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The fall calendar doesn't just warn us of impending cold temperatures: It also points toward seasonal upticks in cases of RSV (respiratory syncytial virus), COVID, and influenza. These respiratory viruses were dubbed a "tripledemic" last year. After they collided to overload health care systems across the country, hospitalizations rose in tandem for all three illnesses over the fall and winter months.
Warding off severe cases — which may lead to hospitalization or death — should be top of mind, especially for those who are most vulnerable, a Harvard expert says. And updated versions of all three vaccines are now available to help protect us.
Why do cases of flu, RSV, and COVID typically rise in fall?
"This is typically the time of year we start to see viral infections increase, which has a lot to do with kids going back to school," says Dr. John Ross, an assistant professor of medicine at Harvard Medical School who is board-certified in infectious diseases.
"Also, we're starting now to have weather that's more favorable for viral transmission, particularly lower humidity. Viruses survive better in dry air. And drier air also affects our airways and makes them more vulnerable to being infected."
Who is eligible for each shot?
Eligibility recommendations vary by age and vulnerability to serious illnesses. Additionally, some shots are designed to help protect specific groups against serious illness.
The CDC recommends these shots for the following groups.
RSV
COVID
Flu
Who is likely to benefit most?
Getting the right vaccines can help people avoid missed work or school days and running the risk of making others sick. And the protection offered by these shots is especially important for certain groups.
For all three viruses, the people most vulnerable to severe illness are similar, Dr. Ross says, including
"Certainly with COVID and flu, pregnancy outcomes are worse with those infections," Dr. Ross says. "I'm not saying that RSV isn't a risk for pregnant mothers, but there's not much data. The reason pregnant women are offered RSV vaccination is so the maternal antibodies they produce protect the newborns, because they're at very high risk for RSV with very bad outcomes."
Additionally, an even wider range of people are more prone to complications from the flu, according to the CDC. This includes
What else should you know about flu, COVID, and RSV shots?
Beyond broad guidance determining who's eligible for each type of vaccine, Dr. Ross offers other useful insight that may guide your choices.
When is the best time to get a flu shot?
The CDC recommends getting a flu shot in September or October, and Dr. Ross agrees. "These are usually the months the flu vaccine becomes available and vaccine clinics are easiest to find," he says. "My personal approach is just to get the vaccine when it's available, so you don't forget."
Will the updated COVID vaccines protect against newer strains of the virus?
The latest mRNA shots by drugmakers Pfizer and Moderna are monovalent, meaning they protect against one variant — XBB.1.5, the most recent to descend from Omicron earlier in 2023. Though that strain is no longer dominant, the boosters should still guard against closely related subvariants that are now circulating, Dr. Ross says. "People can feel comfortable about their protection regardless," he says.
What else should I know about RSV shots?
The version meant for infants, Beyfortus, isn't a vaccine at all. It's a monoclonal antibody product that directly delivers antibodies that protect babies for the duration of a single fall-winter RSV season. These antibodies can prevent RSV or lessen its severity.
Dr. Ross says adults over 60 considering RSV vaccination should be aware of the potential for two rare but potentially serious side effects of the nervous system: the autoimmune conditions Guillain-Barre syndrome and acute disseminated encephalomyelitis, or ADEM. Guillain-Barre can lead to bodywide paralysis, while ADEM can cause weakness and seizures. The risk of these side effects after RSV vaccination in adults is about one in 7,000 — far higher than occurs after flu vaccination, Dr. Ross notes.
"If you're a totally healthy 60-year-old, I'm not sure it makes sense to get the RSV vaccine," he says. "It's a conversation you should have with your doctor."
How should I schedule shots if I'm getting several vaccines?
Research suggests that it's safe to get both flu and COVID vaccines at the same time. Reactions (such as muscle aches, fatigue, and headache) are slightly higher when flu vaccine and an mRNA COVID vaccine are combined, according to one study, though these reactions usually are mild and disappear quickly.
"Because RSV vaccines are newer, I don't think we know much about combining these shots with other vaccines," says Dr. Ross. Scheduling this vaccine separately is a good idea, although you should talk to your doctor about potential risks and benefits for your situation.
Source: Harvard Health Publishing
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Ever ridden an e-scooter or e-bike? The convenience, affordability, and flat-out fun of these "micromobility" modes of transportation are undeniable. But did it also seem a bit dangerous?
In fact, the rate of accidents involving e-bikes and e-scooters is climbing. Maybe that shouldn't be surprising given their dramatic jump in popularity. And then there's the way riders often use them: at high speed, near cars and pedestrians, and on roads and sidewalks that weren't designed for them.
Disruptive innovations, such as e-bikes and e-scooters, inevitably come with downsides. So, how can we minimize risks for accidents?
E-bikes, e-scooters, and injuries
Between 2018 and 2022, sales of e-bikes rose from around 250,000 per year to more than a million. E-bike and e-scooter rentals have also increased dramatically. As their popularity grows, emergency rooms are seeing many more people injured while riding e-bikes and e-scooters.
A 2024 study in JAMA Network Open highlights this. Researchers drew data from the National Electronic Injury Surveillance System, which is run by the US Consumer Product Safety Commission. They analyzed ER care between 2017 and 2022 for people injured while riding an e-bike or e-scooter, compared with people injured while riding conventional bikes and scooters.
What did the study find?
During the six-year study period, roughly three million people riding e-bikes, e-scooters, or their conventional counterparts sought care in the ER, including about 45,500 e-bike riders and 190,000 e-scooter riders, and about 2.5 million conventional bike riders and 305,000 conventional scooter riders.
Certain themes emerged around e-micromobility:
ER care spiked upward
More risky behavior
More accidents occurred in urban areas compared with rural settings:
All riders experienced similar types of injuries: scrapes, bruises, broken bones, and head and neck injuries were most common.
What are the limitations of this study?
This study only included people evaluated in an ER, so it excluded people with less severe injuries — and even those with significant injuries who didn't go to an ER. Some may have sought no care at all, or gone to a primary care practice or walk-in clinic to avoid costly ER care or for other reasons.
Nor did the study count injuries suffered by pedestrians injured by e-bike or e-scooter riders. Property damage, such as damage to a car, wasn't calculated.
And ultimately the study cannot compare the safety of e-bikes and e-scooters with conventional options. That's because no data were collected on the number of miles traveled using a particular mode of transportation, or over how much time.
How can you avoid e-bike or e-scooter injuries?
Ten common-sense precautions can help you avoid injuries and ER visits:
The bottom line
Whether it's part of your daily commute, an occasional quick zip from point A to point B, or just a ride for the fun of it, e-bikes and e-scooters are a great way to get around. Though they do come with some risk, you can do a lot to minimize the odds of wrapping up your travels with a trip to an ER.
Source: Harvard Health Publishing
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Several evenings a week, as Tyler VanderWeele gathers around the dinner table with his wife and two young kids, the family deliberately pauses during the meal to do something simple but profound. Each member shares several things for which they're grateful — an act that VanderWeele, co-director of the Initiative on Health, Spirituality, and Religion at the Harvard T.H. Chan School of Public Health, feels changes his family dynamic for the better.
"I do think it makes a difference and can be a very powerful practice," he says. "Even on those bad days where life seems difficult, that effort is worthwhile."
Gratitude, health, and longevity
How can the power of gratitude affect our lives? Recent research has pointed to gratitude's myriad positive health effects, including greater emotional and social well-being, better sleep quality, lower depression risks, and favorable markers of cardiovascular health. Now, new data from the long-term Nurses' Health Study shows that it may extend lives.
"Gratitude has been one of the most widely studied activities contributing to well-being, but we couldn't find a single prior study that looked at its effects on mortality and longevity, much to our surprise," says VanderWeele, co-author of the new research.
What did the study look at?
Published July 2024 in JAMA Psychiatry, the new study drew on data from 49,275 women enrolled in the Nurses' Health Study. Their average age was 79. In 2016, participants completed a six-item gratitude questionnaire in which they ranked their agreement with statements such as, "I have so much in life to be thankful for," and "If I had to list everything I felt grateful for, it would be a very long list."
Four years later, researchers combed through participants' medical records to determine who had died. There were 4,608 deaths from all causes, as well as from specific causes such as cardiovascular disease, cancer, respiratory diseases, neurodegenerative disease, infection, and injury. Deaths from cardiovascular disease — a top killer of women and men in the United States — were the most common cause.
What did the researchers find?
Participants with gratitude scores in the highest third at the study's start had a 9% lower risk of dying over the following four years than participants who scored in the bottom third. This did not change after controlling for physical health, economic circumstances, and other aspects of mental health and well-being. Gratitude seemed to help protect participants from every cause of death studied — including cardiovascular disease.
But what does this actually mean?
"A 9% reduction in mortality risk is meaningful, but not huge," VanderWeele says. "But what's remarkable about gratitude is that just about anyone can practice it. Anyone can recognize what's around them and express thanks to others for what's good in their life."
While the study couldn't pinpoint why gratitude is associated with longer life, VanderWeele believes several factors may contribute.
"We know that gratitude makes people feel happier. That in itself has a small effect on mortality risk," he says. "Practicing gratitude may also make someone a bit more motivated to take care of their health. Maybe they're more likely to show up for medical appointments or exercise. It may also help with relationships and social support, which we know contribute to health."
What are the study's limitations and strengths?
The study was observational. This means it can't prove that gratitude helps people live longer — only that an association exists. And the particular sample of people analyzed is both the biggest strength and limitation of the research, VanderWeele says. All were older female nurses with high socioeconomic status. The vast majority were white.
"Does the longevity effect extend to men, to those who are younger, and to those with lower socioeconomic resources?" VanderWeele asks. "Those are all open questions."
On the plus side, he says, the study sample's large size is one of its biggest strengths. So is the extensive data gathered on potential confounding factors such as participants' physical health, social characteristics, and other aspects of psychological well-being.
"Between the quality of the data and the size of the sample, we were able to provide reasonable evidence for this modest longevity effect," he says.
Try this: Six questions to evoke gratitude
Not feeling especially grateful today? You have the power to change that. Asking yourself certain questions can evoke gratitude, such as
Similarly, a few simple actions can infuse gratitude into your days. Try VanderWeele's family routine of regularly expressing gratitude around the dinner table. Another well-known practice — that's perhaps becoming forgotten in this digital age — is penning thank-you notes.
"I do think writing a thank-you note or gratitude letter gets your mind to dwell on something positive for a longer period, to think more deeply about it, because you have to put it not just in words, but in writing," VanderWeele says. "It also deepens the relationship and builds that bond."
One less-recognized but valuable gratitude practice is called a "savoring exercise," which builds on aspects of mindfulness. All that's required is "pausing, looking around you, and taking in and enjoying everything that's good in your current setting," VanderWeele says. "It's not a big leap to go from recognizing the good to expressing gratitude for what you have."
Source: Harvard Health Publishing
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Maybe we should add toothbrushes to the bouquet of flowers we bring to friends and family members in the hospital — and make sure to pack one if we wind up there ourselves.
New Harvard-led research published online in JAMA Internal Medicine suggests seriously ill hospitalized patients are far less likely to develop hospital-acquired pneumonia if their teeth are brushed twice daily. They also need ventilators for less time, are able to leave the intensive care unit (ICU) more quickly, and are less likely to die in the ICU than patients without a similar toothbrushing regimen.
Why would toothbrushing make any difference?
"It makes sense that toothbrushing removes the bacteria that can lead to so many bad outcomes," says Dr. Tien Jiang, an instructor in oral health policy and epidemiology at Harvard School of Dental Medicine, who wasn't involved in the new research. "Plaque on teeth is so sticky that rinsing alone can't effectively dislodge the bacteria. Only toothbrushing can."
Pneumonia consistently falls among the leading infections patients develop while hospitalized. According to the Agency for Healthcare Research and Quality, each year more than 633,000 Americans who go to the hospital for other health issues wind up getting pneumonia. Air sacs (alveoli) in one or both lungs fill with fluid or pus, causing coughing, fever, chills, and trouble breathing. Nearly 8% of those who develop hospital-acquired pneumonia die from it.
How was the study done?
The researchers reviewed 15 randomized trials encompassing nearly 2,800 patients. All of the studies compared outcomes among seriously ill hospitalized patients who had daily toothbrushing to those who did not.
What were the findings?
The findings were compelling and should spur efforts to standardize twice-daily toothbrushing for all hospitalized patients, Dr. Jiang says.
Study participants who were randomly assigned to receive twice-daily toothbrushing were 33% less likely to develop hospital-acquired pneumonia. Those effects were magnified for people on ventilators, who needed this invasive breathing assistance for less time if their teeth were brushed.
Overall, study participants were 19% less likely to die in the ICU — and able to graduate from intensive care faster — with the twice-daily oral regimen.
How long patients stayed in the hospital or whether they were treated with antibiotics while there didn't seem to influence pneumonia rates. Also, toothbrushing three or more times daily didn't translate into additional benefits over brushing twice a day.
What were the study's strengths and limitations?
One major strength was compiling years of smaller studies into one larger analysis — something particularly unusual in dentistry, Dr. Jiang says. "From a dental point of view, having 15 randomized controlled trials is huge. It's very hard to amass that big of a population in dentistry at this high a level of evidence," she says.
But toothbrushing techniques may have varied among hospitals participating in the research. And while the study was randomized, it couldn't be blinded — a tactic that would reduce the chance of skewed results. Because there was no way to conceal toothbrushing regimens, clinicians involved in the study likely knew their efforts were being tracked, which may have changed their behavior.
"Perhaps they were more vigilant because of it," Dr. Jiang says.
How exactly can toothbrushing prevent hospital-acquired pneumonia?
It's not complicated. Pneumonia in hospitalized patients often stems from breathing germs into the mouth — germs which number more than 700 different species, including bacteria, fungi, viruses and other microbes.
This prospect looms larger for ventilated patients, since the breathing tube inserted into the throat can carry bacteria farther down the airway. "Ventilated patients lose the normal way of removing some of this bacteria," Dr. Jiang says. "Without that ventilator, we can sweep it out of our upper airways."
How much does toothbrushing matter if you're not hospitalized?
In case you think the study findings only pertain to people in the hospital, think again. Rather, this drives home how vital it is for everyone to take care of their teeth and gums.
About 300 diseases and conditions are linked in some way to oral health. Poor oral health triggers some health problems and worsens others. People with gum disease and tooth loss, for example, have higher rates of heart attacks. And those with uncontrolled gum disease typically have more difficulty controlling blood sugar levels.
Source: Harvard Health Publishing
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Pastor and actor Yul Edochie has said, never say there’s no power in the name of Jesus. It always marks the beginning of downfall.
He revealed there is power in the name JESUS. Never you say there’s no power in the name. You can fault the white man’s religion. Yes, some parts of it have been altered to suit men and not God.
But never you say there’s no power in the name JESUS. It always marks the beginning of downfall. Read history, people who have said such in the past never ended well.
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VeryDarkMan has said on God, they can’t do anything for him.
He said this after being sued for N1 billion by Bobrisky.
