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Respiratory Virus Season 2025-2026: Protecting Our Community
 As the respiratory virus season begins, vaccination remains the most effective way to prevent severe illness from COVID-19, influenza, and RSV. Marin County Public Health (MCPH) and leading medical organizations recommend the updated COVID-19 vaccine and the annual influenza vaccine for everyone 6 months and older. In addition, RSV vaccination is recommended for all adults 75 and older, adults aged 60 –74 with risk factors, and pregnant patients to protect their newborns. Updated vaccines are widely available this fall, including free walk-in access for Kaiser Permanente members ages 6 months and older. California’s new AB 144 secures vaccine access by establishing a statewide schedule and extending liability protection for providers through 2030. Make every patient visit a prevention opportunity by co-administering vaccines when appropriate and proactively scheduling high-risk patients.
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Preserving Vaccine Choice to Protect Marin's Children
The American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP) firmly affirm that clinicians should continue to offer families the option of the Measles, Mumps, Rubella, and Varicella (MMRV) vaccine for children 12 months through 12 years. MMRV has been used safely for nearly two decades, with almost 100 million doses administered nationwide. Its primary benefit is reducing the number of injections children receive, which can ease visits for families and improve vaccine acceptance. The reconstituted ACIP voted to recommend separate MMR and varicella doses for children under 4, citing a slight rise in febrile seizures—events that are very rare, brief, and harmless—underscoring the committee’s limited expertise and break from evidence-based guidance. MCPH remains steadfast in its commitment to science, safety, and equitable access to vaccines, and will work closely with pediatric, family medicine, and community partners to protect children from preventable diseases.
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Back-to-School Resilience
As students return to school, Marin data reveal urgent concerns: local 11th graders report social-emotional distress at rates above the state average—the highest of any grade in California—and teens continue to present with elevated rates of emergency visits for self-harm, suicide attempts, and alcohol-related disorders. The Ask. Listen. Connect initiative calls on clinicians to embrace their critical role in suicide prevention by asking directly about suicidality, listening with empathy, and connecting patients to hope and help. To support providers in this work, resources such as the AAP Bright Futures Toolkit (validated screening tools), the AAP SBIRT clinical report (substance use guidance) and additional resources on suicide risk screening provide practical evidence-based tools to strengthen early identification and intervention in youth mental health.
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ACOG Affirms Safety of Acetaminophen in Pregnancy
 The American College of Obstetricians and Gynecologists (ACOG) has reaffirmed that acetaminophen remains the safest first-line analgesic and antipyretic during pregnancy. A comprehensive review of decades of evidence shows no clear causal link between in-utero acetaminophen exposure and adverse neurodevelopmental or reproductive outcomes. Untreated maternal fever and pain carry well-established risks, making effective management essential. ACOG advises clinicians to recommend acetaminophen as indicated, at the lowest effective dose for the shortest duration necessary. This guidance underscores the importance of reassuring pregnant patients that acetaminophen use is safe and beneficial when clinically appropriate. Unsubstantiated claims about the safety risk of acetaminophen undermines clinical guidance and may lead to delays or avoidance of appropriate treatment, increasing potential harms for both maternal and fetal health.
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Protecting Reproductive Health Access
Reproductive health care is under mounting pressure nationwide. A federal court ruling has suspended Medicaid reimbursements to Planned Parenthood for one year, and mifepristone faces ongoing legal challenges. Locally, the need is clear: between 2021 and 2023, chlamydia rates among Marin teens nearly tripled, and nearly 100 teen births were recorded. These trends highlight the importance of sustaining trusted providers and ensuring timely, evidence-based care. To support clinicians, UCSF has launched the Reproductive Health Hotline (ReproHH)—a free, nationwide, confidential resource offering real-time guidance from UCSF specialists in sexual and reproductive health. Call 1-844-ReproHH (1-844-737-7644), Monday–Friday, 8 a.m.–4 p.m. PT, or learn more at reprohh.ucsf.edu.
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Ebola Advisory: What Marin Providers Need to Know
The CDC has issued a health advisory following a new Ebola outbreak in the Kasai Province of the Democratic Republic of the Congo, the second most populous (and the 2nd largest) country in Africa. With 37 confirmed cases and 19 deaths, including health care workers, clinicians in Marin should remain alert. While the risk to the U.S. is low, providers should remain vigilant for infectious symptoms in patients who have recently traveled to the affected area. If Ebola is suspected, immediately isolate the patient, use appropriate PPE, and call Marin County Public Health immediately (415-473-4163); after hours call (415 479 5305). Marin County Public Health’s Healthcare Preparedness Program (HPP) supports clinics, hospitals, and healthcare facilities in staying prepared for these rare but high-risk threats. Learn more: https://www.marinhhs.org/healthcare-preparedness-program.
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Message from the Health Officer
Dear Colleagues,
As we depart National Preparedness Month, we enter the peak of wildfire season in Marin, when dry landscapes and hot, dry winds create high fire risk. Please help prepare our most medically frail patients for this season. Power outages are likely and pose a significant threat to individuals who rely on oxygen, refrigerated medications, or other electric-powered home medical equipment. Smoke and poor air quality are also common during fire events. Remind patients with asthma, COPD, or cardiovascular disease to keep medications accessible, use well-fitted masks, and stay indoors with filtered air when possible. Extreme heat events may also coincide, placing older adults and those with chronic illness at added risk. Find resources to support your staff and patients at https://www.marinhhs.org/public-health-preparedness
Thank you for supporting patient readiness this wildfire season.
Stay safe, strong, and kind,
Lisa M. Santora, MD, MPH
HealthOfficer@marincounty.gov
This newsletter was reviewed for language and readability using AI-assisted editing tools.
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