public health
How to make a vaccine for a pandemic that hasn’t happened yet
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Sixteen years ago, when the H1N1 “swine flu” began spreading around the world, we had a few crucial lucky breaks. One was that, because multiple vaccines targeting previous H1N1 flu viruses were already licensed in the U.S., the FDA could fast-track approval of pandemic vaccines, swapping out the old H1 virus and replacing it with the new version.
Emergency response planners in the federal government have long hoped to use that strain change rule if the dangerous H5N1 bird flu virus ever triggers a pandemic. Makers of mRNA vaccines were able to move quickly to create vaccines during the Covid-19 pandemic, and they could move even faster on a future pandemic vaccine if they get a head start. In the final days of the Biden administration, HHS issued a nearly $600 million contract to Moderna to develop vaccines protecting against five subtypes of influenza that could prompt pandemics, including H5N1.
Now, RFK Jr.’s HHS is re-evaluating that contract. Read more from STAT’s Helen Branswell on what it means.
health tech
Comparing a race-specific and race-neutral lung equation
An equation used to assess lung function without accounting for a patient’s race can identify 2.5 to four times more Black children with asthma symptoms as compared to an earlier version that does adjust the results for race. That’s according to a study published Friday in JAMA Network Open of more than 1,500 children that compared the Global Lung Initiative’s 2012 equation (which uses race) to the one from 2022 (which does not).
The results are in line with previous research that shows using race in these equations tends to underestimate abnormal results among Black children. Still, some experts say that creating truly neutral tools is harder than it may sound. “Because racial inequality affects health in complex ways, fairness through unawareness can sometimes cause additional harm,” reads a paper published in the latest issue of the American Journal of Respiratory and Critical Care Medicine.
If you’re interested in this topic, consider returning to last year’s Embedded Bias series from STAT’s Usha Lee McFarling and Katie Palmer. You can learn a lot about the history of race-based clinical algorithms and what other factors clinicians are trying to incorporate into these equations instead. Separately, Katie also has a Q&A publishing today on how AI can distort clinical decision-making to prioritize profits over patients.
first opinion
What Medicaid cuts could mean for disabled people
Rachel Litchman is one of at least 5.8 million disabled and elderly Americans who rely on long-term care services to survive. She was approved for Medicaid-funded Home and Community-Based Services last year, five months after she applied as a new full-time wheelchair user. The workers paid through these services help her to get in and out of her (inaccessible) apartment, get food, shower safely, and so much more.
But the Medicaid cuts that the Trump administration has proposed will decimate the care that people like Litchman receive, she argues in a new First Opinion essay. “The shadow of the nursing home looms in the face of Medicaid cuts,” she writes. Read more on what’s at stake.
