National outrage continues to escalate over the Trump administration’s violent immigration crackdown. Over the past two days, protesters urging Immigration and Customs Enforcement and Customs and Border Patrol to leave their cities took to the streets from Minneapolis and Chicago to Houston, Texas; Portland, Oregon; New York; Oakland and San Diego, California.
Continue reading “Photos: Anti-ICE Protests Erupt Nationwide After Minneapolis and Portland Shootings”‘Shared Decision-Making’ for Childhood Vaccines Sounds Empowering. But More ‘Choice’ Can Mean Less Access.
This article is part of TPM Cafe, TPM’s home for opinion and news analysis. It was originally published by The Conversation under a Creative Commons license.
When federal health officials announced on Jan. 5, 2026, that they were taking six out of 17 vaccines off the childhood immunization schedule, they argued that the move would give parents and caregivers more choice.
Instead of all U.S. children routinely receiving them, these six vaccines are now optional – available to families who request them after consulting a clinician, through a process called shared clinical decision-making, officials said. All six – hepatitis A, hepatitis B, influenza, rotavirus, meningococcal disease and COVID-19 – will still be covered by federal programs such as Medicaid and the Vaccines for Children program, and by private insurers, at least through 2026.
I’m a health policy researcher and the co-author of the book “Vaccine Law and Policy.” I’ve spent years studying how vaccine laws and regulations affect uptake – and who gets left behind when policies change.
Shared decision-making sounds straightforward: a patient and their doctor putting their heads together to make an informed choice. But when applied to routine childhood vaccines, the concept shifts the burden of deliberation onto already-stretched clinicians and parents.
What is shared decision-making?
Shared decision-making is an approach doctors use when there’s genuinely more than one reasonable choice – say, weighing two cancer treatments with different side effects – and the “right” answer depends on what matters most to the patient. The idea is that doctor and patient talk it through together to help make the decision that feels right for that patient.
The Centers for Disease Control and Prevention uses this term for vaccines that aren’t automatically recommended for everyone but that might make sense for some people after a conversation with their doctor.
The key difference is what happens if no conversation takes place. For routine vaccines, the default is yes. Children get the shot unless there’s a medical reason not to. For shared clinical decision-making vaccines, there’s no default. If the conversation doesn’t happen, neither does the vaccine.
That distinction matters because the federal vaccine advisory committee has historically reserved shared decision-making for narrow situations. One example is the HPV vaccine for adults 27 to 45. Most people in that age group have already been exposed to HPV, so the vaccine helps some individuals but won’t change infection rates overall. In that case, a conversation with your doctor makes sense: The benefit depends on your personal circumstances.
Childhood vaccines against rotavirus and hepatitis B are different. They’re not for a small subset of people who might benefit – they prevent tens of thousands of hospitalizations a year. https://www.youtube.com/embed/vqynVys3RTI?wmode=transparent&start=0 On Jan. 5, 2026, federal health officials cut six vaccines from the childhood immunization schedule.
When a vaccine is routine, it pops up as an alert in a child’s medical records and becomes part of the clinic’s standard workflow. The nurse draws it up, the doctor gives a heads-up to the parent, and the shot happens before the family leaves. Parents and other caregivers typically encounter it as part of normal pediatric care rather than as a separate decision to weigh.
That’s important because even in well-resourced practices, pediatricians already have limited time to cover many priorities – growth, feeding, sleep, development, safety and any questions the family may have. For lower-income families, who often face even shorter appointments and have fewer options for follow-up visits, that limitation can get magnified.
Studies have found that many low-income families do not receive all recommended care, in part because their time with the doctor during routine visits is so short.
What this looks like for a family coming in for a checkup
Even before this policy change, lower-income children in the U.S. were falling behind on vaccines. From 2011 to 2021, kids in higher-income families got more of their shots on time, while kids in lower-income families didn’t keep pace – and that gap kept widening.
Here’s how the new policy could make things harder:
A mother brings her 2-month-old to a clinic that serves mostly low-income families – the kind of practice that sees 25 or 30 kids a day for well-child visits. Under the old schedule, the visit runs on rails: The nurse pulls up the baby’s chart, sees that six vaccines are due, draws them up, and the doctor gives them during the exam. By the time Mom is buckling the car seat, the shots are done. The whole vaccine portion takes a few minutes.
Under the new policy, two of those vaccines – rotavirus and hepatitis B – are no longer automatic. Now, the doctor has to stop and have a conversation to explain what rotavirus and hepatitis B are, walk through the risks and benefits of each vaccine and ask what the parent wants to do.
That’s fine if there’s time. But this visit is 15 minutes long, and the doctor still has to check the baby’s growth, ask about their feeding and sleep habits and make sure development is on track. If the mother has questions or feels unsure, the clinic might ask her to come back or wait for a phone call. But she took two hours off her shift to get here and she doesn’t have paid leave. There may not be a next visit.
Now multiply that by every baby on the schedule that day. And this is just the 2-month visit. The same thing will happen at other ages when other vaccines that moved out of the “routine” category come due. Something has to give. Often, it’s the vaccines that no longer happen automatically.
Why more ‘choice’ can mean less access
Talking with families about vaccines already takes time. According to the American Academy of Pediatrics, more than half of pediatricians report spending from 10 to 19 minutes counseling parents about vaccines, and nearly 1 in 10 spend more than 20 minutes – often several times per day.
Shared decision-making takes even longer. When vaccines are routine, the system does most of the work. When they require shared decision-making, that work lands on the doctor and parent in an already-packed appointment. The doctor must walk through the disease and the vaccine’s benefits and risks, ask what concerns the parent has, make sure they understand, and then document the whole conversation.
That’s one more barrier to vaccination, and one that won’t fall evenly. Getting medical care can take more time for families with fewer resources. When a policy change adds steps, those families feel it most.
The data might end up showing that some parents “chose” not to vaccinate. But for many families, it won’t really be a choice – it will be a reflection of who had time to come back, and who didn’t.
This article is republished from The Conversation under a Creative Commons license. Read the original article.
The Cover-up of the Fatal ICE Shooting Is Already Underway
Programming note: Join me for the first Morning Memo Live event on Jan. 29 in Washington, D.C. Find details and tickets here.
‘No Matter What’
As far back as early last year, the Trump administration was game-planning for how to respond to state prosecutions of federal agents engaged in its mass deportation operation.
The upshot of the planning, which reportedly included White House deputy chief of staff Stephen Miller, was: “Don’t give an inch, and protect the accused agents ‘no matter what'”, Zeteo reports, quoting a senior Trump administration official.
It fits to a tee the public response of the Trump administration so far in the aftermath of the fatal ICE shooting in Minneapolis. But it’s not merely a rhetorical game plan for winning the messaging war.
The Trump administration has already squeezed out state investigators and prevented them from independently probing the shooting. That move was reportedly driven by Trump-appointed Minnesota U.S. Attorney Daniel Rosen, who had no prior experience as a prosecutor. Defending the firewall the administration quickly erected, DHS Secretary Kristi Noem said that Minnesota “had not been cut out,” declaring that it “doesn’t have any jurisdiction in this investigation.”
While it may seem from the outside that state investigators could proceed on their own, legal experts say being shut out of the federal investigation creates nearly insurmountable obstacles to winning a conviction on state charges:
Without cooperation from federal agencies, it will be close to impossible for state officials to put together a case, said Emmanuel Mauleón, a law professor at the University of Minnesota. State prosecutors are now unlikely to have access to any further evidence—body-worn camera footage, if it exists, interviews with the officer and witnesses, medical reports—and any other investigative material that could be part of a case, Mauleón said.
Minnesota elected officials balked at being shut out of the probe, especially while the Trump White House was making conclusory statements about the incident and vilifying the woman who was killed. “By not allowing Minnesota to participate, and the prejudgment that’s already been made by leadership, creates a very, very dangerous situation,” Gov. Tim Walz (D-MN) said.
Without a state investigation, that leaves the Trump DOJ, which is fully under the control of the White House.
“If the FBI is the only investigative agency and you have Kash Patel, who is basically an extension of Donald Trump’s right arm, doing this investigation, we all know it’s going nowhere,” Rep. Dan Goldman (D-NY) said on The Daily Blast podcast. “It’s not a legitimate investigation.”
CBP Shoots Couple in Portland
Oregon officials are launching their own investigation of a Thursday incident in Portland where Customs and Border Patrol officers shot a couple during a vehicle stop. No video has yet emerged of the incident.
Mass Deportation Watch
- In a Dec. 12 email, the head of Enforcement and Removal Operations for ICE warned agents to be “prepared to take appropriate and decisive action should you be faced with an imminent threat” from protestors, the NYT reports.
- At least 100 more federal agents are being deployed to Minnesota.
- Two Democratic members of Congress are introducing a bill to end qualified immunity for ICE agents, they tell Greg Sargent.
- During Trump’s mass deportation operations, federal agents have fired at vehicles at least 10 times.
- A retired ICE agent who oversaw use of force investigations for DHS takes a dim view of the fatal ICE shooting in Minneapolis:
U.S. Citizen Released After 25 Days in ICE Detention
It took 25 days for a 22-year-old Maryland woman to be released from ICE detention while her lawyers kept providing evidence that she is U.S.-born citizen.
No Doubt Who Runs DOJ Now
The White House is no longer even trying to hide that it’s running the Justice Department directly.
Vice President JD Vance announced in a press conference that a new assistant attorney general — ostensibly tasked with investigating fraud — will be “run out of the White House” and report directly to him and President Trump.
As the NYT’s Alan Feuer put it: “The assertion by Mr. Vance that he and Mr. Trump intended to exercise direct supervision over a senior Justice Department official was one of the administration’s most brazen efforts to date to toss out the traditional boundaries that have long existed between the White House and investigations conducted by federal law enforcement.”
The Retribution: Letitia James Edition
The Trump DOJ — foiled by multiple grand juries in its attempt to indict Letitia James on bogus mortgage fraud charges — is now zeroing in on her hairdresser in a new investigation seeking to carry out President Trump’s campaign of retribution against the New York attorney general, the NYT reports.
James’ longtime hairdresser Iyesata Marsh was indicted last month in federal court in the Western District of Louisiana on bank fraud and aggravated identity theft charges in connection with the purchase of a vehicle that doesn’t appear to have any direct connection to James, according the newspaper:
The investigation is still in its early stages, but prosecutors are interested in talking to Ms. Marsh about past financial transactions involving Ms. James or her campaign, according to people familiar with the matter who spoke on the condition of anonymity to describe the inquiry.
There is no indication that Marsh is cooperating with the investigators targeting James.
USA Sarcone DQ’d In James Case
A federal judge in the Northern District of New York quashed subpoenas issued to New York Attorney General Letitia James by acting U.S. Attorney John Sarcone III, ruling that he was invalidly appointed by the Trump administration:
The judge also barred him from any further involvement in the James cases “regardless of his title.” The ruling adds to the list of disqualified U.S. attorneys in New Jersey, California, and Nevada (plus the Eastern District of Virginia on slightly different grounds), as judges thwart Trump’s effort to bypass Senate confirmation and the law that gives judges the power to appoint interim U.S. attorneys after their initial terms expire.
You Can Tell It’s an Election Year
The signs are real — though they may be fleeting — that Republicans on the Hill are not in lockstep with President Trump to the same degree that they have been for the past year:
- The Senate — with five GOP defections — voted to block further military action in Venezuela. Trump blasted the defectors by name, saying they “should never be elected to office again.”
- The House — over objections from Trump and Speaker Mike Johnson (R-LA) — passed a clean three-year extension of Obamacare subsidies, with 17 Republicans defecting.
Senate Votes to Display Jan. 6 Plaque
With Speaker Mike Johnson (R-LA) still refusing to abide by a 2022 law honoring the officers who defended the Capitol on Jan. 6 — burying the commemorative plaque, still in its crate, in the basement of a House office building like the closing scene of Raiders of the Lost Ark — the Senate voted unanimously yesterday to hang the plaque on its side of the Capitol until it “can be placed in its permanent location.”
The Attack on Higher Ed
- Austin Peay State University in Tennessee has reinstated a professor fired for a social media post in the wake of Charlie Kirk’s assassination and agreed to pay him $500,000 to settle the case.
- Texas A&M’s new policy restricting classroom discussions of race and gender will adversely affect some 200 courses in the College of Arts and Sciences and has already claimed Plato as an early victim.
Trump Ditches Climate Agreement
In an executive order, President Trump this week unilaterally continued his retrograde approach to climate change by purporting to withdraw the United States from:
- the Senate-ratified 1992 U.N. Framework Convention on Climate Change;
- the UN’s Intergovernmental Panel on Climate Change, which shared the 2007 Nobel Peace Prize with Al Gore for its work studying climate change.
Grandiosity Alert
- Nobel Peace Prize: President Trump may get the Nobel Peace Prize after all:
- Ballroom: Updated plans for President Trump’s vanity ballroom indicate that it will be as tall as the White House itself, a disproportionate architectural monstrosity. A one-story addition to the West Wing colonnade is also under consideration, the project architect told a planning commission.
What a Legend
A whimsical end to a brutal news week, featuring a mailman with absolutely the best sense of humor:
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A Turning Point for Trump’s Marauding Secret Police
People who don’t like Donald Trump are kinda gun-shy talking about turning points. Turning points of course can mean very many things. But as I watched first the videos of the murder of Renee Nicole Good and even more the official reactions to it I’ve started to think that we’re in the process of seeing one. I don’t mean Donald Trump is doomed politically, though perhaps he is. I mean a turning point in the public perception of ICE (and the Border Patrol) and their newly hyper-militarized role in American cities beginning last summer.
What we see in the videos of Good’s shooting is some mix of a moment of confusion or perhaps minor panic on the part of Good as the driver. And we see this ICE agent draw his weapon in a fairly calm and methodical way and fatally shoot Good in the face.
Continue reading “A Turning Point for Trump’s Marauding Secret Police”Defiant Protesters Face Noem After ICE Shooting: ‘We Have To Be Here’
Robust Resistance
The fatal shooting of Renee Nicole Good shows that the people who have been resisting President Trump’s mass deportation push are risking their lives. However, waves of protests in the aftermath of her death show the threat is not stopping anyone from showing up. This dynamic was clear as Department of Homeland Security Secretary Kristi Noem visited New York City on Monday and was met with defiant demonstrations.
Continue reading “Defiant Protesters Face Noem After ICE Shooting: ‘We Have To Be Here’”How the Right-Wing Outrage Machine Prompted the Conflagration in Minnesota
More than 2,000 U.S. Immigration and Customs Enforcement agents are on the ground in Minnesota in what President Donald Trump’s administration officials have called the “largest immigration operation ever.” Deployed just days ago by Trump, one agent has already shot and killed a person and federal law enforcement has deployed tear gas and pepper spray against protesters.
Continue reading “How the Right-Wing Outrage Machine Prompted the Conflagration in Minnesota”That’s the Whole Ballgame, Folks
I remember not so many months ago wondering if I was pushing the envelope a bit by writing that the Justice Department was being run out of the Trump White House. Since those quaint times, evidence has continued to amass that that is exactly how things are being run, but both the White House and Justice Department preferred to maintain the fiction that they were separate entities. Until today.
Here’s what Vice President JD Vance announced midday in a White House press appearance (emphasis mine):
Continue reading “That’s the Whole Ballgame, Folks”Will Musk’s Grok Be Held Accountable for Flood of Sexualized, Fake Images of Women and Children?
This story was originally reported by Mariel Padilla of The 19th. Meet Mariel and read more of their reporting on gender, politics and policy.
The social media platform X has been flooded with AI-generated sexualized images of women and children in recent weeks — months before a new law aiming to ban the spread of nonconsensual intimate imagery goes into effect.
Elon Musk, the owner of X, announced a new feature with a post on Christmas Eve encouraging users to try editing images and videos with Grok, the app’s chatbot. Then, a few weeks later, as the new year began, many women noticed something disturbing online: a flood of AI-generated sexualized images of them on the social media platform X. Users on X were able to ask Grok’s latest feature to digitally remove clothing from posted photos and recirculate them.
Continue reading “Will Musk’s Grok Be Held Accountable for Flood of Sexualized, Fake Images of Women and Children?”Listen To This: Happy New War
Kate and Josh discuss Venezuela and Tim Walz dropping his reelection bid.
Continue reading “Listen To This: Happy New War”The Trump-Run DOJ Is Going to Investigate the ICE Shooting, Huh?
Programming note: Our first Morning Memo Live event is coming up on Jan. 29 in Washington, D.C. Find details and tickets here.
No Justice Without Independence
I want to try to reframe yesterday’s shooting in Minneapolis to highlight the dire situation in which we find ourselves with the Justice Department — including the FBI — being run out of the Trump White House.
In the past, the following things would have been generally, albeit imperfectly, true:
- The FBI taking over the federal side of the investigation would have offered a reasonable chance of a vigorous, independent investigation.
- The local U.S. attorney’s office, with help from expertise at Main Justice, would have been in a position to make an independent charging decision based on the FBI’s investigation.
- Politicized comments about the shooting from the president, his White House, and other administration officials — while inadvisable and unhelpful — would not have represented a true threat to the independence of the investigation or of the charging decision.
I could spend another 1,000 words caveating those assertions — noting for example that prosecutors have always had wide-ranging discretion which political considerations can infiltrate, that the law on police shootings has long been stacked heavily in favor of law enforcement, and that law enforcement investigating law enforcement has always created difficult to resolve conflicts of interest — but I don’t want to let the imperfections of the old system trip us up as we try to be clear-eyed about the new system.
The top officials at the Justice Department and the FBI have shown themselves again and again to be beholden to the president, spending most of their days fawning over him and trying to stay in the good graces of his White House. They have demonstrated no independence of thought or action from this president. They do not have their employees’ backs. They have eviscerated the expertise within their ranks, decimating crucial units like the Civil Rights Division.
Meanwhile, President Trump has repeatedly asserted his full and direct control over the DOJ and FBI. He has publicly and unabashedly ordered investigations and prosecutions, most famously in the case of former FBI Director James Comey. Trump has undermined successful prosecutions by his own DOJ by commuting sentences and issuing pardons, in some instances within weeks of conviction. He enjoys immunity from prosecution for his corrupt abuse of the executive powers of policing and prosecution.
And yet despite those familiar facts, I’m not sure we’ve collectively internalized fully the implications of the dependent and compliant Justice Department. The aftermath of yesterday’s shooting only reinforced how dire the situation is. Trump didn’t just comment on the evidence. He and his administration lied about it, twisted it, and propagandized about it. They publicly reached ultimate conclusions about guilt and innocence. They repeatedly savaged the woman killed, calling her a “domestic terrorist“:
Contrast Trump with the Minneapolis Mayor Jacob Frey, who expressed righteous anger — calling the already-emerging administration narrative of the shooting “bullshit” and telling ICE to “get the fuck out of Minneapolis” — but has no authority over the state investigation or prosecution. The state’s investigation is being conducted by the Bureau of Criminal Apprehension.
At the same time, Trump and his administration did nothing to offer assurances that an independent investigation would be conducted, that the FBI would be left alone to do its work, that prosecutors would abide by the facts and the law and not be subject to political pressures from Trump or appointees. They didn’t even spout niceties in that direction. There was no rhetorical pretense of independence or acknowledgement of the conflicting interests that must balanced.
Nothing is stopping Trump from kneecapping the FBI investigation, or political appointees from self-kneecapping. Similarly, even if DOJ political appointees don’t also self-kneecap, there can be little confidence in how the investigation was conducted or the righteousness of the prosecution. Trump could order any putative prosecution ended before it begins, derail it, or use his pardon power after conviction. All of it will, and should be, suspect given the deep structural corruption that Trump has already achieved.
Since there can be no true federal accountability for the shooting of a U.S. citizen — who, the evidence increasingly suggests, may have been a mere bystander to an immigration enforcement action targeting the vilified Somali community — we’re left to rely on the parallel state investigation and possible charges under state law. There is some precedent for states charging federal officers for violations of state law, but the broader historical pattern has been for the feds to be a legal backstop against insufficient or compromised state action against abusive police and policing practices. Trump has firmly steered DOJ away from that role.
None of this even gets into the clear signals investigators and prosecutors already had from the Trump White House before the shooting about which side the bread is buttered on. You can’t have an independent law enforcement agency when it is under constant political siege. Trump and political appointees spent the day yesterday broadcasting those same signals even more directly in the Minneapolis case.
Late Update: It gets even worse. The Minnesota Bureau of Criminal Apprehension says the FBI has ousted it from what had been a joint investigation, Minnesota Public Radio reports. In a statement, the BCA said:
[T]he FBI informed the BCA that the U.S. Attorney’s Office had reversed course: the investigation would now be led solely by the FBI, and the BCA would no longer have access to the case materials, scene evidence or investigative interviews necessary to complete a thorough and independent investigation.
Without complete access to the evidence, witnesses and information collected, we cannot meet the investigative standards that Minnesota law and the public demands. As a result, the BCA has reluctantly withdrawn from the investigation.
Not Just Bad Policing
Videos from targeted cities over the past few months have shown such reckless conduct by immigration agents that it understates it to call it bad policing. It’s just not policing at all. It occupies a new realm of use of force, with outside federal units detached from local communities and with tenuous cooperation from local law enforcement coming in to knock heads, often while masked and driving unmarked civilian vehicles.
Incidents like the shooting in Minneapolis were not just foreseeable, but were foreseen and warned about, local officials angrily noted. Reckless conduct by immigration agents was already documented by a federal judge in Chicago, Chris Geidner reminds us. Two similar incidents occurred in Chicago involving vehicles, where the feds brought charges against the drivers, but the cases quickly fell apart and the charges were later dropped. Nationwide, it was the ninth ICE shooting since September.
One policing expert who reviewed video of the Minneapolis shooting told the NYT, “This is what we call officer-created jeopardy.”
Schools Closed
In the face of the chaos unleashed by the Trump administration — including an immigration enforcement action at a local high school after the shooting incident — Minneapolis has closed schools for the rest of the week.
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