Regarding the White House’s announcement that Trump has a rash to his neck due to a “preventive“ skin cream: -this is almost certainly fluorouracil (probably with calcipotriene added), which treats certain pre-cancers (actinic keratoses) and early stage squamous cell carcinoma. Not deadly.

[THREAD] Why it matters that the FDA is refusing to review Moderna's application for an mRNA based influenza vaccine. 1. Flu is a perpetual threat to human health, because it sometimes mutates and sparks major, deadly pandemics (including the 1918 flu). Our best defense is vaccines.

A legend of public health has died. Dr. William Foege co-led the successful global effort to eradicate smallpox, and later was director of the CDC. I quite recommend his book, "House on Fire." It is a remarkable account of smallpox eradication, one of the greatest public health achievements ever.

I commented on a post and it blew up a bit. I regularly see conspiracy theories on here that because Trump has bruises to the backs of his hands, that he is secretly having IV infusions. I believe a much likelier explanation is solar purpura, a common condition in elderly Caucasian men.

[THREAD] The federal government is trying to hinder gender-affirming care. Something interesting from a medical standpoint is that gender and sex are so complicated, that I don't think you can interfere with care for transgender children without also messing with other children's care.

The vote by ACIP to end universal hepatitis B vaccination at birth is a big mistake that will endanger American children. Our approach to vaccination has prevented thousands of kids from getting infected with a virus that can cause liver damage and early death.

Scattered thoughts on ACIP meeting: -I couldn't handle watching the ACIP meeting but read reports from brave souls like @enirenberg.bsky.social. -Given their anti-vax goals I don't really understand why ACIP is going through the charade of holding meetings and pretending to go through evidence.

Explainer regarding Hep B vaccine: Hepatitis B is a virus that causes chronic liver infection, leading to liver failure or liver cancer. Even in patients who never develop symptoms, just having the virus makes it difficult to treat autoimmune conditions such as rheumatoid arthritis and psoriasis.

My take on the significance of recent developments regarding vaccines at the CDC and FDA. 1. The CDC now falsely states on its website that "studies have not ruled out the possibility that infant vaccines cause autism." and that "Studies supporting a link have been ignored by health authorities."

CDC has overhauled its website to assert that “the claim ‘vaccines do not cause autism’ is not an evidence-based claim”

I will be joining a "No Kings" protest tomorrow (since Canada is a constitutional monarchy, here it is called "No Tyrants"). I hope you will join one in your community, too.

Seeing posts that the CDC's Epidemic Intelligence Service has been (illegally) fired by the Trump Administration. These are the elite disease detectives that are deployed to investigate outbreaks around the world. It's a real loss as far as our ability to detect and combat the next pandemic.

US followers: There is a new next-generation COVID vaccine from Moderna called mNexspike that is superior to the other COVID vaccines. It is slightly more effective at protecting from COVID, it confers immunity for more months, and it causes fewer side effects. It is approved age 12 and up.

After days of trying, a physician friend in California can't get a COVID vaccine for her unvaccinated infant. We're improvising a way for her to obtain an adult dose of Moderna vaccine (which only comes in a pre-filled glass syringe), draw off a portion of it, and administer that instead.

An entire lineage of influenza B viruses literally went extinct due to COVID mitigation measures and people will still say “masks don’t work”

As expected, RFK has populated ACIP with antivaxxers. Expect federal vaccine recommendations to be withdrawn. A significant number of people will likely lose insurance coverage for vaccines by next year.

Former CDC director @drtomfrieden.bsky.social weighs in

Nobody believed us when we warned them RFK Jr.’s endgame is to eliminate all vaccines. They told us we were histrionic and hysterical. I’ve been watching RFK Jr. for 20 years. He’s antivax to the core. He really means it, and NOTHING will change his mind. He will do all he can to eliminate vaccines.

I can't read the article due to paywall. This is quite bad news for vaccine access. ACIP is the CDC's advisory panel that issues vaccine recommendations. Their recommendations largely determine what vaccines insurance will pay for. Presumably RFK will install only antivaxxers on the panel.

COVID vaccine remains on the CDC's immunization schedule, despite RFK's announcement that he was unilaterally removing it. Incompetence? Subtle pushback from the CDC?

I see this as a test case. RFK is seeing if he can get away with this, before unilaterally revoking the recommendations for more vaccines in the future. Vaccine recommendations matter because they dictate what vaccines insurance will cover. It is all part of the multi-pronged assault on vaccines.

An underappreciated point that this article makes: Makary and Prasad were chosen for their positions at FDA *because* they are anti-vaccine, and loudly so. That is essentially their only qualification.

@enirenberg.bsky.social is live-tweeting the VRBPAC meeting (FDA advisory committee vaccines). The members have a tough choice: do they recommend that we continue to use our current vaccine, which is not so well matched to current trains, or recommend an updated vaccine that risks rejection by FDA?

Moderna is (temporarily?) withdrawing its FDA application for its newly-developed combo COVID/flu vaccine. Moderna published a study suggesting that the vaccine provides superior protection against COVID compared to current vaccines. A real loss, thanks to the antivaxx ghouls who now run the FDA.

To summarize a bit: -The COVID vaccine remains quite important for people of all ages to receive. COVID infection and reinfection causes cumulative, progressive damage to the body, It causes organ damage, immune dysfunction, and brain injury. [THREAD]

US COVID vaccine update: The Trump-appointed ghouls running the FDA have published a piece in NEJM. Their plan will make it difficult for people to receive COVID shots if they are under the age of 65.

COVID vaccine update: The European Medical Agency (EMA) is recommending that COVID vaccines be updated to target the newest emerging variant (LP.8.1) . By comparison, the WHO says it is OK to keep vaccines as is. I agree with the EMA's recommendations here.

FDA approved Novavax, with significant restrictions. This is mostly bad news as far as vaccine access. It is now FDA approved for 65+ y/o, and for 12 - 64 y/o "who have at least one underlying condition that puts them at high risk for severe outcomes from COVID-19."

Do *not* underestimate RFK Jr.'s determination to eliminate *all* vaccines, as he was lying through his teeth when he said he didn't want to take away anyone's vaccines. He *will* find ways to eliminate them. First, he will try to delicense specific vaccines, likely starting with HPV or hep B.

Will there be COVID vaccines available in the US this fall? This is becoming a very complicated picture. A summary: -Currently, Pfizer and Moderna are FDA approved for those 12 years old and up. -Pediatric versions of Pfizer and Moderna are only available via emergency use authorization. [...]

Death rates in pregnancy DOUBLED during 2020-2021, and there are mountains of evidence showing COVID infection leads to significantly worse outcomes for pregnancy & baby. There are also mountains of evidence showing COVID vaccination has no adverse effects on pregnancy or baby but does protect them.

The WHO issued recommendations for vaccine manufacturers worldwide as to what virus strain to use in their fall COVID vaccines. They essentially recommend using the same strains as in 2024-2025. I interpret this as both good and bad news.

This pick is a disaster. Prasad is a thin-skinned, academically-dishonest sellout who despises public health and vaccines. He also is a jerk. Now he is in charge of reviewing our vaccines and biologics. God help us.

My thoughts on new obstacles the US govt is imposing on updated vaccines: By law, RFK can overrule the FDA's decision of whether to approve a new (or updated) vaccine. But that would invite legal challenges and look bad. What if the goal is to make it near-impossible to even apply for approval? ...

The measles outbreak in the US cannot end until vaccine uptake increases. Measles will spread in a population until ~95% of people are immune. Because the population is constantly turning over (births and deaths), maintaining 95+% immunity means either repeated outbreaks or vaccinations.

The NYTimes has published a hagiographic puff piece about RFK. Sure he's dismantled our country's medical research and public health infrastructure. But did you know that he also is "an adventurous and spiritual man, ardent in his convictions"?

Pharma and biotech shaken by Peter Marks' ouster from #FDA. “It signals the very infrastructure we rely on to evaluate, approve, & monitor life-saving medicines — & to protect patients from harm — is at risk of collapse.” www.statnews.com/2025/03/29/f...

This is like hiring Andrew Tate for an important national study into whether women talk too much

Bizarre that this was at a closed-door meeting, but this is hopeful news that the US govt is taking steps towards having seasonal flu vaccine for fall 2025

In this NYTimes interview, RFK falsely attacks the measles vaccine as having injured Mennonite children, and he recommends treating measles with cod liver oil, antibiotics, and steroids. This fraudulent, anti-science shilling is on brand for RFK. I draw a deeper lesson from this too: [THREAD]

About 1 in 1000 unvaccinated people who contract measles will die of it. Following patient deaths is a rough way to follow the outbreak. The total number infected (of unvaccinated people) will be roughly 1000x the death toll. The locations of the deaths will correlate to where the outbreak is worst.

His dabble in evidence based medicine lasted 24 hours. This isn’t how to contain measles.

Here I react to the shameful behavior of American leaders and media toward the Ukrainian president. No doubt there were more, but I saw five failures on our side: of hospitality, decency, democracy, strategy, and independence. Please watch and share. snyder.substack.com/p/five-failu...

What would be some foreseeable consequences of no seasonal flu vaccine next season in US, beyond more seasonal flu cases? [THREAD] 1. Increased risk of bird flu pandemic 2. Diminished ability to respond to bird flu pandemic 3. Strain on hospitals 4. Less investment in US vaccine manufacturing.

Explainer about measles and the current outbreak: -Measles is a nasty virus. In those unvaccinated, it kills about 1 in 1000. That might sound small but it becomes a lot of deaths when swathes of people get infected. It also can cause problems years later, like a degenerative brain condition (SSPE)

There is an annual process for the seasonal flu vaccine and the US govt is abandoning its usual seat at the table. Flu vaccines do not have huge profit margins. Mfrs will pull out of making seasonal flu vaccines for the US if they are unsure whether the US will recommend, approve, and pay for them.

I suddenly have a bunch of followers. Welcome! I am a physician who sees patients each day. I have past experience in federal government, public health, and biosecurity (the field that deals with global threats to health).

JUST IN: Another medical horror story in an affidavit from a USAID employee stationed overseas. Says his pregnant wife was not medevac-ed for emergency health care because of directives from DC. Took intervention of a U.S. senator to reverse — but was too late. s3.documentcloud.org/documents/25...

Mass firings of HHS employees across HHS, without even knowing what those employees contributed in the mission of their offices is likely to lead to loss of HHS functions that are important to the country. 1/x

There is no line the Republican Party is not willing to cross with and for Donald Trump. They have now reached a point where even Mitch McConnell, whose place in history as one of democracy’s worst gravediggers is secure, refuses to go. A reminder of how far things have already escalated.