Infection Control Problems Persist in Nursing Homes During COVID


The new analysis draws on self-reported data from nursing homes collected by the federal government over four weeks from late August to late September. While some states fared much worse than others, all 50 states and the District of Columbia had one or more nursing homes that reported inadequate PPE supply, staff shortages, staff infections and resident cases. Forty-seven states reported at least one COVID-19 death among residents.

The analysis found that more than 28,000 residents tested positive for COVID-19 during the four-week reporting period, and more than 5,200 residents died, showing that the virus is still raging in nursing homes. More than 84,000 long-term care residents and staff have died since January, and more than 500,000 residents and staff have contracted the disease, according to the Kaiser Family Foundation’s tally, accounting for roughly 40 percent of the national death toll. Long-term care providers include assisted living, adult day care centers and more, while AARP’s new analysis features just nursing home data.

“This is a nationwide crisis, and no state is doing a good job,” says Bill Sweeney, AARP’s senior vice president of government affairs, adding that the results of AARP’s analysis are “profoundly disappointing.”

“While the pandemic has been unexpected to all of us, basic infection control should have been going on in nursing homes for a long time,” he says. “These are places where people are vulnerable to infection, whether it’s COVID or something else, so for these facilities to still not have basic PPE, even now, with a deadly virus in the air, is outrageous and unacceptable.”

Staff infections nearly match resident infections

For months, providing adequate PPE and developing plans to mitigate staffing shortages have been “core principles” set out by the Centers for Disease Control and Prevention (CDC), for COVID-19 infection control in nursing homes, which generally house older adults with underlying conditions who are at increased risk of infection and severe illness from the disease. PPE stops the transfer of infectious droplets through the air, while adequate staffing ratios mean better care and less person-to-person contact.

Yet in 18 states, more than 30 percent of all nursing homes reported PPE shortages, and in 26 states and the District of Columbia, more than 30 percent of nursing homes are experiencing staff shortages. N95 respirators were the most in-demand PPE item across the country, with 11 percent of all nursing homes reporting shortages. And nursing home aides (certified nursing assistants, nurse aides, medication aides and medication technicians) were the most in-demand staff, with 27 percent of all nursing homes reporting shortages.


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How to know if chest pains are serious

Chest pain can stem from many health issues. Some are quite serious, while others may be nothing to worry about.

Sometimes, chest pain indicates a blocked artery and a heart attack. This is an emergency situation, in which the heart is not receiving enough blood and oxygen to function correctly.

However, chest pain can also stem from a health issue affecting the lungs, stomach, or muscles, for example.

It is crucial to receive emergency care for chest pain, especially if it is sudden and severe and accompanied by shortness of breath, dizziness, or both.

Many heart conditions can cause chest pain, including:

Heart attack

A heart attack may be the best-known cause of chest pain, and the pain usually occurs in the center of the chest.

People experience this pain differently — some describe it as uncomfortable, sharp, sudden, and severe, while others report a squeezing sensation. In some people, the pain comes and goes.

It is worth noting that a heart attack does not always cause chest pain. A person may experience other symptoms, with or without chest pain, including:

  • cold sweats
  • lightheadedness
  • nausea
  • pain in other areas, such as the arms, back, jaw, or stomach
  • shortness of breath
  • dizziness
  • sweating

Also, males and females may experience heart attacks differently. Learn about the symptoms common in females here.

Anyone who believes that they may be having a heart attack should receive immediate medical attention.

Aortic dissection

This cause of chest pain is a life threatening condition in which a tear forms in the lining of the aorta, one of the body’s most important arteries.

If the tear is large enough or a doctor cannot treat it in time, it can cause fatal bleeding.

The symptoms are similar to those of a heart attack, and they may also include:

  • leg pain or paralysis
  • paralysis on one side of the body
  • difficulty speaking or seeing

Anyone who may be experiencing this should receive immediate medical care.

Pericarditis

Pericarditis occurs when the sac that surrounds the heart, called the pericardium, becomes inflamed.

This can cause chest pain, especially when a person takes a deep breath.

Aortic stenosis

The aortic valve allows oxygenated blood to flow out of the heart’s left ventricle and into the rest of the body.

Stenosis occurs when this valve becomes stiff, either from age or disease. When this happens, and the heart pumps out less blood, it can cause chest pain.

Hypertrophic cardiomyopathy

This condition causes the heart’s muscle to become overly thick, shrinking the heart’s chambers. As a result, the heart is able to hold less blood and cannot pump as effectively.

Hypertrophic cardiomyopathy can also prevent the heart from keeping a healthy electrical rhythm.

The lungs reside in the chest cavity, and the following health issues affecting the lungs can cause pain in the area:

COPD

Chronic obstructive pulmonary disease (COPD) is an umbrella term for emphysema and chronic bronchitis.

People with COPD often have pain in the upper middle chest, as well as lung inflammation,

A Canadian spin studio followed public health guidelines. But 61 people still caught the covid-19.

Now, despite appearing to have complied with public health regulations, at least 61 people linked to the studio have tested positive for the novel coronavirus.

“They had done all sorts of things to remove the potential for spread,” Richardson told reporters. “Unfortunately, gyms are a higher-risk place because of the fact that generally people are taking off their masks, they’re breathing at a higher rate.”

Although Hamilton requires masks to be worn in most public settings, the law includes an exemption for anyone “actively engaged in an athletic or fitness activity.” In keeping with that policy, the studio, SPINCO, allowed riders to remove their masks once clipped into their bikes, and told them to cover up again before dismounting.

In a recent Instagram post, SPINCO’s owners said that they had been “hesitant” to reopen after getting the green light in July, and would not resume classes “until it is safe to do so.” Health officials have said that the studio is temporarily closed and cooperating fully with the investigation.

“We took all the measures public health offered, even added a few, and still the pandemic struck us again!’” the owners wrote. SPINCO has more than a dozen locations across Canada.

As of Tuesday, 44 cases linked to specific classes were detected, Richardson said. An additional 17 instances of “secondary cases” were found among other contacts.

The city will reexamine gym protocols, Richardson added Tuesday, but in the meantime, “what seems to be the case is that you need to wear that mask” even though government guidelines do not strictly require it.

“It’s still a good idea to do it, in terms of keeping others safe,” she said.

People should also avoid “classes where you’ve got that kind of yelling or coaching over music.”

She declined to use the term “superspreader” to describe the event but said it is a “very large outbreak.”

“It is concerning that it is extended beyond the initial cases who were related to the classes but gone into of course their household contacts and other contacts,” she said. “We continue to look at what does it mean, what do we need to understand about exercise classes?”

The outbreak offers further evidence of the dangers of people gathering indoors without masks, as health experts warn that cases could spike further in the coming months as winter weather sets in and outdoor gatherings and exercise classes will be harder to maintain.

In August, South Korea confirmed dozens of cases linked to a single Starbucks in the city of Paju where many customers did not wear masks. The store employees, who wore masks, were not infected. The outbreak prompted Starbucks to limit its indoor seating in the country and encourage masks among patrons.

In other instances, mask usage has been credited with preventing potential outbreaks. In May, after the reopening of a hair salon in Missouri that required masks, two stylists — who had worked with more than 100 clients — tested positive for the virus. But masks were

How do pandemics end? History suggests diseases fade but are almost never truly gone

<span class="caption">The COVID-19 new normal might be here for quite some time.</span> <span class="attribution"><a class="link rapid-noclick-resp" href="https://www.gettyimages.com/detail/photo/reflecting-on-her-day-royalty-free-image/1263884394" rel="nofollow noopener" target="_blank" data-ylk="slk:SolStock/E+ via Getty Images">SolStock/E+ via Getty Images</a></span>
The COVID-19 new normal might be here for quite some time. SolStock/E+ via Getty Images

When will the pandemic end? All these months in, with over 37 million COVID-19 cases and more than 1 million deaths globally, you may be wondering, with increasing exasperation, how long this will continue.

Since the beginning of the pandemic, epidemiologists and public health specialists have been using mathematical models to forecast the future in an effort to curb the coronvirus’s spread. But infectious disease modeling is tricky. Epidemiologists warn that “[m]odels are not crystal balls,” and even sophisticated versions, like those that combine forecasts or use machine learning, can’t necessarily reveal when the pandemic will end or how many people will die.

As a historian who studies disease and public health, I suggest that instead of looking forward for clues, you can look back to see what brought past outbreaks to a close – or didn’t.

people in line outside a COVID-19 testing site
people in line outside a COVID-19 testing site

Where we are now in the course of the pandemic

In the early days of the pandemic, many people hoped the coronavirus would simply fade away. Some argued that it would disappear on its own with the summer heat. Others claimed that herd immunity would kick in once enough people had been infected. But none of that has happened.

A combination of public health efforts to contain and mitigate the pandemic – from rigorous testing and contact tracing to social distancing and wearing masks – have been proven to help. Given that the virus has spread almost everywhere in the world, though, such measures alone can’t bring the pandemic to an end. All eyes are now turned to vaccine development, which is being pursued at unprecedented speed.

Yet experts tell us that even with a successful vaccine and effective treatment, COVID-19 may never go away. Even if the pandemic is curbed in one part of the world, it will likely continue in other places, causing infections elsewhere. And even if it is no longer an immediate pandemic-level threat, the coronavirus will likely become endemic – meaning slow, sustained transmission will persist. The coronavirus will continue to cause smaller outbreaks, much like seasonal flu.

The history of pandemics is full of such frustrating examples.

Once they emerge, diseases rarely leave

Whether bacterial, viral or parasitic, virtually every disease pathogen that has affected people over the last several thousand years is still with us, because it is nearly impossible to fully eradicate them.

The only disease that has been eradicated through vaccination is smallpox. Mass vaccination campaigns led by the World Health Organization in the 1960s and 1970s were successful, and in 1980, smallpox was declared the first – and still, the only – human disease to be fully eradicated.

Children holding smallpox vaccination certificates
Children holding smallpox vaccination certificates

So success stories like smallpox are exceptional. It is rather the rule that diseases come to stay.

Take, for example, pathogens like malaria. Transmitted via parasite, it’s almost as old as humanity and still exacts

Is it safe to travel for the holidays in 2020 during the pandemic?

The end of the year is sneaking up, and people are weighing travel plans to join friends and family for the holidays — all against the backdrop of a deadly pandemic.



a group of people walking down the street: There's a lot more to consider when planning holiday travel in 2020.


© Daniel Slim/AFP/Getty Images
There’s a lot more to consider when planning holiday travel in 2020.

Gathering with others — probably the most universal holiday tradition — has never required so much meticulous forethought.

Should you travel for the holidays in 2020? What precautions will make it safer? Who will be there and how careful have they been?

The US Centers for Disease Control and Prevention says that travel increases the chances of contracting and spreading Covid-19. Staying home is the best way to protect against getting and spreading the virus, yet many people are likely to travel before the year is over.



a sign on the side of a snow covered car in a parking lot: Driving is not without risks, but your interactions with others can be more easily controlled than with air travel.


© Jason Connolly/AFP/Getty Images
Driving is not without risks, but your interactions with others can be more easily controlled than with air travel.

CNN spoke with medical experts on how to reduce the risks around holiday travel and when you really should skip it altogether.

Should you travel for the holidays this year?

“Probably not, if you are anxious or vulnerable,” says Dr. Richard Dawood, a travel medicine specialist and director at Fleet Street Clinic in London.

But traveling is fine if you’re willing to be cautious, follow the rules and adapt easily to changes of plan, he said.

“I think the threshold for travel at this time should still be higher than before the pandemic,” says Dr. Henry Wu, director of Emory TravelWell Center and associate professor of infectious diseases at Emory University School of Medicine in Atlanta.



a statue of a man and a woman standing in front of a building: Staying in a hotel may give guests more control of their environment than staying with friends or relatives.


© Benno Schwinghammer/picture alliance/Getty Images
Staying in a hotel may give guests more control of their environment than staying with friends or relatives.

“If you do choose to travel, try to keep gatherings small and take precautions,” such as wearing a mask and practicing social distancing and good hand hygiene, Wu said.

Who should skip it?

People who are especially vulnerable to severe Covid-19 illness are safest staying home.

“Are you older, are you frail, do you have chronic underlying illnesses?” are the questions to ask, says Dr. William Schaffner, an infectious diseases specialist at Vanderbilt University Medical Center in Nashville, Tennessee.

People who are considering meeting up with vulnerable relatives or friends should really weigh the implications of introducing illness to them, Wu said.

“There are well-documented Covid-19 clusters associated with family gatherings, including ones that resulted in deaths,” he said.

Are some locations safer than others?

Gatherings are likely safer in areas around the world where infections remain low, although the standard precautions still apply.



a group of people sitting at a table: Joining hands around a crowded holiday table is best skipped this year.


© Shutterstock
Joining hands around a crowded holiday table is best skipped this year.

For example, it may be possible to have a “relatively normal” Thanksgiving gathering in parts of the United States where infections are very low, according to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

“But in other areas of the

U.K.’s Film and TV Charity Launches Two-Year Program For Better Mental Health in Film and TV

The U.K.’s Film and TV Charity has launched the Whole Picture Program, a two-year initiative designed to to improve the mental health and wellbeing of the 200,000 people who work behind the scenes in film, TV and cinema.

The Film and TV Charity has now secured £3 million ($3.87 million) in funding from Amazon Prime Video, Banijay U.K., BBC, BBC Studios, Channel 4, IMG, ITV, Sky, Sky Studios, Sony Pictures Entertainment, The Walt Disney Company, ViacomCBS and WarnerMedia to deliver the program that is supported by the BFI and backed by U.K. mental health charity Mind. The charity estimates that mental health problems, including staff turnover, cost the sector at least £300 million ($387 million) in losses each year.

The program will deliver a toolkit for mentally healthy productions; enhanced professional and peer support for freelancers; people skills and training guides; industry actions to improve behavior; and anti-bullying services and resources.

Alex Pumfrey, CEO of the Film and TV Charity said: “It has been a devastating year for many people in our industry, and it’s clear we cannot afford to return to ‘business as usual’. Our 2019 research showed a mental health crisis in the industry, which has only been exacerbated by the terrible effects of the pandemic.”

More than 9,000 people took part in the research last year, sharing their experiences and stories confidentially, which identified a mental health crisis within the industry. The findings revealed issues including self-harm and bullying. Since then, the pandemic has meant increased isolation and anxiety for many, and Black, Asian and minority ethnic (BAME) people in the industry have identified the effect systemic racism and discrimination has on mental health.

“The case for improving the mental health of the industry has never been stronger or more urgent,” added Pumfrey. “This program of work is designed to turn the tide on poor mental health by enhancing the available support, changing behavior and improving ways of working; but this will need to be an industry-wide effort to create sustainable change.”

The project has been on hold for six months whilst the charity has dedicated all of its resources to responding to COVID-19, raising £6.4 million ($8.2 million), and supporting thousands of workers with grants and financial and mental wellbeing services.

Emma Mamo, head of workplace wellbeing at Mind, said: “Unfortunately, self-employed people, freelancers and those in the film and TV industry are among those hit hardest by coronavirus. That’s why we’re pleased to be supporting the Whole Picture Program, which will provide much-needed resource and support to the many experiencing poor mental health in the sector.”

Industry leaders are part of the program’s mental health taskforce and they will work collaboratively to adopt and champion the work both within their own organizations and widely across the sector.

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As virus surges anew, Milan hospitals under pressure again

MILAN (AP) — Coronavirus infections are surging anew in the northern Italian region where the pandemic first took hold in Europe, putting pressure again on hospitals and health care workers.

At Milan’s San Paolo hospital, a ward dedicated to coronavirus patients and outfitted with breathing machines reopened this weekend, a sign that the city and the surrounding area is entering a new emergency phase of the pandemic.

For the medical personnel who fought the virus in Italy’s hardest-hit region of Lombardy in the spring, the long-predicted resurgence came too soon.


“On a psychological level, I have to say I still have not recovered,’’ said nurse Cristina Settembrese, referring to last March and April when Lombardy accounted for nearly half of the dead and one-third of the nation’s coronavirus cases.

“In the last five days, I am seeing many people who are hospitalized who need breathing support,” Settembrese said. “I am reliving the nightmare, with the difference that the virus is less lethal.”

Months after Italy eased one of the globe’s toughest lockdowns, the country is now recording well over 5,000 new infections a day — eerily close to the highs of the spring — as the weather cools and a remarkably relaxed summer of travel and socializing fades into memory. Lombardy is again leading the nation in case numbers, an echo of the trauma of March and April when ambulance sirens pierced the silence of stilled cities.

So far, Italy’s death toll remains significantly below the spring heights, hovering recently around 50 per day nationwide, a handful in Lombardy. That compares with over 900 dead nationwide one day in March.

In response to the new surge, Premier Giuseppe Conte’s government twice tightened nationwide restrictions inside a week. Starting Thursday, Italians cannot play casual pickup sports, bars and restaurants face a midnight curfew, and private celebrations in public venues are banned. Masks are mandatory outdoors as of last week.

But there is also growing concern among doctors that Italy squandered the gains it made during its 10-week lockdown and didn’t move quick enough to reimpose restrictions. Concerns persist that the rising stress on hospitals will force scheduled surgeries and screenings to be postponed — creating a parallel health emergency, as happened in the spring.

Italy is not the only European country seeing a resurgence — and, in fact, is faring better than its neighbors this time around. Italy’s cases per 100,000 residents have doubled in the last two weeks to nearly 87 — a rate well below countries like Belgium, the Netherlands, France, Spain and Britain that are seeing between around 300 to around 500 per 100,000. Those countries have also started to impose new restrictions.

This time, Milan is bearing the brunt. With Lombardy recording more than 1,000 cases a day, the regional capital and its surroundings account for as many as half of that total. Bergamo — which was hardest hit last time and has been seared into collective memory by images of army trucks transporting the dead to

Facebook to crack down on ads that discourage vaccines

Facebook announced a new policy that prohibits advertisements on the platform that discourage people from getting vaccines, as part of a new effort to encourage people to get flu shots amid the COVID-19 pandemic.



a sign on the screen: The Facebook logo is displayed on a mobile phone in this picture illustration taken Dec. 2, 2019.


© Johanna Geron/Reuters, File
The Facebook logo is displayed on a mobile phone in this picture illustration taken Dec. 2, 2019.

“We don’t want these ads on our platform,” Kang-Xing Jin, the company’s head of health and Rob Leathern, the director of product management, said in a blog post Tuesday.

The post added that while they already don’t allow ads featuring vaccine hoaxes, “Now, if an ad explicitly discourages someone from getting a vaccine, we’ll reject it.”

MORE: More people engage with verifiably false news outlets on Facebook now than in 2016

Moreover, the social media giant announced the launch of a new campaign to provide information about flu vaccines to users, and pledged to work with “global health partners on campaigns to increase immunization rates,” Jin and Leathern said.



a close up of a sign: The Facebook logo is displayed on a mobile phone in this picture illustration taken Dec. 2, 2019.


© Johanna Geron/Reuters, File
The Facebook logo is displayed on a mobile phone in this picture illustration taken Dec. 2, 2019.

This effort comes as health authorities urge people to prioritize getting a flu shot this year to both prevent twin infections of the flu and coronavirus and to minimize the potential strain on resources amid the ongoing COVID-19 pandemic.

Facebook’s policy, however, stops short of banning posts or other types of content on the platform that discourages vaccines. It also does not ban political ads that “advocate for or against legislation or government policies around vaccines — including a COVID-19 vaccine,” Jin and Leathern wrote.

“We’ll continue to require anyone running these ads to get authorized and include a ‘Paid for by’ label so people can see who is behind them,” the blog post stated.

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Taysha Gene Therapies Receives Rare Pediatric Disease Designation and Orphan Drug Designation for TSHA-102 as a Treatment for Rett Syndrome

Program leverages novel miRARE platform technology used to control transgene expression on a cellular basis

TSHA-102 anticipated to submit Investigational New Drug application in 2021

Taysha Gene Therapies Inc. (Nasdaq: TSHA), a patient-centric gene therapy company focused on developing and commercializing AAV-based gene therapies for the treatment of monogenic diseases of the central nervous system in both rare and large patient populations, today announced that it has received rare pediatric disease designation and orphan drug designation from the U.S. Food and Drug Administration (FDA) for TSHA-102, an AAV9-based gene therapy in development for the treatment of Rett syndrome. Taysha anticipates that it will submit an Investigational New Drug (IND) application for TSHA-102 to the FDA in 2021.

Rett syndrome is one of the most common genetic causes of severe intellectual disability worldwide, with a prevalence of over 25,000 cases in the U.S. and European Union (EU). It is an X-linked disease that primarily occurs in females, but it can be seen very rarely in males. It is usually recognized in children between six to 18 months of age as they begin to miss developmental milestones or lose abilities they had developed. Individuals with Rett syndrome also show symptoms that include loss of speech, loss of purposeful use of hands, loss of mobility, seizures, cardiac impairments, breathing issues and sleep disturbances.

“Patients with Rett syndrome are currently managed with symptomatic treatments as there are no therapies approved to treat the underlying cause of disease,” said Berge Minassian, M.D., Chief Medical Advisor of Taysha and Chief of Pediatric Neurology at the University of Texas Southwestern Medical Center (UT Southwestern). Dr. Minassian is credited with describing the CNS isoform of the MECP2 gene which is responsible for neuronal and synaptic function throughout the brain. “Gene therapy offers a potentially curative option for patients suffering with Rett syndrome.”

Rett syndrome is caused by mutations in the MECP2 gene. TSHA-102 is designed to deliver a healthy version of the MECP2 gene as well as the miRNA-Responsive Auto-Regulatory Element, miRARE, platform technology to control the level of MECP2 expression. “TSHA-102 represents an important step forward in the field of gene therapy, where we are leveraging a novel regulatory platform called miRARE to prevent the overexpression of MECP2,” said Steven Gray, Ph.D., Chief Scientific Advisor of Taysha and Associate Professor in the Department of Pediatrics at UT Southwestern. “In collaboration with Sarah Sinnett, Ph.D. to develop miRARE, our goal was to design a regulated construct that allowed us to control MECP2 expression to potentially avoid adverse events that are typically seen with unregulated gene therapies.”

The FDA defines a rare pediatric disease as a serious or life-threatening disease in which the disease manifestations primarily affect individuals aged from birth to 18 years. Pediatric diseases recognized as “rare” affect under 200,000 people in the U.S. The Rare Pediatric Disease Priority Review Voucher Program is intended to address the challenges that drug companies face when developing treatments for these unique patient populations. Under this program, companies are

It’s Tough to Change the Minds of ‘Vaccine-Hesitant’ Parents, Study Finds | Health News

By Amy Norton
HealthDay Reporter

(HealthDay)

WEDNESDAY, Oct. 14, 2020 (HealthDay News) — When parents have concerns about the safety of childhood vaccinations, it can be tough to change their minds, as a new study shows.

The study involved “vaccine-hesitant” parents — a group distinct from the staunch “anti-vaxxer” crowd. They have worries about one or more routine vaccines, and question whether the benefits for their child are worthwhile.

Even though those parents are not “adamantly” opposed to vaccinations, it can still be hard for pediatricians to allay their concerns, said Jason Glanz, lead researcher on the study.

So Glanz and his colleagues looked at whether giving parents more information — online material “tailored” to their specific concerns — might help.

It didn’t. Parents who received the information were no more likely to have their babies up to date on vaccinations than other parents were, the study found.

The news was not all bad. Overall, more than 90% of babies in the study were all caught up on vaccinations.

So it may have been difficult to improve upon those numbers, according to Glanz, who is based at Kaiser Permanente Colorado’s Institute for Health Research in Aurora.

But, he said, it’s also possible the customized information reinforced some parents’ worries.

“It might have done more harm than good,” Glanz said.

That’s because among vaccine-hesitant parents, those who were directed to general information that was not tailored, had the highest vaccination rates — at 88%.

The findings were published online Oct. 12 in Pediatrics.

Childhood vaccination rates in the United States are generally high. But studies show that about 10% of parents either delay or refuse vaccinations for their kids — generally over safety worries.

Routine childhood vaccines have a long history of safe use, Glanz said, but some parents have questions. They may have heard that certain ingredients in vaccines are not safe, or worry that their baby is being given “too many” immunizations in a short time.

And during a busy pediatrician visit, Glanz said, it can be hard to address all those questions.

So his team tested a web-based tactic to augment routine checkups. They randomly assigned 824 pregnant women and new parents to one of three groups: One received standard vaccine information from their pediatrician; another was directed to the study website for additional, but general, information on immunizations; and the third received tailored information from the website.

That tailoring was done with the help of a survey that asked parents about their vaccine beliefs and concerns.

In the end, however, the targeted messaging flopped. It made no difference among parents overall: Across the three groups, between 91% and 93% of babies were up to date on vaccinations at 15 months of age.

And among the 98 parents who were deemed vaccine-hesitant, the tactic seemed to backfire: Only 67% of those babies were up to date compared to 88% of those whose parents received general vaccine information. The rate was 75% in the standard-care group.

Dr. Edgar Marcuse,