Debbie Johnston Nominated to ADHS Director Post A New Chapter for Arizona’s Health Department?

Over the past four years, Arizona’s Department of Health Services (ADHS) has not had a permanent, Senate-confirmed director. Since 2021, the agency was led by a series of interim leaders, making it hard to keep long-term (and even short term) priorities steady.

That may be about to change. Last week Governor Hobbs named Debbie Johnston as the next director of ADHS, effective Monday. Johnston retired in June 2025 after more than 20 years at the Arizona Hospital and Healthcare Association, where she worked on health policy and regulatory affairs.

I’ve known Debbie for about 20 years, and she’s always struck me as thoughtful and thorough. She listens carefully, studies issues in depth, and can make decisive calls. Her experience is especially strong where ADHS has struggled in the past: licensing and regulating health facilities like nursing homes, assisted-living centers, behavioral health clinics, and other treatment providers.

Under the previous administration, this part of ADHS didn’t perform well — so her background here feels like a real asset.

Even as ADHS made some progress on regulating those facilities, there’s more work to be done. I’m optimistic that Debbie’s leadership can help the agency finish the job.

On the public health side, the agency already has steady leadership: Celia Nabor oversees prevention, Nicole Witt handles preparedness, and Sheila Sjolander, who has been serving as interim director, will return to her role as deputy for public health when Debbie begins.

One thing I hope Debbie will change is how ADHS talks to the public and to journalists. For the last several years, the agency hasn’t been open or clear about public health issues. It would be great to see more transparency — telling the story of public health in Arizona in a way people can understand and trust. I really hope she’s someone who could direct that shift.

Debbie’s nomination will go to the state Senate for confirmation, and I hope  she has a good shot. Her steady, honest approach gives me confidence. But, of course, confirmation is never guaranteed, especially when Hoffman is involved.

Overall, this feels like a promising moment for ADHS. With a confirmed director for the first time in years, the agency may finally get the stability it needs to improve how it regulates facilities and how it communicates with the people of Arizona.

AZPHA at the APHA National Meeting: Making Public Health a Priority

AZPHA has been a proud state affiliate of the American Public Health Association (APHA) since 1928 — nearly 100 years! Being an affiliate comes with great benefits, like national connections and opportunities to share Arizona’s public health work, but it also comes with responsibilities.

One of those responsibilities is choosing an APHA Governing Council and voting for us at the APHA Governing Council.

For the last few years, Rebecca Nevedale has filled that role for us, and this year she also served as the regional lead for the western-state ARGCs. AZPHA usually has members who attend and take part in the APHA Annual Meeting, and this year our representatives from the AZPHA Board of Directors were Rebecca Nevedale and Ryann Whealy.

Every year, APHA hosts its big national conference, bringing together thousands of people from all over the country — and the world — who care about public health. This year’s meeting took place in Washington, D.C., November 2–5, with the theme: “Making the Public’s Health a National Priority.”

There were hundreds of presentations, thousands of attendees, and tons of chances to learn new things, meet new people, and share ideas.

People came to talk about how to keep communities healthy, how to prepare for future health problems, and how to make sure everyone — no matter who they are or where they live — has a fair shot at good health.

Some Highlights

  • Lots of presentations: There were talks, posters, roundtables, lightning sessions — basically nonstop learning all day, every day.
  • Big keynote talks: These “general sessions” brought leaders together to talk about major issues facing public health right now.
  • Special programs: Things like short courses, a film festival, women’s leadership sessions, and “coffee talks” gave people extra ways to learn and connect.
  • The Public Health Expo: A huge exhibit hall where organizations showed off new tools, research, and programs.

Major Themes This Year

  • Health is a human right. The meeting focused on making health a top national priority — not just for some people, but for everyone.
  • Prevention matters. A big message was that stopping problems before they start helps save lives, money, and time.
  • Preparing for the future. Public health leaders talked about how to be ready for the next big challenge, whether it’s a new disease, climate impacts, or community needs.
  • Fairness and equity. A key goal was making sure all communities get what they need to be healthy, especially those that have been left out in the past.

AZPHA’s presence at the national meeting helps make sure Arizona’s voice is heard in national conversations about public health. It also lets our board members and members:

  • Learn about new strategies
  • See what other states are doing
  • Build partnerships
  • Bring back ideas that help improve public health work here at home

Rebecca and Ryann represented Arizona well, joining national discussions, sharing Arizona-based perspectives, and staying connected with other state affiliates.

Relevant APHA 2025 Sessions for Arizona

  • Transforming Public Health through Indigenous-Led Approaches — This session centers Indigenous knowledge, ceremony, and community-led public health strategies. APHA Conference
  • Assessing Health Needs and Barriers in a Tribal Community — A data-driven presentation focused on culturally responsive planning to reduce health disparities in American Indian / Alaska Native communities. APHA Conference
  • Documenting Self-Reported Tribal Affiliation Data in Health Systems — Lessons from expanding electronic health records to better reflect American Indian and Alaska Native (AI/AN) identities. APHA Conference
  • Understanding Health Priorities and Support Strategies in Tribal Health Systems — A panel/session that discusses how tribal health systems find and address their most pressing health needs. APHA Conference
  • Advancing Public Health for AIANNH & API Populations — Focused on public health policy, health equity, and culturally responsive interventions for American Indian, Alaska Native, Native Hawaiian, and Asian/Pacific Islander groups. APHA Conference
  • Whose Water: The People’s Movement for Safe, Affordable, Community-Controlled Water — Examines water justice, public control, and affordability — very relevant in places facing water scarcity or infrastructure challenges. APHA Conference
  • Center for Climate, Health & Equity Program — This “track” / program includes multiple sessions on environmental health, climate resilience, and equity — important for Arizona especially given heat and climate impacts. APHA Conference
  • Protecting Health from Extreme Heat – State Leadership in Action — A related APHA event/webinar (not sure if part of the main meeting track) that highlights state strategies for addressing heat as a health threat. American Public Health Association

You can dive deeper into the various sessions on the APHA conference website at: APHA 2025 Annual Meeting and Expo

Kennedy Directs CDC to Change their Vaccine Messaging Using False Information: Could it be Foreshadowing Harmful Policy Changes Too?

Kennedy has a long history of opposing childhood vaccinations and even worked as a lawyer to try to stop kids from getting vaccinated. Now, with the power of the state, he’s directing the CDC to put out false messages about childhood vaccines.

This week he directed the CDC to change their website to question decades of scientific research than have consistently shown no link between autism and child vaccines – saying that the long-time statement that “vaccines do not cause autism” is not evidence-based. This, despite overwhelming evidence showing no link between vaccines and autism.

Autism and Vaccines | Vaccine Safety | CDC

This change is bad and feeds the anti-vax fire with more false information. But that’s not my primary concern. I’m more worried that he will use his authority to make policy changes that will undermine childhood vaccination.

There are 2 ways he could do it.

The first is to get the Advisory Committee on Immunization Practices (now stacked with anti-vaccine people) to remove some vaccines from the recommended vaccine schedule. That would cause the Vaccines for Children program (which provides free vaccines for more than half of American children) to no longer cover those vaccines – making them cash pay for low-income families. Private insurers would then be able to stop covering them, again making them cash pay.

RFK Jr.’s CDC spreads false facts about vaccines, autism, critics say

Kennedy could also go deeper into using false information to claim that there’s a link between vaccines and autism – making autism compensable under the vaccine injury compensation fund, bankrupting the fund.

An insolvent fund would then provide a powerful incentive for vaccine manufacturers to stop making all childhood vaccines (most of which have a very low profit margin). This would make it much harder to maintain production of childhood vaccines and could harm public health on a large scale.

We all need to cross our fingers that Kennedy doesn’t end up ordering a wholesale removal vaccines from the schedule and/or intentionally bankrupting the VICF to get rid of vaccines altogether.

AZPHA continues to urge parents to follow guidance from trusted health professionals like pediatricians, not Mr. Kennedy.

Note: The Advisory Committee for Immunization Practices is meeting on December 4 and 5 – and a large portion of the 2-day meeting is focused on the child vaccine schedule.

Day 2 has ‘votes’ about the child vaccine schedule without disclosing what those votes will be about. My continuing fear is that Kennedy will use his authority to cut shots from the schedule in order to end vaccination through the back door.

This Year’s Flu Shot & What the New H3N2 Strain Could Mean

Every spring scientists pick which flu viruses to include in the Northern Hemisphere’s fall influenza vaccine. Today we’ll cover the latest influenza surveillance and the content of the 2025-2026 influenza vaccines in the US.

How is the content of the fall influenza vaccine decided? It’s a process that focuses on using the best evidence – but it has challenges because of the wildcards the Southern hemisphere can play during their winter (our summer).

Each spring CDC experts look at flu viruses from all around the world and decide which strains are most likely to circulate during our (Northern hemisphere) influenza season. They check:

  • which flu strains are spreading most,
  • how the viruses’ surface proteins (especially something called hemagglutinin, or HA) have changed,
  • whether existing immunity (from prior infection or vaccination) might not work as well.

Once the strain is selected (usually in March) vaccine makers start growing those picked strains (often in eggs). Because growing and distributing takes time, the vaccine formula has to be selected in the spring.

What Happened in the Southern Hemisphere

The wildcard is in the Southern hemisphere. Flu viruses keep evolving in places like Argentina, Brazil and Australia during our summer – even as US vaccine manufacturers are already making the fall season vaccine. That means a new strain can pop up down under during our summer – but it’s found too late to change what’s in our fall vaccine.

Because the vaccine choice has to be made before all possible changes occur, this means there’s always a bit of “leap of faith” involved.

What’s in the 2025‑26 Vaccine for the Northern Hemisphere

Here are the viruses the CDC recommended for this season (back in March):

  • An A/Victoria/4897/2022 (H1N1)pdm09‑like virus
  • An A/Darwin/9/2021 (H3N2)‑like virus
  • A B/Austria/1359417/2021‑like (B/Victoria lineage) virus

These were picked because they represented what scientists believed would be the most likely flu types to spread.

The New H3N2 Strain: What’s Going On?

As sometimes is the case – the virus evolved in the Southern Hemisphere over our summer (their winter). The new strain isn’t a huge change from what was predicted – but it is a bit different. The new strain is an H3N2 “subclade K” virus – and it’s recently popped up in Canada, the UK, Japan and Europe.

  • Subclade K has several new mutations compared to the H3N2 strain that was chosen for the vaccine.
  • Early data suggest this variant is already dominant in some regions (for example, the UK found high proportions of H3N2 being subclade K).
  • Because it appeared after the vaccine strain was picked—at the tail end of the Southern Hemisphere season—it may mean this year’s vaccine isn’t perfectly matched with what’s likely to circulate in AZ this winter.

What It Means for Vaccine Effectiveness

So, what do these changes mean for how well the vaccine will work? Here’s the assessment:

  • Because subclade K has drifted (i.e., mutated) away from the strain used in the vaccine, there’s a reduced match. That means the vaccine might be less effective in preventing mild or moderate illness compared to a perfectly matched season.
  • But… the influenza vaccines in pharmacies and doctors’ offices still offer important protection, especially against severe illness and hospitalization.
  • For example, early data from the UK show around 70‑75% effectiveness in children and 30‑40% in adults, even with this new K strain dominating circulation.

Bottom Line

  • The vaccine for 2025‑26 was chosen carefully, based on the best information that was available in March.
  • A new H3N2 variant (subclade K) showed up after the CDC’s recommendation for this year’s vaccine. It has more mutations than expected, so it might reduce vaccine effectiveness somewhat, but we don’t know that for sure yet.
  • If this year’s vaccine ends up being less effective than usual it doesn’t appear to be the fault of CDC or Kennedy this time – it’s because the new strain evolved after the vaccine decision was made (and had to be made).
  • Even if there’s some ‘immune escape’ because of the new subclade K virus, early data from the UK suggest it’s likely that the vaccine will still provide strong protection especially for children and seniors and for reducing hospitalizations.

See all the recommendations: Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2025–26 Influenza Season | MMWR

SCC’s Community Health Worker Program Recruiting Students

Scottsdale Community College is excited to announce recruitment for the Community Health Worker (CHW) Program—an 18-credit certificate program designed to be completed in just over one semester. This program equips students with the knowledge and hands-on skills needed to serve as frontline health advocates within their communities and organizations.

For questions or additional information, please contact Angelica Bakalukas, Program Director, at angelica.bakalukas@scottsdalecc.edu.

Thank you for your continued partnership and support in strengthening Arizona’s healthcare workforce.

AHCCCS Approves First Doula Group Practice

Spiritual Garden Healing Doula Services has officially become the first AHCCCS-approved doula group provider in Arizona — marking a major step forward in expanding access to culturally grounded, community-based birth support for Medicaid families.

Doula Care Reduces C-sections, Pre-term Birth & Cuts Birthing Costs by a Net $1,000 – AZ Public Health Association

Leveraging Doulas to Improve Birth Outcomes – AZ Public Health Association

After a several years advocacy effort by AZPHA, AHCCCS recently approved reimbursement for doula services beginning October 1, 2024, an important public health milestone (see article).

AHCCCS Preparing Reimburse for Doula Services: Comment Thru June 10 – AZ Public Health Association

They’re now building partnerships with hospitals, clinics, midwives, and managed care organizations to integrate doula services into care plans for expecting parents statewide. They expect to begin accepting AHCCCS clients at the end of the first quarter of 2026.

Becoming the first AHCCCS-approved doula group isn’t just an accomplishment for us — it’s a victory for Arizona families seeking equitable, compassionate care” — Kay Clinton, Founder, Spiritual Garden Healing Doula Services.

What’s a Doula? A Professional Who Lowers Birth Costs and Improves Outcomes, that’s Who. | The University of Arizona Health Sciences

Responding to Arizona’s Measles Exposures: An Epidemiology Perspective

An alert clinician in Arizona quickly recognized a case of measles in someone – a good thing considering that the doc may not have ever seen a case during her or his residency or practice before. Maybe they have, if they are working on the Colorado Strip and have already seen some cases over the last couple of months.

The doc reported the case to their county health department – which began the public health response to the exposure to measles last week in Maricopa and Coconino Counties.

For county epidemiologists, this index report started a cascade of work in their mostly behind-the-scenes investigations. Their first task is to reconstruct the timeline. They need to know exactly when and where the contagious individual was as measles can spread four days before and after a rash appears and can linger in the air for up to two hours after an infected person leaves a room.

In this case, the timeline points suggest a single index case traveling between Phoenix and Flagstaff — possibly connected to outbreaks currently active in Utah and northern Arizona. I don’t know this for sure – just seems like the most likely scenario.

Next comes exposure assessment. Who is really at risk? Babies under 12–15 months (too young for their first MMR shot) are always a top concern.

Unvaccinated pregnant women are another priority. This was something of a teen-type concert I’m told (a singer named Tate McGraw).

Since the anti-vax movement has ramped up in the last 15 years it’s possible that some of the concert goers were susceptible unvaccinated teens. Outreach interventions come next.

Interestingly, directly contacting concert ticket holders rarely works. Past investigations have shown that email lists bounce, phone numbers are outdated, and tickets don’t always reflect attendance.

Instead, the team focuses on broader interventions: issuing public notices, sending Health Alert Network (HAN) advisories to local clinicians, and using Epi-X to notify providers in other states about potential exposures. Media coverage about the places where exposures happened are important too.

In the coming days, county epis will focus on active case finding, checking logs, watching clinics for anyone presenting with fever, cough, red eyes, or the characteristic measles rash, and preparing for potential secondary cases.

They’ll calculate incubation periods, plan follow-ups, and double-check that messaging reaches the right audiences (the best they can).

Phone calls, log or lab review, case investigations and contact tracing work and public and clinician advisories are important (and sometimes labor-intensive) steps in preventing new cases.

The work is detailed and mostly invisible to the public, but it’s exactly what stops a handful of exposures from snowballing into a full-blown outbreak.

In the end, this cluster of exposures is a reminder about how important it is for doctors and labs to report and for county epidemiologists to move fast, think strategically, and focus on evidence-based interventions where they can make the biggest impact.

Time will tell whether this exposure ends up snowballing or not. The key factors are how many unvaccinated persons were exposed, whether their cases get identified and reported fast, whether or not there’s prompt isolation of new cases and quarantine of unvaccinated exposed persons and how effectively exposed susceptible contacts are found (and whether they cooperate with quarantine recommendations).

What You Need to Know About Measles

  • Symptoms: High fever (101 °F or above), cough, runny nose, red/watery eyes, and a red blotchy rash starting on the face and spreading downward.
  • Who’s at risk: Infants under 12–15 months, unvaccinated children, and unvaccinated pregnant individuals. Adults with two doses of MMR are protected.
  • Exposure windows: Measles can spread four days before and four days after rash onset. The virus can linger in the air for up to two hours after an infected person leaves a space.
  • What to do if you were potentially exposed: Monitor for symptoms through November 27. If symptoms appear, call ahead to your healthcare provider before visiting to prevent the virus spreading..
  • Community impact: Measles is highly contagious (90% of unvaccinated people exposed may get infected) so staying up-to-date on vaccinations protects not just you, but your community.