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Morning Rounds Elizabeth Cooney

AstraZeneca's vaccine shows better-than-expected efficacy

In long-awaited results from a U.S. trial, AstraZeneca announced this morning that its Covid-19 vaccine, developed with the University of Oxford, reduced both mild and serious forms of the disease, paving the way for a likely U.S. authorization. In a statement, the company said the two-dose vaccine reduced symptomatic disease by 79% and severe Covid-19 and hospitalization by 100%. As STAT's Matthew Herper reports, doctors, regulators, and government officials the world over are likely to breathe a sigh of relief following questions about the vaccine's efficacy that were raised after trials outside the U.S. AstraZeneca also saw no risk of blood clots, worries about which led many European nations to pause their vaccine rollouts last week.

Rising Covid-19 cases in some states highlight ‘precarious position’

The U.S. is in for a celebratory summer, experts and political leaders predict — when widespread availability of Covid-19 vaccines will allow the safe return of gatherings and activities shunned for the past year. But now, data in some states are pointing to, if not just stalled progress, increased cases. Just as some states are tossing restrictions aside, the B.1.1.7 variant, a more transmissible version of the coronavirus first seen in the U.K., is building up in the U.S. “This tension between the desire to start opening up and the risk associated with B.1.1.7 is placing us in a precarious position,” Yonatan Grad of Harvard tells STAT’s Andrew Joseph.

What ‘Beans’ taught her parents about pediatric cancer


Francesca Kaczynski and her father, Andrew, on a walk in Boston during her medical treatment. (courtesy kaczynski family)

On what should have been Francesca Kaczynski’s first birthday, her memory was celebrated instead on national television. “Beans,” as she was fondly called, had died on Christmas Eve from brain cancer. Her father, CNN investigative reporter Andrew Kaczynski, spoke with STAT’s Meghana Keshavan about losing his child and working to increase understanding of her rare tumor. Read the full interview here.

How did Francesca first get diagnosed? 
I think it was Labor Day weekend. She got sick and we knew something was very wrong. I wish I could say that Sept. 6 was the worst day of my life — but when your kid has cancer, literally every day is the worst day of your life. 

What do you see as the best approach in tackling rare pediatric cancers?
You have to keep coming at it, like hammering a nail into a wall. Getting legislation passed is a really big part of that, but fundraising is as well. Because pharmaceutical companies will never, ever be incentivized to come up with a drug for pediatric brain cancer, because the amount of kids getting it is too small.

Inside STAT: How pharma companies stacked up in the Covid-19 vaccine race

Caption (mike reddy for stat)

In the early stages of the race to develop Covid-19 vaccines, it wasn’t clear how many would work, which manufacturers would score successes, or which projects would fall by the wayside. Now, just a few days past the first anniversary of the start of Moderna’s Phase 1 trial — the first to begin in the U.S. — we have a much clearer picture of the Covid vaccine landscape. Indeed, the focus is now sharp enough to start to call out some early winners and early losers.  STAT’s Helen Branswell, Matthew Herper, and Damian Garde break down who’s done well and who hasn’t. Hint: They look at a dozen more competitors than front-runners Pfizer-BioNTech, Moderna, Johnson & Johnson, and AstraZeneca. Read more.

Primary care strong in another remote Match Day

For the second year in a row, the medical school rite of passage known as Match Day took place remotely or in hybrid fashion Friday for more than 33,000 fourth-year students and more than 2,600 others around the world seeking residency slots at hospitals across the U.S. Just under half of positions offered were in primary care, which includes internal medicine, pediatrics, and family medicine. Internal medicine kept its place as the number one training specialty, drawing one-quarter of all applicants. Specialties offering more positions than five years ago include neurology (up 45%), family medicine (up 44%), emergency medicine (up 39%), psychiatry (up 28%), and internal medicine (up 25%). Also up: This year’s edition offered the most positions in the program’s history, a 3% increase from last year.

A call to improve care for American Indian and Alaska Native children

Today American Indian physicians on Coast Salish and Pueblo lands call on their colleagues in pediatrics to provide culturally sensitive, family-centered care to American Indian and Alaska Native children and teens. Acknowledging these children and adolescents confront barriers from birth that arise from historical trauma, health inequities, socioeconomic barriers, and racism, the doctors also say in the American Academy of Pediatrics policy statement that young people endure if provided the proper support. Specific recommendations include:
  • Partnering with local tribes and communities to set health priorities.
  • Providing adequate training of clinical and office staff in culturally sensitive care practice.
  • Promoting home visiting models, high-quality child care, and early childhood programs.
  • Creating a medical home sensitive to discrimination in clinical settings and generations of unresolved traumas and racism.

Covid-19 cases in the U.S.

Cases yesterday: 33,645
Deaths yesterday
: 432
Vaccine doses distributed, per CDC156,734,555
Total doses administered: 124,481,412

What to read around the web today

  • José Baselga, renowned cancer researcher and AstraZeneca oncology R&D head, dies at 61.  STAT
  • Rich countries signed away a chance to vaccinate the world. New York Times
  • Don't be surprised when vaccinated people get infected. The Atlantic
  • Covid: Why has the fall in U.K. infection rate stalled despite vaccinations? The Guardian
  • Opinion: We need to start thinking more critically — and speaking more cautiously — about long Covid. STAT

Thanks for reading! More tomorrow,

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Monday, March 22, 2021

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