This episode of "This Week in Virology" features Dr. Daniel Griffin's weekly clinical update, beginning with a sharp critique of what he views as concerning actions and proposals undermining science and public health in the US. He discusses proposals for saline placebo controls in vaccine trials, a government initiative promoting outdated vaccine technology, and legislative efforts to criminalize mRNA technology. Dr. Griffin also provides updates on the epidemiology and clinical aspects of various infectious diseases: a notable rise in pertussis and measles cases, new findings on the broader health benefits of the shingles vaccine (reducing cardiovascular events and dementia risk), a review of the severe recent influenza season highlighting high pediatric deaths due to low vaccination rates, and positive impacts of the Nirsevimab antibody on reducing RSV hospitalizations in infants. For COVID-19, he notes low wastewater activity, reviews early effectiveness data for the updated vaccine (KP.2), stresses the critical importance of early antiviral treatment, and addresses concerning trends in antibiotic over-prescription for viral illnesses. The update concludes with a discussion of persistent long COVID symptoms and objective findings from advanced imaging, listener questions covering vaccine trial controls, MMR immunity, and water fluoridation, and calls for supporting science and global health initiatives.
TWiV Clinical Update: Attacks on Science, Disease Trends, and Long COVID Insights
0:00 The episode introduces "This Week in Virology" and Dr. Daniel Griffin's clinical update, starting with an introduction and a quote about consensus.
3:24 A new section titled "Attack on Science" is introduced, highlighting concerns about recent actions perceived as detrimental to scientific integrity and public health.
3:36 Discussion focuses on RFK Jr.'s proposal to mandate saline placebo testing for new vaccines, which is strongly criticized by experts as unethical, outdated (saline controls were used before adjuvants/carriers were common), and less informative than current standards (testing against a control with all components except the antigen). They emphasize that adjuvant safety is already studied separately.
10:52 Concerns are raised about a new HHS/NIH initiative for a "next-generation universal vaccine platform" using beta-propiolactone inactivated whole virus technology. This is criticized as a regression to 1940s technology, potentially less effective than modern approaches like mRNA, and a poor allocation of resources compared to ongoing innovative vaccine development.
15:20 A Minnesota bill (HF3219), the "mRNA bioweapons prohibition act," is highlighted for attempting to designate mRNA injections as "weapons of mass destruction" and criminalize their possession/distribution. This is condemned as baseless, dangerous disinformation with no scientific evidence of harm.
19:25 Pertussis (whooping cough) cases are significantly climbing in the US, nearly quadrupling compared to the previous year, with over 6,600 documented cases and 10 deaths, including six infants. The high risk and severity of pertussis in unvaccinated infants are emphasized as a vaccine-preventable tragedy.
20:39 New research shows additional benefits of the live zoster (shingles) vaccine. A South Korean study found a 23% reduction in overall cardiovascular events among vaccinated individuals, adding to known benefits like reduced shingles incidence and lower dementia risk.
22:19 Measles outbreaks continue to grow in the US (over 935 confirmed cases across 30 jurisdictions, including large outbreaks in Texas) and Canada (over 1,177 cases), underscoring insufficient vaccination rates and the ongoing risk of this highly contagious, vaccine-preventable disease.
23:13 The recent US influenza season was severe, with 216 pediatric deaths reported so far, the most in 15 years (since the 2009 H1N1 pandemic). This high mortality is linked to low childhood flu vaccination rates (less than half), as vaccination is highly effective at preventing severe illness and death, even if it doesn't always prevent infection.
25:51 The RSV season is winding down. Nirsevimab, a monoclonal antibody providing protection against RSV in infants, has shown dramatic success in real-world studies (e.g., Spain), significantly reducing hospitalizations (78%) and ICU admissions (75%).
28:47 For COVID-19, national wastewater viral activity is currently low. Early effectiveness data for the updated BNT162b2 (KP.2) vaccine in a Veterans Affairs study showed good protection against hospitalization (68%) and urgent/emergency care visits (around 56-57%), despite very low uptake (3.7%) in the study population (median age 68).
32:16 A study highlights the critical importance of early antiviral treatment for COVID-19 in at-risk patients, showing that each day of delay in receiving treatment increased the risk of hospitalization or death by 18%. Emergency physicians playing a role in prompt treatment improved outcomes.
35:52 Data shows a continued trend of over-prescribing antibiotics for viral respiratory infections, including COVID-19 (around 35% of hospitalized cases) and other viral illnesses (around 50%). This contributes to the growing problem of antibiotic resistance.
A European study found one-third of patients still experienced long-lasting symptoms (fatigue, brain fog, respiratory issues, chronic pain) seven months after acute infection.
Advanced imaging studies (PET/MRI, DECT) on Long COVID patients with persistent cardiopulmonary symptoms (9-12 months post-infection) revealed objective abnormalities in 57% of participants, including inflammation and myocardial scarring.
41:17 Listeners are encouraged to contact their government representatives to advocate for supporting science and biomedical research and reminded of opportunities to donate to support MicrobeTV and global health initiatives.
The appropriate control for vaccine trials: Reaffirming that modern standards use controls with adjuvants/carriers (everything but the antigen), not just saline, which is considered outdated and less informative for assessing specific vaccine effects.
Assessing MMR immunity from past individual vaccines via lab tests: Titer levels can indicate sufficient protection, and results should be reviewed with a doctor.
Managing dental health without water fluoridation: Using fluoride toothpaste (starting at age 2) and getting dental sealants are recommended alternatives.
ProMED Mail switching to a premium subscription model: Acknowledging the loss of free access to a valuable infectious disease monitoring service and reiterating the importance of independent science communication like TWiV, which relies on listener support.