In this clinical update for This Week in Virology, Dr. Daniel Griffin and Vincent Racaniello review medical literature and epidemiological trends as of December 2025. The episode highlights a study published in Cell demonstrating that the shingles vaccine significantly reduces the risk of mild cognitive impairment and death from dementia. A substantial portion of the discussion is dedicated to refuting a controversial, leaked FDA memo by Dr. Vinay Prasad that alleges pediatric deaths caused by COVID-19 vaccines; the hosts criticize the memo for its misuse of unverified VAERS data and lack of scientific rigor. Additional topics include the efficacy of single-dose HPV vaccination, safety data on maternal RSV vaccines, and current outbreak statistics for Marburg virus, H5N5 bird flu, and seasonal respiratory viruses. The session also covers emerging research on Long COVID treatments—specifically celiac plexus blocks for gastrointestinal symptoms—and answers listener questions regarding prophylactic antibiotics and antiviral usage for seniors.
TWiV 1276 Clinical Update: Vaccines, Controversies, and Long COVID Interventions
2:52 Dementia Prevention with Shingles Vaccine: Dr. Griffin reviews a study from Cell that used a "natural experiment" in Wales based on age eligibility for the shingles vaccine. The data shows that individuals receiving the vaccine had a significant reduction in new diagnoses of Mild Cognitive Impairment (MCI). Those already living with dementia saw a reduction in deaths from the disease. The takeaway is that the shingles vaccine is strongly recommended, not just for zoster prevention but also for preserving cognitive health.
9:48 FDA/Dr. Vinay Prasad Controversy: The hosts discuss a leaked memo from FDA CBER Director Dr. Vinay Prasad claiming that 10 children died due to COVID-19 vaccines. They heavily criticize this claim as an abuse of the VAERS database, which contains unverified, self-reported data, and note the complete lack of autopsies or other causal evidence. The hosts describe the memo as a politically motivated "assault on science."
19:07 Single-Dose HPV Vaccine Efficacy: A study in the New England Journal of Medicine confirms that a single dose of the HPV vaccine is non-inferior to two doses. Vaccine effectiveness was at least 97% across trial groups, which supports a one-dose regimen to increase global accessibility and compliance.
Marburg: An outbreak in Ethiopia has 13 confirmed cases and 8 deaths.
Bird Flu (H5N5): A patient in Washington state has died from the H5N5 strain of avian influenza.
Measles: Cases continue to rise, with over 1,800 confirmed in the US and over 5,000 in Canada.
22:31 Seasonal Respiratory Viruses: Influenza A (H3N2) is the dominant strain, causing severe illness and hospitalizations, particularly in older adults. RSV activity is also increasing, with pediatric ICU admissions reported.
26:17 Maternal RSV Vaccine Safety: A study of roughly 30,000 women confirmed the safety of the RSV vaccine during pregnancy, finding no increased risk for preterm birth, preeclampsia, or other adverse outcomes.
Vaccines & Long COVID: A systematic review shows vaccination significantly reduces the risk of Long COVID. One dose reduces risk by 19%, while three doses reduce it by 70%.
Maternal Antibody Transfer: Hybrid immunity (infection plus vaccination) in pregnant individuals results in the most effective transfer of protective antibodies to the newborn.
Celiac Plexus Block: A case report in Frontiers in Neuroscience details a procedure where the celiac plexus (near the L1 vertebrae) is injected to reduce sympathetic nervous system activity. This led to near-complete recovery from gastrointestinal Long COVID symptoms in three patients.
Neurodegeneration: A Nature Communications study identified specific blood proteins and MRI changes that serve as objective evidence of neurodegenerative processes in patients with cognitive Long COVID.
H. Influenzae Exposure: For a pregnant woman with a family member exposed to Haemophilus influenzae type b (Hib), Dr. Griffin suggests prophylactic antibiotics (e.g., Cefuroxime) are a reasonable, though not formally guided, precaution to protect the newborn.
RSV in Second Pregnancy: Current guidance is that if a mother was vaccinated for RSV in a previous pregnancy, she should not be revaccinated. Instead, the newborn should receive the monoclonal antibody Nirsevimab.
Paxlovid for Seniors: Dr. Griffin dismisses a recent Canadian study questioning Paxlovid's efficacy in vaccinated elderly as flawed and underpowered. He maintains that high-risk individuals over 70 should still be treated.