Depression Increasing, New Mammogram Guidelines, and a New Universal Flu Vaccine
Three Things Thursday -- on Friday morning!
Three Things Thursday highlights three things I am paying attention to as an epidemiologist each week.
This week’s Three Things are coming at you a day late. I moved mulch yesterday when I should have been writing. Summer problems!
The three things that I am paying attention to this week are the results of a new survey highlighting the record number of depression cases in the US, new mammogram guidelines for women, and the first clinical trial testing a universal flu vaccine.
Hoping this post helps to educate and empower you
to be healthy and create healthy communities.
Record High Number of Depression Cases
A recent Gallup survey found that more than 25% of American adults are depressed. This is a 10% increase in the number of depression cases compared to a decade ago.
The biggest increases were seen among women and Black and Hispanic people. Thirty-six percent of women reported being diagnosed with depression. Compared to 20.4% of men.
The recent surge in cases is definitely tied to the COVID-19 pandemic. And we know that women disproportionately lost their jobs or left the workforce to take care of their families during the pandemic. This likely helps to explain the sharp increase in depression cases among women.
In the 2024 Federal Budget — there is new funding for mental health research and resources for individuals experiencing a mental health crisis.
New Mammogram Guidelines for Women
The US Preventive Services Task Force has issued new guidelines stating that women should begin to get annual mammograms beginning at age 40.
A mammogram is a form of screening — secondary prevention — where we attempt to identify the disease/cancer before clinical symptoms of the disease (feeling a tumor) are present. The idea is to diagnose the disease as soon as possible so that treatment can begin.
The Preventive Services Task Force changed their guidelines (recommending annual mammograms beginning at age 40 — not age 50) because…
New and more inclusive science about breast cancer in people younger than 50 has enabled us to expand our prior recommendation and encourage all women to get screened in their 40s. We have long known that screening for breast cancer saves lives, and the science now supports all women getting screened, every other year, starting at age 40.
While mammograms do save lives, it is important to note that they are not a perfect tool for accurately diagnosing disease. Many women, especially those in their 40s and 50s, will screen positive for cancer via a mammogram only to find out that they do not have cancer (a false positive screen). Mammograms are free (most insurance companies cover the costs of an annual mammogram), but the follow-up diagnostic tests are NOT free. A false positive mammogram can be financially and emotionally draining (there is a huge cost for fearing you may have breast cancer).
That said — with the number of breast cancer cases among younger women increasing and increasing health inequalities (different breast cancer mortality rates between black and white women) — the Task Force believes that recommending annual mammograms beginning at age 40 will save lives. And that the financial and emotional costs of a false positive mammogram outweigh the benefits of catching cases of cancer early.
According to the Task Force vice chair Wanda Nicholson, M.D., M.P.H., M.B.A —
“Ensuring Black women start screening at age 40 is an important first step, yet it is not enough to improve the health inequities we face related to breast cancer. In our draft recommendation, we underscore the importance of equitable follow-up after screening and timely and effective treatment of breast cancer and are urgently calling for more research on how to improve the health of Black women.”
Universal Flu Vaccine Trial Begins
Earlier this week the first Phase I trial of the H1ssF-3928 mRNA-LNP vaccine — a universal flu vaccine — began at Duke University. The study, aimed at determining the appropriate dosing of the vaccine and ensuring it is safe, will enroll 50 healthy volunteers aged 18-49 years. Of those enrolled in the study, 10 will receive a 20-microgram dose of the vaccine; 10 will receive a 25-microgram dose; and 10 will receive a 50-microgram dose. Ten individuals will receive at a later date the optimal dose (10, 25, or 50 micrograms). And the final ten participants will receive the regular quadrivalent seasonal flu vaccine, which will serve as the control.
A universal flu vaccine would likely eliminate the need for an annual flu shot.
Dr. Hugh Auchincloss, M.D, the Acting Director of the National Institute for Allergies and Infectious Diseases (at the NIH) said —
“A universal influenza vaccine would be a major public health achievement and could eliminate the need for both annual development of seasonal influenza vaccines, as well as the need for patients to get a flu shot each year. Moreover, some strains of the influenza virus have significant pandemic potential. A universal flu vaccine could serve as an important line of defense against the spread of a future flu pandemic.”
Questions?