CDC – Go Retire Psychiatrist

Are There Clear and Consistent Racial Differences in Immunity?

So, the short answer is “Probably not.” I did a little digging on this because I heard the recently confirmed HHS Secretary Robert F. Kennedy Jr (RFK Jr) cite studies which he says did indicate there are differences in humoral immunity between Caucasians and African Americans.

Now remember, I’m a retired general hospital psychiatric consultant and my immunology background consists of the standard immunology lecture in medical school. The class I remember most vividly was the one in which the lecturer stopped her lecture abruptly, sighed deeply and looked defeated, probably because she saw the look of confusion on our faces.

Now that you know my credentials, let me just review what I found in a far from exhaustive review of the scientific literature on the topic of whether or not African Americans have, as RFK Jr. remarked, a “better” immune system than Caucasians.

On my own, I found what RFK Jr referred to variously (depending what social media web source you use) as the “Poland” or “pollen” studies as the scientific source of information supporting his view. I suspect it’s this, in which the last author in the citation is GA Poland:

Haralambieva IH, Salk HM, Lambert ND, Ovsyannikova IG, Kennedy RB, Warner ND, Pankratz VS, Poland GA. Associations between race, sex and immune response variations to rubella vaccination in two independent cohorts. Vaccine. 2014 Apr 7;32(17):1946-53. doi: 10.1016/j.vaccine.2014.01.090. Epub 2014 Feb 13. PMID: 24530932; PMCID: PMC3980440.

It was later in the day that I finally also found the NPR news story, the author of which pointed out the same article.

I also found a couple of other articles which tend to contradict the findings of the Poland et al study. One of them was published in eClinicalMedicine in 2023:

Martin CA, Nazareth J, Jarkhi A, Pan D, Das M, Logan N, Scott S, Bryant L, Abeywickrama N, Adeoye O, Ahmed A, Asif A, Bandi S, George N, Gohar M, Gray LJ, Kaszuba R, Mangwani J, Martin M, Moorthy A, Renals V, Teece L, Vail D, Khunti K, Moss P, Tattersall A, Hallis B, Otter AD, Rowe C, Willett BJ, Haldar P, Cooper A, Pareek M. Ethnic differences in cellular and humoral immune responses to SARS-CoV-2 vaccination in UK healthcare workers: a cross-sectional analysis. EClinicalMedicine. 2023 Apr;58:101926. doi: 10.1016/j.eclinm.2023.101926. Epub 2023 Apr 4. PMID: 37034357; PMCID: PMC10071048.

The list of references include the Poland study (reference 27) cited above. The bottom line is the African American immune response to Covid is not “better” than that of white health care workers but the Asian immune response was stronger. I thought it was interesting that in the section “Evidence before this study,” the authors point out that in one previous study, African Americans had lower antibody responses to vaccination than Whites.

I looked at only one other study, published in Clinical Microbiology Review in 2019;

Zimmermann P, Curtis N2019.Factors That Influence the Immune Response to Vaccination. Clin Microbiol Rev 32:10.1128/cmr.00084-18.https://doi.org/10.1128/cmr.00084-18

OK, so I didn’t hunt through all 582 references, but I thought it was enough to note that the authors didn’t mention race as even being relevant anywhere in the body of the paper.

That said, I suspect the more important fact to focus on is racial disparity regarding African Americans even getting vaccines, especially the Covid vaccine. Vaccine hesitancy is common in this population and probably more important to address rather than whether or not there are significant racial differences in immunogenicity. The major challenge is providing accurate information about vaccines in general and Covid vaccines in particular.

The CDC Advisory Committee includes African American members who attend each meeting and emphasize the importance of including black people in vaccination campaigns. OK, so why was the meeting this month cancelled, postponed, or whatever?

Hey, I’m just an old psychiatrist, so don’t take my word for it about anything here. Ask an immunologist. If the immunologist gives you a blank look, you could try a Ouija Board.

CDC Covid Information

Often, I see news agency headlines claiming to have insider information about what’s going on with the Centers for Disease Control (CDC), FDA, etc. I respect the opinions of others about government agencies. On the other hand, I like to get information straight from the horse’s mouth.

With that in mind, here’s what the CDC says is important to know about the Covid-19 situation.

Well, The Times They Are A’Changing at the CDC

We just found out that the CDC is, in fact, changing their recommendations on isolation precautions and other guidance for respiratory illness. It turns out the 5 day isolation rule for a positive Covid 19 test is going away. The Respiratory Virus Guidance page has changed as of today.

Sena found out about it from an article in the Wall Street Journal. The rules for health care personnel are not the same as they are for the public. I guess the times theye are a’changing.

New Large Covid-19 Vaccine Study Shows Association with Rare Side Effects Which Other Smaller Studies Have Found

I’ve seen a couple of news stories about the CDC supported large study across many countries which essentially shows that Covid-19 vaccines can be associated with rare side effects. The stories might tend to raise anxiety about the vaccines’ overall safety, which has been repeatedly proven in other studies.

The study is published in the journal Vaccine and the conclusions are consistent with smaller studies showing the Covid-19 vaccines safety although they do have rare side effects.

One of the news stories contacted an expert, Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center, who confirmed that.

Unfortunately, there are over 1200 comments (and counting) containing alarmist and misleading information about the vaccines.

CDC Reports Respiratory Virus Activity Elevated or Increasing

The CDC on January 12, 2024 reported that respiratory virus activity is elevated or increasing across the country. The summary:

“Summary

Seasonal influenza and COVID-19 activity remain elevated in most parts of the country; however, the rapid increases seen over the past several weeks appear to be slowing. The U.S. continues to experience elevated RSV activity, particularly among young children. Hospital bed occupancy for all patients, including within intensive care units, remains stable nationally. However, some jurisdictions are reporting strain on hospitals locally, driven, in part, by recent increases in respiratory illness.

Influenza

Multiple indicators of influenza activity including test positivity, emergency department visits, and hospitalizations are elevated. Additional information about the recent increases in influenza activity can be found at: Weekly U.S. Influenza Surveillance Report | CDC.

COVID-19

Despite test positivity (percentage of tests conducted that were positive), emergency department visits, and hospitalizations remaining elevated nationally, the rates have stabilized, or in some instances decreased, after multiple weeks of continual increase. Emergency department visits for COVID-19 are highest among infants and older adults but are also elevated for young children. Despite the high levels of infection measured using wastewater viral activity and test positivity data, at this time, COVID-19 infections are causing severe disease less frequently than earlier in the pandemic.

RSV

RSV activity remains elevated nationally in all regions, though decreases have been observed in some areas. Hospitalization rates remain elevated in young children and continue to increase among older adults.

Vaccination

National vaccination coverage for COVID-19, influenza, and RSV vaccines remains low for children and adults. Vaccines are available and can help protect people from the most serious health effects of fall and winter viruses.”

CDC Reports Respiratory Virus Activity Increasing

The Centers for Disease Control (CDC) reported respiratory illness leading to visits to the emergency room and hospitalization are rising across the country.

“Seasonal influenza activity is elevated and increasing in most parts of the country.
COVID-19 activity also remains elevated overall and is increasing in many areas.  Based on the biweekly period ending 12/23/2023, JN.1 is predicted to be the most prevalent SARS-CoV-2 lineage nationally.
RSV activity remains elevated in many areas of the country, though decreases have been observed in some areas.
Hospital bed occupancy and capacity, including within intensive care units, remain stable nationally.”

“National test positivity, emergency department visits, and hospitalizations for influenza continue to increase. Influenza A(H1N1) is the predominant influenza virus circulating although influenza A(H3N2) and influenza B viruses are also being reported.
RSV-associated hospitalization rates remain elevated among young children and are increasing among older adults; of note, only 15.9% of adults 60+ report having received an RSV vaccine.
National vaccination coverage for COVID-19, influenza, and RSV vaccines increased slightly for children and adults compared to the previous week and remains low for both groups.”

However, the overall respiratory illness rates have gone from “moderate” to “low” in Iowa.

Moderate Respiratory Illness Activity in Iowa

The CDC tracks respiratory illness and there is moderate activity in Iowa according the data tracker.

The weekly snapshot as of December 1, 2023 shows highlights including:

“COVID-19 test positivity (percentage of tests conducted that were positive), emergency department visits, and hospitalizations have increased nationally. A group of Omicron variants (XBB and its sublineages) are the predominant lineages detected in the U.S., with HV.1 being most common. The prevalence of another lineage, BA.2.86, is projected to account for 5-15% of currently circulating variants. CDC continues to monitor HV.1, BA.2.86, and all other lineages.
National test positivity, emergency department visits, and hospitalizations for influenza continue to increase.
RSV emergency department visits and hospitalizations continue to increase across the country. RSV-associated hospitalization rates remain elevated among young children and are increasing among older adults; of note, only 14.8% of adults 60+ report having received an RSV vaccine.
National vaccination coverage for COVID-19, influenza, and RSV vaccines increased less than one percentage point for children and adults, where indicated, compared to the previous week and remains low for both groups.
CDC has been monitoring increases in respiratory illness reported recently among children, including potential elevated rates of pediatric pneumonia in parts of the United States. These reported increases do not appear to be due to a new virus or other pathogen but to several viral or bacterial causes that we expect to see during the respiratory illness season. CDC will continue to work closely with our state and local public health partners to maintain strong situational awareness and will provide updates, as needed.”