A group of public health organizations, lawyers, and scholars, has filed an amicus brief in the US District Court of Massachusetts supporting plaintiffs American Academy of Pediatrics (AAP) and others against defendant Robert F. Kennedy Jr., secretary of the Department of Health and Human Services (HHS), and warning that recent federal actions weakening routine childhood vaccination recommendations pose an urgent threat both for children and the public’s health.

The AAP alleges in a lawsuit filed last year that recent changes to the routine childhood vaccine recommendation schedule in the United States violates the Administrative Procedure Act.

Defendants’ actions will depress vaccination rates and cause increased vaccine-preventable outbreaks, preventable hospitalizations, and unnecessary deaths.

“Defendants made these disruptive changes without considering the overwhelming science or following ACIP’s longstanding procedural safeguards,” the brief states, referring to the Advisory Committee on Immunization Practices. “Defendants’ actions will depress vaccination rates and cause increased vaccine-preventable outbreaks, preventable hospitalizations, and unnecessary deaths. Medically underserved communities and the safety-net providers who serve them will disproportionately suffer the consequences.”

Shared decision-making refuted

The Robert Wood Johnson Foundation, the American Thoracic Society, the Network for Public Health Law, and 119 deans and professors are among those listed in the brief.

In the brief, the safety and efficacy of childhood vaccine are emphasized, while the “shared clinical-decision making” (SCDM) model touted by HHS is described as a way to further sow distrust in safe vaccines.

“Placing a vaccine on the routine schedule does not create a mandate, but the routine schedule ensures that immunizations will be part of the preventive standard of practice for children and the default approach. SCDM has the opposite effect,” the brief states.

Polls from the Partnership to Fight Infectious Disease and Research!America find strong support for vaccines and scientific and technologic advancement, regardless of political stripe, with 90% and 91% of Americans saying policymakers must ensure access to vaccines and cement the country’s global leadership in medical progress, respectively.

The first survey asked 1,013 voters nationwide about their views on vaccine access from January 27 to 30. The margin of error was plus or minus 3.4 percentage points.

In total, 93% of participants agree every American should have barrier-free access to affordable vaccines. And 92% say policymakers should safeguard access to, and continued health insurance coverage of, vaccines. That proportion includes 85% of Trump voters who support the Make America Healthy Again movement.

Analysis of Candida auris samples from infected US patients highlights the fungal pathogen’s persistence as a multidrug-resistant threat, researchers from the Centers for Disease Control and Prevention (CDC) reported yesterday in Emerging Infectious Diseases.

The analysis of 8,033 C auris clinical isolates by the CDC’s Antimicrobial Resistance (AR) Laboratory Network during 2022 and 2023 found that over 95% were resistant to fluconazole, a first-line antifungal treatment used for a variety of fungal infections, with percentages exceeding 90% in all US regions except the Midwest (83%). Fifteen percent of C auris isolates were resistant to amphotericin B, 1% were resistant to echinocandins, and less than 1% were resistant to all three antifungal classes.

“The frequency of echinocandin resistance (1%) and panresistance (<1%) among C. auris isolates remains low, including among blood isolates, supporting use of echinocandins as first-line therapy against C. auris infections,” the study authors wrote. “However, the number of resistant isolates has increased, and possible spread among patients has been documented.”

C auris cases continue to rise

Since it first appeared in the United States in 2016, the prevalence of the multidrug-resistant yeast has steadily risen, from 51 clinical cases in 2016 to 4,514 in 2023. The number of clinical isolates tested by the AR Laboratory Network, which works with labs across the country to identify and track antimicrobial-resistant pathogens, rose from 3,064 in 2022 to 4,969 in 2023. Invasive infections caused by C auris have been reported in 39 states.

“Our findings highlight the persistence of C. auris as a multidrug-resistant threat requiring sustained investment in laboratory capacity for early detection and response,” the authors wrote.

In addition to its high levels of antifungal resistance, C auris is associated with high mortality rates and spreads easily in health care settings, causing outbreaks. Among the areas that have been hit by C auris outbreaks is Maricopa County, Arizona, where 28 health care facilities reported clinical cases in an outbreak that stretched from April 21, 2022, to February 23, 2023. Description of the local public health response to that outbreak was published today in Infection Control and Hospital Epidemiology.