This episode of This Week in Virology's clinical update, hosted by Vincent Racaniello and Dr. Daniel Griffin, addresses the severe real-world consequences of anti-science rhetoric, beginning with a discussion of the recent violent attack on the CDC, which was motivated by vaccine disinformation. A major focus is the divergence in public health guidance, as the American Academy of Pediatrics (AAP) has issued its own evidence-based immunization schedule for children, differing from the recently altered recommendations of the CDC's Advisory Committee on Immunization Practices (ACIP).
Dr. Griffin provides updates on several infectious diseases, including a Vibrio vulnificus alert in Massachusetts, an ongoing Legionella outbreak, and rising measles cases in the U.S. and globally. The episode examines new research, including a trial showing ivermectin's effectiveness in reducing malaria incidence and a significant study ("CARTESIAN") revealing that COVID-19 infection is associated with accelerated vascular aging (artery stiffening), an effect seen predominantly in women, even those who were not hospitalized. Key vaccine topics include the AAP's robust recommendations for RSV, flu, and COVID-19 immunizations for children; the proven benefit of high-dose flu vaccines for adults over 65; and the current status of the RSV vaccine for older adults.
TWIV 1246: CDC Under Attack, AAP Issues Independent Vaccine Guidance, and Post-COVID Vascular Aging
0:03:36 - Anti-Science Rhetoric and Violence: The episode opens by discussing the violent attack on the CDC, where a gunman fired hundreds of rounds, killing a police officer. The attack was fueled by disinformation about COVID-19 vaccines. This highlights the dangerous consequences of anti-science movements and threats against public health workers.
0:08:09 - Public Health Alert for Vibrio vulnificus: An alert has been issued in Massachusetts for Vibrio vulnificus, a rare but dangerous bacteria found in warming coastal waters. Infections can occur through open wounds or consumption of contaminated shellfish, leading to severe, life-threatening illness, especially in those with liver compromise.
0:10:40 - Ivermectin Shows Promise for Malaria Control: A cluster-randomized trial in Kenya found that mass administration of ivermectin resulted in a 26% lower incidence of malaria infection in children compared to albendazole. The mechanism is likely twofold, acting as both an insecticide against mosquitoes and an antiparasitic against the malaria parasite itself.
0:15:00 - Legionella Outbreak Update and History: An ongoing Legionella outbreak has grown to 111 confirmed cases and 6 deaths. The hosts differentiate between Legionnaire's disease (a severe pneumonia) and Pontiac fever (a milder, flu-like illness without pneumonia), both caused by the same bacteria.
0:20:28 - AAP Releases Its Own Vaccine Schedule for Children: Citing concerns that the CDC's ACIP has been compromised by individuals spreading vaccine disinformation, the American Academy of Pediatrics (AAP) has published its own evidence-based immunization schedule. Key recommendations include:
Influenza: Annual vaccine for all children 6 months and older, noting that 270 children died from flu last season, most of whom were healthy and unvaccinated.
RSV: Immunization for all infants under 8 months entering their first RSV season (if the mother was not vaccinated during pregnancy).
COVID-19: Vaccine for all children ages 6-23 months, and for older children (2-18 years) in high-risk groups or whose parents desire protection.
0:25:58 - Measles Cases Continue to Rise: As of August 19th, the U.S. has 1,375 confirmed measles cases across 42 jurisdictions. The global situation is also worsening, with recent deaths in Israel and a 34-fold increase in cases reported in the Americas compared to last year.
0:29:43 - High-Dose Flu Vaccine Greatly Benefits Seniors: A study demonstrated that for adults 65 and older, high-dose flu vaccines are significantly more effective than standard-dose vaccines. They were associated with a ~63-67% reduction in hospitalizations and a 74% reduction in all-cause mortality, irrespective of the person's frailty status.
0:36:23 - COVID-19 Linked to Accelerated Vascular Aging: The CARTESIAN study found that COVID-19 infection is associated with increased arterial stiffness, a marker of vascular aging. This effect was observed primarily in women and was present even in those who were not hospitalized for their infection. This finding helps explain the increased risk of cardiovascular events post-COVID.
0:50:42 - Alternative Sources for Measles Data: In response to concerns about the reliability and timeliness of CDC reporting, listeners provide links to alternative measles trackers from Johns Hopkins University and Brown University, which scrape data directly from state and county health departments.