This Is Me Trying

Three Things Thursday

Feb 21, 2025

Three Things Thursday highlights three things I am paying attention to as an epidemiologist each week. Once again it has been a banner week for health news. Influenza is still raging across the country (test positivity for flu is currently ~32%, meaning 32% of people who are tested for flu test positive; we worry when it is greater than 10%). This has been one of the worst influenza seasons in decades, and young children (especially those 0-4 years old) have been hit especially hard. Additionally, NoroSTAT, the CDC’s surveillance system that tracks the number of norovirus cases in the country, has NOT been updated since January; we do not know what is happening with norovirus. Judging from the antidotes I am hearing and the number of students not in class, a lot of people are still sick with norovirus.

There is a lot of vomiting and diarrhea going around.

The new news this week centers around vaccines — an outbreak of a vaccine-preventable disease, the Trump Administration's removal of a vaccine advertisement, and the cancelation of a federal vaccine advisory group.

The news is not only heartbreaking, but it is going to cost lives (details below).

I recognize that people have big feelings when it comes to vaccines. As a parent, I have felt those big feelings as I authorized and watched both of my kids get vaccinated. When my daughter got her first COVID vaccine in 2021, I shared the following with her —

“(I’m pretty sure you know this, but…) My passion and calling in life is to create healthy communities. I am committed to preventive healthcare; love research; advocate for vaccines; and have dedicated my career to educating the next generation of public health professionals. Knowing all of this, you might be surprised to know that I was a wreck at your two-month check-up with the pediatrician (in 2008) where you received four vaccinations. Despite years of training in epidemiology and several years working in public health (advocating for vaccines), it was hard signing the consent forms and permitting them to jab you four times in your super skinny legs. I kept repeating to myself - I don’t want you to get polio; you could die from whooping cough; diphtheria is a terrible disease that will kill you - over and over throughout the appointment.
While it was hard listening to your cries during this set of vaccinations and all those that would follow, each of these shots provided you with protection against deadly diseases. This is primary public health prevention — where we prevent a disease from occurring before you are exposed to or have the potential of developing that disease. Vaccines are one the best and most efficient forms of primary prevention — right up there with safe drinking water, clean air, access to health care, and shelter.”

Four band-aids for four shots at your 2-month check-up.

Big feelings are ok. As parents/guardians (or just people concerned with the health of little ones), we are going to feel something when someone wants to jab a needle (or four) into our babies. From a feelings/emotional perspective, it doesn’t make sense.

BUT — if we stop to learn about the science, our immune systems, and preventive medicine, we will come to understand (not just feel) that these jabs prevent deadly diseases, including influenza (which killed ~28,000 Americans during the 23-24 flu season), COVID (which we anticipate will kill between 19-34,000 Americans this year), measles, polio, diphtheria, Haemophilus influenza, pertussis, and meningitis, among others.

As a parent, I do understand the fear and concern surrounding vaccines. I do.

BUT as an epidemiologist, I know the vaccines included in the immunization schedule are SAFE & EFFECTIVE.

They prevent our children from suffering and dying.

In the words of Taylor Swift —

“And I just wanted you to know
That this is me trying
(And maybe I don't quite know what to say)
I just wanted you to know
That this is me trying
At least I'm trying”

I’m trying to not make light of the fear. I’m trying to be empathetic to the concerns. I’m trying to acknowledge that as a parent I hated hearing my kids cry when they were vaccinated. I’m trying to understand the root of the concern.

I’m trying…

But the science around vaccine safety and effectiveness is rock solid. And it is ongoing. Public health (when we are fully staffed and resourced) is constantly monitoring and looking for any signal that might indicate that a vaccine is either unsafe or ineffective.

We are constantly watching.

We are constantly reporting.

We are constantly monitoring.

And we are constantly publishing and sharing the results of this work.

That is what makes this week’s news so troubling. The data is there and the systems to monitor vaccine safety and effectiveness are in place. When there is an outbreak of a vaccine-preventable disease, the cancelation of an effective vaccine advertisement, and the cancelation of a federal vaccine advisory group — this epidemiologist becomes concerned.

I share this news so we can all be informed. And on alert.

Hoping this post helps to educate and empower you
to be healthy and create healthy communities.

Texas Measles Outbreak

The measles outbreak that began in Lubbock, Texas has grown (in terms of number of cases) and expanded into New Mexico. As of yesterday, there were 58 cases of measles in Texas; up from 45 on Tuesday. Thirteen of the cases have been hospitalized.

In New Mexico, eight cases of measles have been diagnosed.

Why should we care about the measles outbreaks in Texas & New Mexico?

For starters, measles is highly contagious. For every person who is infected with measles, they will infect 12-18 additional individuals. To have community (or herd) immunity against measles, at least 95% percent of the population must be protected (through vaccination — two doses of the vaccine — or previous infection). In the Texas county where the outbreak originated, ~20% of school-aged children are NOT vaccinated. This outbreak is far from over in Texas. Plus — Texas is not alone. Across the United States, the number of children not vaccinated against measles has decreased below the 95% threshold. In my county, only 93% of kindergarteners have received both doses of the MMR (measles, mumps, rubella) vaccine.

We are on the brink of measles outbreaks across the country where pockets of unvaccinated individuals (mostly children) are grouped.

Not only are children sick and hospitalized, but they are missing school. Parents/guardians are missing work. Medical bills are piling up for those who require hospitalization. And for those who are exposed and unvaccinated, they are required to quarantine for long periods (at least 21 days).

Measles not only causes illness in those who are infected, but it disrupts education, work, and extracurriculars, and can be expensive.

Measles is also vaccine-preventable.

The suffering, missed school days, missed days of work, and hospitalizations are all preventable.

Wild to Mild Flu Vaccine Ad Pulled by Trump Admin

The Trump Administration ordered the CDC to STOP promoting/using the Wild to Mild influenza vaccine ad today. The advertisement uses animals (lions and a kitten) to show how the flu vaccine can help reduce the symptoms of influenza. The key to this ad campaign was that it communicated the value of the influenza vaccine even if doesn’t prevent an individual from contracting the flu. According to NPR —

“The campaign sought to ‘reset public expectations around what a flu vaccine can do in the event that it does not entirely prevent illness,’ according to the CDC's webpage describing the launch of the campaign in 2023. It was renewed for the current flu season.”

The website for the Wild to Mild campaign was already been taken offline.

The end of the campaign coincides with one of the worst influenza seasons in decades.

According to STATNews, HHS Secretary RFK Jr wants all vaccine advertisements to promote the idea of “informed consent” in vaccine decision-making (instead of recommending or advising people to get their vaccinations). Please NOTE — “informed consent” is part of medical practice and research. Patients and participants in research are informed of the risks and benefits of whatever treatment, vaccine, screening test, or procedure they are going to have. Advisory groups and the Director of the CDC (or other federal health agencies) often make recommendations — for vaccinations and cancer screening tests — to the general public. When an individual meets with their medical provider, they discuss details of the vaccine or test before it is administered.

This shift proposed by Secretary Kennedy will do away with vaccine recommendations and advertisements focused on the known benefits of vaccines. Instead, the “informed consent” focus will prioritize the risks of vaccines in advertisements (and the possible discontinuation of recommended vaccinations). Ultimately, this will lead to an increasing number of individuals not getting vaccinated (or having their children vaccinated).

As Helen Branswell wrote this afternoon —

“The decision to pull flu shot advertising is an early sign of how RFK Jr. may shift the U.S. approach to vaccinations as the nation’s top health official.”

I am concerned.

CDC Vaccine Advisory Meeting Postponed (Canceled?)

In addition to ending the Wild to Mild advertisements, Secretary Kennedy announced earlier today that the February meeting of CDC’s Advisory Committee on Immunization Practices (ACIP) would be postponed (no timeline given). The ACIP was scheduled to meet February 26-28. That meeting has been postponed, though no date or indication of when it will be rescheduled was given.

ACIP planned to discuss (review safety and efficacy data) the meningococcal vaccine, influenza vaccine, RSV vaccine, HPV vaccine, and the mpox vaccine.

Given that a new date had NOT been set for the ACIP meeting, numerous medical and public health groups signed an open letter to Secretary Kennedy urging him to reschedule the meeting immediately. Those who signed the letter stated —

“Rescheduling this critical meeting and reconciling the absent portal for public remarks would represent a meaningful early follow-through from the Trump administration and its new HHS Secretary to ensure Americans receive the information needed to protect themselves against vaccine-preventable illnesses, confirming immunization’s importance in the mission to make America healthier.”

And now we must wait and see…

This is me trying not to get too worked up over this one meeting postponement.

This is me trying not to see this as the writing on the wall and the end of the ACIP.

This is me trying to remember that vaccines are still accessible.

This is me trying…

As these stories develop (more measles cases as well as updates about vaccine recommendations/ad campaigns and ACIP meetings), I will be sure to update you here. I encourage you to join me in trying to stay informed. Be sure you are subscribed.

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