This episode of "This Week in Virology" provides a clinical update focusing heavily on a critique of the September 2025 Advisory Committee on Immunization Practices (ACIP) meeting. Hosts Vincent Racaniello and Dr. Daniel Griffin express deep concern over several ACIP discussions, including the recommendation to separate the MMR and Varicella vaccines and a controversial, though delayed, proposal to end universal Hepatitis B vaccination at birth. They argue these moves are politically motivated, ignore established science on preventing vertical transmission and subsequent liver cancer, and threaten to dismantle the U.S. childhood vaccination schedule. The episode also covers the ACIP's decision not to recommend COVID-19 vaccines for any group, instead deferring to individual doctor consultations.
Beyond the ACIP analysis, the update includes reports on a New World screwworm case near the U.S. border, ongoing outbreaks of Ebola in the DRC, and surging measles cases in the U.S. and Canada. The hosts highlight alarming statistics on pediatric flu deaths from the previous season and discuss positive new data on the efficacy of the monoclonal antibody Klesro vmap for preventing RSV hospitalization in infants. The episode concludes with a listener Q&A session addressing travel vaccines, post-COVID hypertension, and the true risk of SSPE following measles infection.
TWiV Clinical Update: A Critical Look at Public Health Policy and Infectious Disease Trends
0:01:14 The Persistence of Anti-Science: Dr. Griffin opens with a Charles Darwin quote about ignorance begetting confidence, leading to a discussion on the long history of anti-science sentiment, its current politicization, and how scientific findings are often misrepresented.
0:04:26 Screwworm Nears U.S. Border: An update on the New World screwworm outbreak, noting a new case has been detected in cattle in Nuevo León, Mexico. This is the closest case to the U.S. border since the outbreak began, prompting emergency controls and a suspension of cattle imports from Mexico.
0:05:50 Critique of ACIP's Hepatitis B Vaccine Proposal: The hosts heavily criticize a proposal at the recent ACIP meeting to end the practice of universal Hepatitis B vaccination within 24 hours of birth.
Key Takeaway: They argue this policy is essential for preventing vertical transmission from mothers with unknown status, which protects thousands of infants annually from developing chronic Hepatitis B and subsequent liver cancer. They express dismay at the committee's apparent lack of understanding of this critical public health measure.
0:14:04 ACIP Abdicates Responsibility on COVID-19 Vaccines: The ACIP declined to recommend the updated COVID-19 vaccine for any specific group, instead advising people to "talk to their doctor." A motion to require a prescription for the vaccine was proposed but ultimately rejected.
Key Takeaway: The hosts view this as a politically motivated decision to avoid controversy, which creates barriers to access and goes against previous successful public health strategies. They believe it is part of a larger agenda to weaken childhood vaccine requirements.
Ebola: An ongoing outbreak in the DRC has reached 57 cases with 35 deaths, a case fatality rate over 61%.
Measles: The U.S. has surpassed 1,500 confirmed cases, while Canada is approaching 5,000 cases. The hosts link this surge to declining vaccination rates.
0:21:44 Alarming Rise in Pediatric Flu Deaths: Data from the 2024-2025 influenza season shows 280 pediatric deaths, the highest number since tracking began (excluding the 2009 H1N1 pandemic). A staggering 89% of these children were not fully vaccinated against influenza.
0:23:23 High Efficacy of Monoclonal Antibody for RSV: A new study in the New England Journal of Medicine on Klesro vmap, a monoclonal antibody for RSV prevention in infants, showed an 84% efficacy in preventing RSV-associated hospitalization.
Key Takeaway: This offers a powerful tool for protecting infants, and the hosts note that even individuals resistant to vaccines seem more accepting of monoclonal antibody therapies.
0:32:44 Listener Q&A on Clinical Topics: The episode concludes by answering listener questions, including:
Post-COVID Hypertension: This condition is often related to autonomic nervous system dysregulation and typically resolves within a year.
Measles and SSPE Risk: A listener who is a pediatric ID physician shares an article indicating the risk of the fatal neurological condition SSPE after measles is far higher than the commonly cited 1-in-10,000, possibly as high as 1-in-600 for children infected under 12 months of age.