On the heels of the recent White House announcement about acetaminophen (Tylenol) in pregnancy, we -- as reproductive psychiatrists who focus on the well-being of pregnant patients throughout preconception, pregnancy, and postpartum -- can attest that guilt, self-blame, and panic has set in. [ MEDPAGE Today]

Just the other day, a patient at 26 weeks of pregnancy messaged us that she is now "totally freaked out" about all medications during pregnancy. Even though her obsessive compulsive disorder is severe, even incapacitating at times, she still wants to stop taking every medication she is on: "Maybe I just shouldn't take any medications at all. I should just be strong enough to get through anything. I just wouldn't be able to live with myself if anything went wrong. It would be all my fault."

It wasn't just the degree of anxiety that was striking about her message. It was that guilt and self-blame permeated every word.

Last week, the White House delivered a stunning claim: acetaminophen use in pregnancy increases the risk of autism in children. Officials pledged swift action: new FDA labels, physician notices, and federal research initiatives. Yet, much of the "evidence" for any potential link comes from observational studies showing correlation, not causation. And sibling-controlled studies have shown those associations disappear once confounding variables are accounted for. Further, it doesn't take into account the potential harms of not treating important medical conditions.

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Black babies died suddenly and unexpectedly in their sleep at a rate 14 times higher than white babies in Cook County between 2019 and 2023 — a startling disparity revealed in a report released Wednesday by county and health officials. [Chicago Tribune]

“I know what it is like to be a Black woman in America, so when I see data like that, it shakes me to my core,” said Dr. Olusimbo Ige, Chicago Department of Public Health commissioner, during a news conference. “Babies are dying simply because mothers don’t have the information and the support that they need.”

Photo credit:(Eileen T. Meslar/Chicago Tribune)

In all, 208 infants in Cook County died suddenly and unexpectedly while sleeping between 2019 and 2023, with 99% of those deaths occurring in sleeping situations that are considered unsafe for babies, such as sleeping with another person, or sleeping with soft bedding items including pillows, blankets or stuffed animals, according to the report.

Black babies died suddenly and unexpectedly in their sleep at a rate 14 times higher than white babies in Cook County between 2019 and 2023 — a startling disparity revealed in a report released Wednesday by county and health officials.

“I know what it is like to be a Black woman in America, so when I see data like that, it shakes me to my core,” said Dr. Olusimbo Ige, Chicago Department of Public Health commissioner, during a news conference. “Babies are dying simply because mothers don’t have the information and the support that they need.”

In all, 208 infants in Cook County died suddenly and unexpectedly while sleeping between 2019 and 2023, with 99% of those deaths occurring in sleeping situations that are considered unsafe for babies, such as sleeping with another person, or sleeping with soft bedding items including pillows, blankets or stuffed animals, according to the report.

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In a progress report covering its activities in 2024, Gavi, the Vaccine Alliance, today reported that Gavi-supported vaccines saved a record 1.7 million lives, 400,000 more than in 2023. In a statement, the group also reported major progress in boosting vaccine campaigns in some of the countries experiencing some of the biggest humanitarian challenges. [CIDRAP - Center for Infectious Disease Research & Policy Research and Innovation Office, University of Minnesota, Minneapolis, MN]

Photo Credit : Julien Harneis/Flickr cc

Beyond just public health benefits, the group estimated that Gavi-supported countries gained nearly $20 billion in economic benefits from having healthier populations, reducing healthcare costs, and boosting productivity. 

Since the group was established in 2000, Gavi said its immunization investments have generated $280 billion in economic benefits, which it said supports stability and growth. As a result, recipient countries have been able to assume more responsibility for their vaccine programs. For example, countries paid a record $255 million toward the cost of their own vaccines in 2024. 

Gavi’s other achievements for 2024 include the fastest vaccine rollout in the group’s history, with wide malaria vaccine deployment in 2024 protecting millions of children in Africa who represent 70% of the world’s disease burden.

Gains and some declines in conflict nations

Coverage for all Gavi-supported vaccines rose in 2024, including in fragile and conflict settings. Mali, Syria, and Haiti experienced major improvements in basic vaccine coverage. However, some countries struggling with humanitarian crises, such as Yemen and Sudan, saw major declines.

Sania Nishtar, MD, PhD, Gavi’s chief executive officer, said, “Every person—no matter how hard to reach—should have access to the life-saving power of vaccines. That vision is both very simple and immensely complex to bring to life. The historic progress we have made towards this goal is thanks to incredible commitment from governments, health care workers and communities all over the world.”

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As part of the FDA’s broader strategy to combat the crisis of youth vaping, we are launching an initiative to increase voluntary compliance from retailers—including vape shops, convenience stores and gas stations—that play a key role in the distribution of both legal and illegal products into American communities.  [FDA- U.S. Food & Drug Administration]

Too often, retailers in communities are selling illegal vaping products marketed to young people with fruit or candy flavors and even marketing gimmicks such as built-in video games and Bluetooth speakers. The FDA has not authorized any such products, which are mainly illegally imported from China. As much as 54% of vaping products sold nationally are illegal. These products frequently contain chemicals such as formaldehyde, lead, and acrolein—materials more commonly found in industrial textiles and pesticides. 

We have received questions from retailers about which tobacco products are legal to sell, so we’re mailing materials to more than 300,000 retailers nationwide containing: 

• A list of the 39 vapes and 20 nicotine pouch products that can be legally marketed in the United States, which features QR codes linked to the FDA real-time digital versions of these lists (www.fda.gov/authorizedecigs and www.fda.gov/authorizednicotinepouches); 
• Information on accessing FDA’s new Searchable Tobacco Product Database, a database of over 17,000 tobacco products—covering all categories, such as cigarettes, cigars, hookah, and e-cigarettes—that may be legally marketed in the United States; and  
• New tobacco retailer education materials, including a wall calendar of reminders focused on retailer requirements such as only selling tobacco products to those 21 and older and requiring a photo ID check of anyone under 30. 

We know that most businesses want to follow the law. The purpose of this initiative is to help retailers better understand relevant laws and regulations, removing any excuses for noncompliance. We are particularly interested in increasing compliance around the distribution and sale of illegal vaping products, which are often marketed to, and widely consumed by, American teens.  

Mailings will begin this fall. Retailers looking to order additional free materials—including a digital age verification calendar—can do so via FDA’s Tobacco Education Resource Library. 

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Two new reports this week from the Centers for Disease Control and Prevention (CDC) provide more detail on the deadliest flu season for US children in more than a decade. [CIDRAP -Center for Infectious  Disease Research & Policy Research and Innovation Office, University of Minnesota, Minneapolis, MN,] 

The reports, published yesterday in Morbidity and Mortality Weekly Report (MMWR), include data on the 280 US children who died during the 2024-25 flu season, along with information on 109 children who died from a rare and severe neurologic complication of flu during the season. The 280 pediatric flu deaths are the highest number reported in the United States since the 2009-10 H1N1 pandemic and the highest for a non-pandemic flu season since child deaths became nationally notifiable in 2004.

The reports add further information on what the CDC has previously described as a high-severity flu season.

Highest mortality rate seen in infants

In first report, researchers with the CDC's National Center for Immunization and Respiratory Diseases analyzed data from the Influenza-Associated Pediatric Mortality Surveillance System, which collects reports on pediatric flu deaths from state and local health departments.

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The National Institutes of Health (NIH) has launched effort aimed at reducing the rate of preventable stillbirths in the United States. Investigators will develop tools, devices and other technologies that have the potential to affect diagnosis and prevention efforts relevant to stillbirth, which occurs in 1 in 160 deliveries in the U.S. About 23,600 stillbirths at 20 weeks or greater gestation are reported annually. [NIH]

More than 60% of the nearly 24,000 stillbirth cases annually remain unexplained.

More than 60% of stillbirth cases remain unexplained even after exclusion of common causes, such as congenital abnormalities, genetic factors, and obstetric complications. NIH will fund the Stillbirth Research Consortium for more than $37 million over five years, pending the availability of funds, with $750,000 in co-funding from the Department of Health and Human Services.

“This consortium will provide an integrated, collaborative program to support cutting edge research to identify the root causes of stillbirth and inform evidence-based strategies to address stillbirth risks,” said Alison Cernich, Ph.D., acting director of NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development. “Too many families needlessly face the grief of stillbirth.”

People who have experienced stillbirth are almost five times as likely to experience another stillbirth or other pregnancy associated complication. The rate of stillbirth is considerably higher among Black, American Indian, and Alaska Native people. About 40% of stillbirths that occur during labor and birth are considered potentially preventable.  

The Stillbirth Consortium will consist of four research centers and a data coordinating center.

• The Data Coordinating Center at RTI International, Research Triangle, North Carolina, will facilitate development and implementation of common projects across the research centers and ensure rigor in study data and data sharing. The center will support common data elements, standard measures, and uniform data collection across research centers. The project will be led by Elizabeth McClure, Ph.D., and Carla Bann, Ph.D.
• The University of California San Diego Center for Stillbirth Prevention Center specializes in identifying the causes of placental dysfunction that underlie fetal growth restriction and contribute to stillbirth. The project is led by Mana Parast, M.D., Ph.D., director of the Perinatal Pathology Service; and Cynthia Gyamfi-Bannerman, M.D., chair and professor of obstetrics, gynecology and reproductive services.
• The Collaborative Action for Research to End Stillbirth (CARES) Research Center at Columbia University, New York City, has expertise in electronic health records and artificial intelligence-aided analysis to develop automated algorithms specifically for early identification of stillbirth risk and to develop novel biomarkers of underlying placental dysfunction for predicting stillbirth. The project is led by Uma Reddy, M.D., professor of obstetrics and gynecology; and Xiao Xu, Ph.D., associate professor of reproductive sciences.
• The University of Utah Stillbirth Research Center has expertise in education, bereavement/mental health and advocacy. The center will evaluate decreased fetal movement, stratification of stillbirth risk based on decreased fetal movement, and optimal strategies for managing it. This project is led by Robert Silver, M.D., professor of obstetrics and gynecology, University of Utah Health Sciences Center, Salt Lake City.
• The Nutrition and Outcomes of Reproductive Injury and Stillbirth related Harms (NOURISH) Research Center at Oregon Health & Science University, Portland, has expertise in the role of nutrition, chronic stress, cardiometabolic health, and placental dysfunction to identify promising interventions aimed at reducing preventable stillbirth. This project is led by Karen Gibbins, M.D., assistant professor of obstetrics and gynecology; and Leslie Myatt, Ph.D., professor and director of perinatal research.

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Mental health will be a primary focus for the first time at an United Nations General Assembly session [ on Sept. 25].  [Becker's Behavioral Health] 

World leaders are expected to adopt a declaration that outlines global priorities to improve mental healthcare access, according to a Sept. 25 report. The declaration calls for expanded access to primary care, recognition of shared risk factors between noncommunicable diseases and mental health, and the creation of a mechanism for sustainable financing — particularly in low- and middle-income countries. 

“This is the first time that we can report more than 1 billion people have a mental health condition,” Devora Kestel, MD, director ad interim director of noncommunicable diseases and mental health at the World Health Organization said. “Only 9% of people with depression … receive support. Only 40% of people with psychosis receive help.”

The proposed declaration prioritizes integrated, community-level services and cross-sector collaboration in areas such as nutrition, air quality and economic policy, according to the report. WHO leaders also emphasized the need to amplify the voices of people with lived experience and reduce stigma around mental health.

The meeting aims to elevate mental health as a core global health issue and spur coordinated political action across UN member states, according to the report. 

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The CDC made a strong recommendation based on a high certainty of evidence to use the long-acting injectable lenacapavir (Yeztugo) for HIV pre-exposure prophylaxis (PrEP), but will that ensure the treatment's place in the nation's health plan formularies? [MEDPAGE Today]

"[Lenacapavir] is a highly effective and safe PrEP option administered every 6 months, which provides the potential to improve PrEP adherence and thus enhance HIV prevention in the United States," the CDC's PrEP Guidelines Work Group stated in its clinical recommendation, published last week in the Morbidity and Mortality Weekly Report.

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— The same measures can help prevent both atrocities |

For American kids, the new school year marks the return of active shooter drills. While events like Columbine and Sandy Hook are flash-points in the debate over gun rights and safety, some experts suggest these drills may do more psychological harm than good. Our priorities are misguided because a far greater firearm threat is the leading cause of death among children and teens: suicide. [MEDPAGE Today]

Since the Columbine High School massacre, the total number of deaths from school shootings is dwarfed by the number of young lives lost to firearm suicide. Estimates suggest upwards of 500 K-12 students have have died in U.S. school shootings since 1999; in contrast, over 3,400 young people (ages 10-24) die by firearm suicide each year in our country. At the individual level it is worse. American children are 20 times more likely to die by firearm suicide at home than in a shooting at school.

This preventable loss of life from suicide and school shootings shares a common thread: easy access to firearms. In fact, 76% of firearms used in school shootings and 79% used in suicides are obtained from the home of a family member. One way to prevent these deaths is secure storage, as promoted by campaigns like Be SMARTand proposed federal legislation like Ethan's Law.

The problem of youth suicide isn't going away: research confirms a rise in suicidal ideation among American teens. A CDC report based on 2023 data showed that nearly 40% of U.S. high school students reported persistent feelings of sadness or hopelessness.

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The Department of Public Health said Tuesday it will adopt new fall vaccine guidance that recommends COVID-19 vaccines for all adults and most children. [Health News Illinois]

The recommendations come from IDPH’s Immunization Advisory Committee Meeting, which voted Monday to recommend vaccinations for all Illinoisans 18 and older. 

The agency also adopted the committee’s COVID-19 vaccine recommendations for those between 6 and 23 months old, and for children between 2 and 17 years old if they are in a higher-risk category or if parents want them to have the vaccine.

The guidance also covers RSV immunization and flu vaccinations.

IDPH Director Dr. Sameer Vohra also said Tuesday that he has issued a standing order to allow eligible providers in pharmacies and other clinical settings to administer vaccines recommended by the agency.

IDPH said it recommends that healthcare providers follow Centers for Disease Control and Prevention immunization schedules for children and adults issued as of last month, which it said are based on years of science, research, data and best practices.”

“All Illinoisans, including concerned parents and healthcare providers, deserve credible, transparent, science-based vaccine guidance,” Vohra said. “(Our) recommendations, made in consultation with our Immunization Advisory Committee, will ensure that residents can protect themselves and their family members this upcoming respiratory season.”

Monday’s meeting comes as the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices voted last week on a more restrictive approach to coronavirus vaccines by recommending that everyone consult a clinician before getting a shot.

The CDC must still adopt the recommendation before it becomes official.

State-regulated insurers will be required to cover vaccines based on IDPH recommendations. That includes seasonal and routine child and adult vaccines.

Illinois health leaders said Tuesday they were grateful for the state’s efforts to lead on vaccine policy.

“These vaccine recommendations provide clear guidance to patients, physicians and payers,” said Dr. Richard Anderson, president of the Illinois State Medical Society. “As we enter the fall respiratory virus season, it’s important for children and adults to get timely immunizations to protect themselves, their loved ones, and the community from these easily transmissible diseases.”

AHIP, the national association for health insurance, recently said its member health plans will continue to cover all the vaccines that they covered as of Sept. 1, including updated COVID-19 vaccines, through the end of 2026.

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