• Are mRNA Covid-19 vaccines safe?  More strong evidence that the answer is YES:

From: Semenzato L, Le Vu S, Botton J, et al. COVID-19 mRNA Vaccination and 4-Year All-Cause Mortality Among Adults Aged 18 to 59 Years in France. JAMA Netw Open. 2025;8(12):e2546822. doi:10.1001/jamanetworkopen.2025.46822

“Design, Setting, and Participants  This cohort study used data from the French National Health Data System for all individuals in the French population aged 18 to 59 years who were alive on November 1, 2021. Data analysis was conducted from June 2024 to September 2025.

Exposure  Exposure was defined as receiving a first mRNA dose between May 1 and October 31, 2021. Individuals who were unvaccinated by November 1, 2021, were assigned a random index date based on vaccinated individuals’ vaccination dates.

Results  A total of 22 767 546 vaccinated and 5 932 443 unvaccinated individuals were followed up for a median (IQR) of 45 (44-46) months. Vaccinated individuals were older than unvaccinated individuals (mean [SD] age, 38.0 [11.8] years vs 37.1 [11.4] years), more frequently women (11 688 603 [51.3%] vs 2 876 039 [48.5%]) and had more cardiometabolic comorbidities (2 126 250 [9.3%] vs 464 596 [7.8%]). During follow-up, 98 429 (0.4%) and 32 662 (0.6%) all-cause deaths occurred in the vaccinated and unvaccinated groups, respectively. Vaccinated individuals had a 74% lower risk of death from severe COVID-19 (weighted hazard ratio [wHR], 0.26 [95% CI, 0.22-0.30]) and a 25% lower risk of all-cause mortality (wHR, 0.75 [95% CI, 0.75-0.76]), with a similar association observed when excluding severe COVID-19 death. Sensitivity analysis revealed that vaccinated individuals consistently had a lower risk of death, regardless of the cause. Mortality was 29% lower within 6 months following COVID-19 vaccination (relative incidence, 0.71 [95% CI, 0.69-0.73]).

Conclusions and Relevance  In this national cohort study of 28 million individuals, the results found no increased risk of 4-year all-cause mortality in individuals aged 18 to 59 years vaccinated against COVID-19, further supporting the safety of the mRNA vaccines that are widely used worldwide.”

• Katelyn Jetelina writes (with Hayden Rooke-Ley) in her Your Local Epidemiologist blog on the wildly disproportionate cost/delivery ratio of health care in the United States; read  “5 ways our health care system has become utterly insane” to get a summary of that sad story.  One tidbit – wages may have kept pace with inflation over the last 15 years, but they have decidedly NOT kept pace with health insurance costs.  And then there’s this:

“One in three Americans has medical debt, and more than half worry they’ll fall into debt any time they use the health care system. That fear changes behavior: people delay appointments, skip medications, or avoid care altogether…Medical debt is now the most common form of debt in collections ahead of credit cards, utilities, or personal loans. Nearly 60% of those in medical debt have insurance.”

• Brian Lee PhD, one of the authors of the 2024 JAMA sibling study suggesting that there is no causal relationship between acetaminophen use in pregnancy and neurodevelopment disorders talks about this study in this free interview in JAMA.

He mentions a more recent 2025 Japanese study that came to the same conclusions:

“A nationwide Japanese study with about 200 000 persons looked at this exact same question and also did a sibling analysis. The use of acetaminophen in this population was roughly 40%. And they found the exact same thing that our Swedish study did, where there’s an apparent statistical association initially, but it completely disappears when you do the sibling control analysis. And so, the evidence is pointing a certain way that is going to be challenging for other studies to try and overcome.”

• Frank Bruni outdoes his usual excellence in this week’s NYT newsletter “The Unchecked, Unbalanced Reign of King Donald.” His For the Love of Sentences is especially good as well. Some examples:

Frank’s own, nominated by me:

“But the Republicans who control the House and the Senate have instead surrendered all control to Trump, whose vanquishing of Democrats and potential wrath speak more loudly to them than ethics, a word I feel silly typing. They’re dutiful handmaidens and gushing cheerleaders who have given him whatever he wants, including a roster of senior administration officials who are, incredibly, yet more dutiful and gushing than they are. Where two or three gather in Trump’s name, there he is to bask in their obsequiousness, as if he were extending his legs for a pedicure and each of them were calling dibs on a different toe.”

and from others:

In The Pickup, John Paul Brammer took issue with a proposal to build the tallest skyscraper in the United States in a very flat state: “It’s difficult to communicate just how dramatically its completion would transform the Oklahoma City skyline, but picture, if you would, a pancake with a yardstick plunged into it.”

In her newsletter, Mary Geddry experienced Trump’s ramblings to journalists in the Oval Office last Monday as “less a press conference than a slurred soliloquy of decay, staged under the chandeliers of American decline.”