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What's next for Covid vaccines, how medical mistrust follows Roe's reversal, & monkeypox vaccine strategy

    

 

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Good morning. If you've already shared your favorite books or podcasts related to health, medicine, and life sciences, thank you. If not, there's still time to tell us for our annual summer roundup (see lists from 2021, 2019, and 2018). Polls close Friday.

FDA panel recommends update booster to target Omicron subvariants

By a vote of 19 to 2, an FDA advisory panel has recommended that the agency authorize new Covid-19 vaccine boosters to meet the challenge of Omicron. Yesterday’s vote followed a day of data and questions covered by STAT’s Helen Branswell and Matthew Herper, as experts considered Omicron and its subvariants, weighing whether to combine existing vaccines with elements that also target the BA.4 and BA.5 now circulating.

The vote comes as waning immunity, the possible emergence of a new variant, and the looming arrival of colder weather in much of the country makes a fall surge in cases likely. The day began with an epidemiologist's model suggesting that in an optimistic scenario, there could be 95,000 additional Covid deaths in the U.S. between March 2022 and March 2023. Under the most pessimistic scenario, that number could be 211,000.

White House plans to widen access to monkeypox vaccine

The Biden Administration said yesterday it will broaden availability of monkeypox vaccine as it attempts to contain a growing outbreak of the disease. That means in addition to offering vaccine to people who have had known exposure to the virus, federal health officials will make vaccine available to men who have sex with men who have had multiple recent partners in venues where it is known monkeypox virus was spreading or in a geographic area where monkeypox is transmitting.

When vaccine supplies are more robust, the response may shift to a pre-exposure approach, CDC Director Rochelle Walensky said at a media briefing. The current outbreak, first detected in mid-May, has spread to at least 49 countries, with more than 4,700 monkeypox cases reported so far. In the U.S., 306 cases have been detected in 27 states and the District of Columbia. STAT's Helen Branswell explains the shift in strategy.

Residency matching into competitive specialties 'suggests systemic disparities,' study says

My colleague Usha Lee McFarling brings this report: Applicants from groups underrepresented in medicine (Black, Hispanic, Native American/Alaska Native, and Native Hawaiian/Pacific Islanders) are also underrepresented among those who match into competitive medical specialties, according to a new analysis in JAMA. The study of 11 specialties — which attract more than 50 applications per available position — found the proportion of applicants from underrepresented groups who matched was significantly lower than the proportion who applied in those specialties: dermatology, emergency medicine, general surgery, neurosurgery, obstetrics and gynecology, orthopedic surgery, otolaryngology, plastic surgery, radiation oncology, radiology, and urology.

The proportion of white students who matched was significantly greater than the proportion who applied in six specialties: dermatology, emergency medicine, general surgery, obstetrics and gynecology, orthopedic surgery, and radiology.

“Overrepresentation of white matched residents and underrepresentation of racial and ethnic minority groups other than Asian across competitive specialties suggests systemic disparities within the residency selection process,” wrote the authors, suggesting that research is needed to determine why the differences exist and what roles screening, reviewing, interviewing, and ranking play in creating them.

Closer look: A doctor's suspicion after miscarriage foreshadows an era of lost trust

(CHANTAL HEIJNEN FOR STAT)

Janneke Parrish (shown above) never dreamed she was pregnant. She used contraceptives, so she worried the pain she felt might be from her one remaining kidney, after donating her other one to a friend 10 months before. But no, the pain she felt was a miscarriage, the sympathetic urgent-care doctor told her before asking her medical history. A chill replaced that warm concern when she said she’d had an abortion 12 years before. His questions felt like an interrogation, and because they were in Austin just after Texas enacted a restrictive abortion law, she was convinced he was trying to determine if she’d caused her own miscarriage.

It’s a glimpse of a new era of medical mistrust, STAT’s Eric Boodman writes. “Our ability to take care of patients relies on trust, and that will be impossible moving forward,” OB-GYN Sarah Prager told him. Read more.

Placebo response reveals bias under the skin

The placebo effect is fascinating proof of our inseparable minds and bodies. A new study in PNAS shows it can reveal unconscious bias from white patients toward female and Black doctors. Here’s how the researchers designed their experiment: 187 white women and men had an allergy skin prick test, after which a physician applied an inert skin cream but told the participants it was an antihistamine cream that would ease any allergic reaction. Every element about the sham treatment was the same, except the gender and race of the physicians.

Patients treated by Black and female health care providers had more significant reactions to the skin test than those treated by white and male doctors. That suggests the placebo response to the skin cream — feeling better from an inactive cream — was blunted by the patients’ bias. STAT’s Katherine Gilyard has more.

Get some sleep

That’s today’s message from the American Heart Association as it updates its recommended components for heart health. Vanishingly few Americans achieve ideal cardiovascular health on its now-eight measures, even though research suggests the vast majority of cardiovascular events could be prevented by improving health behaviors (diet, physical activity, nicotine exposure, and sleep) and managing health factors (body mass index, cholesterol levels, blood sugar, and blood pressure).

Sleep could help people better deal with their weight, blood pressure, or risk for type 2 diabetes, the authors of a Circulation paper say. That means seven to nine hours daily for adults; 10 to 16 hours for children 5 and younger; 9 to 12 hours for ages 6 to 12; and 8 to 10 hours for teenagers. Other updates include monitoring non-HDL cholesterol rather than total cholesterol and adding hemoglobin A1c readings to blood glucose levels to test for diabetes.

 

What to read around the web today

  • When Brazil banned abortion pills, women turned to drug traffickers, New York Times
  • Sheriffs who denounced Colorado’s red flag law are now using it, Kaiser Health News
  • 100 lawmakers ask HHS to use controversial federal laws to combat high drug prices, STAT
  • Michigan court tosses charges against ex-governor, others stemming from Flint water crisis, Reuters
  • Opinion: Wheelchair users live outside the home, not just inside. Medicare policies need to acknowledge that, STAT

Thanks for reading! More tomorrow,

@cooney_liz
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