In this clinical update from the podcast "This Week in Virology" (TWIV), hosts Vincent Racaniello and Dr. Daniel Griffin discuss several key topics in infectious disease and public health. They begin with a tribute to the legacy of primatologist Jane Goodall and delve into the science behind the 2025 Nobel Prize in Physiology or Medicine, awarded for the discovery of T-regulatory cells and their role in immune tolerance. A significant concern is raised regarding political interference, specifically the involvement of an anti-vaccine law firm in vetting members for the CDC's Advisory Committee on Immunization Practices (ACIP).
The episode provides updates on several outbreaks, noting positive signs of containment for Ebola in the DRC, while highlighting the tragic consequences of resurgent measles in Canada and its detection in New York wastewater. The hosts review studies on influenza, COVID-19, and Long COVID. Key findings include strong evidence supporting a two-dose initial flu vaccine series for children, the elevated risk of adverse neonatal outcomes from maternal COVID-19 infection, and the limited clinical benefit of retreating Paxlovid rebound. Two studies underscore the significant risk and persistence of Long COVID in children, especially after reinfection. Finally, the discussion touches upon the increased risk of vascular dementia following severe respiratory infections, including COVID-19.
TWIV 1260: Nobel Prizes, Measles Resurgence, and Long COVID in Kids
0:02:53 Jane Goodall's Legacy: The hosts pay tribute to the late Jane Goodall, highlighting her major contributions, including humanizing primates, inspiring women in science, and her skill in science communication. Her lasting message is that "the greatest danger to our future is apathy."
0:05:06 Nobel Prize for Immune Tolerance: The 2025 Nobel Prize in Physiology or Medicine was awarded to Mary E. Bruncow, Fred Ramdell, and Shimon Sakaguchi for their discovery of T-regulatory (T-reg) cells. Dr. Griffin explains how these cells are crucial for preventing autoimmune diseases by controlling self-reactive T-cells that escape elimination in the thymus.
0:11:01 Political Influence on Vaccine Policy: A news report reveals that an anti-vaccine law firm is involved in interviewing and selecting members for the CDC's Advisory Committee on Immunization Practices (ACIP), raising serious concerns about the integrity and scientific basis of future public health recommendations.
0:14:38 Measles Outbreaks and Tragedies: Dr. Griffin reports on the devastating impact of rising measles cases. In Alberta, Canada, a premature baby died after the mother contracted measles during pregnancy. This follows a similar death in Ontario, highlighting the danger measles poses to pregnant women and newborns.
0:15:49 Measles Detected in New York Wastewater: The New York State Department of Health has issued an advisory after detecting measles virus in wastewater from Oswego, a city in upstate New York. This signals community transmission and prompted alerts to clinicians, many of whom have never seen a case of measles.
0:19:17 Two-Dose Flu Vaccine Is More Effective for Kids: A meta-analysis published in JAMA confirms that for vaccine-naive children under nine, an initial two-dose series of the influenza vaccine provides significantly better protection than a single dose. The increase in effectiveness is particularly pronounced (28 percentage points) for children under three.
0:24:06 COVID-19 Increases Risks in Pregnancy: A systematic review and meta-analysis found that maternal COVID-19 infection is associated with significant risks for newborns, including a 2.66% rate of vertical transmission, a 16.4% rate of neonatal ICU admission, and a 1.29% neonatal death rate.
0:28:32 Retreating Paxlovid Rebound Shows No Clinical Benefit: A randomized, placebo-controlled trial examined whether a second 5-day course of Paxlovid helps patients with symptomatic rebound. While the drug was safe and reduced viral RNA levels slightly faster, it did not lead to a significant clinical benefit or faster symptom resolution.
0:31:48 Reinfection Doubles Long COVID Risk in Children: A large retrospective study found that children and adolescents who get a second SARS-CoV-2 infection have more than double the risk of developing Long COVID (PASC) compared to those with only a first infection.
0:36:26 Long COVID Symptoms Persist in Children for Over a Year: A prospective study of unvaccinated children with Long COVID found that nearly a third (32.5%) still experienced symptoms—most commonly fatigue, reduced physical activity, and headaches—more than one year after their initial infection.
0:38:30 Respiratory Infections Linked to Vascular Dementia: A study of UK adults over 50 found that COVID-19 survivors had a higher likelihood of developing new-onset vascular dementia. However, this increased risk was not unique to COVID-19 and was comparable to the risk observed after other non-COVID respiratory illnesses.
0:45:31 Navigating Vaccine Bureaucracy: A listener from Georgia shares a frustrating rant about the new state-level requirement for a doctor's prescription to get a COVID-19 vaccine, followed by insurance claim rejections, illustrating the political and bureaucratic hurdles being created to obstruct access to vaccination.