Category: health care

CDC Advisory Committee Meeting on Vaccines Starts Tomorrow

The CDC ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES (ACIP) is scheduled to begin their meeting tomorrow at 10:00 AM ET despite US Senator Bill Cassidy’s recommendation that it be postponed due to concerns about the lack of experience of the committee members and because there is not yet confirmation of a new CDC Director.

In fact, the CDC Director nominee, Dr. Susan Monarez, of Wisconsin, is scheduled for her confirmation hearing at the same time as the start of the CDC ACIP meeting tomorrow morning at 10:00 AM ET. Dr. Monarez would be the first CDC director “…in decades…” (according to a report posted in The Hill in May) who has neither previously worked at the CDC “…nor obtained a Doctor of Medicine degree…”

As of this morning around 10:00 AM, the meeting agenda has not yet been finalized. So far, it looks like there will be no vote on the Covid-19 vaccine update, although there will be a vote on Thimerosal in flu vaccines about which the FDA has previously published an extensive summary.  

More Mall Walking for Everyone!

I don’t get out often to the mall to do mall walking, but I did today. I put on a little over 2.5 miles on my step counter. Mall walking is OK for exercise although I have to drive over there. Right next door to the entrance to the mall is the outdoor entrance to Planet Fitness, which is kind of ironic. But you have to pay a membership fee to use the facilities there. You can just walk through the mall for free and it opens an hour before the other shops just to accommodate mall walkers.

I think mall walking does wonders for my lower back. I see a lot of older people who look like they make mall walking regular exercise. They’re my age or older. Some of them have physical challenges that may be the reasons why they mall walk, that is, for conditioning. Their physicians might have even recommended it.

A minority of mall walkers I see are young, so this isn’t just for the elderly. Occasionally I’ll see a group who are challenged in various ways. Today it looked like the guy who was blind and using a cane was right out in front, actually leading the group.

Mall walking has advantages over, say, walking downtown. It beats getting clobbered by an exploding manhole lid, bit by a dog, or mugged.

There are some studies about mall walking, but the authors of a 2015 review mainly noted that there’s a need for more rigorous studies. Their conclusion sounds a little grumpy:

“We found the potential for mall walking programs to be implemented in various communities as a health promotion measure. However, the research on mall walking programs is limited and has weak study designs. More rigorous research is needed to define best practices for mall walking programs’ reach, effectiveness, adoption, implementation, and maintenance.”

Farren L, Belza B, Allen P, Brolliar S, Brown DR, Cormier ML, Janicek S, Jones DL, King DK, Marquez DX, Rosenberg DE. Mall Walking Program Environments, Features, and Participants: A Scoping Review. Prev Chronic Dis. 2015 Aug 13;12:E129. doi: 10.5888/pcd12.150027. PMID: 26270743; PMCID: PMC4552141.

Maybe the authors need to go for a walk.

It’s inspiring to see some of the mall walkers out there despite having major disability of one kind or another. I often see a lady who uses a wheeled walker and cannot hold her head up straight. When she sits down for a break, it looks like she’s collapsed. But she just gets up and at it again a few minutes later.

Mall walking may be understudied—but it’s also underestimated as a sign of resilience in anyone young or old.

University of Minnesota CIDRAP Story on CDC ACIP Meeting Next Week

The University of Minnesota Center for Infectious Disease Research and Policy (CIDRAP) posted a news report about the upcoming CDC ACIP meeting next Wednesday. Apparently, so far the new advisory committee draft agenda does not include a vote on the Covid-19 vaccine.

Sit and Rise Exercise Related to Longevity?

I just read a few news articles and saw a couple of videos on something called the sit and rise or sitting rising exercise. It’s not the same as the sit to stand exercise, which is how many times you stand up from a chair without falling down after drinking several beers. The sit and rise exercise is sitting down and then standing back up in a cross-legged position.

Just to let you know, there are dozens of news stories that claim if you can’t do the sit and rise exercise without using one or both hands or a crane to get back up, you’re marked for death within hours. Make sure your last will and testament is notarized.

OK, I also saw a Snopes fact-check story about the sit and rise thing and it’s a myth that the inability to do it predicts mortality within a few years. It does indicate you have problems with mobility and that could be from a number of factors, including previous joint injuries and not having legs. Check a full-length mirror.

Apparently, there was a study done in Brazil in 2012 that got this story going about imminent mortality if you can’t do the sit and rise cross-legged routine. It looks like there have been news stories about it every year or so since then just to scare old people.

I can’t do the sit and rise cross-legged and wondered if there’s some kind of trick to it. There isn’t and the main problem according to experts are weak glutes. And I’m able to stand on one leg for 30 seconds and I can do 3-4 reps of the single sit to stand exercise on both legs. I also have no problem getting up from a chair from a sitting position without pulling myself up using grab bars or having somebody haul me up with a tow chain.

I can’t remember a time when I could even sit cross-legged, although I guess I did when I was in kindergarten. When I took a Mindfulness Based Stress Reduction (MBSR) course, I had to try to sit cross legged to meditate and I was numb in my hips and knees within a couple of minutes. When I got up, I usually fell over, sustained a minor head injury and was rushed to the ER about 1,200 times (“It’s Dr. Amos again; he’s been trying to sit in that lotus position” “OK, put him in the rack.”).

There’s a web page that gives advice on how to fix a problem with not being able to sit in a crossed leg position for longer than a minute. The author provides a short list of exercises without instructions for how to do them:

Child Pose: I imagine this resembles standing pigeon-toed, holding your crotch and dancing around a little about an hour after drinking a half-gallon of Kool-Aid.

Pigeon Pose: This is kind of like the Child Pose only it’s done while pooping on the head of a statue.

Toe Touch: Self-explanatory but apparently you can touch anything with your toe as long as it’s not something recently expelled from a pigeon.

Vajrasana: It involves contacting extraterrestrials who will assist you by inserting various probes in several orifices while you remain very still to allow the tracking device to be correctly installed.

Lung Pose: I’m not sure how this strengthens your glutes but obviously it involves surgery. Check your insurance.

Bridge Pose: This might tone your glutes if you dive off a bridge without a parachute. Make sure your life insurance policy is up-to-date.

That about does it for the sit and rise cross-legged issue. Remember, it’s only when you do it while cross-eyed that all the trouble starts. Glad I could clear that up.

This essay is satirical.

The Short Story on Kiwi for Health

Sena was at the store yesterday and some guy (a total stranger) in a motorized scooter rode up to her and said, “I have trouble sleeping” and asked her where to find the kiwi fruit in the produce section. It didn’t faze her because this didn’t sound like a pickup line, you know like that joke on the TV commercial: “Why do iguanas reproduce only once a year? That’s because they have e-reptile dysfunction.”

Actually, the guy was looking for kiwi fruit because he had heard that it can help you sleep. So, she told him where it was. A little later, she saw him wandering around and asked him if he’d found the kiwi fruit. He hadn’t so she got a package for him.

It turns out there is a news article saying there are a few small studies indicating that eating a couple of kiwis (remember, this is about the fruit, not the birds) about an hour before you hit the sack can help you sleep. They have a lot of serotonin which your body turns into melatonin which can promote sleep.

You have to be careful about eating kiwis if you have a latex or fruit allergy because you could have a reaction. And if you have diabetes you need to be aware kiwis are high in sugar.

The thing is, you have to eat a couple of them about an hour before bedtime. Often enough I find that I’m napping in the evening in front of the TV long before then—but that’s probably because there’s usually nothing on but reruns and the usual commercials about cannabidiol (CBD) products, total body deodorants, and snake oil for e-reptile dysfunction.

In fact, there’s also some limited evidence that kiwi fruit can just help you feel better in general. It’s mainly about yellow kiwi fruit rather than the green ones. The yellow ones are called SunGold, and they have a lot of vitamin C. Actually, if you don’t like kiwi fruit, you can find other fruits and vegetables containing a lot of vitamin C, including strawberries and oranges—and broccoli. Go with kiwi fruit.

On the other hand, it looks like you might pay about 3x more for the yellow kiwi than the green.

Kiwi fruits are packed with vitamins. You can get 100% of vitamin C from SunGold and they have more than 20 vitamins and minerals. More than a million tons of kiwi fruit are produced every year. You can make kiwi pizza-if you’re on drugs!

And if you eat a couple of SunGold kiwis a day you could feel so good you might be more willing to contribute to the foundation for assisting iguanas with e-reptile dysfunction.

Center for Infectious Disease Research and Policy Outlook on Covid Data and New CDC ACIP Committee

I have a lot more faith in the infectious disease news from the University of Minnesota Center for Infectious Disease Research and Policy Outlook (CIDRAP) than most other news outlets. Their review of the so far 8 newly appointed CDC ACIP committee members is interesting. I plan to watch the upcoming June 25-27 CDC ACIP meeting.

They also provide updates on the CDC Covid-19 variant tracking data. While the LP.8.1 has been in the spotlight lately as the upcoming variant of note, the Nowcast estimates of the proportion of NB.1.8.1 are currently almost equal to LP.8.1. They report the NB.1.8.1 is minimally more immune evasive than LP.8.1. They are both descended from the JN.1 lineage. Overall, Covid-19 activity is low.

Can We Calm Down?

First of all, I want to make it clear that I am not now nor have I ever been pregnant. Now that I have your attention, I’ll add some context to that weird statement by saying how puzzled I am by all the controversy about whether or not there’s actually a federal recommendation against pregnant women getting the Covid-19 vaccine.

I admit, I actually did think about the movie “Signs” in which the lead character, Graham Hess, says “Everybody in this house needs to calm down and eat some fruit or something.” I think it fits.

I found a lot of news stories claiming that HHS and the CDC don’t recommend that pregnant women get the Covid-19 vaccine. What I actually found on the HHS web site says the opposite—the agency recommends it.

That seems to agree with the paper from the FDA leadership, published in the New England Journal of Medicine by Drs. Prasad and Makary (An Evidence-Based Approach to Covid-19 Vaccination. Authors: Vinay Prasad, M.D., M.P.H., and Martin A. Makary, M.D., M.P.H. Author Info & Affiliations). Published May 20, 2025. DOI: 10.1056/NEJMsb2506929.

“Moving forward, the FDA will adopt the following Covid-19 vaccination regulatory framework: On the basis of immunogenicity — proof that a vaccine can generate antibody titers in people — the FDA anticipates that it will be able to make favorable benefit–risk findings for adults over the age of 65 years and for all persons above the age of 6 months with one or more risk factors that put them at high risk for severe Covid-19 outcomes, as described by the CDC (Figure 2).”

Figure 2 is a table which lists many medical conditions that are indications for getting the Covid-19 vaccine. Pregnancy is one of them, based on the idea that it could increase the severity of Covid-19 disease.

On the other hand, when I looked at the health care provider page on the CDC website, the table showing the clinical indications for the Covid-19 vaccine sends a confusing message by showing pregnancy as a condition for which there is currently “No Guidance/Not Applicable.”

Just in case this web page gets updated, I took a screenshot of that part of the table:

screenshot June 12, 2025

But elsewhere on the CDC website are pages which clearly recommend that pregnant women get the Covid-19 vaccine.

I’m not making any political statements here. I’m just an old guy who clearly does have an indication for getting the Covid-19 vaccine and I recently did just that last month.

Dept of Health & Human Services to Reconstitute CDC Advisory Committee on Immunization Practices

HHS announced the removal and replacement of the current members of the CDC Advisory Committee on Immunization Practices in a press release today. The CDC ACIP meeting for vaccine recommendations is still scheduled for June 25-27. According to the Federal Register announcement under Supplementary Information:

“SUPPLEMENTARY INFORMATION:

Purpose: The Advisory Committee on Immunization Practices is charged with advising the Director, Centers for Disease Control and Prevention (CDC), on the use of immunizing agents. In addition, under 42 U.S.C. 1396s, the Committee is mandated to establish and periodically review and, as appropriate, revise the list of vaccines for administration to vaccine-eligible children through the Vaccines for Children program, along with schedules regarding dosing interval, dosage, and contraindications to administration of vaccines. Further, under applicable provisions of the Affordable Care Act and section 2713 of the Public Health Service Act, immunization recommendations of ACIP that have been adopted by the Director, CDC, and appear on CDC immunization schedules generally must be covered by applicable health plans.

Matters To Be Considered: The agenda will include discussions on anthrax vaccines, chikungunya vaccines, COVID-19 vaccines, cytomegalovirus (CMV) vaccine, Human papillomavirus (HPV) vaccine, influenza vaccines, Lyme disease vaccine, meningococcal vaccines, pneumococcal vaccines, Respiratory Syncytial Virus (RSV) vaccines for adults, and RSV vaccines for maternal and pediatric populations. Recommendation votes are scheduled for COVID-19 vaccines, HPV vaccine, influenza vaccines, meningococcal vaccine, RSV vaccines for adults, and RSV vaccine for maternal and pediatric populations. Vaccines for Children (VFC) votes are scheduled for COVID-19 vaccines, HPV vaccine, influenza vaccines, and RSV vaccines. Agenda items are subject to change as priorities dictate. For more information on the meeting agenda, visit https://www.cdc.gov/​acip/​meetings/​index.html.

Meeting Information: The meeting will be webcast live via the World Wide Web. For more information on ACIP, please visit the ACIP website: https://www.cdc.gov/​acip.“

The Wild West Sandbox of AI Enhancement in Psychiatry!

I always find Dr. Moffic’s articles in Psychiatric Times thought-provoking and his latest essay, “Enhancement Psychiatry” is fascinating, especially the part about Artificial Intelligence (AI). I liked the link to the video of Dr. John Luo’s take on AI in psychiatry. That was fascinating.

I have my own concerns about AI and dabbled with “talking” to it a couple of times. I still try to avoid it when I’m searching the web but it seems to creep in no matter how hard I try. I can’t unsee it now.

I think of AI enhancing psychiatry in terms of whether it can cut down on hassles like “pajama time” like taking our work home with us to finish clinic notes and the like. When AI is packaged as a scribe only, I’m a little more comfortable with that although I would get nervous if it listened to a conversation between me and a patient.

That’s because AI gets a lot of things wrong as a scribe. In that sense, it’s a lot like other software I’ve used as an aid to creating clinic notes. I made fun of it a couple of years ago in a blog post “The Dragon Breathes Fire Again.”

I get even more nervous when I read the news stories about AI making delusions and blithely blurting misinformation. It can lie, cheat, and hustle you although a lot of it is discovered in digital experimental environments called “sandboxes” which we hope can keep the mayhem contained.

That made me very eager to learn a little more about Yoshua Bengio’s LawZero and his plan to create the AI Scientist to counter what seems to be a developing career criminal type of AI in the wild west of computer wizardry. The LawZero thing was an idea by Isaac Asimov who wrote the book, “I, Robot,” which inspired the film of the same title in 2004.

However, as I read it, I had an emotional reaction akin to suspicion. Bengio sounds almost too good to be true. A broader web search turned up a 2009 essay by a guy I’ve never heard of named Peter W. Singer. It’s titled “Isaac Asimov’s Laws of Robotics Are Wrong.” I tried to pin down who he is by searching the web and the AI helper was noticeably absent. I couldn’t find out much about him that explained the level of energy in what he wrote.

Singer’s essay was published on the Brookings Institution website and I couldn’t really tell what political side of the fence that organization is on—not that I’m planning to take sides. His aim was to debunk the Laws of Robotics and I got about the same feeling from his essay as I got from Bengio’s.

Maybe I need a little more education about this whole AI enhancement issue. I wonder whether Bengio and Singer could hold a public debate about it? Maybe they would need a kind of sandbox for the event?