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Morning Rounds Elizabeth Cooney

Good morning! STAT reporter Andrew Joseph here filling in for the day. 

Parents are increasingly hesitant about the HPV vaccine for their teens, survey indicates

More providers are recommending teenagers get the HPV vaccine — which blocks a cancer-causing virus — but new survey data indicate that hesitancy around the HPV vaccine from parents has also risen, going from 50.4% in 2012 to 64% in 2018. The researchers suggested that misinformation could be playing a role in the increased hesitancy, but also said that pediatricians could do a better job with their guidance. Even in 2018, providers only recommended the shot to about half of the more than 7 million unvaccinated adolescents who were eligible for it. HPV causes nearly 36,000 cancers each year.

When will J&J's Covid-19 vaccine get authorized?

On Feb. 4, Johnson & Johnson applied to have its Covid-19 vaccine authorized by the FDA. The agency then scheduled the meeting of its outside advisory committee (“ad comm”) for Feb. 26, meaning the authorization won’t come until after that. That led to questions in recent days about, essentially, what's taking so long?

To answer that, I chatted with my D.C. bureau colleague Nick Florko.

Nick, some people say the FDA is dragging its feet. But what's really up with the period before the ad comm?
The FDA has to actually review all of the data that's been submitted with J&J’s application. Regulators aren't going to just peruse a press release or an executive summary of the data J&J, or any other company, submits. They comb through every bit of data, reanalyzing and checking every conclusion a company makes. The FDA's standard review timeline is 10 months — and the FDA is doing this all in just three weeks. Folks who are angry about the three-week timeline have joked that the FDA panel "is traveling by stagecoach," but these hot takes totally misinterpret the FDA's process. This has nothing to do with scheduling issues, it's all about making sure the FDA actually reviews the data.

So presuming the ad comm recommends the authorization of the vaccine (and I remember in the pre-election days when the FDA stressed it was going to have ad comms as an extra layer of scrutiny over the regulatory process), then the FDA will announce its decision soon after that?
That's right. The FDA issued the authorizations for the Pfizer and Moderna vaccines just a few days after the ad comms. You'd expect the same here for J&J, assuming the FDA doesn't find anything concerning in the company's application. The meeting is an opportunity for the FDA to let outside experts check their work, and raise any additional questions.

For more from Nick, you can sign up here for his weekly health politics and policy newsletter, D.C. Diagnosis.

How medical specialty and gender influence physician salaries

One potential factor for why female physicians make less than male physicians has been attributed to the specialties they tend to fill. Now, researchers have built a model based on the proportion of women in each specialty using salary data from nearly 120,000 faculty at U.S. medical schools, finding that the more women in a field, the lower the salaries, including for the male physicians in that specialty. For every 10% increase in the percentage of women in a specialty, there was a loss of more than $8,000 for male and female physicians. Salaries vary among specialty in part based on the number of procedures performed, but as the researchers wrote, "The days of devaluing women’s work should be long behind us; yet, in the medical profession, the work has hardly begun."

Inside STAT: Hospitals set to go on the offensive in Washington after earning pandemic goodwill

The coronavirus pandemic has been an exhausting drag for health systems, but their hard work could end up being rewarded in another arena: Washington. Lawmakers have authorized hundreds of billions in spending for hospitals, and industry lobbyists plan to use the goodwill generated during the pandemic for hospitals to ask for policy changes in their favor. There are potential hurdles, however. President Biden and Xavier Becerra, his nominee for HHS secretary, haven't been as friendly to the hospital industry as other policymakers. STAT's Rachel Cohrs has the story here.

With safety measures, day cares don't seem to be hubs of Covid-19 transmission, study finds

With precautions, day cares do not seem to be major sites of Covid-19 spread, a new study suggests — adding to the evidence that schools and day cares can be more safely opened with certain measures in place. In the study, researchers in France looked at infections among children from 5 months to 4 years who went to day care during the country’s spring lockdown. (Some day cares remained open for the children of essential workers; staff wore masks, distanced, and worked with small groups of children.) Overall, the children had low rates of infection, and those who contracted the coronavirus were more likely to have done so at home than at the centers. Infection rates for staff were comparable to adults working in other fields. Kids generally get less sick than adults from Covid-19, but experts still aren’t sure if they’re less likely to spread the coronavirus as well.

Fetal surgery for spina bifida leads to lasting benefits, study finds

Doctors have known that performing fetal surgery for the most severe form of spina bifida leads to better outcomes early in life than waiting until the baby is born to do the surgery. Now, they’re finding increased evidence that those benefits persist for years. In a new study of kids from 5 to 10 years old, those who had fetal surgery were more likely to be able to walk independently, go up and down stairs, and perform other tasks on their own than children who had surgery after they were born. Spina bifida occurs when the spinal column doesn’t fully form, leaving the spinal cord and nerves exposed. The most severe form is called myelomeningocele.

Covid-19 cases in the U.S.

Cases yesterday: 89,727
Deaths yesterday
: 1,596

What to read around the web today

  • Rep. Ron Wright dies after 18-day battle with Covid-19. Dallas Morning News
  • Consulting giant McKinsey allegedly fed the opioid crisis. Now an affiliate may profit from treating addiction. NBC News
  • A Q&A with WHO’s emergencies chief on Covid-19, why he’s hopeful, and when normalcy might return. STAT
  • Miami-Dade trails other Florida counties in vaccinating seniors for Covid-19 — by a lot. Miami Herald
  • Woodcock vs. Sharfstein: A head-to-head comparison of Biden’s top choices for FDA commissioner. STAT+

Thanks for reading! Liz will be back tomorrow. 

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Tuesday, February 9, 2021


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