Black History Month Begins February 1, 2023

Black History Month begins February 1, 2023. There are many learning resources available and activities available.

Websites include:

Black History Month

BlackPast

African American Museum of Iowa (Building is closed for renovation although online collections are available for viewing)

FDA VRBPAC Discussion Topics Today

The FDA VRBPAC 178th annual meeting on future Covid-19 vaccine regimens includes two main discussion topics:

“Future periodic vaccination campaigns:
Simplification of COVID-19 vaccine use:

  • Immunization schedule: Please discuss and provide input on simplifying
    the immunization schedule to authorize or approve a two-dose series in
    certain young children, and in older adults and persons with compromised
    immunity, and only one dose in all other individuals.
    Periodic update to COVID-19 vaccines:
  • Vaccine composition: Please discuss and provide input on the
    consideration of periodic updates to COVID-19 vaccine composition,
    including to the currently authorized or approved vaccines to be available
    for use in the U.S. in the fall of 2023.”

Among the members attending the web conference is University of Iowa Professor Stanley Perlman, MD, PhD, Departments of Microbiology and
Immunology, Professor of Pediatrics, Mark Stinski Chair in Virology.

The meeting is today from 8:30 AM to 5:30 PM ET.

Update: Dr. Stanley Perlman MD, PhD from the University of Iowa will be the acting voting chairman of today’s meeting.

Update: Dr. Jerry Weir gave a clarifying and practical bird’s eye view of the issue at hand which began at 2:30 PM on the live play today (the meeting is being recorded). The questions and comments for Dr. Weir by Offit, Levy, and Chatterjee were also helpful to hear.

Update: Voting Question is:

“VRBPAC Voting question
Simplification of current COVID-19 vaccine use:

  • Vaccine composition: Does the committee recommend harmonizing the
    vaccine strain composition of primary series and booster doses in the U.S.
    to a single composition, e.g., the composition for all vaccines administered
    currently would be a bivalent vaccine (Original plus Omicron BA.4/BA.5)?”

Voting Result: Unanimously upvoted.

Today is National Opposite Day!

As we were listening to the Mike Waters Wake Up Call radio show on KOKZ, we were disoriented when he gave the temperature as “83” degrees and that it’s “Wednesday evening”. The more he talked, the more bizarre he began to sound and I wondered if KOKZ was for whatever reason broadcasting a past recording of his show.

Then he announced that it’s National Opposite Day, which occurs on January 25th annually. It’s not a holiday on any calendar, and when I looked it up on the internet, I found out it arose from a kids game. It dates way back to the turn of the 20th century.

You get the idea. What would be opposite goal of a game of tag? You’d have to try to catch each other, of course!

This holiday creates a paradox for itself. You’re supposed to declare that it’s Opposite Day, but that would imply you would have to not observe it. Huh?

We had pot pie for breakfast today. Does that count?

Reminder: FDA Advisory Committee Meeting Thursday January 26, 2023 on Future of Covid-19 Vaccination Regimens

Remember, the 178th Annual Meeting of the FDA Advisory Committee on the future of Covid-19 Vaccination Regimens is this Thursday from 8:30 AM-5:30 ET.

The details so far include the voting question:

“Simplification of current COVID-19 vaccine use:

  • Vaccine composition: Does the committee recommend harmonizing the
    vaccine strain composition of primary series and booster doses in the U.S.
    to a single composition, e.g., the composition for all vaccines administered
    currently would be a bivalent vaccine (Original plus Omicron BA.4/BA.5)?”

More Crazy Announcements!

Here are crucial announcements.

Sena bought me Bigfoot pajamas. They clearly show Bigfoot doing the Patty walk, which refers to the historic sighting of Bigfoot caught on video decades ago in the Patterson-Gimlin film.

The Amaryllis leaves have grown to about 11 inches! There is no flower.

Cattle ranchers are now putting diapers and masks on their cows to reduce methane emissions. Soon there will be statutes requiring humans who fart and belch in public to take Beano gummies several times daily. You know who you are.

FDA Advisory Committee Meeting to Discuss Future Covid-19 Vaccine Regimens

The FDA 178th Meeting of the Vaccine and Related Biological Products Advisory Committee will meet in open session January 26, 2023 to discuss future Covid-19 vaccination regimens. The meeting will run between 8:30 AM-5:30 PM ET.

National Day of Racial Healing Today

I just found out about the National Day of Racial Healing, which is today. It follows the National MLK Day, which this year was yesterday. The annual National Day of Racial Healing was started in 2017. The website tells what the event is about:

“The National Day of Racial Healing is a time to contemplate our shared values and create the blueprint together for #HowWeHeal from the effects of racism. Launched on Jan. 17, 2017, it is an opportunity to bring ALL people together in their common humanity and inspire collective action to create a more just and equitable world.”

Read more about the origins of the National Day of Racial Healing here.

My Two Cents on The Embrace Sculpture Honoring MLK Jr and Coretta Scott King

I first saw a photo of the sculpture honoring Dr. Martin Luther King Jr and Coretta Scott King, called “The Embrace” a couple of days ago. I remember my first impression being that it would have been nice to see a full sculpture of the couple rather than disembodied arms.

Sena mentioned it today because it was unveiled at Boston Commons. This was just before my mindfulness meditation, so I just told her that I saw the picture of it and said I would have to think about it some more.

As I sat in meditation, it occurred to me that “The Embrace” expressed what I think is a basic abstract idea, which is the challenge for us to embrace the notion that we’re all humans who ought to accept each other, and be kind and generous to one another.

That’s what I think the Kings did. That’s why Dr. King won the Nobel Peace Prize.

You could make a sculpture of the King as a couple embracing each other after he won the Nobel Prize. It would have been beautiful. On the other hand, you could make a sculpture which tries to do more than that. How difficult would it be to make a representation of what it might look like if all of us embraced our humanity—and each other?

It sounds too difficult. Yet the artist managed to do just that. Anyway, that’s my two cents.

MLK Week Redux for the New University of Iowa Psychiatry Fellows

I discovered the University of Iowa Dept of Psychiatry had a very successful match, filling key residency slots in Child Psychiatry, Addiction Medicine, and Consultation-Liaison fellowships. Congratulations! That’s a big reason to celebrate.

This reminds me of my role as a teacher. I retired from the department two and a half years ago. But I’ll always remember how hard the residents and fellows worked.

And that’s why I’m reposting my blog “Remembering My Calling.”:

Back when I had the blog The Practical C-L Psychiatrist, I wrote a post about the Martin Luther King Jr. Day observation in 2015. It was published in the Iowa City Press-Citizen on January 19, 2015 under the title “Remembering our calling: MLK Day 2015.”  I have a small legacy as a teacher. As I approach retirement next year, I reflect on that. When I entered medical school, I had no idea what I was in for. I struggled, lost faith–almost quit. I’m glad I didn’t because I’ve been privileged to learn from the next generation of doctors.

Faith is taking the first step, even when you don’t see the whole staircase.”

Martin Luther King, Jr.

As the 2015 Martin Luther King Jr. Day approached, I wondered: What’s the best way for the average person to contribute to lifting this nation to a higher destiny? What’s my role and how do I respond to that call?

I find myself reflecting more about my role as a teacher to our residents and medical students. I wonder every day how I can improve as a role model and, at the same time, let trainees practice both what I preach and listen to their own inner calling. After all, they are the next generation of doctors.

But for now they are under my tutelage. What do I hope for them?

I hope medicine doesn’t destroy itself with empty and dishonest calls for “competence” and “quality,” when excellence is called for.

I hope that when they are on call, they’ll mindfully acknowledge their fatigue and frustration…and sit down when they go and listen to the patient.

I hope they listen inwardly as well, and learn to know the difference between a call for action, and a cautionary whisper to wait and see.

I hope they won’t be paralyzed by doubt when their patients are not able to speak for themselves, and that they’ll call the families who have a stake in whatever doctors do for their loved ones.

And most of all I hope leaders in medicine and psychiatry remember that we chose medicine because we thought it was a calling. Let’s try to keep it that way.

You know, I’m on call at the hospital today and I tried to give my trainees the day off. They came in anyway.

CDC Identifies Preliminary Covid-19 Vaccine Safety Signal

The CDC announced that a prelimary Covid-19 Vaccine Safety signal has been identified in a recent update on their website:

“Following the availability and use of the updated (bivalent) COVID-19 vaccines, CDC’s Vaccine Safety Datalink (VSD), a near real-time surveillance system, met the statistical criteria to prompt additional investigation into whether there was a safety concern for ischemic stroke in people ages 65 and older who received the Pfizer-BioNTech COVID-19 Vaccine, Bivalent. Rapid-response investigation of the signal in the VSD raised a question of whether people 65 and older who have received the Pfizer-BioNTech COVID-19 Vaccine, Bivalent were more likely to have an ischemic stroke in the 21 days following vaccination compared with days 22-42 following vaccination.

This preliminary signal has not been identified with the Moderna COVID-19 Vaccine, Bivalent. There also may be other confounding factors contributing to the signal identified in the VSD that merit further investigation. Furthermore, it is important to note that, to date, no other safety systems have shown a similar signal and multiple subsequent analyses have not validated this signal:

  • A large study of updated (bivalent) vaccines (from Pfizer-BioNTech and Moderna) using the Centers for Medicare and Medicaid Services database revealed no increased risk of ischemic stroke
  • A preliminary study using the Veterans Affairs database did not indicate an increased risk of ischemic stroke following an updated (bivalent) vaccine
  • The Vaccine Adverse Event Reporting System (VAERS) managed by CDC and FDA has not seen an increase in reporting of ischemic strokes following the updated (bivalent) vaccine
  • Pfizer-BioNTech’s global safety database has not indicated a signal for ischemic stroke with the updated (bivalent) vaccine
  • Other countries have not observed an increased risk for ischemic stroke with updated (bivalent) vaccines”

The CDC says it’s “very unlikely  that the signal in VSD represents a true clinical risk…” The data and additional analyses will be discussed at the January 26, 2023 meeting of the FDA’s Vaccines and Related Biological Products Advisory Committee.

No changes are recommended to the current Covid-19 vaccination practice:

“CDC continues to recommend that everyone ages 6 months of age and older stay up-to-date with COVID-19 vaccination; this includes individuals who are currently eligible to receive an updated (bivalent) vaccine. Staying up-to-date with vaccines is the most effective tool we have for reducing death, hospitalization, and severe disease from COVID-19, as has now been demonstrated in multiple studies conducted in the United States and other countries:

  • Data have shown an updated COVID-19 vaccine reduces the risk of hospitalization from COVID-19 by nearly 3-fold compared to those who were previously vaccinated but have not yet received the updated vaccine.
  • Data have shown that the updated COVID-19 vaccine also reduces the risk of death from COVID-19 by nearly 19-fold compared to those who are unvaccinated.
  • Other preliminary data from outside the U.S. have demonstrated more than 80% protection against severe disease and death from the bivalent vaccine compared to those who have not received the bivalent vaccine.

Overall safety data for the bivalent COVID-19 vaccines are available here.

Once again, no change is recommended in COVID-19 vaccination practice, which can be found here.”

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