Robert Califf
@robcaliff.bsky.social
📤 860
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Something we need to talk about more in my view.
substack.com/@robcaliff27...
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Interventions for Low-Probability Events
Recently, I have been struggling to understand why so few people have taken the updated COVID booster when the benefit-risk calculation seems so straightforward.
https://substack.com/@robcaliff272993/note/p-174249895?utm_source=notes-share-action&r=7bit1
about 13 hours ago
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This article highlights the lack of much needed evidence about potential benefits and risks of dietary supplements.
www.statnews.com/2025/09/23/l...
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FDA’s leucovorin approval could be a boon for supplement makers
Parents may flock to a dietary supplement with the same key ingredient as leucovorin, which the FDA just approved for children with autism. But there are drawbacks.
https://www.statnews.com/2025/09/23/leucovorin-autism-treatment-folinic-acid-supplements-are-different/
about 14 hours ago
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Given the prominence this is being given from the top, i hope NIH or PCORI will fund an adequate sized, high quality clinical trial to define the benefit-risk profile of this intervention to treat autism.
www.nytimes.com/2025/09/22/w...
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What Is Leucovorin, the Medicine Being Approved for Autism Treatment?
https://www.nytimes.com/2025/09/22/well/leucovorin-autism-fda.html?smid=li-share
about 15 hours ago
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Painful points.
open.substack.com/pub/insideme...
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"I move to reconsider." Notes from Day 2 of the CDC's ACIP meeting.
Plus, legal expertise from Professor Dorit Reiss.
https://open.substack.com/pub/insidemedicine/p/i-move-to-reconsider-notes-from-day?utm_campaign=post&utm_medium=email
2 days ago
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An opinion about the need to better understand the framing and decision making that impacts so much of preventive public health--"habits" and inconveniences to prevent low probability, but high impact future events in return for some up front risk.
substack.com/@robcaliff27...
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Interventions for Low-Probability Events
Recently, I have been struggling to understand why so few people have taken the updated COVID booster when the benefit-risk calculation seems so straightforward.
https://substack.com/@robcaliff272993/note/p-174249895?utm_source=notes-share-action&r=7bit1
2 days ago
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Academic institutions and professional organizations would be well-served to read this article.
carnegieendowment.org/research/202...
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For Expertise to Matter, Nonpartisan Institutions Need New Communications Strategies
To avoid irrelevance when they are needed most, experts and nonpartisan analysts must rethink not just their channels of communication but also their theory of influence.
https://carnegieendowment.org/research/2025/09/communications-social-media-nonprofit-institutions-new-media-environment?lang=en
3 days ago
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reposted by
Robert Califf
Eric Topol
4 days ago
That's right. It could have been worse. Brace for more to come.
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I hope this is widely read. It reflects the extraordinary diligence of CDC during the extreme stress of the pandemic. None of this information is secret--it was discussed and presented publicly.
www.statnews.com/2025/09/19/c...
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Covid-19 vaccines protect children from severe disease. Here is the evidence
“Over and over again, Covid-19 has shown it can cause severe disease in children, disease that is preventable by a safe and effective vaccine,” writes former CDC Director Rochelle Walensky.
https://www.statnews.com/2025/09/19/covid-19-vaccines-children-evidence-safety-protection-severe-disease/
4 days ago
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4 days ago
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"“I hope Dr. Cassidy shows up,” said Dr. Benjamin, “and not Senator Cassidy.”
www.nytimes.com/2025/09/16/u...
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Cassidy, His Job in Peril, Scrutinizes Kennedy on Vaccines
https://www.nytimes.com/2025/09/16/us/politics/bill-cassidy-vaccines-rfk-kennedy.html?smid=nytcore-ios-share&referringSource=articleShare
7 days ago
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Can't say we weren't warned.
www.statnews.com/2025/09/16/r...
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I’m a former CDC director. I’m deeply concerned about the future of vaccines in the U.S.
“I am deeply saddened for the agency I was honored to lead, for colleagues put in harm’s way, and for the quiet heroism of public health workers who are derided for political gain,” Rochelle Walensky ...
https://www.statnews.com/2025/09/16/rfk-jr-cdc-vaccines-rochelle-walensky/
8 days ago
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The DTC ad debate for prescription drugs is heating up, but i was glad to see the paragraph from WSJ on supplements-
www.wsj.com/opinion/rfk-...
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Opinion | HHS Tries to Stifle Corporate Speech
RFK Jr. and Marty Makary want to regulate pharma ads so they are ‘no longer feasible.’
https://www.wsj.com/opinion/rfk-jr-marty-makary-pharma-advertising-hhs-trump-administration-b8bf4194?st=seCK46&reflink=article_copyURL_share
9 days ago
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Children dying from measles in the US? Seems like science fiction.
open.substack.com/pub/yourloca...
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School shootings, brace for vaccine headlines this week, Covid-19 vaccine access, another measles death, and more.
The Dose (September 15)
https://open.substack.com/pub/yourlocalepidemiologist/p/school-shootings-brace-for-vaccine?utm_campaign=post&utm_medium=email
9 days ago
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Concise summary of concerns about the MAHA plan.
www.washingtonpost.com/opinions/202...
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Opinion | Anyone who bought RFK Jr.’s hype should read this report
RFK Jr.’s new MAHA plan bears a cruel irony.
https://www.washingtonpost.com/opinions/2025/09/12/kennedy-maha-report-health-vaccines/
9 days ago
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Skeptic is not the right word to describe the failure to transparently examine evidence in favor of conspiracy theories.
www.washingtonpost.com/health/2025/...
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‘Can we talk about RFK Jr.?’ A dark cloud hangs over vaccine makers
The ascendance of vaccine critic Robert F. Kennedy Jr. as the top health official is creating an environment where promising vaccines are harder to develop, scientists and investors say.
https://www.washingtonpost.com/health/2025/09/14/vaccine-innovation-investment-rfk-jr/
9 days ago
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Good, logical thinking.
www.medpagetoday.com/opinion/seco...
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Opinion | I'm a Former Surgeon General. Here's Why I'm Getting the COVID Shot This Year.
Vaccines continue to prevent hospitalizations and save lives
https://www.medpagetoday.com/opinion/second-opinions/117395?xid=nl_secondopinion_2025-09-14&mh=2f881679d15a2bcfca9382a17c92dec1&zdee=gAAAAABm4x7EkMXOiCs98IMNq3LyNpgOORvDZvbiCUSHFKALlRaItTNaJqIehCyHBx6Uwyg2zURze-QX_piMvQqIWzT__WgoPg%3D%3D&utm_source=Sailthru&utm_medium=email&utm_campaign=WeekendOpinions_091425&utm_term=NL_Gen_Int_SecondOpinion_Active
10 days ago
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Good to see dietary supplements put to the test of high quality evidence development. We need more of these trials since there is no pre-market requirement by US law.
add a skeleton here at some point
11 days ago
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Sensible approach well outlined.
open.substack.com/pub/drjessic...
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What Actually Reduces Gun Deaths
A clear look at the data on reform, and the fight to defund gun-violence research, in the wake of two more tragic shootings
https://open.substack.com/pub/drjessicaknurick/p/what-actually-reduces-gun-deaths?utm_campaign=post&utm_medium=email
11 days ago
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Dr. Nestle keeps coming up with these interesting goings on. While the Healthy label can always be improved, its a big step forward towards an informed public. And putting good information on the front of the pack--that's just common sense.
www.foodpolitics.com/2025/09/fact...
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Food industry does survey to defend Facts Up Front labels - Food Politics by Marion Nestle
The Consumer Brands Association (formerly the Grocery Manufacturers Association) did a survey to prove that its icons on the front of cereal boxes and some other products are trusted by consumers: Fac...
https://www.foodpolitics.com/2025/09/facts-up-front/?lctg=333222006
13 days ago
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A young physician points out the failure of our biomedical institutions to adapt to the huge changes in our information ecosystem. We need to work together to fix this.
open.substack.com/pub/robcalif...
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The Rising Tide of Medical Misinformation
I was pondering the vast universe of medical information on social media when the following missive was sent to me by a young physician who has already mastered medical school, a rigorous internship a...
https://open.substack.com/pub/robcaliff272993/p/the-rising-tide-of-medical-misinformation?utm_campaign=post&utm_medium=email
13 days ago
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Important and direct. I hope this gets the air time it needs.
www.nytimes.com/2025/09/10/o...
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Opinion | It’s Not You. It’s the Food.
https://www.nytimes.com/2025/09/10/opinion/food-environment-chronic-disease.html
14 days ago
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Fairy dust won't solve the problem!
open.substack.com/pub/robertwa...
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Can AI Rescue Us from the Mess of Prior Auth?
Yes, But It’ll Take More Than Putting Lipstick on Today’s Pig of a System
https://open.substack.com/pub/robertwachter/p/can-ai-rescue-us-from-the-mess-of?utm_campaign=post&utm_medium=post%20viewer
14 days ago
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As expected, a common-sense and informed perspective. As we're addressing this, i hope we'll include compounded drugs and dietary supplements, which are also heavily promoted, but most with no high quality evidence about risks and benefits.
open.substack.com/pub/yourloca...
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Pharmaceutical ads in the U.S.: Top questions answered
The Administration's order and what can actually be done
https://open.substack.com/pub/yourlocalepidemiologist/p/pharmaceutical-ads-in-the-us-top?utm_campaign=post&utm_medium=email
14 days ago
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Slogans are nice, but the massive subsidy of an adverse food environment will largely dictate what happens.
www.foodpolitics.com/2025/09/grow...
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Growing crops for fuel: Big Ag wins, the public loses - Food Politics by Marion Nestle
I know I've been posting this graph multiple times, but to me it sums up everything that's wrong with the U.S. agricultural system. Close to half the biofuels grown in the U.S. is used to make biofue...
https://www.foodpolitics.com/2025/09/growing-crops-for-fuel-a-huge-and-growing-problem/?lctg=333222006
15 days ago
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Clearly stated by the Lancet
www.thelancet.com/journals/lan...
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RFK Jr and MAHA: dangerous, emboldened, and escalating
The week beginning Aug 4, 2025 was the most dangerous and tragic week of Robert F Kennedy Jr's tenure yet: a fatal CDC shooting by a gunman distrustful of COVID-19 vaccines, the cancellation of US$500...
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2825%2901683-6/fulltext
17 days ago
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Well done. I hope a lot of people read this essay. i would just add that if we don't align the payment for health care delivery with the priorities, so much of this good work will continue to go to waste.
www.nytimes.com/2025/09/05/o...
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Opinion | American Health Care Gets a Lot Wrong. Here’s What It Gets Right.
https://www.nytimes.com/2025/09/05/opinion/health-care-america-kennedy.html?unlocked_article_code=1.jk8.iFz_.vPRbY7Zcn4xM&smid=url-share
17 days ago
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Powerful. This strategy of rubber stamping non-evidence based dogma laid out here is frightening. I hope oversight happens--Sen Cassidy knows better.
www.wsj.com/opinion/robe...
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Opinion | Robert F. Kennedy Jr., the CDC and Me
I was fired after 29 days because I held the line and insisted on rigorous scientific review.
https://www.wsj.com/opinion/robert-f-kennedy-jr-the-cdc-and-me-b4ca2eaa?gaa_at=eafs&gaa_n=ASWzDAjvlIPWVy3H0ep39Y0zxDKAvq2jn7MhlL4VfxN3HEiw6au7yktKhd-XqiEEmng%3D&gaa_ts=68b99657&gaa_sig=V7U9j9vZPF0152wgBy59wM9NyXhvFI6W3gdDdp4VTWNsZTtnKEAbiXpEF9c06X3kg35H13g_rPsJS9zDJrob1w%3D%3D
21 days ago
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Some thoughts about vaccines stimulated by a robust RCT using real world data and efficient methods.
jamanetwork.com/journals/jam...
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Evidence About Benefits and Risks of Vaccines
In this issue of JAMA Cardiology, Johansen and colleagues1 report findings from a prespecified secondary analysis of the DANFLU-2 pragmatic randomized clinical trial2 comparing the efficacy of standar...
https://jamanetwork.com/journals/jamacardiology/fullarticle/2838477
21 days ago
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Thoughts worth reading if you care about safe and nutritious food.
open.substack.com/pub/drjessic...
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Food Additives and the MAHA Disconnect
How tearing down the FDA undermines their own fight for “cleaner” food
https://open.substack.com/pub/drjessicaknurick/p/food-additives-and-the-maha-disconnect?r=7bit1&utm_campaign=post&
[email protected]
22 days ago
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This is a very meaningful commentary--not politics--urging prevention of catastrophic disease outcomes by Dr. Giroir.
www.usatoday.com/story/opinio...
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America needs warp speed on vaccines, not RFK Jr.'s warped decision making | Opinion
Use of mRNA technology saved millions of lives during the COVID pandemic. It's a mistake not to explore its uses in treating other diseases.
https://www.usatoday.com/story/opinion/2025/09/01/trump-kennedy-hhs-mrna-vaccine-covid/85833361007/
23 days ago
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I wish we could have more honest and analytical discussions about farm workers as a highly valuable labor force. An interesting take here from Dr Nestle.
www.foodpolitics.com/2025/09/its-...
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It's Labor Day: Let's talk about ICE versus farm workers - Food Politics by Marion Nestle
If we want more vegetables, somebody has to pick them. Raids by ICE on farmworkers are not helping this situation; they are wrong, morally and legally, and must stop.
https://www.foodpolitics.com/2025/09/its-labor-day-lets-talk-about-ice-versus-farm-workers/?lctg=333222006
23 days ago
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This is a good one. There is specific information for all those protein enthusiasts, but equally important--its clear that we need high quality research on nutrition and health outcomes.
open.substack.com/pub/erictopo...
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Our Preoccupation With Protein Intake
The data on high protein diets, bars, supplements, and powders will surprise you
https://open.substack.com/pub/erictopol/p/our-preoccupation-with-protein-intake?r=7bit1&utm_campaign=post&utm_medium=email
24 days ago
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Humpty dumpty. Good summary.
www.nytimes.com/2025/08/29/h...
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Will the C.D.C. Survive?
https://www.nytimes.com/2025/08/29/health/cdc-kennedy-public-health.html
25 days ago
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I had the chance to opine about an important clinical trial of high vs low dose influenza vaccine. The result was interesting, but the methods were spectacular.
jamanetwork.com/journals/jam...
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Evidence About Benefits and Risks of Vaccines
In this issue of JAMA Cardiology, Johansen and colleagues1 report findings from a prespecified secondary analysis of the DANFLU-2 pragmatic randomized clinical trial2 comparing the efficacy of standar...
https://jamanetwork.com/journals/jamacardiology/fullarticle/2838477
25 days ago
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need to close the gap between rhetoric and policy...
www.foodpolitics.com/2025/08/trum...
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Weekend reading: National Food Museum's update on Trump Administration Food Scorecard - Food Politics by Marion Nestle
Michael Jacobson, founder and former president of the Center for Science in the Public Interest, is now promoting development of a National Food Museum. One of its projects is keeping score on admini...
https://www.foodpolitics.com/2025/08/trump-administration-food-scorecard/?lctg=333222006
26 days ago
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Historians will look back at this and ask how we let this happen.
open.substack.com/pub/insideme...
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Minnesota has permissive gun laws. Yesterday showed us what that means for kids.
Merging what I'm seeing in the ER with rigorous deep-dives on the very latest medical and public health data. I want you to know what really matters.
https://open.substack.com/pub/insidemedicine/p/minnesota-has-permissive-gun-laws?r=7bit1&utm_campaign=post&utm_medium=email
28 days ago
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Another helpful update from YLE--clarifies common question on Covid vaccines, but parts of it are unknown at this point.
open.substack.com/pub/yourloca...
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Covid-19 vaccine license change: 12 key questions answered
And an important note about the ousted CDC leaders
https://open.substack.com/pub/yourlocalepidemiologist/p/covid-19-vaccine-license-change-12?r=7bit1&utm_campaign=post&utm_medium=email
28 days ago
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reposted by
Robert Califf
Mark Zaid, Esq
28 days ago
Abbe Lowell and I represent CDC Director
#SusanMonarez
. Contrary to govt statements, Dr. Monarez has neither resigned nor yet been fired. She will not resign. We have issued the following statement:
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Seasoned leaders leaving. Vulnerability of public health is significant.
open.substack.com/pub/insideme...
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Breaking News: Top CDC scientist resigns. Dr. Debra Houry had "a long history of working across seemingly partisan divides."
Two other respected center directors also resigned in the wake of the sacking of newly-confirmed CDC Director Dr. Susan Monarez earlier today.
https://open.substack.com/pub/insidemedicine/p/breaking-news-top-cdc-scientist-resigns?r=7bit1&utm_campaign=post&utm_medium=email
28 days ago
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This is a good one.
www.foodpolitics.com/2025/08/nutr...
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Nutritionally hilarious: Louisiana's definition of "soft drinks" for its SNAP waiver - Food Politics by Marion Nestle
The USDA has just approved a waiver for the State of Louisiana to exclude soft drinks, energy drinks, and candy from allowable purchases with SNAP benefits. “Soft drinks” are defined as any carbonated...
https://www.foodpolitics.com/2025/08/nutritionally-hilarious-louisianas-definition-of-soft-drinks-for-its-snap-waiver/?lctg=333222006
28 days ago
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Good to see the ACC on top of this. CV disease patients continue to benefit from guidelines grounded in the evidence.
www.cidrap.umn.edu/adult-non-fl...
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New ACC guidance urges uptake of 5 vaccines for heart patients
https://www.cidrap.umn.edu/adult-non-flu-vaccines/new-acc-guidance-urges-uptake-5-vaccines-heart-patients
29 days ago
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Good update with scary rumor about withdrawing Covid vaccines from market. That would be a bad idea.
open.substack.com/pub/theunbia...
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One Week Later: Reflecting on "The Playbook Used to 'Prove' Vaccines Cause Autism"
The hunger for clear, honest science communication is real.
https://open.substack.com/pub/theunbiasedscipod/p/one-week-later-reflecting-on-the?r=7bit1&utm_campaign=post&utm_medium=email
29 days ago
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Good to see men's health getting some attention. Outcome measures are not looking good!
www.nytimes.com/2025/08/25/m...
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What Does It Take to Get Men to See a Doctor?
https://www.nytimes.com/2025/08/25/magazine/mens-health-doctor-masculinity.html?unlocked_article_code=1.g08.ky6d.YoOcCgNaa85j&smid=url-share
30 days ago
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Helpful summary--note Covid upswing.
open.substack.com/pub/yourloca...
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Covid-19 summer wave, flying flesh-eating maggots, radioactive shrimp, DEI research cuts, publication fraud, and science fighting back in the best way
The Dose (August 25)
https://open.substack.com/pub/yourlocalepidemiologist/p/covid-19-summer-wave-flying-flesh?r=7bit1&utm_campaign=post&utm_medium=email
about 1 month ago
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Redefining "the swamp"
open.substack.com/pub/insideme...
about 1 month ago
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Sean's article
www.insights.phyusionbio.com/p/the-misnom...
add a skeleton here at some point
about 1 month ago
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Sean hit the nail on the head here in my view. One important piece of the puzzle not mentioned is BEST (
pubmed.ncbi.nlm.nih.gov/27010052/
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BEST (Biomarkers, EndpointS, and other Tools) Resource [Internet] - PubMed
Effective, unambiguous communication is essential for efficient translation of promising scientific discoveries into approved medical products. Unclear definitions and inconsistent use of key terms ca...
https://pubmed.ncbi.nlm.nih.gov/27010052/
about 1 month ago
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Excellent summary as expected from YLE on Long Covid. Seems like vaccine skeptics are reluctant to talk about the data on this.
open.substack.com/pub/yourloca...
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Long Covid research roundup
What have we learned since last year?
https://open.substack.com/pub/yourlocalepidemiologist/p/long-covid-research-roundup-f37?r=7bit1&utm_campaign=post&utm_medium=email
about 1 month ago
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Good, but depressing description of economic forces in our medical care system--some glimmer of hope included.
jamanetwork.com/journals/jam...
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The Vocabulary of Our Discontent
This Perspective examines the vocabulary used to describe how US health care is increasingly governed by the rules, values, and practices of other sectors of the market economy.
https://jamanetwork.com/journals/jama/fullarticle/2837776
about 1 month ago
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Another concise summary from YLE
open.substack.com/pub/yourloca...
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https://open.substack.com/pub/yourlocalepidemiologist/p/covid-19-vaccine-label-change-alpha?r=7bit1&utm_campaign=post&utm_medium=email
about 1 month ago
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