Theres always a baseline of US measles cases, mostly from unvaxxed travelers. Normally, 1 case stays 1... or maybe 5-10, b/c CDC + state/local health depts have staff, funding, & authority to investigate, isolate contacts, and vaccinate in the outbreak zone. cnn.com/2026/02/27/hea… But under RFK’s HHS, we've seen massive cuts: ~20,000 HHS jobs slashed (including thousands at CDC), funding clawed back from state/local response programs, and mixed/weak messaging on catch-up vaccination & isolation. Result? One case spirals into dozens/ hundreds / thousands. thelancet.com/journals/lance…

Weird story that might save your life.

Today at lunch, I choked on a piece of food. Not “coughing a little” - actually choking. I needed the Heimlich maneuver.

I was terrified.

But neither I nor the person who helped me panicked - and that made all the difference. 🧵👇🏽 If you’re choking, don’t run off (which was my first instinct).

If you can’t clear the obstruction, you could pass out- then, you’ll really need someone there to help.

First: try to cough forcefully. If you can still cough or speak, keep coughing - that means air is moving.

We’re heading into another seasonal/post-holiday COVID surge - something that now happens EVERY winter. So it’s worth revisiting a fair question:

Why were (and are) COVID vaccines recommended by doctors, even for ‘healthy,’ lower-risk people, including kids?
🧵 1/ You may hear: “The Pfizer trial didn’t show fewer deaths in healthy people.”
That’s true - but here’s the key reason why:
Deaths were rare overall in the trial because participants were mostly healthy and followed for only a few months.
2/

Many European countries skip universal hepatitis B birth doses, giving only to high-risk infants & starting routine vax at 6-8 weeks. Why do U.S. Hep B birth dose recs differ from Europe? 🤔

I’m glad you asked! 🧵👇🏽
1/4 Big factor: U.S. healthcare access. No universal coverage means prenatal screening & follow-ups can slip - late care or barriers leave some maternal status unknown, risking exposure. Birth dose provides immediate protection & boosts completion rates. Europe’s universal systems enable near-100% screening & lower transmission. 2/4

Why do vaccine makers have some immunity from lawsuits in U.S.?🤔

It started in the 1980s when lawsuits over the DTP (whooping cough) vaccine drove nearly every manufacturer out of the market. By 1986 only ONE company was making several childhood vaccines → shortages.
🧵 1/5
So Congress passed the 1986 Vaccine Act. Core idea is vaccines are different from other drugs. They’re given to most people, profit margins are tiny, and a 1-in-a-million side effect can trigger thousands of lawsuits. Unfettered liability = companies exit the business. 2/5

I’m deeply concerned about the new FDA move limiting COVID vaccines only to “high-risk groups.” CDC data shows those 50+ face rising risks, with 65+ at up to 340x higher death risk. Add in those with chronic disease and 71% of U.S. adults are at elevated risk! Underlying conditions like diabetes or heart disease, plus long-term career residents (35% of deaths, <1% pop), and minorities with access barriers heighten risk. Even with this change, vaccination remains critical for all adults. Talk to your health provider and stay protected! cdc.gov/covid/risk-fac…

mRNA research helped develop COVID vaccines in record time - saving millions of lives.
Cutting half a billion in mRNA funding, as HHS Sec. Kennedy proposes, isn’t just bad policy - it’s dangerous. As a physician & recipient of mRNA vaccines, here’s what people need to know 🧵 mRNA vaccines weren’t “rushed.”
They were built on decades of research funded by NIH, DARPA, and global scientists.
This investment let us go from COVID’s genetic code to safe, effective vaccines in under a year - and out of lockdowns FAR faster than predicted.

1/
🚨 Over 28 falsehoods and common anti-vaccine talking points were shared during yesterday’s ACIP meeting. The zone is being flooded with misinformation, and it’s impossible to debunk it all in real time. But here are some key ones you should know. 🧵 2/
The new ACIP Chair, Martin Kulldorff, falsely claimed kids may be getting “too many vaccines” and suggested re-evaluating long-used ones.
📌 Reality: Kids today actually get exposed to fewer antigens via vaccines than in past decades.
📖: cdc.gov/vaccines/hcp/a…

Elon Musk is clearly a visionary leader in technology and innovation. He recently endorsed Grok, an AI chatbot designed to provide “up-to-date” information on all subjects. So I asked Grok: Are Covid vaccines safe? Stay tuned for the answer in this🧵 👇🏽 According to Grok (which again Elon says has the most up to date information) the “vast majority of scientific evidence” says covid vaccines are “safe AND effective…” Grok points out the initial trials had “tens of thousands of volunteers…”

By this time next week, @elonmusk could be in change of coordinating US tech and innovation strategy for the next 4 years. So I asked Grok- Musk’s new AI chat engine- a simple question: Do vaccines cause autism?

Here’s what Grok had to say (notice the word “conclusively”)👇🏽 Grok goes on to point out the source of this “myth” (Grok’s words, not mine)- a discredited study by Andrew Wakefield. It highlights “serious ethical violations, incorrect data interpretation,” and notes Wakefield’s license was revoked. 😮

This summer, Americans have seen the biggest summer #COVID19 wave recorded in at least the last two years. This recent rise in COVID cases is a reminder about the importance of staying up to date with COVID vaccinations. Let’s get into it! #WhyIVax
👇🏽🧵 I recently spoke with several local news stations about all of this – COVID-19 continues to pose a greater burden than flu in the US, with significantly lower vaccination rates, despite its more severe outcomes.  msn.com/en-us/video/he…

It will be fascinating to see if
A) Anyone actually ultimate looks at covid infections at the #Olympics (many teams tested)
B) Anyone correlates that to performances (lots of anecdotal reports of “didn’t feel great” or mystery virus)
C) Anyone looks at Paxlovid use by athletes

https://twitter.com/elisaperego78/status/1821214718100390146

Would also be interesting to learn how many knowingly competed (and exposed others) and if they took any specific actions to protect themselves or others when they knew they were positive. This could’ve been (and still can be) a great learning opportunity on “living with Covid.”

Spoke at @AspenInstitute #aspenideas yesterday. Was asked about Tony Fauci, lab leaks, and GOF research. My response:

Tony Fauci is a friend, mentor, and 50+ year public servant, who retired as an Admiral. I’ve personally not known him to be anything but honest + patriotic. 1/ On lab leaks, we’re asking the wrong questions IMO. We’ll likely never know true Covid origins as China has withheld /destroyed information. So practically this is not a question we can answer.

We SHOULD be focusing on China and WHO accountability vs lab leaks and Fauci. 2/

American Indian, Alaska Native, & Black youth face SIGNIFICANTLY higher mortality rates vs their White counterparts- and the gap is widening!

This demands urgent attention, and highlights the danger of abandoning all DEI programs and data collection. 🧵
jamanetwork.com/journals/jama/… Injury, especially from firearms, is primary cause of pediatric death. Shockingly, Black youth saw a 39.2% surge in firearm deaths between 2019 and 2020, with a further 23.0% ⬆️ in 2021. Reasons range from increased gun access to pandemic social upheaval to policing. 😞

The problem with infectious disease scares is a) they happen ALL the time and b) most of them flame out.

But this (H5N1/ Bird Flu) is starting to feel a lot like 2020 again. And we seem to be making the same testing and communication mistakes. 🤦🏽‍♂️

amazon.com/Crisis-Chaos-L… In 2020, we had an incumbent President running for reelection who was loathe to overreact and spoke the public- especially if it meant harm to the economy. Because the truth is, these things really do typically “just disappear” on their own…

Once you get past all the “it’s just a cold” bluster, it’s amazing to consider how many people who will tell you they still have a cough/ wheeze/ are taking an inhaler/ fatigue/ are “not back to normal” long after they’ve had Covid.

I know I’m not the only one who hears this.🤷🏽‍♂️ I get it- people don’t want to give us socialization / have their lives and plans impacted. That’s human nature. I also think most people KNOW covid can be really harmful, and the downplaying of it is really is psychological compensation to justify the risk to themselves.

Bird flu /H5N1 update: 🧵

On April 1, 2024, a Texas resident with exposure to dairy cattle tested positive for highly pathogenic avian influenza (HPAI) A(H5N1), also known as bird flu and avian influenza. The person was treated and has recovered.

cdc.gov/media/releases… This incident is separate from a March 2024 report confirming this year’s first U.S. human infected with an influenza virus that normally spreads in pigs and not people. This person also was treated and has recovered.

Interesting #COVID_19 stats- a 🧵:

1) 95% of current covid hospitalizations are in people who are not up to date on their vaccinations. So especially if you or a loved one is in a higher risk group, please consider a vaccine or boost. 2) Covid fell from the 3rd leading cause of death in 2021 to 10th in 2023. Things ARE objectively better. And we have to also focus on the other top 9 causes of death (eg opioid overdoses, heart disease, cancer).

Latest update on my @MayoClinic ER visit bill dispute:
They talked to their coding company (whose primary purpose is to maximize THEIR collections), and said they also checked regional average charges… and say they are justified in charging $9000+ for IV fluids and labs. 🤦🏽‍♂️ Disputing a medical bill can feel like facing an unjust justice system, as hospitals are police officer, judge, and jailer. Despite my familiarity with the system, I’ve hit the same dead-end as too many in U.S. - pay up or face collections. 🤷🏽‍♂️

businessinsider.com/former-surgeon…

Recently had an ER visit for dehydration while out of town. Received some labs and 3 IV bags. Here's the bill- AFTER insurance. It's no wonder medical debt is the top cause of bankruptcy in the U.S. 🏥💸 #HealthcareCosts #MedicalDebtCrisis I’m a doctor who is in the top 1% of earners. And even I don’t have $4896.43 lying around. So I clicked “billing options” and was relived to see that I was offered an alternative to “pay us $5k right now or have your credit ruined.” I could go on the $1632.15 per month plan! 🤦🏽‍♂️

ICYMI: A “systematic review to evaluate the evidence for effectiveness of child mask mandates in reducing transmission or disease severity in COVID-19.” 🧵

adc.bmj.com/content/early/… As with the prior Cochrane review, many - including the authors of this study - conflate masking efficacy with mask mandate efficacy.

One is a medical / health intervention and the other is a policy intervention, and it’s imperative to distinguish one from the other…