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Morning Rounds Elizabeth Cooney

The curious case of AstraZeneca’s Covid-19 vaccine

AstraZeneca’s Covid-19 vaccine is facing a crisis of confidence, with one European country after another temporarily suspending its use over concerns about reports of blood clots in people who received it. Experts and Europe’s regulatory body insist that the vaccine’s benefit — preventing Covid-19 and helping to stop the pandemic — outweighs its risks. They note that the number of people to report the side effect is relatively small, and no causal link has been established. But experts are also now worried that the decisions by multiple countries to suspend the vaccine’s use could make it harder to convince people to receive it should the concerns turn out, as they expect, to be a false alarm. STAT’s Matthew Herper has more.

Xavier Becerra’s most urgent challenges as Biden’s soon-to-be HHS Secretary

Xavier Becerra has survived the worst of a tense confirmation battle to become HHS secretary, but in the days ahead he will face a more intimidating challenge: governing during a pandemic. The Biden administration couldn’t slow down its Covid-19 response efforts to wait for Becerra’s confirmation, so his responsibilities have so far been farmed out to the White House and officials who didn’t need Senate approval. Once confirmed, which is expected this week, Becerra will have to carve out his role in the Covid-19 response while juggling other crises and staffing a massive department. Read more from STAT’s Rachel Cohrs on what health policy experts and former government officials see as Becerra’s most pressing concerns as he takes office.

First Covid-19 vaccine dose protected nursing home residents during outbreak

While Covid-19 vaccines exceeded many people’s wildest expectations last fall in clinical trials showing efficacy above 90%, it’s easy to forget that participants in those trials weren’t among the most vulnerable to the virus: medically frail people over 65 who live in long-term care facilities. New research confirms hopes for that population. In two Connecticut nursing homes that experienced Covid-19 outbreaks after residents and staff got their first doses of the Pfizer-BioNTech vaccine, partial vaccination was 63% effective in preventing new SARS-CoV-2 infections. That’s comparable to levels seen in clinical trials and in a later study from Israel. Second doses are strongly recommended. A limitation: The race and ethnicity of the 463 participants in this trial do not reflect the general population.

Inside STAT: Medical atlas with Nazi history now going to university's exhibition in Vienna

 The Medical University in Vienna (HELMUT FOHRINGER/APA/AFP via Getty Images)

The drawings in the anatomical atlas are seen as unparalleled in their detail of winding nerves and minute blood vessels, and still used today in medical education and surgery. But many of those images in the Pernkopf Atlas of Topographical and Applied Human Anatomy were based in part on the bodies of people executed by the Nazis, and the illustrators were Nazis themselves. Now the original illustrations have been donated to the Medical University of Vienna by publisher Elsevier. “I’m almost speechless, I’m so grateful,” surgeon Susan Mackinnon tells STAT’s Rebecca Sohn. Mackinnon has grappled with her continued use of the atlas in teaching and procedures. "I don’t think this is an ending. I think this is just the beginning."

Most breast cancer centers recommend more screening than national guidelines

When and how often women should be screened for breast cancer has been a question addressed repeatedly by the U.S. Preventive Services Task Force. In recommendations updated in 2009 and 2016, women were advised to get screening mammograms every two years between age 50 and 74, in line with most other countries, with earlier screening based on individual doctor-patient discussions. A new study finds that more than 80% of U.S. breast cancer centers offer screening advice that differs from national guidelines, recommending annual mammograms starting at age 40. False-positive rates are higher for women screened every year (61%) compared to every other year (42%) over 10 years, the researchers note, with more biopsies, surgeries, and other treatment for benign tumors or indolent cancers.  

FDA posts dashboard to track adverse events related to Covid-19 products

In response to the Covid-19 pandemic, the FDA has launched a public dashboard allowing people to search for information about adverse events reported on the drugs, vaccines, and other therapeutic biological products granted emergency use authorization by the agency. These reports, known by their acronym FAERS, come from the pharmaceutical industry, health care providers, and consumers. And they are just reports — not verified, not evidence of cause-and-effect, possibly incomplete, possibly duplicative. Caveats aside, the public is invited to peruse the reports, updated weekly, and submit their own reports to help identify “safety signals.” Yesterday, out of 3,022 events reported so far this year, most concerned treatments while eight were about Moderna’s Covid-19 vaccine and one was about Pfizer-BioNTech’s vaccine.

Covid-19 cases in the U.S.

Cases yesterday: 56,649
Deaths yesterday
: 740

What to read around the web today

  • Virus variants likely evolved inside people with weak immune systems. New York Times
  • Fewer smokers seem to be trying to quit during pandemic, report finds. Washington Post
  • Covid-19 data miss a lot of people — raising questions. NPR
  • How well do COVID vaccines protect after organ transplant? Associated Press
  • Why the pandemic experts failed. The Atlantic

Thanks for reading! More tomorrow,

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