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Sliding vaccine rates hang over vote on CDC director nominee as US measles cases hit dangerous milestone

Sliding vaccine rates hang over vote on CDC director nominee as US measles cases hit dangerous milestone

CNN14 hours ago
The US Centers for Disease Control and Prevention on Wednesday tallied the highest number of US measles cases since the disease was declared eliminated a quarter-century ago, just as a key Senate committee split the vote to advance President Donald Trump's nominee to lead the public health agency.
There have been more measles cases in the US this year than any other since the disease was declared eliminated a quarter-century ago, according to CDC data, with at least 1,288 confirmed cases.
Just halfway through the year, the case tally has already surpassed the previous record from 2019, when there were a total of 1,274 cases. And it's well above the average of about 180 measles cases that have been reported each year since the disease was declared eliminated in the US in 2000.
CNN reported this new milestone on Saturday using data from the Johns Hopkins University Center for Outbreak Response Innovation, which updates its numbers more frequently than the CDC.
HHS has not responded to CNN's request for comment about the measles milestone.
Childhood vaccine coverage has been declining in the US, and the vast majority of measles cases this year – more than 90% – have been in people who were unvaccinated or whose vaccination status was unknown, according to the CDC.
When the measles case count reached its previous record in 2019 – during the first Trump administration – both the CDC director and the secretary of the US Department of Health and Human Services at the time released statements emphasizing the safety and effectiveness of the measles-mumps-rubella (MMR) vaccine and encouraging Americans to get vaccinated.
However, almost six months into Trump's second term, the CDC still does not have a director and HHS Secretary Robert F. Kennedy Jr. has a long and complicated history with measles vaccines.
Concerns about vaccine skepticism were front and center Wednesday as members of the Senate Health, Education, Labor and Pensions Committee voted to advance President Donald Trump's nominee to lead the CDC, Dr. Susan Monarez, for a vote by the full Senate.
Committee members voted 12-11 to move Monarez's nomination. All of the committee's Republicans backed the longtime immunologist and government scientist, who spoke in her confirmation hearing about restoring trust in the CDC and defended Kennedy's decision to replace the members of a federal panel of vaccine advisers.
The vote puts Monarez one step closer to taking the helm at the public health agency, and she will now progress to a full Senate vote.
HELP Chairman Sen. Bill Cassidy, a Louisiana Republican and a doctor, voted to advance Monarez's nomination but nodded to falling vaccine coverage and the ongoing measles outbreak.
'Dr. Monarez will work to modernize our data health systems, to improve public health coordination and response while protecting American sensitive health information,' Cassidy said. 'This is especially crucial as the nation combats reemerging public health threats like measles, which has taken three lives in the United States this year.'
He continued: 'One that's not included but is tragic: A Canadian woman who was pregnant got exposed to measles and lost her child. [The ongoing outbreak has] hospitalized many more due to misinformation regarding the measles vaccine.'
Cassidy publicly pressed Kennedy last month to delay a meeting of the health agency's new vaccine advisers — several of whom have expressed skepticism and safety concerns about long-approved immunizations — amid concerns about their biases.
During Wednesday's meeting, Sen. Patty Murray, a Washington Democrat, called on the committee to hold a hearing about the ongoing measles outbreak and Kennedy's shakeup of vaccine oversight.
'I am concerned because this committee, it feels like, has all but abandoned its serious oversight of this crisis,' she said. 'We haven't had a hearing on the record-breaking number of measles outbreaks or a hearing on how the CDC vaccine panel is now stacked with people who are actually not vetted, and all the previous board members, every single one of them, was removed with no credible explanation.'
There needs to be congressional oversight of these actions, Murray said after casting a vote against Monarez.
'I really do hope that Dr. Monarez will defy my expectations. I hope she will stand up for science and put public health first. But again, I hope I have hoped that for others, and here we are today,' she said.
Some health experts have emphasized the importance of vaccination rates and their trepidation about precedents being set under Kennedy's leadership of HHS.
'It is no surprise that the most widespread measles outbreak affecting the United States in a generation has occurred under Secretary Kennedy's watch,' Dr. Richard Besser, president and CEO of the Robert Wood Johnson Foundation and former acting director of the CDC, said in a statement Wednesday.
'His decades-long campaign to discredit vaccines at every turn, which has continued unabated during his time as health secretary, directly contributes to the alarming decline in routine childhood vaccination rates in our country that is resulting in more frequent outbreaks of vaccine-preventable diseases,' he said. 'In addition, the dramatic funding cuts to public health will mean that small outbreaks will grow and spread.'
Three people have died of measles in the US this year – two children in Texas and one adult in New Mexico, all of whom were unvaccinated – matching the total number of US measles deaths from the previous two and a half decades.
'I worry that even more children will be forced to pay with their lives or health because of Secretary Kennedy's malfeasance,' Besser said. 'As a pediatrician, I strongly encourage all parents to talk to their healthcare providers, listen to their local public health officials, and learn the facts about measles vaccines, which are incredibly effective and safe.'
The MMR vaccine is highly effective. One dose offers 93% protection against measles, and two doses are 97% effective, according to the CDC.
'Vaccines work—full stop. They are one of the most powerful tools we have to protect patients, families and entire communities. We can prevent diseases through vaccines, but too many diseases that we once had under control are starting to reappear because people are choosing to delay or skip immunization,' Dr. Jennifer Brull, president of the American Academy of Family Physicians, said in a statement.
'There's a lot of confusion around vaccinations, but patients don't have to navigate this alone. Family physicians, pediatricians, pharmacists and other public health workers can help patients wade through all the information and cut through the noise,' she said. 'The bottom line is vaccines are safe, effective and save lives. It's critical that we continue to protect not just individual families, but the health of our entire nation.'
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Oura Ring vs Ultrahuman Ring—We're Settling the Debate
Oura Ring vs Ultrahuman Ring—We're Settling the Debate

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AMR Isn't Just Coming but Already Undermining Your Practice

Antimicrobial resistance (AMR) is one of the most urgent public health challenges in 2025. This phenomenon occurs when microorganisms such as bacteria, viruses, fungi, and parasites evolve resistance to drugs that were once effective. According to the CDC's 2025 report, AMR could lead to as many as 10 million deaths annually by 2050, overtaking major diseases like cancer. AMR stems from the natural evolutionary ability of microbes to survive selective pressure from antimicrobials. This process is significantly accelerated by the overuse and misuse of these drugs in human health, veterinary medicine, and agriculture. Resistant infections often require longer treatment courses, are associated with increased disability and mortality, and lead to extended hospital stays and higher healthcare costs — placing a growing burden on health systems and global economies. The CDC estimates at least 2.8 million resistant infections and over 35,000 related deaths annually in the US alone. Resistance Mechanisms AMR typically arises through two primary mechanisms: spontaneous genetic mutations and horizontal gene transfer (via conjugation, transformation, or transduction). Recent findings outline several well-characterized resistance pathways: Target modification: Structural alterations in drug targets — often key proteins or cell components — can prevent effective drug binding. Enzyme production: Certain bacteria produce enzymes such as beta-lactamases that deactivate antibiotics like penicillins and cephalosporins. These enzymes are increasingly common in gram-negative species such as Escherichia coli and Klebsiella pneumoniae . and . Efflux pumps and permeability barriers: Some bacteria limit drug entry or actively expel antibiotics using multidrug efflux pumps. This is particularly problematic in gram-negative organisms due to their additional outer membrane. These resistance mechanisms can coexist within a single organism, giving rise to 'pan-resistant' strains that are unaffected by nearly all available antimicrobial agents. Resistance can emerge rapidly — even during the course of treatment — turning previously susceptible infections resistant mid-therapy and narrowing treatment options dramatically. Recent Trends and Global Data New international data highlight the accelerating spread of AMR, with particularly concerning developments across both bacterial and fungal pathogens. The World Health Organization (WHO)'s 2024 Bacterial Priority Pathogens List documented rising resistance rates in K pneumoniae and E coli , especially in Asia and Africa — regions where therapeutic options remain severely limited. These findings align with projections from a 2024 commentary published in The Lancet , which estimates that AMR could cause up to 10 million deaths annually by 2050, disproportionately affecting low- and middle-income countries. In the US, the CDC reported that more than 35% of hospital-acquired urinary tract infections in 2024 were caused by multidrug-resistant (MDR) organisms. This surge is driven in large part by the horizontal transmission of resistance genes via mobile genetic elements such as plasmids and transposons. MDR tuberculosis also continues to pose a serious global health threat. Data from Eastern Europe and parts of Asia show that over 20% of new tuberculosis cases now involve MDR strains. These cases require longer, more toxic regimens and are associated with poorer clinical outcomes, adding further strain to public health systems. Fungal resistance is emerging as a parallel crisis. A recent review reported that more than 90% of Candida auris isolates collected from hospitals in Europe and North America were resistant to multiple antifungal agents. This poses a serious risk to patients who are immunocompromised and critically ill, particularly in ICUs where infection control remains challenging. Despite the growing threat, treatment pipelines remain thin. While several new antimicrobial agents are under investigation, most remain in preclinical or early clinical stages. The report underscores an urgent need for sustained investment in antimicrobial drug development to replenish a shrinking therapeutic arsenal. Adding to the concern, recent studies describe the emergence of novel resistance mechanisms in gram-positive pathogens such as methicillin-resistant Staphylococcus aureus . Some strains have developed traits that compromise the efficacy of even newly approved agents — further complicating treatment strategies and escalating costs of care. As AMR continues to evolve across multiple fronts, these findings reinforce the need for comprehensive, coordinated strategies to monitor resistance patterns; support antimicrobial stewardship; and accelerate therapeutic innovation. Economic Toll The global economic impact of AMR could be staggering. The 2024 Lancet commentary projects that AMR could result in up to $100 trillion in economic losses by 2050. The burden is expected to fall disproportionately on low- and middle-income countries, where weaker health systems and limited access to effective therapies could exacerbate existing disparities in both health outcomes and economic development. Clinical consequences are already evident in hospitals around the world. Recent research shows that resistant healthcare-associated infections — such as bloodstream infections and ventilator-associated pneumonias — are associated with mortality rates approaching 30% higher in patients in resource-limited settings. Contributing factors include poor hospital infrastructure, limited access to diagnostics and therapeutics, and inadequate infection control measures. Meanwhile, a 2024 review highlights the growing threat of hospital-acquired infections caused by Acinetobacter baumannii and Pseudomonas aeruginosa — both of which exhibit high levels of resistance to multiple antibiotic classes. Without effective interventions, these infections may become increasingly difficult, if not impossible, to treat, further driving up hospital mortality and straining intensive care resources. Emerging Strategies and Solutions Several promising strategies are being explored to slow AMR progression and strengthen the clinical response. Development of new antimicrobials: Recent research highlights novel compounds designed to overcome common resistance mechanisms. While early in development, these agents may offer new hope against multidrug-resistant pathogens. Alternative therapies: Early-phase studies suggest that bacteriophage therapy and antibacterial nanoparticles could serve as complementary approaches to combat infections that no longer respond to conventional treatments. These technologies are gaining traction but require rigorous clinical validation. Antimicrobial stewardship and surveillance: Effective stewardship programs remain central to the AMR response. Core components include the rational prescribing of antimicrobials, real-time infection surveillance, and access to rapid diagnostic tools for antimicrobial susceptibility testing. Education and global awareness: The WHO and CDC continue to emphasize the need for coordinated global education campaigns to promote the appropriate use of antimicrobials and curb self-medication — particularly in countries with weak regulatory oversight. National initiatives: In Spain, the 2025-2027 Plan Nacional frente a la Resistencia a los Antibióticos (National Plan against Antibiotic Resistance) stands out as a model. The plan includes enhanced epidemiologic surveillance, increased funding for antimicrobial research, ongoing training for healthcare providers, and public education campaigns. It also calls for integrated action across all levels of the health system to ensure a coordinated national response. Conclusions AMR is no longer a looming threat — it is a present-day global health emergency. Its continued spread is undermining the foundations of modern medicine, with far-reaching consequences for clinical care, public health, and global equity. As resistance mechanisms become increasingly complex and widespread, the therapeutic arsenal is shrinking — particularly in hospital settings and for vulnerable populations. Meanwhile, antibiotic development continues to lag, with most new agents stalled in early-phase research. To avoid a future where routine infections become untreatable, the global response must be ambitious and coordinated. Expanding antimicrobial stewardship, accelerating drug development through sustained investment, and enforcing rational prescribing practices are all urgent priorities. These efforts must be anchored in the One Health approach, which recognizes the interconnectedness of human, animal, and environmental health. Education and behavior change are equally essential. Clinicians, patients, and policymakers all play a role in preserving the effectiveness of existing antimicrobials. And while emerging therapies such as phage therapy, nanomedicine, and immunomodulation offer hope, they require rigorous testing and clear regulatory pathways before they can be integrated into clinical practice. The window for action is narrowing — but meaningful progress is still possible. With global alignment, scientific innovation, and sustained commitment, the trajectory of AMR can be reversed.

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