Mind & Body · Tuesday, 20 October 2026

01 Briefing what happened

Ending the hepatitis B shot for every US newborn could raise lifelong infections by up to 83%, a new study finds

A study published on Monday says dropping the hepatitis B shot at birth, as Robert F. Kennedy Jr.'s vaccine advisers voted to do, would sharply raise lifelong infections; a court has paused the change while the case goes on.

up to 83%

more lifelong hepatitis B infections if the shot at birth for every baby ends

the top estimate of the study published on Monday [1]

95%

fall in hepatitis B among US children and teenagers since every newborn began getting the shot in 1991

fewer than 1,000 now catch it each year [2]; a review of more than 400 studies found the same fall [6]

8-3

the advisers' vote to drop the birth shot for babies of mothers who test negative

taken in December 2025, six months after Kennedy replaced every member of the panel [3]

90% vs 5%

share of infected newborns, and of infected adults, who keep the virus for life

which is why the first days of life are the most dangerous time to catch it [7]

The lead story — what happened

A study published on Monday found that ending the hepatitis B shot for all US newborns would raise lifelong infections by as much as 83%. [1] The researchers say the change would also put more than half of Americans at risk of hepatitis B by the age of 20. [1]
Hepatitis B is a virus that infects the liver and spreads through blood and body fluids. [2] A lasting infection can lead to scarring of the liver, liver failure and liver cancer. [1]
A baby who catches it is far more likely to keep it for life: about 90% of infected newborns do, against about 5% of infected adults. [7] About 1 in 4 US children with a lasting infection die early of liver disease or liver cancer. [2]
In December 2025, modellers at several US universities estimated that a two-month delay would leave more than 1,400 babies infected for life in the first year alone. [5] They expected 482 of those children to die of the infection as they grew older; that study had not yet been checked by other scientists. [5]
In December 2025, advisers picked by Robert F. Kennedy Jr., the US health secretary, voted 8-3 to stop recommending the shot at birth for babies whose mothers test negative. [3]
Those parents were told to decide with a doctor, and to wait until at least two months old if they skip the birth dose. [3][4]
In January, US health officials went further and recommended the shot routinely only for babies at high risk. [7]
In March a federal judge paused both changes, so the shot at birth is again the official advice of the CDC, the US public health agency. [1] The court case is still going on. [1]
Before 1991 the US gave the birth shot only to babies judged at risk, and tens of thousands of babies were still infected every year. [2] About 18,000 children a year caught the virus before turning 10. [2]
Babies were missed when a mother was never tested, caught the virus late in pregnancy, or got a wrong test result. [2] Children can also catch it at home or in child care, from a shared toothbrush or a bite. [2]
Before every baby got the shot, only half of the children later infected had caught it from their mother, says Michaela Jackson of the Hepatitis B Foundation, a US charity. [4] Fathers and carers can carry the virus without knowing it, she says, and many carriers are never tested. [4][2]
Denmark gives the birth shot only to babies at risk. [2] That works there because few people carry the virus and pregnant women are widely tested. [2]

Children infected before age 10, each year before 199118,000

Children and teenagers infected each year now1,000

Before every baby got the shot, about 18,000 US children a year caught hepatitis B before turning 10. Now fewer than 1,000 children and teenagers do; that bar is drawn at 1,000.

Who is involved

Robert F. Kennedy Jr.

the US health secretary; he and his allies argue babies need the shot only if their mother is infected
ACIP

the panel that advises the CDC on vaccines; Kennedy replaced all its members in June 2025, and it voted for the change
A US federal judge

paused both changes in March, so the shot at birth stays the official advice while the case goes on
The Vaccine Integrity Project

a University of Minnesota group; its review of more than 400 studies backed the shot at birth for every stable baby

How it unfolded

1980s A hepatitis B vaccine becomes available [8]
1991 The US starts giving every newborn the hepatitis B shot [2]
Dec 2025 Kennedy's new vaccine panel, picked in June, votes 8-3 to drop the birth shot for babies of mothers who test negative [3]
Jan 2026 US officials recommend the shot routinely only for babies at high risk [7]
Mar 2026 A federal judge pauses both changes [1]
19 Oct A study estimates up to 83% more lifelong infections without the birth shot [1]

Where this points

The next step is the court: its final ruling could still move the first dose to two months or later, which is the change the new study warns about. [1]

What is pushing on the whole day

The bar and the word are our reading of how hard each one is pushing today. The arrow is where it is heading. The evidence is in the stories below.

Health in the US election High↑

Republican candidates are making fraud in health programmes a main theme before November's vote. [13] Two former Republican congressmen, both doctors, say their party's mixed messages on vaccines are costing it votes. [11] In a KFF poll, voters trusted Democrats more on health costs by 42% to 22%. [12]

Shame keeping people from help Building→

James McClean, a footballer, said seeing a psychologist would make him weak. [16] A young man in Liverpool was too ashamed to tell his doctor he was using ketamine. [15] A researcher says embarrassment delays the diagnosis of lichen sclerosus, a painful skin condition. [17]

Studies that cannot show the cause Steady→

A review linked ADHD medicine to fewer early deaths but says it cannot show the medicine caused that. [9] A study of 3,093 adults linked more daily steps to better attention, and one of its researchers says it does not prove walking helps. [20] A small LSD study found an effect in women only, from a re-analysis of 48 people. [18]

The rest of the day

14 more stories on this beat.

Each with its own sources. None of these is a link to the story above.

02
ADHD linked to a higher risk of early death

A review in JAMA Network Open, a medical journal, brought together 19 studies covering more than 15.9 million people in seven countries. [9] People with ADHD had a 70% higher risk of dying from any cause than people without it. [9] Their risk of death by suicide was 90% higher, and by injury 50% higher. [9] ADHD, attention deficit hyperactivity disorder, makes focus and planning hard and affects about 5% of children. [9] People taking ADHD medicine had a lower risk of dying, but the review cannot show the medicine caused it. [9]

Death from any cause70%
Death by suicide90%
Death from injury50%
Death from natural causes30%
How much higher the risk of each kind of death was for people with ADHD than for people without it.

Why it matters — The authors say the results show why people with ADHD need support to manage their health risks. [9] They also point to wider causes of poor health that fall more often on people with ADHD. [9]
03
US surprise-bill referees mostly side with doctors

STAT, a US health news site, reported on Monday that a payment referee system set up by the No Surprises Act has cost 22 billion dollars, far more than expected. [10] The 2020 law protects patients from huge bills when they are treated by doctors outside their insurer's network, and mostly does. [10] When a doctor and an insurer disagree on the price, an arbitration firm decides. [10] Those firms side with doctors and hospitals in more than 80% of cases and work largely in secret. [10]

Why it matters — Doctors and hospitals file most of the disputes, and STAT says ruling their way may partly be how the firms win more work. [10] Patients are mostly spared the bills; the fight over the 22 billion dollars is between doctors and insurers. [10]
04
Pennsylvania bans vapes nobody has checked

A Pennsylvania law took effect on 19 October that bans selling any vape not listed on a state register. [14] Only products from six makers are listed, including Juul and NJoy, because the FDA, the US medicines regulator, has looked at them. [14] Many popular disposable vapes are now banned. [14] Shops face fines of up to 500 dollars per product for a first offence and can lose their licence to sell tobacco. [14] Buyers are not punished. [14]

Why it matters — The law aims at young people vaping, which the US surgeon general called an epidemic in 2018. [14] But New Jersey and Delaware are a short trip from Philadelphia and still sell many of the banned brands. [14]
05
Young people fill a Welsh ketamine rehab

Kaleidoscope, a drugs charity, says referrals to its rehab centre in Wales rose from 2 in 2021 to 112 so far this year. [15] Most are aged 18 to 24, and half its clients are being treated for ketamine. [15] Ketamine is an anaesthetic that, used heavily, can damage the bladder and kidneys. [15] Across the UK, the number of people seeking treatment for ketamine rose twelvefold in a decade. [15] Staff say the drug is very cheap and easy to get. [15]

Referrals in 20212
Referrals so far in 2026112
Referrals to Kaleidoscope's rehab centre in Wales, five years apart.

Why it matters — Rehab services were built for older adults, and a researcher says nobody yet knows what treatment works best for this younger group. [15] The charity says fewer people now arrive having only just started, which it credits to lessons in schools and colleges. [15]
06
Two Republican doctors warn their party over vaccines

Larry Bucshon and Michael Burgess, two former Republican members of the US Congress who are both doctors, wrote in STAT on Monday that their party's mixed messages on vaccines are costing it votes. [11] They say the US has recorded more than 4,000 measles cases this year, the most since 1991, and six deaths. [11] They cite a KFF poll in which more than 60% of voters disapprove of the Trump administration's handling of vaccine policy. [11]

Why it matters — It is an argument made from inside the governing party, weeks before November's midterm elections. [11] Measles was declared eliminated in the US in 2000, and the authors say that status is about to be lost. [11]
07
Republicans turn health talk to fraud

KFF Health News, a US health newsroom, reported that Republican candidates are making fraud in government health programmes a main theme before November's midterm elections. [13] In a KFF poll in September, 44% of voters said fraud is extremely important for candidates to talk about. [13] The Trump administration has held back billions of dollars of Medicaid money, the US public health cover for people on low incomes, from states it accuses of weak checks. [13] In New York, officials claimed 5 million people got one home-care service, then admitted the real number was nearer 450,000. [13]

Why it matters — A KFF expert said fraud gives Republicans a health message when they would otherwise be defending cuts to Medicaid. [13] Voters trusted Democrats more on health costs, by 42% to 22%, in a KFF poll published this month. [12]
08
Tiny LSD doses help women focus, in a small study

Researchers at Maastricht University presented a study on 12 October in which women given tiny doses of LSD focused for longer than people given a dummy pill. [18] On a 10-minute attention test, women on the drug reacted 8% faster and had fewer lapses. [18] Men showed little change. [18] The team re-examined an earlier trial of 48 healthy people, half of whom took 15 micrograms four times over two weeks. [18] A microdose is about a tenth of the amount that causes a full trip. [18]

Why it matters — Earlier controlled studies of microdosing gave mixed results. [18] A neuroscientist not involved called the finding a notable addition, and said some people may be more sensitive than others to small doses. [18]
09
The brain reads feelings from faces and voices together

A study in the Journal of Neuroscience scanned the brains of 24 people as they watched and heard actors showing feelings such as happiness, disgust and fear. [19] Clips with sound only still lit up brain areas known for handling faces. [19] Clips with pictures only lit up areas known for handling voices. [19] Stefania Mattioni of Ghent University, who led the study, says these areas seem to be organised by the feeling, not by the sense. [19]

Why it matters — It may help explain how people read feelings on a phone call, with no face to see. [19] Scientists hope it could one day help people who struggle to read social cues. [19]
10
More daily steps, slightly sharper attention

A study of 3,093 US adults used Fitbit step records from as long as 14 years to compare activity with test scores. [20] People who averaged about 8,900 or 14,200 steps a day did better on attention tests than people who averaged about 5,100. [20] The differences were small. [20] The data came from All of Us, a US government health research programme, and the study was published in Scientific Reports. [20]

Why it matters — Olaoluwa Okusaga of Baylor College of Medicine, who worked on the study, says it does not prove that walking causes better thinking. [20] People who already think more clearly may simply stay more active. [20]
11
A footballer calls therapy weak, and his wife disagrees

James McClean, a 37-year-old Derry City footballer who played 103 times for the Republic of Ireland, told a newspaper that seeing a psychologist would be a sign of weakness. [16] His wife Erin said on Monday that he has been struggling for some time and that she is urging him to get therapy. [16] Men's Action Network, a men's mental health charity, offered to meet him. [16] Fans at a Derry match that night held up a banner saying it is not weak to speak. [16]

Why it matters — The charity says many men still feel they cannot say they are not OK. [16] It wants to meet McClean because many young men in Derry look up to him. [16]
12
A painful condition hidden by embarrassment

Lichen sclerosus is a lifelong skin condition that causes itching, soreness and tears on the genitals, and it is not catching. [17] Monica Thomas, 34, told the BBC she was examined 28 times in six months before a biopsy, while doctors kept calling it thrush. [17] Doctors also told her she was too young; it is more common in women over 50. [17] A University of Bristol study estimated it affects about 1% of women. [17]

Why it matters — A researcher says that figure is almost certainly too low, because shame and a lack of awareness, even among health workers, delay diagnosis. [17] The condition carries a small risk of vulval cancer, and one woman says hers was found at stage three. [17]
13
A brain pathway keeps fear memories precise in rats

Scientists at the University of Iowa found a pathway in the front of the rat brain that controls how narrowly a frightening memory is stored. [21] When they switched it off with light after training, rats feared a safe place as well as the dangerous one. [21] Switching it on made them better at telling the two apart. [21] Stress hormones were thought to drive this, but the effect held in rats that could not make them. [21]

Why it matters — The work was done only in male rats. [21] The authors say it may help explain stress-related conditions in which fear spreads to safe places. [21]
14
Norway widens its planned social media ban for under-16s

Norway's government said on Monday that it is finishing a law to keep children under 16 off social media, to go to parliament by the end of the year. [22] The ban will now also cover online games and messaging apps judged risky for children. [22] TikTok, Snapchat and Roblox, a game where players make games and play them with others, would likely be covered. [22] Technology firms would have to check users' ages, and messaging apps used by schools could stay open. [22]

Why it matters — Norway's minister for children, Lene Vagslid, said children's safety must come first. [22] Denmark has passed similar limits and Spain is working on one, while France's ban for under-15s was struck down by its top court in September. [22]
15
Ebola leaves fear and loneliness in eastern Congo

Health workers in eastern Congo are warning of a mental health crisis growing alongside the Ebola outbreak there, Africanews reported on Monday. [23] At a treatment centre in Bunia, a woman who lost five relatives to the disease said her neighbours were too afraid to come near her family. [23] Workers say the stigma hits patients, survivors and medical staff alike. [23] The outbreak is spreading in a region already torn by fighting, where many people have fled their homes. [23]

Why it matters — Mirella Riccardi of MSF, the medical charity, said the war had already left people fragile, and Ebola adds one more blow. [23] Aid workers say grieving and frightened families need psychological help as well as medical care. [23]

02 Lesson why it matters

Why protecting only the people known to be at risk misses many who catch it

Hepatitis B passes from people who do not know they carry it, so a shot only for babies of infected mothers misses babies infected another way.

The twist

A shot only for babies judged at risk sounds efficient. But before 1991, when the US worked that way, half of the children who caught hepatitis B got it from someone other than their mother.

The picture

Shot at birth for every baby (drawn as 100)100

Without the routine birth shot, top estimate183

Lifelong infections under today's rule are drawn as 100. The new study's highest estimate without the routine birth shot is 83% more.

How it works

Hepatitis B can pass from people who do not know they carry it
A mother's test can only find her own infection, and tests can be missed, late or wrong
So a baby of a mother who tested negative can still meet the virus at home or in child care
A shot for every baby at birth covers sources nobody has found
Give it only to babies judged at risk, and the babies infected another way go unprotected

The same force, elsewhere today

Where this chain is also running, in today's other stories.

Young people fill a Welsh ketamine rehab

Drug services were planned around older adults, so young people with ketamine damage arrived at services not built for them.
A painful condition hidden by embarrassment

Doctors who thought of it as a condition of women over 50 told a young woman she was too young, and she was examined 28 times before a biopsy.
Pennsylvania bans vapes nobody has checked

The new law bans every vape the FDA has not looked at, instead of waiting for each product to be shown harmful.

Where you've seen this

Airport security

every bag is scanned, because nobody can tell in advance which one holds the danger

Smoke alarms

fitted in every home, not only homes where someone smokes

Seat belts

worn by every passenger, not only by drivers judged careless

The catch

A rule for everyone costs more and reaches many people who would never have been hit. In Denmark, where few people carry the virus and pregnant women are widely tested, the targeted shot works.

And the whole of it

A parent deciding about the shot sees one baby and one test result. Nobody in that room can see which relative, carer or child at nursery carries the virus without knowing it.

03 Truth what's really going on

What is really going on

Robert F. Kennedy Jr.'s vaccine advisers want the hepatitis B shot given at birth only to babies judged at risk, the plan the US dropped in 1991 because it missed tens of thousands of babies a year. [3][7][2] A judge has paused it, and a study published on Monday says it would raise lifelong infections by up to 83%. [1]

Why it works on us — Letting parents choose sounds like more freedom, but it leaves out that many babies catch the virus from carriers who do not know they have it.

Who gains

The six vape makers on Pennsylvania's register, including Juul and NJoy — Their products stay legal while many rival disposable vapes are now banned from shop shelves. [14]
Doctors and hospitals that bring surprise-bill disputes — The private referees side with them in more than 80% of cases, in a system that has cost 22 billion dollars. [10]
The private firms that settle surprise-bill disputes — Their business grows with every dispute filed, and doctors and hospitals file most of them. [10]
Republican candidates in November's US elections — Talking about fraud gives them a health message instead of defending cuts to Medicaid, a KFF expert says. [13]
Democratic candidates in the same elections — Voters trust them more on health costs, by 42% to 22%, and more on vaccine policy, the Republican doctors write. [12][11]

Who pays

US babies whose mothers test negative but who meet the virus elsewhere — Under the advisers' plan they would no longer get the shot at birth by default, and newborns who catch the virus usually keep it for life. [3][7]
Young people in Wales with ketamine damage — They arrive at rehab services built for older adults, and nobody yet knows what treatment works best for them. [15]
Women with lichen sclerosus — Shame and a lack of awareness among health workers delay diagnosis, in one case through 28 examinations. [17]
Pennsylvania shops selling disposable vapes — They face fines of up to 500 dollars per product for a first offence and can lose their licence. [14]

What nobody knows yet

Open questions from across today’s stories — ours included.

01

How the new study reached its estimate of up to 83% more lifelong infections.

We could read only the opening of the New York Times report, which does not name the journal or show the method. [1]
02

Whether the court will let the change go ahead.

A judge paused it in March, but the case continues and the final ruling could still move the first dose to two months or later. [1]
03

Whether ADHD medicine itself prevents early deaths.

The review links medicine to lower risk, but it pools studies that watched people and cannot show cause; people who get treatment may differ in other ways. [9]
04

Why surprise-bill referees side with doctors and hospitals more than 80% of the time.

The firms work largely in secret, and STAT says winning more business may be part of the reason, not all of it. [10]
05

Whether tiny doses of LSD really help women focus.

The finding comes from re-examining 48 people, presented at a meeting, and earlier controlled studies gave mixed results. [18]
06

How many young people in Wales are harmed by ketamine.

A researcher says the scale of the problem and the long-term damage are still unclear. [15]
07

How many women have lichen sclerosus.

The 1% estimate is almost certainly too low, because many people are diagnosed late or never. [17]
08

Whether Pennsylvania's ban will cut vaping by young people.

Many banned brands are still sold a short trip away in New Jersey and Delaware. [14]

04 Hope carry this

Since every US newborn began getting the hepatitis B shot in 1991, infections in American children and teenagers have fallen by about 95%, to fewer than 1,000 a year.

Also true today

A Welsh drugs charity says fewer young people now come to it having only just started on ketamine, and it credits lessons in schools and colleges.
People with ADHD who took medicine for it had a lower risk of early death, in a review of studies covering more than 15.9 million people.
At a Derry City match on Monday night, fans held up a banner saying it is not weak to speak.