Updated Covid boosters and flu shots: When should we get them?

It’s a guessing game, multiplied. As we enter our third Covid winter, the time to get vaccinated against flu — whose peak is always a question mark — will likely come when it’s also time for another Covid booster (whose composition is also up in the air). But as STAT’s Andrew Joseph notes, scientists can’t predict when SARS-CoV-2 might peak either. It’s been spreading all summer, and it’s expected to roar along even stronger this fall and winter, at least in colder parts of the country.

Ed Belongia, director of the Center for Clinical Epidemiology and Population Health at the Marshfield Clinic, said while October might be a better time to get a flu shot than September, September was better than never — a lesson for Covid, too. “Forecasting is a futile effort right now. If it’s available and authorized, the best thing is to not wait but to get it.” Read more.

‘What aren’t we facing?’: Or, distributing monkeypox vaccine is not easy

The good news is we have a monkeypox vaccine. The bad news is we don’t have nearly enough. Stretching available vaccine by giving one-fifth of a dose per person, as the Biden administration has decided to do, isn't as easy as it sounds, Claire Hannan, executive director of the Association of Immunization Managers, told STAT’s Helen Branswell.

What do your members face with vaccine distribution?
Well, what aren’t we facing? You can only have it shipped to five sites per state. We don’t have a standardized or centralized distribution. We don’t have standardized provider enrollment. We don’t have standardized data sharing. All of that infrastructure that’s been built for Covid, we don’t have that. We don’t have specific funding for it.

So fractional dosing isn’t like taking one can of soda and pouring a little bit into five glasses?
Exactly. How do you take a fifth of a dose out of the vial? You need all new supplies. Ancillary supplies have to be ordered. Providers have to be trained. And people are exhausted.

You can read the full interview here.

What will change with drug pricing

We’ve all seen the headlines about the new drug-pricing law Congress passed last week. Most trumpet Medicare being allowed to negotiate prices for some costly drugs. There’s much more to the package, and the changes won’t be made overnight. STAT’s Rachel Cohrs breaks down a multitude of provisions. Here’s some of what I learned — I invite you to explore more:

Though the price negotiation policy will certainly result in lower costs for some medications, some companies may choose to charge more when they first launch drugs.
A separate policy aimed at moderating price growth would make drugmakers pay back Medicare if they hike prices faster than inflation.
In 2024, patients won’t have to pay any cost-sharing above the so-called catastrophic benefit threshold of roughly $3,250 out of pocket. In 2025, costs will be capped at $2,000 per year.

Closer look: Now the stakes are higher for pre-procedure pregnancy tests

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Just when you can’t imagine another unforeseen consequence of the Dobbs ruling that overturned abortion rights, there’s another one you may not have considered. STAT contributor Trisha Pasricha, a gastroenterologist at Massachusetts General Hospital, tells us about pregnancy tests routinely administered before scheduled surgical procedures. The idea is to guard against potential harm to a fetus, from the procedure itself, a drug, or imaging.

Now the testing is anything but routine, given the high stakes of a positive pregnancy test in the states where abortion is now banned or sharply restricted, she writes. What happens next? Amiko Uchida, a gastroenterologist practicing at the University of Utah School of Medicine, felt an urgency to start the conversation with a patient right away. And she devised a care pathway for fellow non-OB-GYN providers to navigate managing a positive pregnancy test. Read more about what’s involved.

Study: Don’t forget about meth in the rural overdose epidemic

Illicit fentanyl may be driving overdose deaths in the opioid epidemic, but a new study warns that methamphetamine, often contaminated with fentanyl, is becoming pervasive in rural America. A survey in JAMA Network Open reports nearly four of five people taking drugs in rural areas across 10 states used methamphetamine in the past 30 days. Nonfatal overdoses in the past six months were higher among people using both methamphetamines and opioids (22%) compared to opioids alone (14%) or methamphetamines alone (6%).

Just over half of survey respondents were homeless and 4 in 10 said they tried but were unable to get treatment in the past six months. “People using both substances reported the least access to treatment,” the researchers write in a call for more help in rural communities.

A pediatric cancer researcher admired the FDA — until he got ALS

When it comes to regulatory action on treatments for life-threatening diseases, William Woods knows whereof he speaks. As a pediatric oncologist, he’s seen the FDA radically reshape its approach to cancer drugs, where the cure rate has leapt from 20% to 80% for all children’s cancers, powered by clinical trials that did not wait for confirmation from other trials to move forward.

Woods was diagnosed with ALS in 2019. Few approved drugs offer more than a few months’ benefit, so he searched the medical literature for experimental hope. He found it, in AMX0035, a two-drug oral combination approved in Canada and Europe. But the FDA he knows from oncology is not the same as the division that reviews neurological drugs, which makes far less use of accelerated approval pathways. “If AMX0035 was a new cancer drug,” he writes in a STAT First Opinion, “this would be a home run.” Read more. And for news of another ALS treatment before the FDA, read here.

What to read around the web today

Google maps regularly misleads people searching for abortion clinics, Bloomberg
Community health centers’ big profits raise questions about federal oversight, Kaiser Health News
Sales from controversial drug discount program rose to $44 billion last year, STAT
Bright Health Group heads toward insolvency as it rushes to raise more cash, STAT
Why thinking hard makes us feel tired, Nature