The pre-vaccine era was HELL for kids. We have already failed them on gun safety, we cannot fail them on the issue of vaccines. #VACCINES cause Adults!
Physician Scientist MDPhD Infectious Diseases Academic Medicine Global Health Science Communicator Posts are my opinions, not my employer's and not medical advice I bet on myself and double down https://substack.com/@bktitanji
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The pre-vaccine era was HELL for kids. We have already failed them on gun safety, we cannot fail them on the issue of vaccines. #VACCINES cause Adults!
Medical groups must continue to stand up for science and truth. Physicians must continue to support their patients with sound guidance and empathy."
"Congress must exercise its oversight authority over H.H.S. State and local governments must fill funding gaps where they can. Philanthropy and the private sector must step up their community investments....
Important Essay in @nytimes.com by 9 former CDC directors. "We have a message for the rest of the nation as well: This is a time to rally to protect the health of every American...." www.nytimes.com/2025/09/01/o...
Excellent
The answer is I do not know yet but we will find out soon enough. I was unable to get a booster at CVS today without a prescription from my dr. I will try with employee health as soon as I know if they are available.
Recommend and prescribe the vaccines they may need to their local preferred pharmacy. They will thank you for it.
It can be very hard to get an appointment with a healthcare provider these days because most facilities are critically understaffed which is why instead of leaving it up to patients to try to reach out for a appointment to get a script it's easier to remove the additional step and
Prescriptions for boosters for patients who want to get vaccinated ahead of the colder months. Flu, RSV, COVID.The goal here is to keep folks out of hospital.
Also making vaccine access easy for patients would be crucial. Sending those prescriptions to pharmacies for patients who want the covid booster in states that are making vaccines prescription only will make a huge difference. I for one will be reviewing my patient panel this week and calling in
One of the most important things healthcare systems across America can do to protect patients, and the workforce that attends to them this winter is to ensure #Covid vaccines are available to healthcare workers. That includes clinics, hospitals,and nursing homes.
My PCP will be ok writing a script for me and I will message him about doing so.
No they asked if I had a prescription from my health care provider. I said know and was informed this season they are only giving it out to those who have a prescription.
Welp! Couldn't my #COVID shot at #CVS appointment today. I was informed I will only be able to get it by prescription in the state of Georgia. Let's see if my healthcare system will provide shots for medical staff. I will update you on this as well.🤷🏽♀️
PS- I will travel out of state to get a vaccine if I need to. It shouldn't be this hard to get access to a vaccine that's so safe 8 billion doses have been administered world wide but here we are.
Yeah it's run by idiots. I suspect they will go with vaccines are woke .
“It’s important for New Mexicans to know the New Mexico Department of Health is committed to keeping residents safe as we enter the 2025 – 2026 respiratory virus season,” said Health Secretary Gina DeBlassie. “This order will remove obstacles to vaccination access.”
States have a lot of power to dictate health policy for their residents. The New Mexico Department of Health has issued a public health order to help ensure all New Mexicans can access the COVID-19 vaccine. I hope other states follow suit. www.nmhealth.org/news/vaccine...
some people may also time their shots with planned travel and or large gatherings. Whatever you decide the important thing is ensuring you are vaccinated and protected. Both vaccines reduce illness severity and prevent hospitalization.
The general recommendation is to get the flu vaccine when the flu virus circulation is ticking up i.e. End of September to mid October to ensure peak protection when the community circulation of virus peaks. COVID cases are up now, get a booster once it is available to you.
Thank you, it means a lot 💚
The CDC shaped my career and saved countless lives around the world. To see it hollowed out and replaced by ideology is devastating. In my latest essay, I share my own CDC story and why its unraveling matters for all of us. open.substack.com/pub/bktitanj...
We should be able to agree that funding research for pediatric cancer should be prioritized and expanded. Not canceled. Clinical trials that can be the last hope for kids with cancer stopping recruitment due to funding loss is heartbreaking 💔 www.nytimes.com/2025/08/28/w...
Maybe the only we survive this is with a twinge of sarcasm and very dark humor😞.
🦟 Did you know the CDC was originally created in 1946 to help eradicate malaria in the U.S.? A quick 🧵 on how they accomplished this mission & eliminated malaria by 1951
The CDC like any major government agency has it's flaws but through but was for decades a shining beacon of public health leadership and excellence in outbreak response world wide. This isn't a trivial loss for our country and for the world.
My uncontroversial opinion is that the head of the country's top public health agency should be a physician or a scientist or both not a former presidential speech writer and investor but here we are. Sadly I think this is the end of the CDC as we once knew it. www.theguardian.com/us-news/2025...
Sometimes clinicians will use the thigh (anterolateral aspect) as an alternative injection site This is standard practice in adults when arms aren’t an option.
They should be injected at least 1 inch apart (usually different spots on the deltoid). This is safe, though you may get more local soreness in that arm. If the available “good” arm is too sore.
If one arm is off-limits (e.g., after axillary node dissection) That arm should be avoided for injections and blood draws to lower the risk of lymphedema or complications. Both vaccines can be given in the same arm if needed.
It is safe and effective to receive both shots at the same visit. Normally, clinicians recommend different arms (one in each deltoid) to reduce local soreness and to make it easier to attribute side effects.
Novavax, Pfizer and Moderna booster shots have been approved this week
- Vaccine effectiveness and immunogenicity. - Animal and human immunogenicity against candidate strains They unanimously recommended a monovalent JN.1-lineage vaccine, preferably using the LP.8.1 subvariant, which was the dominant strain in the U.S. at the time
The FDA’s VRBPAC did meet (May 22, 2025) after the flu frenzy to address COVID‑19 vaccine composition for fall 2025.During that session, the committee examined robust real-world data: - What strains and subvariants are currently circulating. - Antigenic characteristics of those variants.
The World Health Organization (WHO) convened its own strain-selection meeting and published its Northern Hemisphere recommendations. Historically, FDA often aligns with those WHO selections
This skipped-over process, sidestepping the usual expert panel, understandably raised concerns in the infectious disease community, including the Infectious Diseases Society of America
Instead, the FDA convened a closed-door interagency discussion among FDA, CDC, and DoD experts, then issued strain recommendations directly to manufacturers by March 13 officially claiming vaccine availability wouldn’t be affected.
FDA canceled its usual VRBPAC advisory meeting (Vaccines and Related Biological Products Advisory Committee) scheduled for March 13, 2025, which traditionally reviews data and recommends flu strains for the upcoming season.
That may be challenging given changes to covid booster recommendations for children. the shots have now been restricted only to children with co-morbidities which are associated with severe covid. Please discuss with your child's pediatrician for best guidance how to navigate.
Sadly very high. I think that is the end goal here if congress does nothing ti stop him. All of his actions so far point to that.
Georgia
There is a massive walk out at the CDC by staff unfolding right now. It is NECESSARY. I stand in solidarity with my CDC colleagues. standing up for science and public health. It is a moral imperative.
Vibrio species bacteria is one of the 6 food borne pathogens for which the CDC recently discontinued surveillance. Louisiana is currently experiencing an uptick in infections and two deaths have occurred so far. www.yahoo.com/news/article...
Even if you rely on non-U.S. guidance, insurance coverage and access in the U.S. still often track CDC/ACIP decisions, which has been in flux this year as we are all aware. Please check payor policies and local health departments and discuss vaccine with your health care provider.
GAVI- Global alliance for vaccine initiative www.gavi.org/vaccineswork Australia's Melbourne Vaccine Education Center mvec.mcri.edu.au/media-library/ There are many others but I wanted to compile a list of sources I use and trust for quick reference.
3. Independent academic & nonprofit vaxx info CHOP Vaccine Education Center www.chop.edu/vaccine-educ... Johns Hopkins Institute for Vaccine Safety www.vaccinesafety.edu Oxford Vaccine Group - Vaccine Knowledge Project vaccineknowledge.ox.ac.uk/home Immunization Action Coalition www.immunize.org
2. Non-US National Agencies UK -The Green Book (UKHSA) for clinical vaccine guidance www.gov.uk/government/c... EU- EMA/PRAC safety assessments and monthly highlights www.ema.europa.eu/en/committee... Canada www.canada.ca/en/public-he... Australia immunisationhandbook.health.gov.au
1. International Public Health Agencies - WHO SAGE www.who.int/groups/strat... - WHO Vaccine Safety Net (VSN) directory www.who.int/teams/regula... - PAHO (americas) www.paho.org/en/topics/im... - ECDC (Europe) www.ecdc.europa.eu/en/immunisat...
If you are worried about misinformed U.S. federal guidance on vaccines and preventative health measures right now, here’s a list of well sourced and science backed alternative sources of information. A thread that you can bookmark for future reference and pass on to others 🧵
It's pretty insane. Disinformation travels faster when it is being back by the highest levels of leadership. Our work to educate the public and counter the fire hose attacking science and public health in the US right now is playing catch up. It quite troubling and sad to witness.
Do NOT allow them to rewrite history with disinformation. #COVID vaccines worked remarkably well and allowed us to come out of a global pandemic. A picture is worth a thousand words.
I assume you are referring to the antibody infusion for RSV (called nirsevimab)? It is not a vaccine but instead directly gives babies protective antibodies that block the virus right away and reduce severe illness. There are no approved RSV vaccines for babies.
If you’re lower risk and want peak protection for winter, waiting until early/mid October is reasonable. No harm in either just don’t wait until the surge is already here and you are playing catch up .
For COVID, protection also wanes, but severe disease protection lasts longer. The main goal is to be covered before community spread spikes. So should you wait until mid/late October? If you’re high risk or traveling soon, don’t delay, better to have some protection than none.
It takes about 2 weeks after the shot for your immune system to mount a strong response. For flu, protection tends to wane over months. That’s why we suggest aiming for late Sept through mid-Oct so your immunity is peaks during the winter surge.
Bridge Access, or Medicare Part B without ACIP support. Individual uptake would collapse outside niche settings, few people would pay out of pocket for a vaccine not backed by CDC. It is always bad if ACIP does not back a vaccine that ia approved.
Hospitals, pharmacies, and clinics might not stock it, healthcare systems follow ACIP/CDC guidance for operational, liability, and reimbursement reasons. Public programs wouldn’t include it no federal purchase or distribution through VFC
What happens if ACIP declines to recommend? The vaxx would still be legal to use in the U.S. FDA approval means providers can prescribe/administer it. Most insurers would not be required to cover it w/out cost-sharing under the ACA, since ACIP recss are what trigger mandatory first-dollar coverage.
CDC/ACIP decides how (and if) the vaccine should be used, who should get it, how often, and under what circumstances. Their recommendations drive clinical practice, insurance coverage, and inclusion in public health programs like Vaccines for Children (VFC).
FDA decides if a vaccine is safe and effective enough to be licensed (full approval) or authorized (EUA). That’s the legal green light for a manufacturer to market and distribute it in the U.S.
Yup . Three vaccines were approved yesterday www.worldpharmaceuticals.net/news/us-fda-...
I will keep you informed if I face any barriers getting vaccinated when I go for my appointment . I do not think I will get push back. there is simply no cost effective way to enforce verifying whether people qualify given the very broad criteria which cover most of the adult American population.
yes the Novavax booster was approved alongside COVID and Moderna booster shots by the FDA yesterday. Most of the shots will be available in the pharmacies next week. I just booked myself an appointment with any issues. www.worldpharmaceuticals.net/news/us-fda-...
I called my local CVS this morning to book my #COVID vaccine and #Flu vaccine shots. I was simply asked if I qualify and answered yes. No further details or prescription was requested. My appointment is made. The shots will be available in the pharmacy September 4th.
- By making sure they are up to date on vaccines - Proper hand hygiene and masking for patient facing care - staying home is sick and symptomatic to prevent spreading infection to their patients - Educating their communities about the importance of vaccination
- Improved ventilation and air purification systems in healthcare settings - Hand hygiene enforcement - Sick leave allowing HCWs who are symptomatic to take time off and not spread their infection to staff and patients Layered prevention models are so important because these are additive
- Appropriate PPE use by staff. I still mask for all patient facing care but unfortunately most health systems have done away with mandatory masking for HCWs - Making vaccine access to patients easier - PharmD administration, primary care clinic availability etc
Infection prevention programs exist within most hospitals and some of the things they do include : - Recommending staff get vaccinated and protected against respiratory viruses - Isolating patients who test positive for these viruses to reduce nosocomial spread.
The best way to protect an at risk household member is by cutting down your own risk of catching & bringing RSV home. -Stay up to date on your vaccines (flu, COVID, e) - Practicing good hand hygiene and masking in crowded indoor spaces during RSV season -Avoid close contact w others if you’re sick
Right now, RSV vaccines are only recommended for: - Adults ≥60 after discussion with their clinician - Pregnant people (to protect newborns) - Adults with serious underlying conditions If you’re a healthy adult <60 without risk factors, the vaccine isn’t currently advised for you.
I think you mean people under 65. The guidance allows for people with any one of the qualifying criteria that increases risk for severe COVID to receive the vaccine if they under 65. I posted the list on my page but here is the a link for reference. www.cdc.gov/covid/hcp/cl...
Today I will be doing a Q&A special on #vaccines especially respiratory virus vaccines : #RSV, #COVID, #Flu. For the next 24 hours drop your questions in reply to this post and I will do my best to answer them and clear up some of the confusion around changing guidance. #AskAnIDDoc
Whatever I had imagined the assault on public health and vaccines would look like under RFK Jr. is a lot worse. So many people are going to die as a direct result of the systematic destruction of our public health agencies. www.nytimes.com/2025/08/27/h...
Thank you for your service, your leadership and bravery.
Dr. Demetre resigned as the director of the division of respiratory viruses at the CDC this evening. He posted his resignation letter on various social media channels. It is worth taking the time to read it. x.com/dr_demetre/s...
This is an awful lot for one day. Just blow after blow to the public health infrastructure and vaccine access. It's a sad day.
"3 CDC leaders resigned: Dr Debra Houry, the chief medical officer; Dr Daniel Jernigan, the director of the National Center for Emerging and Zoonotic Infectious Dz; and Dr Demetre Daskalakis, MD, director of the National Center for Immunization and Respiratory Dz" www.theguardian.com/us-news/live...
And there you have it - it was the vaccines. www.nytimes.com/2025/08/27/h...
Very ominous especially on the heels of CDC rolling back monitoring on several food borne pathogens and new COVID vaccine approvals from FDA making it harder for healthy people to access booster shots.
I guess to "qualify" for the CDC director job these days you have to be antivaxx, anti-science and willing to spread whatever health misinformation or lies the current head of the DHHS wants to push. My guess is she pushed back with science and got axed. www.washingtonpost.com/health/2025/...
It's about to 🙃
74% of Americans are overweight. That is a risk factor for severe COVID and thus qualifies you to get the now approved COVID vaccine booster shot this fall if you want it. I figured I'd drop this pearl, for no reason at all.
Heart conditions are on the list
Moderna is approved as well. I just posted the list of eligible comorbidities as per the CDC www.fiercehealthcare.com/pharma/pfize...
The list is long and includes low hanging fruit like physical inactivity which means most adults Americans will still meet criteria to get a COVID vaccine booster if they wish. Know the list, find your comorbidity and get your booster come fall.💅🤷♀️
Smoking (current or former) Solid organ or blood stem cell transplant Substance use disorders (alcohol, opioids, cocaine, etc.) Tuberculosis (TB) For children: – Same conditions as above plus congenital heart disease, genetic/metabolic conditions, medical complexity.
Immunocompromised state (disease or treatment, e.g., chemo, transplant meds) Mood disorders (depression, schizophrenia spectrum) Overweight or obesity (higher BMI = higher risk) Physical inactivity Pregnancy (and up to 42 days postpartum) Sickle cell disease Thalassemia
Cystic fibrosis Dementia and other neurologic conditions Diabetes (Type 1 or Type 2) Disabilities (e.g., cerebral palsy, Down syndrome, intellectual/developmental disabilities) Heart conditions (heart failure, coronary artery disease, cardiomyopathies; hypertension evidence is mixed) HIV infection
Chronic lung diseases: – Moderate/severe asthma – COPD (chronic bronchitis, emphysema) – Interstitial lung disease – Bronchiectasis – Bronchopulmonary dysplasia – Pulmonary hypertension – Pulmonary embolism
CDC list of medical conditions associated w higher risk for severe COVID-19, you need 1 to to qualify for vaccines now: -Cancer (solid or blood cancers) -Cerebrovascular disease (e.g., stroke) -Chronic kidney disease (any stage) -Chronic liver disease (fatty liver, cirrhosis, autoimmune hepatitis)
I hope the COVID vaccines would at least be available through employee health for healthy HCWs this winter: 1. A vaccinated health workforce reduces nosocomial spread of respiratory viruses 2. No hospital wants Drs and nurses out sick with COVID during peak utilization healthcare months.
That is what it looks like. I doubt healthcare systems would want to roll that dice and so may still make it available through employee health. Having several HCP out of work 2/2 COVID during the winter months is a recipe for disaster.
Let's not forget that COVID infections can cause severe debility even in the young and healthy. We know vaccination reduced the risk for long COVID, reduces virus shedding and risk of spreading the virus to the more vulnerable and reduces illness severity for everyone.
This narrower recommendation signals a shift toward targeting those most likely to benefit. But it raises tough questions: Will fewer shots mean more virus spread? Will access gaps widen? For now, only the elderly and medically vulnerable have clear approval.
All previous emergency use authorizations have been rescinded. The days of “everyone line up annually” are gone. Off-label vaccination for healthy under-65s is legally gray, pharmacies may refuse, and insurance coverage is uncertain.
The FDA has overhauled COVID-19 vaccine access. for 2025 updated Pfizer-BioNTech shots are approved only for: – Adults 65+ – Ages 5–64 with at least one high-risk condition for severe COVID. If you’re healthy and under 65, you’re no longer automatically eligible. finance.yahoo.com/news/pfizer-...
Yikes! The CDC has quietly scaled back its FoodNet surveillance, now only tracking salmonella and STEC. Monitoring for Listeria, Campylobacter, Vibrio and other pathogens has stopped- even after last year’s deadly Listeria outbreak. buff.ly/OyTTIOA h/t @boghuma.bsky.social #medsky #IDsky 🛟🧪
Only in America does the start of a new school year have parents and kids bracing for headlines populated with news of school shootings. Children deserve to be safe at school. Parents shouldn't have to worry that their kids will be shot or killed because they went to school. IT IS 100% THE GUNS.
Coffee is now a luxury item in the U.S. Discuss. #Tariffs
In case the first post in this thread is unclear, here is the list of pathogens for which surveillance has been discontinued: Campylobacter Cyclospora, Listeria, Shigella, Vibrio Yersinia