Top news stories from AMA Morning Rounds®: Week of May 15, 2023

Read AMA Morning Rounds®’ most popular stories in medicine and public health from the week of May 15, 2023–May 19, 2023.

The New York Times (5/18, Jewett) reports a FDA advisory panel voted on Thursday in favor of approving a vaccine by Pfizer given to pregnant women to prevent RSV infection in infants. All 14 of the “agency advisers unanimously agreed that the vaccine was effective.” However, only 10 “agreed that the vaccine was safe, with some airing concerns about elevated rates—not all statistically significant—of preterm births among mothers who got the vaccine compared to those who received a placebo.” The Pfizer vaccine for pregnant women, branded Abrysvo, is under review “ahead of another option submitted to the FDA that would be given to infants—a monoclonal antibody shot meant to provide five months of protection.”

The AP (5/18, Neergaard) reports, “In Pfizer’s international study of nearly 7,400 pregnant women, maternal vaccination proved 82% effective at preventing severe RSV during babies’ most vulnerable first three months of life.” At six months of age, “it still was proving 69% protective against severe illness.” Although the experts agreed “the safety data seem generally favorable,” the agency “did ask its scientific advisers to consider whether a slight difference in premature birth between the two groups was of concern.” Pfizer “predicts the U.S. could prevent as many as 20,000 infant hospitalizations a year, and 320,000 doctor visits, if enough pregnant women were vaccinated.”

Reuters (5/18, Sunny) reports that these recommendations pave “the way for likely U.S. approval.”

CNN (5/17, McPhillips) reports, “Depression is more widespread than ever in the United States, according to” new survey data from Gallup that indicated that “about 18% of adults—more than one in six—say they are depressed or receiving treatment for depression.” Additionally, “nearly three in 10 adults have been clinically diagnosed with depression at some point in their lifetime, according to the survey, which is also a record high.” The findings emphasize the “undeniable toll” taken on mental health by the COVID-19 pandemic.

STAT (5/17, Owermohle, Subscription Publication) reports that “the Gallup survey of more than 5,000 adults in late February indicates that depression, already labeled a crisis among children amid COVID-19 shutdowns and social media use, is much more widespread.” In particular, “depression rates have sharply risen among women and Black and Hispanic people.” These “data come as the Biden administration tries to overhaul mental health care costs and boost the number of health care workers licensed to practice behavioral health care.” In this year’s budget, Congress “also allotted hundreds of millions of dollars to mental health care grants and programs, many of them trained on children or substance misuse.”

The Washington Post (5/16, Johnson) reports, “America’s Black communities experienced an excess 1.6 million deaths compared with the white population during the past two decades, a staggering loss that comes at a cost of hundreds of billions of dollars, according to two new studies that build on a generation of research into health disparities and inequity.” In the one study, “researchers conclude that the gap in health outcomes translated into 80 million years of potential life lost.” In the other study, researchers “determined the price society pays for failing to achieve health equity and allowing Black people to die prematurely: $238 billion in 2018 alone.” The findings of both studies were published in JAMA.

Bloomberg (5/16, Muller, Subscription Publication) reports, “Age-adjusted death rates ranged from 21% to 40% higher among Black males and from 13% to 31% higher among Black females compared with their white counterparts.”

The New York Times (5/15, Kolata) reports that researchers have discovered a genetic mutation in one patient that appears to delay Alzheimer’s disease from entering the patient’s entorhinal cortex, even though brain scans “revealed severe atrophying and...rough, hard, amyloid plaques and spaghetti-like tangles of tau proteins.” This particular “mutation results in a potent version of a protein, Reelin, in the entorhinal cortex,” and this “super-potent Reelin ultimately prevents tangled strands of tau proteins from sticking together and forming the structures that are a characteristic of Alzheimer’s.” The discovery has prompted researchers to investigate this as a potential target in developing the next generation of Alzheimer’s therapeutics. The findings of the research were published in Nature Medicine.

The Washington Post (5/15, A1, Johnson) reports that “this man is only the second patient identified with the miraculous ability to defy the devastating Alzheimer’s gene.” A previously known patient with a different mutation also had a brain “clogged with the characteristic amyloid plaques of Alzheimer’s, [but] it was relatively free of the tangles of tau that are also associated with the disease.” Investigators “did find an overlap between the two different gene mutations that helped protect these individuals: Both mutations affect proteins that bind to the same receptors on the surfaces of brain cells.”

HealthDay (5/12, Norton) reported, “Older Americans are dying of falls at more than double the rate of 20 years ago—with women, men and all racial groups showing increases, according to a new study.” After adjusting for age, researchers found a “more than twofold increase in the rate of fall-related deaths among older Americans: from 29 per 100,000 in 1999, to 69 per 100,000 in 2020.” While researchers were unable to pinpoint the exact causes, they suggested “more older adults these days are surviving serious medical conditions like heart attack and stroke,” and “living with the aftereffects of those conditions can...put people at increased risk of falls.” Additionally, one researcher said “that so many older adults...are taking multiple medications—some of which, or combinations of which, can cause dizziness or other side effects that contribute to falls.” The findings were published as a research letter in JAMA.

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