The Idiotic Executive Order on Vaccines

• Leaving aside the evident ignorance (?idiocy) implicit in T***’s comments when presenting his executive order on immunizations (e.g. “bottle of soda”, “gallons”, “possibility they’re quite lethal”, “nothing bad can happen from what we’re doing”, “72 shots”, etc.), there was no discussion of any cost/benefit analysis.  Robert Shpiner MD does a good job explaining in his Medpage Today perspective Trump’s Vaccine Order Will Show Up in My ICUSome excerpts:

“The order recommends that childhood vaccines be given at separate visits. The president was explicit at the signing: “at 1 year, you should have five separate visits for vaccines rather than getting them all in the same day.” It also says the measles, mumps, and rubella (MMR) vaccine should be split into separate shots for each disease, even though no such versions are licensed in the U.S. The order also reduces the number of universally recommended childhood vaccines, placing hepatitis A and B vaccines, meningococcal B and ACWY vaccines into the high-risk only category, and moving flu and COVID shots to shared decision-making.”

The costs:

“This is arithmetic any of us can run — and a calculation the government should have run. Based on the existing schedule, U.S. children need roughly 25 injectionsopens in a new tab or window by age 6 (not including annual flu shots), delivered today across seven visits or so. One at a time, they would need 25 individual visits. That would mean nearly four times the time spent traveling to and enduring doctor’s visits; four times the co-pays that too many families already can’t afford; four times the complaints from the child who fears needles. More visits would mean more missed visits. Hours for each visit — between travel, time in the pediatric waiting room, and the visit itself — are hours of pay that would not appear in a parent’s paycheck.

None of this appears in the order. Sections 1 through 5 say nothing about cost, Medicaid, or resources, and the supplementary White House fact sheet is similarly silent.”

Of course, right now it’s impossible to accurately compute the additional costs of controlling future outbreaks related to a decline in vaccine-induced herd immunity, or medical care for the many possible delayed medical issues related to decreased immunizations (liver failure from congenitally acquired Hepatitis B, brain damage or death due to meningococcal meningitis, congenital rubella syndrome, increased pediatric admissions for influenza and COVID, etc., etc.).

The benefits: The only one cited was fewer shots in one pediatric visit — which of course will likely result in increased costs rather than any benefit.

2026-08-14T13:17:21-05:00August 14th, 2026|HomeRecommended|

Waymo beats human drivers in urban environments

From Governing.com: a study from the Insurance Institute for Highway Safety finds that Waymo’s autonomous driving record is better than the average human driver in multiple urban areas. “These results provide further evidence that Waymo’s deployments of L4 vehicles in driverless operation have lower crash rates than human drivers in comparable areas—68% lower in Waymo’s current state of technology and current locations.”  From the Governing story:

  • That rate varied by city: In Phoenix, Waymo had a 76 percent lower crash rate than human drivers; 71 percent lower in Los Angeles; 35 percent lower in San Francisco; and 3 percent higher in Austin. (Researchers caution that they had a small sample size for both Waymo and human drivers in Austin, which could have affected results).
  • Waymo cars operating in driverless mode also got into fewer collisions severe enough to merit reporting to the police. From 2021-2024, Waymo driverless cars were involved in an average of 1.28 such crashes per million vehicle miles traveled, while human-driven cars were involved in 4.06.
  • Compared to human-driven cars, Waymo cars were involved in 85 percent fewer single-vehicle crashes per vehicle miles traveled.
  • Waymo cars were also involved in 81 percent fewer injury- or fatality-causing crashes per vehicle miles traveled, compared to human-driven cars.

It’s important to note that this data does not include interstate highway or freeway driving, so the results can’t necessarily be extrapolated to those venues.

2026-08-10T09:37:01-05:00August 10th, 2026|Home, Musings|

The Ceaseless Lying and Weaponization

No surprise here: news outlets are reporting that federal prosecutors today acknowledged that contractors hired by the Trump administration had “botched” the renovation of the Lincoln Memorial Reflecting Pool and sought to drop charges against David Hearn, a former Olympic canoeist who was one of several people accused of vandalizing the landmark. The NY Times said that in a court filing the prosecution said it had received documents showing that the damage to the pool “was the result of a flawed installation by the contractor, Atlantic Industrial Coatings, and the rush to complete the project prior to events associated with the America 250 celebration.”   And Jeanine Pirro said “Given all of this newly discovered information, it is difficult to attribute the widespread damage to the reflecting pool to vandalism.”  Earlier this month she had claimed there was abundant evidence of vandalism.

What a sad administration we live under.

2026-07-31T19:25:29-05:00July 31st, 2026|Home, Musings|

Good News on Acetaminophen in Pregnancy

A large and nicely done (matched sibling to reduce confounding)  study from Hong Kong by Luo S, Gong Q, Ai Y, et al. adds more reassurance to the safety of acetaminophen in pregnancy.  From the study’s key points:

“Question  Does prenatal exposure to paracetamol (acetaminophen) increase the risk of autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) in offspring after accounting for unmeasured familial confounding?

Findings  From an initial cohort of 708 020 mother-child pairs in Hong Kong (approximately 43.3% with prenatal paracetamol exposure), a sibling-matched cohort was constructed of 124 333 children who were assessed for ASD and 97 285 for ADHD. Prenatal paracetamol exposure was not associated with an increased risk of either ASD or ADHD and these findings were consistent across paracetamol exposure timing, pattern, and dose.”

2026-06-29T16:52:04-05:00June 29th, 2026|Home, Musings|

Brilliant Blog Post

Ryan Moulton has a slightly technical, but a thoroughly entertaining review of how nature produces colors, how we perceive them, and how our screens don’t quite manage to exactly reproduce the real world on his WordPress Blog.  If you are interested in color , it’s highly recommended!

2026-06-24T17:19:35-05:00June 24th, 2026|Musings|

ITER Fusion Reactor

• Alan Taylor has a wonderful photo essay in the Atlantic on the construction of what will be the world’s largest fusion reactor – ITER (International Thermonuclear Experimental Reactor) in Saint-Paul-lès-Durance, France. It’s a fantastically complicated construction challenge.

ITER collaboration Members China, the European UnionIndiaJapanKoreaRussia and the United States will share in the cost of project construction, operation and decommissioning, and also share in the experimental results and any intellectual property generated by the project. Europe is responsible for the largest portion of construction costs (45.6 percent); the remainder is shared equally by China, India, Japan, Korea, Russia and the United States (9.1 percent each).

The target date for completion with plasma generation is 2033.

2026-06-24T17:15:51-05:00June 24th, 2026|HomeRecommended|

A Couple of Interesting Topics in Medicine

Here are two medicine-relevant papers that I found very interesting.  The first discusses the work being done on the development of a fentanyl vaccine in the hope of decreasing the tragic death toll from its non-medical use.  The second is from Eric Topol’s terrific Ground Truths Substack where he talks about two recent papers, one from Germany and the other from Google in Cal, both looking at the performance of agentic AIs compared against clinicians.  Both were text based (not verbal) interactions, one with an agent presenting real world HPIs and the other with patient actors — and so decidedly not real world scenarios. Nevertheless, in both cases the AI agents outperformed real world physicians.  Read Topol’s post for his excellent summary, cautions, and analysis.

Schweitzer K. Inside the Push for a Fentanyl Vaccine. JAMA. Published online June 12, 2026. doi:10.1001/jama.2026.6392

• Eric Topol’s Agentic AI Comes to Medicine here: https://jamanetwork.com/journals/jama/fullarticle/2850522

2026-06-17T16:55:58-05:00June 17th, 2026|Home, Musings|
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