Elizabeth Cooney , 2025-04-29 12:00:00
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Good morning. Liz Cooney here taking a turn with the newsletter while Theresa’s out exploring the world.
Today is officially the 100th day of the second Trump administration, a tenure marked by so many significant events we need Usha Lee McFarling’s timeline to remind us what we’ve lived through. To recap STAT’s lookback last week: The $2.3 billion in cuts to the NIH loom above all, but to see who’s behind those figures, read five accounts of grants terminated, dreams crushed, and futures in the balance.
Makary’s vaccine playbook at FDA reads like RFK Jr.’s
When it comes to vaccine criticism, it appears both FDA Commissioner Marty Makary (above) and Health Secretary Robert F Kennedy Jr. are on the same page. Never mind the hopes public health experts once expressed, believing that as a physician-scientist, Makary would protect the agency from the broader vaccine skepticism circulating in the Trump administration. Last weekend Makary signaled that the FDA may depart from longstanding precedent by requiring Covid vaccine makers to submit new effectiveness data before adjusting their products for new strains, potentially hobbling efforts to protect people from evolving disease.
Like Kennedy, Makary has downplayed the seriousness of the current measles outbreak while saying he supports the MMR vaccine. He also decried “absolutism” in the vaccine schedule. He didn’t defend ousted vaccine regulator Peter Marks. And information from the HHS media office directed FDA officials to add “the decision to vaccinate is a personal one” when responding to a journalist’s question about how the agency monitors safety. Read more from Lizzy Lawrence.
Americans’ trust in public health wavers with health agency changes
Looking ahead to the next four years, 44% of Americans say leadership changes in the federal government have eroded their trust in public health recommendations. That’s down from the 77% of adults who previously had faith in the CDC’s guidance after the Covid-19 pandemic, a poll released today by the Harvard T.H. Chan School of Public Health and the de Beaumont Foundation reports. There is a divide along political party lines, with Democrats more doubtful (76%) and Republicans more confident (57%) about health directives going forward.
Among the adults concerned about the next four years, most fear that the CDC’s recommendations will be skewed by politics (76%), and that it will trim programs too much (75%), downplay infectious disease outbreaks (72%), and reduce public access to important health information on such topics as about vaccines (70%).
There is common ground. Most adults favor:
- Preventing chronic diseases (Republicans 86%, Democrats 91%)
- Protecting against new viruses that could seed pandemics (Republicans 75%, Democrats 92%)
- Reducing maternal and infant mortality (Republicans 81%, Democrats 86%)
- Ensuring the safety of tap water
One dose of HPV vaccine may be enough to prevent cancer, new data say
Ready for some good news? Clinical trial data presented Monday at a large cancer research meeting in Chicago showed that whether one dose or two were given to 20,000 girls between ages 12 and 16 in Costa Rica, estimated efficacy rates at preventing cancer came in upwards of 97% after four and half years of follow-up. The vaccine is already known to prevent cervical cancer as well as anal, penile, and some head-and-neck cancers, but getting two doses to adolescents around the world has proved difficult, whether it’s in the U.S., where in 2019 only 54.2% of adolescents had received two shots, or in lower-income countries where rates are even lower.
Ned Sharpless, who was NCI director in the first Trump administration and is now a managing director at Jupiter Bioventures, called the study the “most important cancer trial” underway in the world. “To have such clear evidence to support our practice is terrific and this will make the dissemination of HPV vaccine worldwide much easier and much cheaper to do — and it will save millions of lives.” STAT’s Matthew Herper has more.
As compounded versions of weight loss drugs disappear, patients are left behind
Now what? The end of compounded versions of powerful and popular obesity drugs leaves people adrift after depending for two years on copies of medications such as Wegovy, Ozempic, and Mounjaro. Because they are no longer deemed by regulators to be in shortage, compounding pharmacies and the telehealth companies they work with must stop offering copies of the treatments. It’s a struggle to afford the brand-name medications that can cost as much as $1,000 a month. The pharma companies Novo Nordisk and Eli Lilly now offer their drugs at around $350 to $700 a month, but that’s still unaffordable to many patients used to paying about $200 a month.
“This is kind of like a lose-lose situation,” said Yale’s Reshma Ramachandran, a physician who treats many patients taking compounded GLP-1s because they can’t afford the branded drugs.
These are more than pocketbook concerns. When patients suddenly stop these medications, their weight and all the other health conditions they were trying to address, like high blood pressure, cholesterol, and blood sugar, can rebound. STAT’s Katie Palmer and Elaine Chen explain how compounding and telehealth companies are responding, including with offers of “personalized” doses.
Over the last century, where people lived was linked to how long they lived
Life expectancy in many southern U.S. states — especially for females — has risen little over the past century, according to a new analysis of mortality from 1900-2000 published Monday in JAMA Network Open. Despite life expectancy increasing nationally by 10 years in that period, from 73.8 to 84.1 years, life expectancy for females increased by three years or less in several southern states, including Tennessee, Alabama, Arkansas, Mississippi, Kentucky, Oklahoma, and West Virginia. For males in many of these states, life expectancy increased between 1900 and 1950, but increased little after 1950. Areas with the highest gains in life expectancy included Washington D.C., which saw an increase from 61.1 to 72.8 years of age, as well as the western and northeastern U.S.
The researchers attribute these state level differences to factors such as cigarette smoking, drug use, environmental factors, vaccination rates, access to effective health care, and socioeconomic factors. They noted that policy choices, such as the tobacco-control policies adopted decades ago by some states, like California, and not adopted in many southern states, could have a marked impact on life expectancy and suggested state level analysis of mortality should help guide policy choices and public health resource interventions. — Usha Lee McFarling
Report on transgender health for children coming from the White House this week
The Trump administration is set to release a sweeping report about transgender health for children in the United States, according to a new executive order published Monday.
The order says the report has been developed by “eight distinguished scholars.” The document also summarizes how the federal government has targeted the trans community and trans health care since the president’s inauguration in January — including ending 215 health grants totalling over $477 million, pushing medical professionals to stop using internationally recognized standards of care, and ending federal health benefits coverage for the “mutilation of the children.”
Many experts expect the review to resemble the so-called “Cass Review,” a lengthy overview of health care for trans youth in England that has been decried by researchers and advocates for failing to provide an adequate picture of gender-affirming care. — O. Rose Broderick
What we’re reading
- NHS to test all ‘trans’ children for autism, The Telegraph
- To become a doctor, denial helps, New York
- Pharma’s reputation with patient groups dips again, mostly due to pricing issues, STAT
- As a diversity grant dies, young scientists fear it will haunt their careers, NPR
- Opinion: The future of preventive care depends on the Supreme Court’s reading of two words, STAT
