It's complicated: Covid vaccine program raises concern about potential errors

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Here’s an added challenge to increasing uptake of Covid vaccines: keeping all the different doses straight. Patient safety is paramount but confidence in the public health benefits of vaccination could also take a hit from any errors. As STAT’s Helen Branswell notes, the current Covid vaccine schedule seems tailor-made to trip up people delivering the doses. Before getting into the many colors of caps topping vials, there are multiple vaccines administered in different volumes, some after dilution but many not, and with intervals between doses ranging from three weeks to at least five months.

“This immunization schedule is among the most complex that I've personally had to deal with, and it is constantly changing,” Grace Lee of Lucile Packard Children’s Hospital in Palo Alto, Calif., told Helen. The CDC says it has developed strategies to minimize the risk. Read more.

Neurologic complications reported in two people in the U.S. with monkeypox

Monkeypox cases may be declining in the nearly 100 countries outside West and Central Africa coping with the current outbreak, but a new report from the CDC reminds us of potentially serious complications. Two previously healthy young gay men in Colorado and Washington, D.C., developed encephalomyelitis — inflammation of the brain and spinal cord — after monkeypox infections. Both were presumed not to be immunocompromised and neither had a known monkeypox exposure or recent travel.

The monkeypox virus typically causes fever, swollen lymph nodes, and rash. But because the current monkeypox outbreak differs from previous outbreaks, little is known about potential neurologic complications. The two cases might stem from the virus invading the central nervous system or from an autoimmune process triggered by the wider infection. The report’s authors urge awareness among clinicians and recommend vaccination for people at risk of being exposed.

To soothe your crying baby, follow the science

It’s been a while since I’ve been in the trenches of sleep training (back when “Ferberize” became a verb), but no parent forgets how desperately you want a full night’s sleep for your baby, despairing they’ll ever close their eyes again once awakened. Enter science: A new study of 21 babies in Current Biology applies metrics to measure heartbeat while standing and holding the baby (not enough), walking while holding the baby (5 minutes was good), sitting while holding the baby (5-8 minutes worked), and returning the baby to the crib with either head or back touching first (didn’t matter).

It became clear that these techniques can actually work, surprising one co-author who raised four children without the benefit of such data. They say it’s the “transport response,” linking it to the animal kingdom where quietly going along for the ride could mean survival.

Closer look: How drugmakers are turning telehealth into a marketing gold mine

We all know the “ask your doctor” tagline on TV and print commercials for prescription drugs. Now, thanks to pandemic-loosened telehealth rules, you might notice a stronger call to action: “Talk to a doctor now.” Dozens of drug sites have built-in buttons that send consumers to third parties sitting between drug manufacturers and providers writing prescriptions. For pharma, online prescribing has become a powerful tool to drive sales, sending patients to the clinic at the moment they’re most primed to ask for a specific prescription.

“This is a way of making prescription drugs about as available as over-the-counter drugs,” Georgetown University Medical Center professor Adriane Fugh-Berman told STAT’s Katie Palmer. “This is pharma’s dream.” But health policy and medical ethics experts caution that it could become a nightmare for patients. Read more here, and if you’d like to share your experience, scroll down in Katie’s story.

Opinion: It’s time for a challenge trial to test hepatitis C vaccines

Medicine is full of trade-offs. The rigor of a chemotherapy regimen, for example, is balanced against its impact on cancer, immunologist Andrea Cox of Johns Hopkins writes in the opening lines of a STAT First Opinion. After years overseeing a clinical trial that tested a new vaccine against the sometimes deadly hepatitis C virus, she found the trade-off in this research meant that her team would try to prevent the infections that they needed for the trial to succeed.

The vaccine trial failed, which strengthened her resolve to try another option: challenge trials, in which healthy volunteers get a hepatitis C vaccine and are then deliberately infected with the virus. If infected, they could be treated with the highly successful hep C drug in yesterday’s story. “The continued need to develop a vaccine against hepatitis C and to mount challenge trials to test them should be clear,” Cox writes. Read more.

Golden Goose Awards honor LASIK, paper microscopes, and cone snail venom

The Golden Goose Awards celebrate the unexpected benefits that federally funded scientific research brings to society. Some history: U.S. Rep. Jim Cooper (D-Tenn.), aka “Father Goose,” saw the award as a way to rebut criticisms of basic research as a waste of federal dollars, in contrast to the Golden Fleece Award bestowed by the late Sen. William Proxmire (D-Wis.). This year AAAS will recognize:

Ron Kurtz, Tibor Juhasz, Detao Du, Gerard Mourou, and Donna Strickland: Bladeless LASIK, the corrective eye surgery that resulted from an accidental laser injury.
Manu Prakash and Jim Cybulski: A $1, high-performing paper microscope inspired by origami applied to printer paper, matchboxes, and file folders to make medicine and science accessible everywhere.
Craig Clark (in memoriam), Lourdes Cruz, J. Michael McIntosh, George Wahlen, and Baldomero Marquez Olivera: A non-opioid pain reliever drawn from the venom of tiny cone snails, which also helps researchers map the body’s nervous system.

On this week's episode of the "First Opinion Podcast," First Opinion editor Patrick Skerrett talks with Christopher Hartnick, a pediatric ear, nose, and throat physician who specializes in treating fetuses and babies who are unable to breathe, about how prospective parents make life-or-death decisions over the course of a pregnancy. Listen here.

What to read around the web today

'The future of hospitals’: Flexible space for the next pandemic, New York Times
The myopia generation, The Atlantic
Medical journals broaden inquiry into potential heart research misconduct, Reuters
The fraught quest to account for sex in biology research, Nature
Akero treatment for NASH reduces liver scarring, achieves goals of mid-stage study, STAT