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RSV vaccines, HPV tests, & who's Bernie Moss?

June 22, 2023
Reporter, Morning Rounds Writer
Good morning. A U.S. Supreme Court decision on affirmative action could come as soon as this morning. We'll be watching for the impact on medical schools, but first, here's a look at what CDC advisers make of new RSV vaccines, how a genomic HPV test might work where it's needed the most, and what's reigniting the debate over open access to scientific journals.

Health

CDC advisory panel gives a watered-down RSV recommendation for older adults

A panel of experts who advise the CDC on vaccinations voted yesterday not to recommend new RSV vaccines from Pfizer and GSK for all older adults. Instead, they voted 9-5 to recommend that people 65 and older "may" get an RSV vaccine, based on "shared decision-making," meaning a discussion with a doctor. And by a vote of 13-0, with one abstention, it recommended the same policy for people 60 to 64.

Both vaccines were approved last month by the FDA for people 60 and older. Earlier yesterday, it looked like the vaccines would get full recommendations, but several committee members expressed serious concerns about the decisions they were being asked to make based on the data the companies had provided. These recommendations now go to CDC Director Rochelle Walensky, who must sign off on them before the vaccines can be made available. STAT's Helen Branswell has more.


health tech

Crisis lines testing AI to help review response quality

Crisis support lines are built on carefully trained counselors who can navigate sensitive conversations. Their efforts are reviewed for quality control, including whether signs of suicide are picked up. That review of randomly selected recordings taxes the already strained services, and the challenge is growing larger with the new 988 system, which in May routed nearly 470,000 calls.

Enter AI. The National Institute of Mental Health has awarded a $2 million grant to Protocall Services, which operates crisis support lines, and Lyssn, whose platform uses AI to analyze recordings of behavioral health encounters. They'll explore whether the technology can do, at scale, what human reviewers do in a study that will take several years. "These are people's lives, right?" Lyssn co-founder Dave Atkins told STAT's Mario Aguilar. "You've got to do some really hard work if you want reliable, valid, high-quality AI." Read more.


global Health

Simpler test to detect cervical cancer raises hopes for use in low-resource settings

A genomic HPV test looks promising after early trials in the U.S and Mozambique, researchers report, moving closer to improving cervical cancer detection in sub-Saharan Africa, where death rates are highest. A study in Science Translational Medicine demonstrated how well the DNA test detected the two HPV viruses that cause 70% of cervical cancer cases. In Maputo, Mozambique, the tests were less sensitive in samples with low concentration of cervical cells than in Houston, Texas, and showed some false positives in samples with high cell amounts.

The test uses self-collected cervical swab samples that can be read by minimally trained health workers using a mini-centrifuge, much simpler than the more expensive Pap smear, which requires specialized instruments and health professionals. "You could run this test in decentralized locations to detect if somebody has high-risk HPV that causes cervical cancer, and then proceed with diagnosis and treatment," study co-author Kathryn Kundrod told STAT's Abdullahi Tsanni. Read more.



Closer Look

GOP lawmakers want to question a giant of virology. Who is Bernie Moss?

Photo of Bernard Moss sitting in desk chair in front of two computer monitors

Courtesy NIAID

Bernard Moss (above) is a titan of virology, publishing hundreds of scientific papers while working for more than 55 years in labs at the National Institute of Allergy and Infectious Diseases. He's been prying biological secrets from poxviruses and other microbiological targets, including mpox viruses that a recent outbreak vaulted into wider awareness. Now Moss is in the news, too, after House Republicans seized upon his mention of gain-of-function research in an interview last year with Science about two strains of mpox virus.

Gain-of-function research — in which genes are added or removed to study a pathogen's potentially greater risk — has become radioactive in politics, suspected as the origin of the current pandemic. Moss declined to speak to STAT's Helen Branswell for a profile, but colleagues did: "Bernie Moss is unquestionably one of the best, if not the most important poxvirus scientist in the country, if not the world," former NIAID chief Anthony Fauci said. "He has an amazing brain," said CDC's Inger Damon. Read more.


research

Doctors' group fights more open access for research

When the AMA speaks, people listen. Just last week we told you the doctors' group has taken a new stance on BMI, a policy reverberating in obesity medicine. AMA lobbyists on Capitol Hill advocate for Medicare payments and weigh in on scope-of-practice laws. Now they have a new focus: PubMed Central, the government's repository of scientific articles. More than a decade ago, the NIH wanted any research it funded to be free for American taxpayers who funded it.

That got pushback from scientific publishers who charge for access, so a 2008 compromise was reached to keep articles behind a paywall for 12 months. Now the AMA, which publishes the JAMA family of 13 journals, is objecting to a White House plan to make federally funded research available immediately. "Publishing research takes money, and someone has to pay, but who?" STAT's Brittany Trang asks, then takes us through alternative models. 


population health

Report: Preventable deaths have surged widely, during Covid, pregnancy, and the opioid crisis

Screen Shot 2023-06-21 at 2.00.59 PM

Commonwealth Fund

The U.S. has gone backward on life expectancy and avoidable deaths, the Commonwealth Fund says in a report that also reveals unaddressed mental health needs and the spread of medical debt. The 2023 Scorecard on State Health System Performance, based on data gathered from 2019 through 2021, shows how deeply the pandemic has cut into the nation's health. Every state saw a spike in preventable deaths, whether from Covid-disrupted care or overdoses or maternal mortality, but the largest increase came among Black and American Indian/Alaska Native people. 

The report breaks out women's health before the Dobbs decision a year ago, finding that women of reproductive age died at increasing rates from preventable causes, including pregnancy and childbirth as well as Covid-19 and substance use. Adolescents and adults with mental health needs cannot get the care they need, including 60% of 12- to 17-year-olds who had a major depressive episode. And even before pandemic Medicaid coverage dropped, medical debt was especially high in the South.


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What we're reading

  • PhRMA sues Biden administration over Medicare drug price negotiation program, STAT
  • 'No kill' meat, grown from animal cells, is now approved for sale in the U.S., NPR

  • European companies outline opposition to proposed overhaul of pharma policy, STAT
  • Revealed: a toxic metal is in a US city's air — and may be harming children's brains, The Guardian
  • After promising early data, gene therapy trial for Huntington's takes puzzling turn, STAT

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