Breaking News

Why so many adults aren't up to date on vaccines

October 26, 2023
Reporter, Morning Rounds Writer
Good morning. Are you confused by all the adult vaccinations on offer? You're not alone. Let Helen Branswell walk you through why that's the case.

vaccines

Crowded vaccination schedules— and other obstacles —  can prevent adults from getting them

Molly Ferguson for STAT

Alison Buttenheim couldn't believe her eyes. The professor of nursing at the University of Pennsylvania, who studies vaccine acceptance and hesitancy, was heading to her doctor's office to get a shingles vaccine. A sign there said ​​"Medicare patients cannot receive Tdap or zoster vaccines here," pointing patients to pharmacies unless they wanted to pay out of pocket. That defies the logic of getting protection before you need it. "We're absolutely making it too hard," Buttenheim, who is not yet on Medicare, said of the current patchwork system for adult vaccination.

Adult vaccination rates in the U.S. are already low for flu and for updated Covid shots. Vaccine hesitancy may be to blame, or the fact that many adults don't have a primary care provider (or can't get an appointment). But it could also come down to just how hard it is to know what to get, when, and where. STAT's Helen Branswell explains.


scientific publishing

Gaza tweet spurs concerns about freedom of speech after firing of prominent life sciences editor

eisenCourtesty Noah Berger/AP/HHMI

Science and politics collided when the life sciences journal eLife fired its top editor Michael Eisen following his endorsement of a satirical article expressing sympathy for Palestinians caught in the growing violence in Gaza between Israel and Hamas. Some members of the scientific community had called for Eisen's dismissal, while others criticized the board's decision. At least seven editors at eLife and advisers to the journal have resigned in protest of his dismissal, saying a commitment to academic freedom of expression is at stake. 

On Monday, Eisen, a Berkeley biologist who is Jewish, posted on X (formerly Twitter) that he was being replaced "for retweeting a @TheOnion piece that calls out indifference to the lives of Palestinian civilians." But in a statement on its website, the journal suggested that was not the only reason. Neither the journal nor Eisen responded to STAT's requests for comment. Megan Molteni has more.


health inequity

Just being in a clinical trial isn't enough to dispel health disparities in cancer

There's been hope that increasing diversity in clinical trials might improve medical knowledge of different populations — and narrow gaps in care by offering what could be the latest advances to all comers. A new study in JAMA Network Open quashes that theory, suggesting it will take more to eliminate disparities than enrolling diverse participants in research. In this case, disparities persisted for some breast cancer patients, including young Black and Hispanic patients and Hispanic patients with certain breast cancer subtypes.

Social, environmental, and biological differences may dictate adherence to endocrine therapy after breast cancer treatment for hormone receptor positive cancers, for example. "Why isn't just being in a trial enough? It's because we don't come into trials as blank slates," co-author Erica Warner said. "We have experienced the harms of systemic racism, and we bring that in our bodies into the trial. And then, trials don't last forever." STAT's Angus Chen has more.



closer look

The health care problem Democrats can't seem to solve: hospital costs

stat_capitolhospital_f1_2000-1600x900Mike Reddy for STAT

Democrats could justify taking a couple of victory laps for engineering some major reforms in the health sphere. Without needing Republican votes, they passed health insurance reform, and protected it later. They made it possible for the federal government to negotiate some drug prices with pharmaceutical companies. But Democrats may not be equal to the task of taming hospital costs, which by themselves add up to the largest share of U.S. health care spending. That leads to medical debt (see item below), a burden borne by both the insured and uninsured.    

This Congress has seen little willingness among lawmakers to address hospital costs for the Medicare program, STAT's Rachel Cohrs reports. Democratic leaders in the House have watered down hospital payment reforms, blocking even incremental reform, and the prospects for reform seem even dimmer in the Senate. Rachel explains why.


health care

Half of Americans struggle to pay medical bills

Having health insurance is no guard against high medical bills and deep medical debt, a new report from the Commonwealth Fund tells us. Just over half of insured working-age adults have a hard time affording health care, and nearly one-third are burdened by medical debt, the Health Care Affordability Survey found in phone and online interviews in English and Spanish earlier this year. Whether their coverage was through their employer, Medicaid, Medicare, or a marketplace plan, about 3 in 10 people said health care costs made it hard to pay for food and utilities. How it breaks down:

  • Medical debt: 85% had debts of $500 or more, with nearly half carrying $2,000 or more. 
  • Access to care: 38% delayed or skipped needed health care or prescription drugs in the past year because they couldn't afford them.
  • Household impact: 57% said 10% or more of their monthly budget goes to health care costs.

insurance

More employers cover doulas, menopause benefits 

Speaking of health coverage provided by employers, two developments could help women in the workforce. Walmart, the nation's largest private employer, will cover doulas — persons trained to assist women during pregnancies — for employees nationwide beginning next month, the Associated Press says. The company said its goal is to address racial inequities in health care and improve the maternal and infant health of its workers and their babies, especially where access to care may be limited. 

And Microsoft, Palantir Technologies, and Abercrombie & Fitch are three of a small but growing number of U.S. businesses offering menopause benefits, a move that could affect up to 20% of the female workforce. Among employers that offer sick leave, about 4% of them also provide additional support for menopause such as access to hormone therapy and counseling, according to the benefits consultant NFP, Bloomberg reports.


More around STAT
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What we're reading

  • Poison specialist and former medical resident at Mayo Clinic is charged with poisoning his wife, Associated Press
  • A home help for eight days after giving birth? Why Dutch maternity care is the envy of the world, The Guardian
  • Oncologists more likely to provide low-value care after receiving pharma money, study finds, STAT
  • Facing dementia without a diagnosis is crushing. A new program in Kenya offers help, NPR

  • Biogen's tau-lowering drug slows cognitive decline in early study of Alzheimer's disease, STAT

Thanks for reading! More tomorrow,


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