As usual thank you for a clear explanation and practical advice.
I fear you have overlooked a very important, transformative harm created by the new HHS/FDA/CDC/ACIP policies. You note the new emphasis, nay, requirement for " individual informed decision making." It should be noted that this activity contravenes and is epistemically destructive to the public health, population protection paradigm. Public health depends on trust and a general acceptance that individuals may undertake a small risk (which must be - and has been - scientifically well defined) for the greater good of protecting the whole community. Unfortunately this social contract has been dwindling in the USA and recent FDA/CDC/ACIP decisions are stabbing it in the heart. This is a giant step in the obliteration of public health as discipline and as a general social protection mechanism.
Thank you for your comment. I had at least somewhat realized that the current administration is trying to destroy public health, because of their attitude toward vaccines. Over my lifetime I've come to believe strongly in what public health does for us as a society, and am totally clueless as to why so many people have become skeptics.
As a longtime reader/supporter of YLE and someone who has stayed up-to-date, using your guidance, on his COVID vaccinations, I've been concerned lately about what seems to me to be some slightly misleading wording in regard to some important issues. For example, today you say: "Let’s be clear: Covid-19 vaccines are still recommended for everyone over 6 months of age—even by RFK Jr.’s handpicked ACIP members."
This seems to me to be less than accurate. Would it not be more accurate to describe the decision as HHS does, thusly: "The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) today unanimously recommended that vaccination for COVID-19 be determined by individual decision-making."
The HHS wording is less positive than your wording, and it seems to me, a more accurate reflection of what was recently decided. I need to know that YLE is presenting the facts in a clear, objective manner, as opposed to presenting facts in a way that favors a particular point of view, even when I sympathize that point of view, as I do here (and indeed regarding most everything you write).
The statements you conpare say the same thing. The only difference is the YLE's includes clear frustration. While one can desire pure objectivity, one can't deny that humans get frustrated. And it is immensely understandable that a highly trained epidemiologist would have monumental frustrations navigating an amateur-hour experience at the highest levels of public health. Let them be frustrated, it doesn't change the accuracy of the information being provided.
I have to respectfully disagree. They do *not* say the same thing. Furthermore, "frustration" with the current clown show at HHS does *not* provide a valid explanation for the wording issue that I've raised here. YLE has, especially in the last year, aimed high in their standard for communications, and the statement that I've quoted falls short of that standard.
If you can't find patience for a moment of valid frustration given the situation, I don't know what to tell you, but you might be struggling with lack of relevant empathy for her position and the challenges therein.
You have misunderstood my previous reply to you. The issue here is about the need for clear, accurate, unbiased presentation of *facts*. Value judgements and any related emotions about those facts are a *separate* matter that should *not* influence statements of fact. Saying that taking this position means that I "lack...relevant empathy" is simply wrong.
I will not be replying further to your misguided argument. Have a good day.
That you won't provide a person who has been struggling to assist for five years a little bit of grace for their very human passions truly says more about you than you realize
The reporting on the ACIP meeting has been confusing due to the chaos and confusion caused by the committee. Confusion that included members not knowing what they were voting on.
Their "recommendation" was a non-recommendation, leaving it to "individual-based" decision, which actually meant consulting with a provider. Levi, one of the most vocal vaccine critics on the committee and now heading the vaccine work group, proclaimed that they have no confidence in the "low-quality" evidence for the safety and effectiveness of the vaccines and could no longer recommend them.
The HHS statement you cited is from the HHS website, which I guess most people are not aware of. I agree that it better describes what ACIP did Friday.
I agree. The muddled wording could create substantive questions of law, if someone's health plan were to refuse to cover the vaccine. It's not clear whether the recommendation applies to self-funded plans, for example.
Thank you, as always, for your clear explanations of what is going on. While vaccines and respiratory illnesses are uppermost in the news, since fall-related deaths in those over 65 are a big issue, can you do a letter about that. You might share with readers that AARP offers a free, downloadable and printable HomeFit Guide at www.aarp.org/homefit to help fall-proof one's home. Suggestions for ways to improve and maintain balance, such as yoga, would be useful. Also, how to access resources (such as free or low cost grab bars in the bathroom), especially for those who have a low income. Again, many thanks.
We just ordered two more grab bars for my bathroom, given that I tried to fall into the shower one night recently. The fall didn't happen because I was able to grab my towel bar and keep from falling. Other than that, our house is pretty well fall proof: one story, the same flooring (vinyl planks) throughout, and only two low thresholds near the front door (which can't be changed, due to the tile flooring in the entry).
I will also mention tai chi as being good for balance, as well as dealing with back pain. We have a routine that my husband got on a cruise ship (it's a home video), that is designed for older people. I will definitely check out your AARP link to see if there is anything else we can do.
At 78, every time I see a doctor (roughly one or two every week), I get asked, "Have you fallen?" I always say, "I never fall." They tune me out while I show them my cane and mention that while walking in our very rugged yard I use a long-handled weeding tool as a cane. While taking my daily 1 or 2 mile walk, I use LL Bean trekking poles I found on eBay.
THAT is why I never fall despite taking around 700 mg of gabapentin every day and coping with very painful Achilles tendinitis.
I appreciate all this and would love it if you would answer two questions: 1) Why are covid vaccines recommended more in the US than say the UK where they barely talk about it anymore. Could you tell us some comparisons between the UK vs US and the current outcomes for health, long covid risks, etc.? If they are having less risks, is it that more people originally had the vaccine there? Would that matter if it wears off anyway?
2) I realize autism is a diversity issue and everyone deserves respect and support. All for that. I still wonder why it has seemingly gone up over the last many decades. I don't think it's just more diagnoses and I don't think it's vaccines, but is there something more going on to explain it, from your perspective?
I agree that's a factor in overall health outcomes due to higher access to care.
Yet, I imagine the UK would have more incentive to vaccinate if it meant less hospitalizations. Yet they vaccinate less. I'm not questioning vaccines effectiveness. Just curious to hear more comparisons and thoughts.
My point is that the US health care system is basically "Hope you don't get sick!" so of course we need to go all in with vaccines. In a single payer system, the contingency isn't as dire.
I so appreciate your discussions of issues we’re seeing tossed out in headlines, as well as issues that seem to now be totally under the mainstream’s radar.
What you wrote today is worth the price of my subscription, and then some. When you mentioned fall risk-inducing drugs, you mentioned gabapentinoids. I had been put on what I think was a heavy dose of gabapentin (300 mg/day), and it left me groggy and dizzy. It was given as a supplement to primidone to help with my essential tremors, but did nothing for them, so I quit taking it and have been doing much better ever since. Since I am 80 years old and have balance issues, you have made me really glad that I got off that drug. I'm not sure my prescriber knows that it increases risk of falls, and although my pharmacist warned me to take the first dose at night, nobody else has mentioned fall risk.
On a different note, I find what appears to me to be the rise in frequency of autism. I remember back in the mid to late 90s meeting a kid with autism, but back then it seemed to be a rare condition. In the last 30 years it seems to have become more common. Was it always common and just not recognized for what it was, or has the frequency actually risen? Just curious.
Hi... I am wondering if you might have some insight. I'm having a very difficult time finding out where I can get the Novavax COVID vaccine. They've been approved but I can't find out where I can get the shot. Even their own website doesn't have the page working where you can find out who is carrying their vaccine. I am unable to take the Moderna or Pfizer vaccines because I had a serious allergic reaction to the Moderna vaccine. I did not have any bad reaction to Novavax the following year. So... whatever help you might be able to offer... I'm going to call Novavax again tomorrow to see what they have to say but CVS and Walgreens only has the Pfizer and Moderna so far.
Can you do an update on the increasing falls and frailty? I'm specifically interested in the science behind resistance training as a key method for preventing frailty and presumably reducing fall risk
Thank you for reporting on the autism/Tylenol story. It's important to make as much of the science around autism accessible, because of how emotionally fraught the topic is. And now, even more so, when HHS is platforming a suspect explanation of the condition.
YLE -- LOVE your reports and they are so helpful and often my guide to what I want to do for want to do for myself, my family, and the suggestions I give to my patients. I feel like I have to take issue with the idea that that autism is not something to be "cured." On milder forms, what we use to call Asperger's Syndrome, this may be true, this may not be an illness or disorder, but a form of human diversity. But for people with severe and debilitating autism -- those who are non-verbal, those who are but who will never be able to live independently because their autism prevents them from being able to negotiate the world ---this is an illness and something that we should hope we will someday fully understand in terms of etiology, and hopefully prevention and treatment. I agree completely with you that we don't want to blame parents, that the cause is not vaccines or acetaminophen (per reasonable and repeated studies), and that we want to nurture and support those who are impacted.
As usual thank you for a clear explanation and practical advice.
I fear you have overlooked a very important, transformative harm created by the new HHS/FDA/CDC/ACIP policies. You note the new emphasis, nay, requirement for " individual informed decision making." It should be noted that this activity contravenes and is epistemically destructive to the public health, population protection paradigm. Public health depends on trust and a general acceptance that individuals may undertake a small risk (which must be - and has been - scientifically well defined) for the greater good of protecting the whole community. Unfortunately this social contract has been dwindling in the USA and recent FDA/CDC/ACIP decisions are stabbing it in the heart. This is a giant step in the obliteration of public health as discipline and as a general social protection mechanism.
Thank you for your comment. I had at least somewhat realized that the current administration is trying to destroy public health, because of their attitude toward vaccines. Over my lifetime I've come to believe strongly in what public health does for us as a society, and am totally clueless as to why so many people have become skeptics.
Thank you for writing about falls. I'm not terribly old (turned 50 last November) but I recently ruptured my Achilles tendon.
I immediately invoked my right under the ADA to have my landlord install grab bars in my bathroom. Additionally, I was approved for Access-A-Ride.
I think a big reason for both loneliness and falls is that as a society we tend to stigmatize
(a) people getting non-romantic roommates, past a certain age
(b) people asserting their rights when it comes to accessibility
I'll also add that a lot of states and cities create draconian legal barriers to unrelated adults living together.
As a longtime reader/supporter of YLE and someone who has stayed up-to-date, using your guidance, on his COVID vaccinations, I've been concerned lately about what seems to me to be some slightly misleading wording in regard to some important issues. For example, today you say: "Let’s be clear: Covid-19 vaccines are still recommended for everyone over 6 months of age—even by RFK Jr.’s handpicked ACIP members."
This seems to me to be less than accurate. Would it not be more accurate to describe the decision as HHS does, thusly: "The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) today unanimously recommended that vaccination for COVID-19 be determined by individual decision-making."
The HHS wording is less positive than your wording, and it seems to me, a more accurate reflection of what was recently decided. I need to know that YLE is presenting the facts in a clear, objective manner, as opposed to presenting facts in a way that favors a particular point of view, even when I sympathize that point of view, as I do here (and indeed regarding most everything you write).
The statements you conpare say the same thing. The only difference is the YLE's includes clear frustration. While one can desire pure objectivity, one can't deny that humans get frustrated. And it is immensely understandable that a highly trained epidemiologist would have monumental frustrations navigating an amateur-hour experience at the highest levels of public health. Let them be frustrated, it doesn't change the accuracy of the information being provided.
I have to respectfully disagree. They do *not* say the same thing. Furthermore, "frustration" with the current clown show at HHS does *not* provide a valid explanation for the wording issue that I've raised here. YLE has, especially in the last year, aimed high in their standard for communications, and the statement that I've quoted falls short of that standard.
If you can't find patience for a moment of valid frustration given the situation, I don't know what to tell you, but you might be struggling with lack of relevant empathy for her position and the challenges therein.
You have misunderstood my previous reply to you. The issue here is about the need for clear, accurate, unbiased presentation of *facts*. Value judgements and any related emotions about those facts are a *separate* matter that should *not* influence statements of fact. Saying that taking this position means that I "lack...relevant empathy" is simply wrong.
I will not be replying further to your misguided argument. Have a good day.
That you won't provide a person who has been struggling to assist for five years a little bit of grace for their very human passions truly says more about you than you realize
The reporting on the ACIP meeting has been confusing due to the chaos and confusion caused by the committee. Confusion that included members not knowing what they were voting on.
Their "recommendation" was a non-recommendation, leaving it to "individual-based" decision, which actually meant consulting with a provider. Levi, one of the most vocal vaccine critics on the committee and now heading the vaccine work group, proclaimed that they have no confidence in the "low-quality" evidence for the safety and effectiveness of the vaccines and could no longer recommend them.
The HHS statement you cited is from the HHS website, which I guess most people are not aware of. I agree that it better describes what ACIP did Friday.
Regardless of the ACIP antics, the public should generally benefit from the non-recommendation (https://covidandvaccineupdate.substack.com/p/acips-non-recommendation-recommendation). However, I'm not holding my breath given the ringmaster of the current circus in town.
I was also a bit surprised by that phrasing.
Informed consent is very important as is bodily autonomy.
I agree. The muddled wording could create substantive questions of law, if someone's health plan were to refuse to cover the vaccine. It's not clear whether the recommendation applies to self-funded plans, for example.
Thank you, as always, for your clear explanations of what is going on. While vaccines and respiratory illnesses are uppermost in the news, since fall-related deaths in those over 65 are a big issue, can you do a letter about that. You might share with readers that AARP offers a free, downloadable and printable HomeFit Guide at www.aarp.org/homefit to help fall-proof one's home. Suggestions for ways to improve and maintain balance, such as yoga, would be useful. Also, how to access resources (such as free or low cost grab bars in the bathroom), especially for those who have a low income. Again, many thanks.
We just ordered two more grab bars for my bathroom, given that I tried to fall into the shower one night recently. The fall didn't happen because I was able to grab my towel bar and keep from falling. Other than that, our house is pretty well fall proof: one story, the same flooring (vinyl planks) throughout, and only two low thresholds near the front door (which can't be changed, due to the tile flooring in the entry).
I will also mention tai chi as being good for balance, as well as dealing with back pain. We have a routine that my husband got on a cruise ship (it's a home video), that is designed for older people. I will definitely check out your AARP link to see if there is anything else we can do.
At 78, every time I see a doctor (roughly one or two every week), I get asked, "Have you fallen?" I always say, "I never fall." They tune me out while I show them my cane and mention that while walking in our very rugged yard I use a long-handled weeding tool as a cane. While taking my daily 1 or 2 mile walk, I use LL Bean trekking poles I found on eBay.
THAT is why I never fall despite taking around 700 mg of gabapentin every day and coping with very painful Achilles tendinitis.
I appreciate all this and would love it if you would answer two questions: 1) Why are covid vaccines recommended more in the US than say the UK where they barely talk about it anymore. Could you tell us some comparisons between the UK vs US and the current outcomes for health, long covid risks, etc.? If they are having less risks, is it that more people originally had the vaccine there? Would that matter if it wears off anyway?
2) I realize autism is a diversity issue and everyone deserves respect and support. All for that. I still wonder why it has seemingly gone up over the last many decades. I don't think it's just more diagnoses and I don't think it's vaccines, but is there something more going on to explain it, from your perspective?
Thank you!
Well for starters UK has single payer
I agree that's a factor in overall health outcomes due to higher access to care.
Yet, I imagine the UK would have more incentive to vaccinate if it meant less hospitalizations. Yet they vaccinate less. I'm not questioning vaccines effectiveness. Just curious to hear more comparisons and thoughts.
My point is that the US health care system is basically "Hope you don't get sick!" so of course we need to go all in with vaccines. In a single payer system, the contingency isn't as dire.
😊Laughed out loud at your encouragement to stay sane this week. It is a challenge in these times🙏
I so appreciate your discussions of issues we’re seeing tossed out in headlines, as well as issues that seem to now be totally under the mainstream’s radar.
Thank you.
As always relevant and up to date information, but especially important in these moments of “keeping up with the firehose” as you say. THANK YOU!!!
What you wrote today is worth the price of my subscription, and then some. When you mentioned fall risk-inducing drugs, you mentioned gabapentinoids. I had been put on what I think was a heavy dose of gabapentin (300 mg/day), and it left me groggy and dizzy. It was given as a supplement to primidone to help with my essential tremors, but did nothing for them, so I quit taking it and have been doing much better ever since. Since I am 80 years old and have balance issues, you have made me really glad that I got off that drug. I'm not sure my prescriber knows that it increases risk of falls, and although my pharmacist warned me to take the first dose at night, nobody else has mentioned fall risk.
On a different note, I find what appears to me to be the rise in frequency of autism. I remember back in the mid to late 90s meeting a kid with autism, but back then it seemed to be a rare condition. In the last 30 years it seems to have become more common. Was it always common and just not recognized for what it was, or has the frequency actually risen? Just curious.
Kaitlyn - can you address studies the relationship between older fathers and autism ASD babies.
Hi... I am wondering if you might have some insight. I'm having a very difficult time finding out where I can get the Novavax COVID vaccine. They've been approved but I can't find out where I can get the shot. Even their own website doesn't have the page working where you can find out who is carrying their vaccine. I am unable to take the Moderna or Pfizer vaccines because I had a serious allergic reaction to the Moderna vaccine. I did not have any bad reaction to Novavax the following year. So... whatever help you might be able to offer... I'm going to call Novavax again tomorrow to see what they have to say but CVS and Walgreens only has the Pfizer and Moderna so far.
Can you do an update on the increasing falls and frailty? I'm specifically interested in the science behind resistance training as a key method for preventing frailty and presumably reducing fall risk
Thank you for reporting on the autism/Tylenol story. It's important to make as much of the science around autism accessible, because of how emotionally fraught the topic is. And now, even more so, when HHS is platforming a suspect explanation of the condition.
Great info, but could you please tell us what vaccine programs were cancelled by the FDA that we won’t have
YLE -- LOVE your reports and they are so helpful and often my guide to what I want to do for want to do for myself, my family, and the suggestions I give to my patients. I feel like I have to take issue with the idea that that autism is not something to be "cured." On milder forms, what we use to call Asperger's Syndrome, this may be true, this may not be an illness or disorder, but a form of human diversity. But for people with severe and debilitating autism -- those who are non-verbal, those who are but who will never be able to live independently because their autism prevents them from being able to negotiate the world ---this is an illness and something that we should hope we will someday fully understand in terms of etiology, and hopefully prevention and treatment. I agree completely with you that we don't want to blame parents, that the cause is not vaccines or acetaminophen (per reasonable and repeated studies), and that we want to nurture and support those who are impacted.