recommends starting there.

“It helps build a record of what’s going on out there if consumers are having issues,” she says.

Hines also suggests contacting your state’s attorney general’s office, member of Congress or even a consumer attorney.

Going public can also be a useful option that helps other consumers, Skowronski says.

“Go write a review. People will use that to determine where they shop next.”

Kimberly Palmer writes for NerdWallet. Email: kpalmer@nerdwallet.com. Twitter: @kimberlypalmer.

The article 4 Ways to Become Your Own Consumer Advocate originally appeared on NerdWallet.