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CDC backs new Covid boosters. Now what?

CDC’s vaccine advisory panel yesterday backed new boosters from Pfizer and its partner BioNTech as well as from Moderna that target both the original SARS-CoV-2 virus strain that all previous vaccines have protected against, and the Omicron subvariants BA.4/BA.5. CDC Director Rochelle Walensky signed off on the recommendation hours later. Sometime this weekend or early next week, pharmacies and doctor's offices will start to receive the reformulated Covid-19 boosters. More from STAT’s Helen Branswell here on the deliberations.

Meanwhile, Helen, Matthew Herper, and Sarah Owermohle answer some questions:

Who can’t get the new booster? People who haven’t been vaccinated yet. Why? The boosters contain less vaccine, perhaps not enough to elicit good protection.
Will I need to get a booster every year? That’s the schedule many infectious disease experts want, but we’re not there yet.
What if I had Covid this summer? The CDC suggests waiting up to three months before getting the booster.

Who’s getting vaccinated and boosted

As CDC’s vaccine advisory panel put the new Covid boosters under the microscope, the agency released four reports on vaccination coverage, and not just for Covid. The news is mixed:

Vaccination coverage among adolescents: First doses of meningococcal vaccine by age 13 dropped 5 percentage points and tetanus, diphtheria, and pertussis (Tdap) vaccine receipt by age 12 fell 4 percentage points. But HPV vaccine doses among those who turned 12 or 13 during the pandemic stayed stable.
Parents’ attitudes about Covid vaccines: 64% were likely to have their kids under 5 vaccinated, 19% were unsure, and 10% were unlikely.
Covid vaccine safety: The mRNA Covid vaccines are safe for children 6 months to 5 years old, with rare reports of serious adverse events among than 1 million young children vaccinated.
Booster uptake: Half of eligible people age 5 and up got a first Covid booster and one-third of people 50 years and older got a second booster. Second booster levels were lowest among men, non-Hispanic Black and Hispanic/Latino people, residents of rural counties, and people who got the J&J vaccine first.

Stigma breeds apathy toward addiction crisis, federal drug czar says

Drug use and overdose defined Rahul Gupta’s tenure as the top health official in hard-hit West Virginia. Now the nation’s top drug policy official, Gupta told STAT’s Lev Facher that the current U.S. drug crisis is unlike anything he’s ever seen.

Which will result in more deaths in the next five to 10 years — Covid-19 or drug addiction and overdose?
We have an American dying [of a drug overdose] every five minutes around the clock, more than 300 a day. Clearly, drug overdoses were here before, and they’ll be here beyond, Covid-19.

Why isn’t the public treating a crisis that’s killing 100,000 Americans each year with more urgency?
One of the reasons for that apathy is stigma … that prevents so many people from asking for help and others for providing the help. The stigma in my own profession is no less than what we see in communities and individuals.

Read the full interview here.

Closer look: People with terminal cancer need to know they are dying, internist argues

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In the bad old days, cancer doctors thought they were doing their patients a favor by not telling them there was no hope of a cure. But in 2022, despite decades of progress toward a model of palliative care, some patients still don’t know their disease is terminal. Internist S. Monica Soni writes in a STAT First Opinion about intervening when her friend Zach was unaware of his imminent death. It was a heartbreaking lapse in the doctor-patient relationship, one she connects to a larger issue.

“Unrealistic expectations fueled by direct-to-consumer pharmaceutical advertising depicting happy cancer survivors and the pharma industry’s influence on oncologists hang over patient-doctor conversations,” she writes. “For every truly game-changing new drug or treatment indication, dozens of others offer just days or weeks of additional survival — if any — but at additional costs of hundreds of thousands of dollars and false hope.” Read more.

Clues to women's increased risk for A-fib

Atrial fibrillation is the most common heart rhythm disorder, one that can lead to blood clots in the heart and raise the risk of stroke and heart failure. Because the prognosis for women is worse than for men, researchers have looked at sex hormones and reproductive history for answers. A large new study in JAMA Network Open followed more than 235,000 women and found that A-fib risk was higher among women with early or delayed menopause, irregular menstrual cycles, and having given birth to no children or more than four children.

The observational study can’t say what caused the differences it found. But as a companion editorial notes, “The time has come for cardiologists and other health care professionals to get into the rhythm of routinely assessing reproductive history as part of standard [cardiovascular disease] and AF risk assessment.”

Hormone improves cognition in Down syndrome, pilot study in males says

One of the hallmarks of Down syndrome, a genetic disorder marked by intellectual disability, is an Alzheimer's-like decline in cognition and sense of smell. A small pilot study in Science based on research in animals showed that giving gonadotropin-releasing hormone — commonly associated with fertility and reproduction and administered to treat other conditions — improved cognitive function, but not the ability to smell.

In a mouse model of Down syndrome, the scientists had discovered that strands of microRNA regulating the production of the hormone were dysfunctional, leading to abnormalities in neurons that secrete the hormone. When they restored production of the hormone in mice, they reversed defects in cognition and smell. Tests in seven males, using timed pulses of hormone under the skin for six months, succeeded in improving cognition in all but one of the participants. The researchers say their work is “paving the way for clinical trials.”

What to read around the web today

ADHD specialists plan new U.S. guidelines to curb irresponsible prescriptions, Wall Street Journal
Illumina wins case against FTC in bid to hold onto early cancer detection company Grail, STAT
The tragedy of North Birmingham, ProPublica
Yale psychiatrist loses attempt to get her job back after assertions about then-President Trump’s mental health, Hartford Courant
Poll: One year after SB 8, Texans express strong support for abortion rights, NPR
Opinion: Prediction markets and the future of Covid-19, STAT