Vaccination bills are popping up in more than 15 states as lawmakers aim to potentially resurrect or create new religious exemptions from immunization mandates, establish state-level vaccine injury databases, or dictate what providers must tell patients about the shots.
Many see a political opportunity to rewrite policies in their states after President Donald Trump’s return to the White House and anti-vaccine activist Robert F. Kennedy Jr.’s nomination as the next secretary of HHS. The agency oversees virtually every aspect of vaccination efforts in the U.S., from funding their development to establishing recommendations for medical providers to distributing vaccines and covering them through federal programs.
Childhood vaccination rates against dangerous infections like measles and polio continue to fall nationwide, and the number of parents claiming non-medical exemptions so their kids don’t get required shots is rising.
In 2024, whooping cough cases reached a decade-high and 16 measles outbreaks, the largest among them in Chicago and Minnesota, put health officials on edge. Most states are below the 95% vaccination threshold for kindergartners — the level needed to protect communities against measles outbreaks.
About half of Americans are “very” or “extremely” concerned that those declining childhood vaccination rates will lead to more outbreaks, according to a new poll by the Associated Press-NORC Center for Public Affairs Research. Yet only about four in 10 Americans oppose reconsidering the government’s recommendations for widely used vaccines, while roughly three in 10 are in favor. The rest — about three in 10 — are neutral.
Scott Burris, director of Temple University’s Center for Public Health Law Research, has tracked public health legislation for years, and watched backlash against COVID-19 vaccines grow to include more routine vaccines as anti-vaccine activists take hold of powerful political pulpits.
“I think COVID and the politics gave standard vaccine denialists a lot of wind in their sails,” he said.
It’s hard to predict what will pass into law in the states, Burris said, considering the vast majority of proposed bills in any state go nowhere. But the proposed legislation offers a glimpse into lawmakers’ thoughts, and what else might follow.
Religious Exemptions Lead the Pack
Religious exemptions for school vaccine requirements are among the most popular proposals so far. Lawmakers in New York, Virginia, Connecticut, and Mississippi have introduced bills that would allow more people to waive routine shots. Indiana lawmakers will weigh religious exemptions for medical students.
Earlier this month, West Virginia Republican Gov. Patrick Morrisey issued an executive order on his first day in office that enabled families to receive religious exemptions from required school vaccinations.
“That’s a huge step,” said Brian Festa, co-founder of the law firm We The Patriots USA, which works on vaccination-related cases throughout the country. “That’s a state that never had a religious exemption.”
Now, only four states allow just a medical exemption from childcare and K-12 immunization requirements: Connecticut, California, New York, and Maine.
Festa credited West Virginia’s new religious exemption to Trump’s nomination of Kennedy, as well as a 2023 federal court ruling that required Mississippi to allow residents to cite religious beliefs when seeking exemptions from state-mandated vaccinations for children.
“I think the writing’s on the wall and they did feel the pressure,” Festa said of West Virginia.
In Connecticut, at least four Republican bills will try to revive the state’s religious exemption for schools, colleges, and daycares — something a contentious 2021 state law eliminated for students without an existing exemption.
Connecticut health experts said at the time there was a slow but steady increase in the number of religious exemptions and declining vaccination rates in some schools. The state has historically maintained some of the highest childhood vaccination rates in the county, and in the 2023-2024 school year, more than 97% of kindergarteners were protected against chickenpox, measles, tetanus, diphtheria, polio, and more.
Given that the U.S. Supreme Court last year rejected a challenge to the Connecticut law and the statehouse is controlled by Democrats, GOP state Sen. Eric Berthel said he’s not optimistic legislative leaders will allow debate on his exemption bill, but does believe the broader cultural shift means “maybe there is a bit of an appetite to look at things like this again.”
“I think that we’re not being fair to families who have a true faith-based reason to not vaccinate their child,” he said.
There’s one outlier so far among statehouse trends on exemptions. Hawaii, where legislators are looking to move in the opposite direction with a bill to eliminate all non-medical waivers after struggling for years with high exemption rates.
Vaccine Injuries and Consent Laws
Other vaccine-related bills touch on some of the opposition that’s been growing since the pandemic.
Oklahoma and Alabama have proposals that would require parental consent for any vaccine given to minors. Bills in Wyoming, Oregon, and Oklahoma would prohibit “discrimination” against people who aren’t vaccinated against COVID-19 or other diseases.
New York and Oklahoma have bills that would require providers to give people getting shots a full ingredient list, and Florida legislation would ban edible vaccines, though none are approved for use in the U.S. and research is still in early stages.
Vaccine injury is also a popular topic, and bills in Indiana and North Dakota propose creating state versions of the CDC’s Vaccine Adverse Event Reporting System — a federal database that drew the attention of vaccine skeptics during the pandemic. Anyone can file a report about a potential issue after a vaccine, though the CDC’s website notes a report doesn’t prove the shot caused a health issue.
North Dakota Republican state Sen. Dick Anderson said he’s not against people getting vaccines — he got one COVID-19 shot himself — but proposed the bill because many people don’t trust the CDC.
“We have to do something to restore trust in the system,” Anderson said.
But experts note state databases are unnecessarily duplicative.
“A lot of these proposals, they’re trying to fix something that’s not broken and really working to counter the goal of preventing the spread of communicable disease,” said Andy Baker-White, senior director of state health policy for the Association of State and Territorial Health Officials.
Policy should be focused on getting rid of barriers to vaccination, not adding to them, said Susan Kressly, MD, a pediatrician and president of the American Academy of Pediatrics.
Many families miss vaccinations not because of ideology, she said, but because of lack of transportation or not having primary care doctors or clinics nearby, among other things.
But because most Americans are vaccinated, they haven’t seen the effects of dangerous infections like bacterial meningitis that Kressly fielded calls about from fearful parents early in her career.
“Vaccines are really an American success story,” she said.

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6 hours agoDavid Gregory-KumarCorrespondent for science, environment & rural affairs

SARS-CoV-2 infection was associated with more severe disease outcomes than influenza or respiratory syncytial virus (RSV) during the 2022-2023 respiratory illness season, while differences were less striking during the 2023-2024 season, according to a retrospective cohort study of veterans.
The 30-day risk of death during the 2022-2023 season was 1.0% for COVID-19 compared with 0.7% for both influenza and RSV, and 0.9% for COVID versus 0.7% for both flu and RSV during the 2023-2024 season, reported Kristina L. Bajema, MD, of the Veterans Affairs Portland Health Care System in Oregon, and colleagues.
The 30-day risks of hospitalization were 17.5%, 15.9%, and 14.4% for COVID, influenza, and RSV, respectively, during the 2022-2023 season, and 16.2%, 16.3%, and 14.3%, respectively, during the 2023-2024 season, they noted in JAMA Internal Medicine.
Meanwhile, risk of 30-day intensive care unit (ICU) admission during the 2022-2023 season was similar when comparing influenza and RSV (risk difference -0.3%) and higher when comparing COVID with either influenza or RSV (risk difference 2.2% and 1.9%, respectively). For the 2023-2024 season, risk patterns were similar.
Of note, mortality risk at 180 days was higher for COVID during both seasons. During the 2022-2023 season, there was an increase in estimated risk difference to 1.1% at 180 days between COVID and both flu and RSV. During the 2023-2024 season, the mortality risk difference increased to 0.8% between COVID and influenza, and to 0.6% between COVID and RSV, at 180 days.
Veterans were more likely to die from COVID if unvaccinated than to die from flu if unvaccinated, but mortality rates were similar when they were vaccinated against the illness they had.
“Vaccination remains an important strategy for minimizing the impact of [respiratory viral illnesses] and particularly Omicron variants,” Bajema and team concluded.
William Schaffner, MD, of Vanderbilt University Medical Center in Nashville, Tennessee, told MedPage Today that the study “demonstrates that COVID continues to be a serious infection in this population, causing more serious illnesses and deaths than infections caused by influenza and RSV.”
“Importantly, it also showed that vaccination reduced the risks of serious, life-threatening disease,” he added. “It is a timely reminder that vaccination against all these respiratory viruses — COVID, influenza, and RSV — can prevent illness and save lives.”
For this study, Bajema and colleagues used national Veterans Health Administration electronic health record data for non-hospitalized veterans who underwent same-day testing for SARS-CoV-2, influenza, and RSV, and were diagnosed with a single infection between August 2022 and March 2023, or between August 2023 and March 2024. Median age was 66, and 87% were men.
Updated COVID vaccination was defined as receipt of the bivalent vaccine from Sept. 1, 2022 through 7 days prior to the index date during the 2022-2023 season and receipt of the monovalent XBB.1.5 vaccine from Sept. 12, 2023 through 7 days prior to the index date during the 2023-2024 season. For influenza, vaccination was defined as receipt of any same-season influenza vaccine from August 1 through 14 days prior to the index date. Vaccination for RSV was rare, and was not included in the vaccinated subgroup analysis.
Among the 68,581 veterans with a respiratory illness in the 2022-2023 season, 9.1% had RSV, 24.7% had flu, and 66.2% had COVID. Among 72,939 veterans with an illness in the 2023-2024 season, 13.4% had RSV, 26.4% had flu, and 60.3% had COVID.
Starting on the first day of a positive test, the researchers tracked all-cause 30-day hospitalization, ICU admission, and death at 30, 90, and 180 days.
Most veterans were diagnosed in the emergency department or urgent care, ranging from 68% to 76% depending on the virus and season. Those diagnosed with COVID or RSV tended to have higher comorbidity scores and Care Assessment Need Scores than those diagnosed with flu.

Tara Haelle is an independent health/science journalist based near Dallas, Texas. She has more than 15 years of experience covering a range of medical topics and conferences. Follow

Disclosures
This study was supported by the Department of Veterans Affairs Cooperative Studies Program and funded in part by HHS, the Biomedical Advanced Research and Development Authority, and the FDA.Bajema reported no conflicts of interest. A co-author reported receiving grants from the Department of Veterans Affairs.Schaffner had no disclosures.

Primary Source
JAMA Internal Medicine
Source Reference: Bajema KL, et al “Severity and long-term mortality of COVID-19, influenza, and respiratory syncytial virus” JAMA Intern Med 2025; DOI: 10.1001/jamainternmed.2024.7452.

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LOS ANGELES — Surgeries to remove small tumors in stage IA non-small cell lung cancer (NSCLC) were associated with varying odds of long-term survival depending on the amount of lung removed, based on real-world data collected from across the country.
In routine practice, unadjusted 10-year overall survival (OS) for lobectomy reached 44.8%, while for segmentectomy it was 44.2%, and for wedge resection 41.4%, according to Christopher Seder, MD, of Rush University Medical Center in Chicago, at the annual meeting of the Society of Thoracic Surgeons (STS).
Lobectomy was associated with a significantly lower risk of all-cause mortality relative to sublobar resections in general (HR 0.87, 95% CI 0.83-0.92), though on closer inspection, this was really an advantage over wedge resections (HR 0.84, 95% CI 0.80-0.88) but not segmentectomy (HR 0.96, 95% CI 0.88-1.03). Segmentectomy was associated with fewer deaths than wedge resection (HR 0.88, 95% CI 0.81-0.95), Seder’s group reported.
“This research is a significant step forward in understanding the long-term implications of surgical choices for lung cancer patients. Using real-world data to complement [randomized controlled trial] findings offers surgeons additional context for tailoring treatment strategies,” Seder said in a press release.
The study was based on the STS General Thoracic Surgery Database. Findings were similar for lung cancer-specific survival, according to the authors.
For early-stage NSCLC, lobar resection has been the gold standard since 1995 with publication of the LCSG trial. Given that many people do not meet criteria or cannot tolerate the procedure, however, there are alternatives in the less invasive sublobar resection surgeries, namely wedge resection or segmentectomy.
Some research goes as far as to suggest that sublobar resections are the new standard of care for selected patients.
In 2022, the CALGB randomized trial showed that sublobar resection performed as well as lobectomy for NSCLC tumors ≤2 cm. Around the same time, the JCOG 0802 trial reported that, in patients with NSCLC ≤2 cm, segmentectomy was not inferior to lobectomy in terms of the primary endpoint of OS.
Seder pointed out the questionable generalizability of these studies. JCOG included 44% never-smokers and mostly adenocarcinoma, and the median forced expiratory volume in 1 second was over 2L. CALGB was characterized by strict inclusion criteria, upfront node dissection, and confirmation of N0 status by means of frozen-section examination.
Thus, his group opted to perform a study using real-world data.
“I want to stress that these data should not be seen as contradictory to the CALGB trial or the JCOG trial, but instead complementary,” Seder told the audience. He pointed out that in the real world, 20% of wedge resections don’t have nodal dissections and there is overall less station sampling.
“The take-home message here is really that if you expect trial results, the very strict selection criteria that are used on-trial need to be applied in the intraoperative protocol of sending your nodes first and so on and so forth,” he said.
The ostensibly inferior results of the wedge resection group also prompted session discussant John Mitchell, MD, of the University of Colorado School of Medicine in Aurora, to ask what the data might suggest about other treatments such as stereotactic body radiotherapy (SBRT) for NSCLC.
Seder responded with the advantages of surgery, citing the surgeons’ track records of safety and lymph node dissections that can help pathology reporting. “However, is SBRT worse than a wedge [resection] with 1 mm margin and one node taken? I can’t say for sure.”
He urged that thoracic oncology teams put more patients on trials trying to answer the question of whether the alternative forms of treatment are better than lung surgery, especially for high-risk patients.
The STS database used for the present study covered 346 participating institutions, with data spanning the years 2012 to 2022. Included were 32,340 adults undergoing lung resection surgery for clinical stage IA NSCLC 2 cm or smaller, excluding high-risk patients.
In the registry cohort, 61.2% underwent lobectomy, 13.2% segmentectomy, and 25.6% wedge resection.
To determine the long-term vital status of these patients, the investigators linked the STS database to national death and hospitalization records from the CDC and CMS.
In sensitivity analyses excluding pathologic-upstaged cases, Seder and colleagues found that lobectomies were associated with improved long-term survival versus sublobar resection, wedge resection, and segmentectomy.
Seder acknowledged the study’s potential for residual confounding. “There are multiple factors that may affect long-term survival that are not collected and cannot be accounted for,” he cautioned.

Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow

Disclosures
Seder had no disclosures.Mitchell reported serving on an advisory board and consulting for DaVinci Intuitive Surgical.

Primary Source
Society of Thoracic Surgeons
Source Reference: Seder CW “Anatomic lung resection is associated with improved survival compared with wedge resection for stage IA non-small cell lung cancer” STS 2025.

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When President Trump tapped Robert F. Kennedy Jr. to become the nation’s top health official, his administration inherited a sprawling list of ideas to “Make America Healthy Again,” from banning TV drug advertisements to dropping restrictions on raw milk.
While those unorthodox proposals — and Kennedy’s discredited views on vaccines — have dominated recent headlines, a slate of more familiar ideas have attracted interest on Capitol Hill and across the U.S.: making school lunches healthier, banning certain food additives, and cracking down on ultraprocessed foods linked to obesity and diabetes.
For decades, public health groups have called for similar steps, lobbying federal leaders and mounting public campaigns about the risks of American diets loaded with salt, sugar, and fat.
As Kennedy faces Senate confirmation hearings Wednesday and Thursday, health advocates find themselves in an uncomfortable position: voicing cautious support for some of Kennedy’s ideas while warning of the catastrophic consequences of others.
“If there’s an opportunity to advance the public health, you have to seize it,” said Peter Lurie, MD, MPH, a former FDA official who now leads the nonprofit Center for Science in the Public Interest. “So you can’t ignore the guy on everything because you oppose him on some things.”
Like many experts, Lurie says Kennedy’s record on vaccines should disqualify him from becoming health secretary. And he’s deeply skeptical Kennedy can deliver on his ideas for food and nutrition.
Kennedy’s confirmation is far from certain in the Senate, where he is expected to face pointed questioning from both Republicans and Democrats on the chamber’s health and finance committees. Kennedy has been downplaying his long history in the anti-vaccine movement, but experts say that’s where lawmakers should focus.
“The elephant in the room is vaccine policy,” said Tom Frieden, MD, MPH, former director of the CDC under Barack Obama. “In medicine we say: ‘Above all, do no harm.’ I’m certainly not convinced that RFK Jr. wouldn’t do a lot of harm to our vaccine policy and to our kids.”
Still, such worries haven’t stopped some Democrats from finding shared interests.
Former Ohio congressman Tim Ryan penned an op-ed last month titled: “Hey Democrats: We should work with RFK Jr. on fixing America’s food system.”
Sen. Cory Booker (D-N.J.), a vegan, told reporters that he and Kennedy are “talking out of the same playbook” when it comes to food reforms.
Booker’s office did not respond to a request for comment.
Trump and Kennedy Are an Unlikely Alliance
Trump’s unlikely alliance with Kennedy, a lifelong Democrat until 2023, reflects a diverse segment of Americans who increasingly worry about chemicals in their food and water and distrust medical experts, government officials, and big food and drugmakers.
Supporters of Kennedy’s long-shot presidential campaign included California parents concerned about food dyes in cereal and Midwestern factory workers resentful of COVID-19 vaccine mandates.
But the clash between Trump’s antiregulatory approach and Kennedy’s anticorporate stance has many observers skeptical that much of the so-called MAHA agenda will ever happen.
Requiring healthier foods in school lunches, for example, has long been opposed by food and agriculture companies that overwhelmingly backed Trump in the last election, donating to his campaign by a nearly 4-to-1 margin over Kamala Harris, according to records compiled by Opensecrets.org.
During Trump’s first term, political appointees weakened school nutrition guidelines introduced as part of Michelle Obama’s “Let’s Move” campaign. The rules required schools to offer more fruit and vegetable options.
Making major changes to the federal program involves coordination between the Agriculture Department, the Department of Health and Human Services, and dozens of state educational programs.
“They don’t have the policy coherence to make that happen,” said Georges Benjamin, MD, MPH, of the American Public Health Association. “People have been talking about improving the quality of school lunches for many years, but it takes a lot of money and collaboration to do it at a national level.”
Even seemingly smaller goals like banning potentially harmful food additives would require new regulations and staffers at FDA — which Kennedy has vowed to “clear out.”
U.S. foods contain hundreds of ingredients that aren’t permitted in Europe because American companies aren’t required to seek FDA approval before introducing them. Companies can self-certify that new colors or chemicals are “generally recognized as safe.”
Efforts to reform the decades-old system have been rejected in court and defeated in Congress, with backing from industry lobbyists.
Seemingly popular ideas like discouraging ultraprocessed foods could also prove untenable.
“I don’t think most Americans know that when you talk about ultraprocessed foods you’re talking about ice cream, frozen dinners, fast food,” said Benjamin. “Are we really talking about changing the entire American food experience?”
Experts Hope for the Best, but Prepare for the Worst
If Kennedy is blocked from overhauling the nation’s food system he would still have many other ideas to pursue.
“What we have is a bunch of good things that are very unlikely to happen weighed against a bunch of bad things that are very injurious but are much more feasible,” Lurie said.
Kennedy has threatened to fire hundreds of employees at the National Institutes of Health and slash FDA regulations on a host of unproven treatments, including stem cells, psychedelics, and discredited COVID-era treatments like ivermectin.
Even seemingly small changes on vaccines could have damaging consequences, experts say.
Kennedy could dissolve current federal vaccine committees and staff them with advisors who are hostile to vaccines. Currently, insurers must pay for children to receive shots recommended by those experts. But the requirement would lapse if Kennedy’s appointees declined to endorse updated shots and immunization schedules.
For now, Georgetown University’s Larry Gostin says he and other advocates are hoping for the best but preparing for the worst.
“If he comes up with ideas that are good and actionable, I will be the first one to applaud and put my back into helping them succeed,” said Gostin, a health attorney. “I’m just very skeptical that he will do that.”

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The CIA now believes that COVID-19 most likely originated from a lab, but cited “low confidence” in its new assessment. (AP)
A Department of Labor investigation on insurance coverage of mental health care revealed broad noncompliance and an “alarming” rate of ghost networks. (ProPublica)
Acute respiratory illness causing people to seek healthcare is at a high level across the U.S., the CDC said.
The Trump administration tapped Sara Brenner, MD, MPH, to serve as FDA’s acting commissioner, Matthew Memoli, MD, to serve as acting NIH director, and Jeff Wu, MBA, as acting administrator at CMS.
FDA scrubbed its initiative to increase clinical trial diversity from its website after the Trump administration’s crackdown on diversity, equity, and inclusion programs. (Reuters via MSN)
Experts predict the communications freeze across HHS and FDA could delay some drug approvals. (Endpoints News)
Over at NIH, scientists are having trouble purchasing supplies for their studies after the communications freeze. (CNN)
Apparently in violation of federal law, Trump terminated the HHS inspector general and at least 14 other inspectors general. (Washington Post)
Trump’s new Department of Justice (DOJ) dropped a case against Texas doctor Eithan Haim, MD, who had been charged with leaking transgender care data. (Texas Tribune)
DOJ also issued an order to curtail prosecutions of anti-abortion protestors who blocked access to reproductive health centers. (AP)
Robert F. Kennedy Jr.’s advisors are fighting amongst themselves over how far he should go to with targeting childhood vaccines. (Politico)
Meanwhile, Kennedy was conspicuously absent at a recent meeting to discuss pandemic preparedness. (Washington Post)
Kansas is dealing with an “unprecedented” outbreak of tuberculosis, with 66 cases recorded so far. (The Independent)
Among pediatric and young adults with cancer, living in historically redlined neighborhoods at the time of diagnosis was linked with higher mortality. (Cancer)
The FDA approved a monthly maintenance dosing of intravenous lecanemab (Leqembi) for early Alzheimer’s disease, drugmakers Eisai and Biogen announced.
Loretta Ford, NP, who co-founded the profession of nurse practitioners, died at age 104. (Washington Post)
The world’s only person with a gene-edited pig kidney is thriving 2 months after the transplant. (AP)
The Trump administration reinstated the so-called global gag rule, which prohibits foreign aid to any group outside the U.S. that provides abortion services or counseling. (NPR)
And the administration paused funding for PEPFAR, the nation’s global HIV program, after a Trump executive order called for a 90-day review of all foreign aid programs. (CBS News)
All 43 monkeys that fled a South Carolina testing and breeding farm after a caretaker left several doors open in November, have been recovered. (The Post and Courier)

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A 12-year-old girl died after drinking a milkshake made in an unwashed blender at a cafe in south-east London.

In “Eureka Day,” changes were made to a scene because “the laughter was so robust backstage, they couldn’t hear the cues.”The third scene of the new Broadway production of “Eureka Day” could be titled The Way We Discourse Now. As written by the playwright Jonathan Spector, the scene reliably has audiences laughing so loudly that the actors are drowned out.The situation is this: It is 2018. The principal of the progressive private school Eureka Day in Berkeley, Calif., and the four members of its executive committee must inform the other parents that a student has mumps, and therefore by law any students who have not been vaccinated must stay home to avoid exposure. (Vaccine skepticism was not uncommon in this milieu, particularly pre-pandemic.)The school leaders, an optimistic bunch dedicated to diversity and inclusion, hold a town hall-style meeting “to see,” says the principal, Don, “how we can come together as a community and exchange ideas around a difficult issue.”At the meeting, which is being held remotely, Don speaks while sitting in front of a laptop in the school library, addressing parents on a Zoom-like video app. The executive committee members are behind him. The rest of the school’s parents weigh in on a chat-like function. Their messages — 144 of them — are projected above the actors for the audience to read.The online conversation quickly descends into vicious attacks. “Typical behavior from the Executive Committee of FASCISM.” “Sorry, chiropractors are not doctors.” “That’s child abuse!!!”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

A bird-flu pandemic is far from inevitable. But health experts are closely monitoring an outbreak that could quickly escalate among people.When bird flu first struck dairy cattle a year ago, it seemed possible that it might affect a few isolated herds and disappear as quickly as it had appeared. Instead, the virus has infected more than 900 herds and dozens of people, killing one, and the outbreak shows no signs of abating.A pandemic is not inevitable even now, more than a dozen experts said in interviews. But a series of developments over the past few weeks indicates that the possibility is no longer remote.Toothless guidelines, inadequate testing and long delays in releasing data — echoes of the missteps during the Covid-19 pandemic — have squandered opportunities for containing the outbreak, the experts said.In one example emblematic of the disarray, a few dairy herds in Idaho that were infected in the spring displayed mild symptoms for a second time in the late fall, The New York Times has learned. In mid-January, the Department of Agriculture said that no new infections in Idaho herds had been identified since October. But state officials publicly discussed milder cases in November.That a second bout of infections would produce milder symptoms in cattle is unsurprising, experts said, and could be welcome news to farmers. But reinfections suggest that the virus, called H5N1, could circulate on farms indefinitely, creating opportunities for it to evolve into a more dangerous form — a “high-risk” scenario, said Louise Moncla, an evolutionary biologist at the University of Pennsylvania.“You could easily end up with endemically circulating H5 in dairy herds without symptoms, obscuring rapid or easy detection,” Dr. Moncla said.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.