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Garcia: Unfortunately,
we've seen the first death
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from the measles
outbreak that's been
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going on in West Texas
and a neighboring
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county in New Mexico.
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The patient was an
unvaccinated, school-aged child,
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who had been hospitalized
in Lubbock, Texas.
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Unger: Hello everyone and
welcome to the AMA Update
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video and podcast.
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Today is our weekly look at
public health issues facing
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physicians and patients
across the country,
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with the AMA's Vice President
of Science, Medicine and Public
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Health, Andrea Garcia.
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I'm Todd Unger, AMA's
chief experience officer.
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Welcome back, Andrea.
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Garcia: Thanks.
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It's great to be here.
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Unger: Well, one of the
biggest developments
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that people are
still talking about
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is the FDA canceling a meeting
about next year's flu vaccines.
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Andrea, can you walk us
through what happened?
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Garcia: Sure, Todd.
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So the FDA has a
panel of experts
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that advise the agency by
reviewing and evaluating data
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on the safety and effectiveness
and appropriate use of vaccines.
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This panel is called the
Vaccines and Related Biological
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Products Advisory
Committee, or VRBPAC.
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It had been scheduled
to meet on March 13
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to discuss the composition
of this fall's flu vaccine.
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Last week, the
members of this panel
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reportedly received
an email from the FDA
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saying that this meeting
had been canceled
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and there was no reason
given for the cancelation.
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In a statement, the FDA did
confirm the cancelation and said
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that it would make its
recommendations to manufacturers
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in time for updated
vaccines to be available
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for the 2025-'26
influenza season.
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And that is what we know so far.
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Unger: Well, Andrea,
this development
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has many public health
experts concerned.
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What's your take on it?
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Garcia: Well, the
FDA VRBPAC meeting
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to discuss flu vaccine
strains happens every March.
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The timing, we know,
is critical to help
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ensure that manufacturers
have enough time
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to produce the updated
flu vaccine for the fall.
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Cancelation of this meeting
is highly irregular.
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We know that advisory
committees do
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allow agencies to obtain
advice from experts outside
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of government.
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They provide an open
and transparent process.
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They also allow opportunities
for public comments.
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But it is the FDA that makes the
final decision on all matters
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that come before the committee.
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Last week, the WHO held
its meeting on flu vaccine
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composition for the
2025-'26 flu season.
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And representatives
from the CDC and FDA
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were able to participate.
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It does sound like the
FDA will move forward
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with making a recommendation
to manufacturers
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without advisory
committee input.
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This is something we'll
be keeping an eye on,
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and we'll be sure to share
updates once we know more.
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Unger: And given that we're
in a record-breaking flu
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season this year, that's just
such an important development
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and we'll report
more as it comes.
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Andrea, that wasn't the only
big story over last week.
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There was also a
tragic development
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in the measles outbreak
that we've been covering.
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What happened there?
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Garcia: Well,
unfortunately, we've
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seen the first death from
the measles outbreak that's
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been going on in West
Texas and a neighboring
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County in New Mexico.
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The patient was an
unvaccinated, school-aged child,
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who had been hospitalized
in Lubbock, Texas.
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For context here, the U.S.
achieved measles elimination
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in 2000 after documenting
a year of no endemic spread
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of the virus.
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Since that time,
it's been pretty rare
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for us to see
deaths from measles.
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This latest tragedy is
really a sobering reminder
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of the severity of measles.
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And it's all the more concerning
because the outbreak in Texas
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is still ongoing.
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Unger: It is, indeed.
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And speaking of that, have
the case counts changed
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since we talked last time?
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Garcia: Well, as of
today, the number
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of measles cases in West
Texas has risen to 146.
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That's up from 90 when
we talked last week.
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20 patients have now
been hospitalized, which
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is up from 16 the week before.
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Most of these cases continue
to be in children age 5 to 17,
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who are either unvaccinated
or whose vaccination status
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is unknown.
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And as we've discussed,
this outbreak
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has also spread to a nearby
county in New Mexico.
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Last week, that county
had nine measles cases,
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and I'm glad to report
that no new cases have
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been identified in New Mexico.
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Unger: Andrea, given
that continued spread,
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what efforts have been made
to contain the outbreak?
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Garcia: Well, in Texas,
local health departments
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have expanded
vaccination and testing
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to help slow the outbreak.
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We saw HHS Secretary
Robert F. Kennedy
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Jr. direct federal health
agencies, including the CDC,
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to provide support to
Texas Health authorities.
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We know CDC continues to
be in close communication
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with health officials in Texas.
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And in a statement, the
CDC did remind parents
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that vaccination
remains the best defense
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against measles infection.
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Long term, hopefully, these
efforts will make a difference.
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In the short term, we know
that cases will likely
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continue to rise.
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Unger: Andrea,
unfortunately, measles
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isn't the only outbreak that
we're tracking at the moment.
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Bird flu is still spreading
extensively among poultry.
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And the USDA recently unveiled
a plan to address that.
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Andrea, what is
the USDA proposing?
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Garcia: Well, Todd,
the USDA is proposing
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a five-pronged approach
to combat bird flu
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and reduce egg prices, which it
initially announced in an op ed
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in the Wall Street Journal.
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That plan includes
investing $500 million
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to enhance biosecurity measures
to keep bird flu out of farms.
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Additionally, it will
expand a pilot program
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that started under the
Biden administration that
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sends USDA inspectors
to farms to assess
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their current
biosecurity measures.
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The plan also
includes approaches
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that are meant to help farmers
who've been impacted by bird flu
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and to bring down
the cost of eggs.
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For example, the plan
notes that the government
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will consider temporarily
importing eggs to reduce prices.
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Unger: Andrea, how
much of an impact
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do you think a plan like
this is going to have?
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Garcia: Well,
Todd, first of all,
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I'd just say that we're
glad that the USDA is
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making bird flu a priority.
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As for the impact of
these specific efforts,
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we know the next
couple of months
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will be really critical to see
if they're making a difference
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or if more interventions
are necessary.
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I do think it's essential that
we keep working to contain
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the spread of bird flu.
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This plan from the USDA is a
step in the right direction.
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Unger: Now, we've talked
about the spread of bird flu
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among poultry.
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We're going to stay with
the topic of bird flu.
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But this time, let's
talk a little bit
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about human transmission.
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Andrea, there's some more
information about recent cases
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of H5N1 in humans.
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What do physicians need
to know about that?
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Garcia: That's right, Todd.
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The CDC shared sequencing
findings on samples
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from two people with H5N1
avian flu infections.
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One was from the
patient in Wyoming,
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and the other was from
a patient in Nevada.
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The sequencing revealed
that the D1.1 genotype,
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which is circulating in
wild birds and poultry,
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and it's also recently made the
jump to dairy cows in Nevada
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and Arizona.
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The CDC found some notable
mutations the virus in Wyoming,
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that patient had the E627K
mutation in the PB2 protein.
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That has been linked to
efficient replication
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in people and mammals.
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And then the Nevada patient,
the virus had the D701N mutation
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in PB2, which has
also been linked
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to more efficient
replication in mammals.
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With that being said, for
both of these patients,
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the CDC didn't identify
any genetic changes
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in the virus that would
impact the efficiency
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of antiviral medications or
the H5 candidate vaccine virus.
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Unger: Well, Andrea, Thank you
so much for breaking that down.
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Last topic, two new studies
about long COVID in kids.
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What can you tell us about them?
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Garcia: Well, Todd, one study
was published in radiology
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and the other was from the CDC
and published in JAMA Network
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Open.
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The study in radiology
included 54 patients.
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It used an advanced form of
MRI called free breathing.
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These resolve functional lung
MRI on children and teens
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with long COVID.
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And it found that they
had lung abnormalities.
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These abnormalities correlated
to specific long COVID symptoms
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like chronic fatigue and an
overall loss of blood flow
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in the lungs.
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What's notable about
the study is the type
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of MRI imaging
they used, which is
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radiation-free
and contrast-free.
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This makes it more
suitable for children,
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and it means it
can be used to help
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diagnose long COVID
in these patients
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and track their recovery.
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Unger: It seems like
COVID is in the rear view
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mirror for a lot of folks,
but obviously, there
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are still people
suffering from long COVID.
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And diagnosing long COVID
remains a real challenge,
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so this is a
welcome development.
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Andrea, what about the
study from the CDC?
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Garcia: Well, Todd,
that study from the CDC
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looked at how effective the mRNA
COVID vaccine was on reducing
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the risk of long COVID in kids.
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It found that
vaccination lowered
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the risk of having two or
more long COVID symptoms
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by 73% and one or more
long COVID symptom by 57%.
00:10:02
And that was in
children ages 5 to 17.
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We know that long COVID can
be debilitating and incredibly
00:10:09
disruptive for anyone,
especially children.
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This study reinforces
the benefits
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of children staying up-to-date
with their COVID vaccinations.
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But right now, that's really
just not what we're seeing.
00:10:21
According to the CDC, the
current vaccination rate
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for children aged six months
through 17 years is around 12%.
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And it was largely the
same the year before.
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Hopefully, studies
like this that
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demonstrate the
benefits of vaccination
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will help encourage parents
and guardians to take action.
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Unger: Well, Andrea, it's not
only protection against COVID,
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but obviously from
long COVID as well.
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It's certainly
something we'll continue
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to advocate for as well.
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Andrea, thank you, as
always, for being here
00:10:55
and keeping us informed.
00:10:57
If you found this
discussion valuable,
00:10:59
you can support more programming
like it by becoming an AMA
00:11:02
member at ama-assn.org/join.
00:11:06
You can always find all
our videos and podcasts
00:11:08
at ama-assn.org/podcasts.
00:11:11
Thanks for joining us today.
00:11:13
Please take care.
00:11:14
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