Breaking News

Will older adults get RSV vaccines, what experts say about  'weaning' youth off gender-affirming care, & how to improve clinical trials

May 26, 2023
Reporter, Morning Rounds Writer
Good morning. In observance of Memorial Day, we're pausing the newsletter on Monday. Let's catch up Tuesday.

public Health

Will older adults go for new RSV vaccines?

Colorful illustration of three seniors sitting on top of a large vaccine syringe and surrounded by abstract circles

Maria Fabrizio for STAT

After decades of research, scientists have created vaccines to protect older adults against RSV. Two drugmakers will likely have versions available this fall, which could mean when seniors go for their annual flu and additional Covid shots, they could also get an RSV one, right? Not necessarily. Among the obstacles on this course are vaccine hesitancy (or indifference), questions about combined effectiveness, a rare side effect, and common payment problems.

RSV can resemble the common cold, but these under-the-radar infections are more severe in the very young and in older adults. Even when a virus like Covid is known to be deadly, only 43% of people 65 and older get their boosters. Giving an RSV shot with others could weaken efficacy, and the rare Guillain-Barré syndrome in RSV trials has attracted attention. And who pays for it in the maze of Medicare B and D plans is another unanswered question. STAT's Helen Branswell explains.


reproductive health

Poll: Concern and confusion color views on abortion

KFF

A year after the Supreme Court's Dobbs decision, confusion and concern about abortion are widespread, a KFF poll reports today. While awareness of the abortion pill mifepristone grew from less than one-third of respondents in January to nearly two-thirds now, people are uncertain about its legality in states that ban or limit the procedure. Almost three-quarters of women said they don't trust the Supreme Court to make decisions on reproductive health cases, and two-thirds of men and women have faith in the FDA on drug safety and effectiveness.

The poll also tells us two-thirds of Americans are concerned that abortion bans make it hard for doctors to treat major complications during pregnancies. And in response to shrinking abortion access, more than half  of women under age 50 say that they or someone they know has changed their contraceptive method to reduce their likelihood of getting pregnant.


coronavirus

RECOVER study offers framework defining long Covid

It's a start. The NIH-funded RECOVER initiative studying long Covid has been criticized for its slow pace toward its goal of preventing and treating the long-term effects of Covid. Yesterday, in what RECOVER researchers call a "first step" for identifying cases and "a launching point for further investigations," a paper in JAMA Network Open defines the condition based on symptoms persisting six months after infection. Among more than 9,700 participants recruited starting in October 2021, there were 37 common symptoms across multiple tissues and organs. 

Twelve symptoms predominated: in descending order, postexertional malaise, fatigue, brain fog, dizziness, GI symptoms, palpitations, changes in sexual desire or capacity, loss of or change in smell or taste, thirst, chronic cough, chest pain, and abnormal movements. The study also confirmed earlier research finding unvaccinated people and people infected before the Omicron variant's arrival were more likely to develop long Covid.



Closer Look

Texas wants to wean trans youth off hormones in a 'safe' way. Not possible, doctors say

Demonstrators wear and raise transgender flags, along with a pride texas flagEric Gay/AP

Bans on gender-affirming health care for young people under age 18 are rolling out across the country, despite medical evidence and major medical groups backing the treatments. The 19 states that outlaw such care for minors direct clinicians to stop prescribing hormones or puberty blockers, and a proposed Texas ban tells young patients to "wean off the prescription drug over a period of time and in a manner that is safe and medically appropriate and that minimizes the risk of complications."

But that's not possible, experts told STAT's Theresa Gaffney. "There's no appropriate way to do that because it's medically necessary treatment," said Alex Keuroghlian of Harvard Medical School. There is evidence showing trans youth are already much more likely to consider suicide than their cisgender peers. Gradually reducing the hormones that young people take may delay these crises, he said, but won't address the impact of denying them care. Read more.


research

U.K. launches plan to reinvigorate clinical trials

The U.K. has long had a sterling reputation for research, bolstered by studies run during the Covid-19 pandemic that helped the world learn which treatments might work. But judging by sheer numbers, the biomedical enterprise is slipping: According to the Association of the British Pharmaceutical Industry, Phase 3 industry clinical trials in the U.K. fell by 48% from 2017 to 2021. The pharma trade group says studies have been so slow to launch that companies look to other countries for faster trials.

Yesterday the U.K. government presented an $800 million package to bolster the life sciences, including $190 million for the genomics powerhouse known as the U.K. Biobank to build a new research facility. Other funding will support mental health clinical research, pharmaceutical manufacturing technology and workforce development — and a plan to grow and streamline industry clinical trials. STAT's Andrew Joseph has more.


opinion

In the U.S., there may be a better way to diversify clinical trials

Speaking of clinical trials, an author of a report on underrepresentation in clinical research from the National Academies of Sciences, Engineering, and Medicine writes in a STAT First Opinion that safety-net clinics might hold the key to more diversity. About 30 million Americans, 59% of whom belong to racial and ethnic groups underrepresented in research, receive care in Federally Qualified Health Centers, whose patients are low-income and at high risk for chronic diseases.

Including these people in research would improve geographic diversity, too, by moving trials out of academic medical centers in cities to safety-net clinics, half of which are outside metropolitan areas. "At a time when trust in public health may be at an all-time low, institutions and health providers need to make concerted efforts to run research trials that more closely resemble the demographics of the U.S.," health care researchers Gloria Coronado and Leslie Bienen write. Read more about the remedy they suggest.


More around STAT
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What we're reading

  • The toll of police violence on Black people's mental health, New York Times
  • How doctors buy their way out of trouble, Reuters
  • Bristol drug reduces reliance on transfusions for people with chronic blood disorder, STAT
  • As India's electrical grid strains, rural hospitals and clinics find reliable power in rooftop solar, Associated Press
  • Gilead and Teva defend antitrust claims that prices for HIV medicines were unfairly kept high, STAT

Thanks for reading! Til Tuesday,


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