In this comprehensive clinical update, Dr. Daniel Griffin and Vincent Racaniello critically examine the "MAHA - Make America Health Again" report, exposing its inclusion of fictitious studies. They delve into the ongoing controversy surrounding RFK Jr.'s statements on childhood COVID-19 vaccination, contrasting them with the CDC's emphasis on shared decision-making, and highlight the resignation of a CDC advisory expert. The discussion covers alarming trends, including a national decline in MMR vaccine coverage leading to increased measles outbreaks, and the multifaceted challenges posed by bird flu (H5N1) outbreaks, including the cancellation of a human vaccine contract and inhumane culling practices. The episode addresses the General Accounting Office's directives for HHS to improve infectious disease testing preparedness and provides current statistics on RSV, influenza, and SARS-CoV-2, noting an anticipated summer COVID-19 spike. Updates include the FDA's approval of Moderna's mNEXSPIKE vaccine and results from a phase 3 trial of pemivibart (Pemgarda) for COVID-19 prophylaxis. Finally, new genetic research linking the FOXP4 gene to long COVID is discussed, alongside a call to action for supporting biomedical research and addressing listener questions on a range of public health and personal health concerns.
TWiV 1224 Clinical Update: MAHA Report, Vaccine Misinformation, Outbreaks, and Long COVID Research
2:23 "MAHA" Report Scrutinized: Dr. Griffin details the "MAHA - Make America Health Again" report from the Trump administration, revealing that at least seven of its 522 references were fictitious studies, never published. The report lacked named authors, and officials couldn't confirm or deny AI generation, raising significant ethical concerns about scientific integrity.
6:43 RFK Jr. vs. CDC on Child COVID Vaccines: RFK Jr.'s public statements about removing COVID-19 shots from the federal immunization schedule for children were largely contradicted by the CDC. The CDC maintained recommendations for children aged 6 months to 17 years, emphasizing a "shared decision-making" approach between healthcare providers and parents/caregivers.
10:14 CDC Expert Resignation: Dr. Lakshmi Panagiotakopoulos, a pediatric infectious disease expert involved with the ACIP, resigned from her advisory role, citing her belief that she could no longer effectively help vulnerable US populations.
11:35 Declining MMR Vaccination Rates: A JAMA study shows a concerning national decline in MMR (Measles, Mumps, Rubella) vaccination coverage in US children between 2019 and 2024, dropping below the critical 94% herd immunity threshold. This correlates with a surge in measles cases, with over 1,000 confirmed cases in the US reported in 2025 so far.
14:32 Bird Flu (H5N1) Concerns: The US government canceled a nearly $600 million contract with Moderna for a human bird flu vaccine. H5N1 outbreaks continue to impact poultry farms, leading to millions of bird deaths (e.g., over 5 million in Arizona), and raise questions about inhumane culling methods like "ventilation shutdown plus" and controversial proposals by RFK Jr. and Dr. Oz regarding infected ostriches.
21:12 Measles Outbreak Updates: The US has recorded 1,088 confirmed measles cases across 33 jurisdictions. A specific case in Colorado involved a vaccinated adult traveler who, despite being vaccinated, transmitted the virus, leading to seven associated cases, highlighting the ongoing risk from international travel and the importance of high community vaccination rates.
24:09 GAO Calls for Testing Preparedness: The US Government Accountability Office (GAO) issued a directive to the Department of Health and Human Services (HHS) to address "persistent deficiencies" in infectious disease testing. Key recommendations include developing a coordinated national testing strategy, expanding research and development, and improving communication and data standardization for future pandemic preparedness.
25:59 COVID-19 Summer Spike Anticipated: While current wastewater surveillance data for COVID-19 appears low, Dr. Griffin observes an increase in ER patients, suggesting an upcoming summer surge. He also points out challenges with the current "fall booster" strategy given year-round transmission and difficulties patients face accessing vaccines due to confusing guidelines.
28:23 Moderna's mNEXspike Vaccine Approved: The FDA approved Moderna's new mRNA COVID-19 vaccine, mNEXspike (mRNA-1283). It is indicated for previously vaccinated individuals aged 65 years or older, or those 12-64 with at least one risk factor, and demonstrated slightly higher efficacy than the original Spikevax in a phase 3 trial.
32:35 CDC COVID-19 Vaccine Recommendations Clarified: Dr. Griffin clarifies the CDC's official COVID-19 vaccine recommendations directly from their website, which differ from RFK Jr.'s public statements. Routine vaccination is recommended for adults 18+ (yearly for most, twice yearly for 65+ or immunocompromised), while for children aged 6 months to 17, "shared clinical decision-making" with a healthcare provider guides vaccination.
38:13 Pemgarda (Pemivibart) Shows Efficacy: Interim results from the phase 3 "Canopy" clinical trial of pemivibart, a long-acting monoclonal antibody for COVID-19 pre-exposure prophylaxis, showed an 84% standardized relative risk reduction for symptomatic COVID-19. The study demonstrated efficacy in both immunocompromised and immunocompetent individuals, providing another option for prevention.
42:44 FOXP4 Gene Linked to Long COVID: A significant genome-wide association study (GWAS) published in Nature Genetics identified an association between variants in the FOXP4 gene and an increased risk of developing long COVID. This finding is independent of initial COVID-19 severity and suggests a genetic predisposition to the condition, opening new avenues for research into long COVID mechanisms.
46:58 Call to Support Science & Listener Questions: Dr. Griffin urges listeners to contact their federal representatives to advocate for continued funding of science and biomedical research. He also appeals for donations to Parasites Without Borders. The episode concludes with discussions on combating pseudoscience, the broader implications of declining vaccination rates, post-viral syndromes, COVID-19's impact on lung development, and practical advice for vulnerable individuals navigating COVID-19 risks during family visits.