What's Keeping Me Up at Night...
Three Things Thursday
Three Things Thursday highlights three things I am paying attention to as an epidemiologist each week. The number of measles cases in the US continues to increase (though the rate of increase is slowing down). In Mexico, there have been four measles deaths so far this year; three unvaccinated children. This statistic suggests two things — first, we are underestimating the true number of measles cases across North America. And two, being unvaccinated is risky business.
Reports from Texas show that the number of infants receiving their MMR (measles, mumps, and rubella) vaccine early (before their first birthday) is increasing. There are a lot of parents who are paying attention to public health messaging and protecting their children from measles via vaccination.
Also in the news… early yesterday morning, the House of Representatives passed a budget that includes Medicaid cuts that “could cause roughly 8 million people to lose their health insurance coverage, and that number could rise to 15 million thanks to other provisions in the legislation.”
The budget now moves to the Senate for a vote.
Please take the time to call your Senators and tell (beg, plead) them to vote AGAINST the budget, specifically the cuts to Medicaid.
Use this link to find your senators and their contact information.
Call/email them. NOW.
Your message should be short and clear. Tell them —
Your name and where you live.
You are calling to OPPOSE the proposed budget/Medicaid cuts.
And opposing the budget is important to you because…
Follow up and be public about your opposition — post on social media and tag your representatives.
Medicaid matters because it facilitates access to care, improves health outcomes, and provides financial protection from medical debt.
Do not wait. We all need to reach out to our senators now.
The BIG news this week (that’s right, we haven’t even gotten to the big news) is that the FDA announced on Tuesday that COVID vaccines in the fall will only be available to individuals 65+ and those at high risk for severe complications from the disease.
Here are the three things you need to know about the FDA’s announcement…
Hoping this post helps to educate and empower you
to be healthy and create healthy communities.
What Did the FDA Recommend?
FDA Director Dr. Marty Makary and Dr. Vinay Prasad, Director for the Center for Biologics Evaluation and Research at the FDA, have decided that the fall COVID-19 vaccine will only be available to —
Individuals who are 65 years of age and older
Individuals (under 64) who are at high risk of severe infection
Why Is This Recommendation Big News?
For the past four years, the COVID vaccine has been recommended universally, meaning everyone six months of age and older has been encouraged to get a shot (at least) every fall.
Drs. Makary and Prasad published their recommendation — that universal vaccination is not recommended — in a “sounding board” piece (aka an opinion piece) in the New England Journal of Medicine on May 20. In their opinion, annual COVID-19 shots are NOT needed by everyone. They argue that other countries only recommend COVID shots for individuals who are older and at high risk for severe disease. However, they fail to acknowledge the extensive body of research that shows that COVID vaccines prevent long COVID,1 reduce the risks of severe outcomes caused by the disease, and provide protection to the community by reducing the spread of the disease.
I believe there is room for discussion and debate regarding who needs a vaccine.
Review and discussion of the science is necessary before translating that science into policy or recommendations.
The recommendations made by Drs. Makary and Prasad, this week, feel political, not evidence-based. Their opinion piece in the New England Journal of Medicine is not a review of the science. They decided not to focus on the science or the fact that the COVID vaccines have saved an estimated 19.8 million lives. Instead, they assume that recommendations made by other countries — with different demographics, a different healthcare system, different environmental and social determinants of health, and different leading causes of death and disease — would be appropriate and healthy for those here in the US.
What’s The Bigger Story Here?
Why Is This News Keeping Me Up at Night?
The FDA's decision (really by Drs. Makary and Prasad, alone) to change the vaccine recommendations was made without input from the FDA advisory committee (VRBPAC). There was no review of the data; there were no public comments. The CDC was not consulted, and the FDA made its recommendation nearly a month before the CDC’s advisory committee was scheduled to meet. There was just a “sounding board” publication and webinar to share the new recommendations.
This is a break from established protocols for developing vaccine recommendations.
The decision made by Drs. Makary and Prasad did not include any analysis of the data.
The process used to make the recommendation is NOT clear.
And the collaborative process that has long been used to develop public health recommendations was bypassed.
Politics trumped transparency and data-informed decision-making.
Why is this keeping me up at night?
I worry that the process (or lack thereof) used by Drs. Makary and Prasad, to create new COVID-19 vaccine recommendations, will be used again.
I worry that politics will trump data-informed decision-making in the future.
I worry that health policy is being created for political purposes, not to keep people healthy.
I worry that trust in governmental public health agencies will continue to erode.
I worry that fewer people will get the COVID-19 shot this fall, resulting in more disease, hospitalizations, and deaths.
I worry… because I want our communities to be safe and healthy.
While I am worried, I am also going to double down on my mission and will work hard and more collaboratively to CREATE HEALTHY COMMUNITIES FOR ALL.
I will be here with you (at least) weekly throughout the next four years.
To create healthy communities for all, I am committing to —
Using data/science to create public health (aka preventative health) programs, policies, and interventions to save lives and decrease suffering.
Fighting misinformation.
Inspiring others to understand the science to make healthy decisions and create healthy communities.
If you are local, please join me next Friday, May 30, at the Meadville Public Library for a Community Coffee Hour Conversation about our community’s health needs.
What else can you do?
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Comment on the posts. Hearing from you is a form of encouragement & it helps move Epi(demiology) Matters up in the Substack algorithm.
Send me your ideas & questions.
Epi(demiology) Matters is written by Dr. Becky Dawson, PhD MPH — an epidemiologist, teacher, mom, wife, and dedicated yogi. She is a tenured professor at Allegheny College, Research Director at a community hospital, and an exclusive contributor (all things health & medicine) at Erie News Now (NBC/CBS). Her goal is to create healthy communities for all. She writes Epi Matters — first & foremost because epidemiology does matter (to all of us), and she hopes that each post will help to educate and empower readers to be healthy and create healthy communities.
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Thanks for all you’re doing!
Your “Three Things” are also keeping me up at night.