Recent case reports in The Lancet and Clinical Infectious Diseases have indicated that non-immunosuppressed individuals can suffer from repeat mpox (monkeypox) infections. We hope that vaccination can reduce incidence and severity of disease, but we’re still lacking high-quality data. An RCT would be ideal, but ethically challenging. Mpox risk is highly concentrated in men who have sex with men, typically with multiple partners. I’m not sure that it would be ethical to randomize this high-risk group to placebo. Perhaps alternative control groups such as a single dose schedule could be considered. Since other demographic groups so far remain at very low risk, a broader trial would be almost impossible to statistically power.
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Lisa Rosenbaum, one of my favorite physician writers, is now hosting a podcast for the New England Journal of Medicine. This week she talks with another one of my casual Twitter acquaintances, physician Ziad Obermeyer. I first became familiar with his work when he asked for some feedback on a fascinating manuscript that used “big data” to show how changes in the weather can nudge the results of common lab tests, potentially impacting treatment decisions.
A new study in JAMA Internal Medicine offers further data showing that the US lags behind other countries in active surveillance for low-risk prostate cancer. Prostate cancer is one of the most overdiagnosed tumors, often leading to unnecessary treatment, financial burden, and worry.
Stephanie Lee, one of the best health reporters in the business, has a new story in the Chronicle of Higher Education explaining how a terrible anti-vax article landed in a legitimate infectious disease journal.is a substacker now. Like all substackers, he’s required to weigh in on whether children should be vaccinated against COVID and whether SARS-CoV-2 originated in a lab leak. The difference, of course, is that Dr. Offit is actually qualified to opine on such matters.
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