Senator Bill Cassidy, MD (R-LA), voted “yes” today to advance Robert F. Kennedy Jr.'s nomination to be Secretary of the Department of Health and Human Services (HHS) from the Senate Finance Committee to a vote on the Senate floor.

Cassidy's vote was a tie-breaker, and closely watched after RFK Jr.'s testimony in front of two senate committees last week on which Cassidy serves. During appearances in front of both the Finance Committee and the Committee on Health, Education, Labor and Pensions, Cassidy engaged Kennedy in contentious and lengthy debate about Kennedy’s support of childhood immunizations in the United States. 

RFK Jr., a lawyer with no medical or public health training, is a longtime vaccine critic who has said vaccines cause autism and has suggested Black Americans should adhere to a different vaccine schedule than white peers. 

Cassidy claims Kennedy made several promises, commitments  

During last week’s testimony, Cassidy pushed Kennedy on the topic of vaccines several times, asking, “Does a 70-year-old man, who spent decades criticizing vaccines and was financially vested in finding fault with vaccines - can he change his attitudes and approach now that he'll have the most important position influencing vaccine policy in the United States?”

Today Cassidy took to the Senate floor to explain his vote, saying he and Kennedy spoke at length over the weekend and that Kennedy had made several promises to him, including a promise to alert the Senate with a 30-day advance notice before changing vaccine safety monitoring programs.

Cassidy, who chairs the Senate Finance Committee, said he will also meet with Kennedy regularly if he is elected head of HHS. A final confirmation vote for Kennedy is scheduled next week. If senators vote on party lines, four Republican senators would need to vote “no” for his confirmation to fail. 

Federal officials today confirmed more H5N1 avian flu outbreaks in poultry in three states, with commercial farms in Missouri especially hard hit.

According to the latest updates from the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS), the virus was confirmed at five farms in Missouri, all of them commercial facilities. 

Affected premises include a layer farm in Newton County that has nearly 1.15 million birds. Other producers include a turkey farm in Newton County, a broiler breeder farm in McDonald County, and three turkey farms in three different counties.

Over the past 30 days, the virus has led to the loss of nearly 4.3 million poultry in Missouri.

Outbreaks in California, Oregon

In other poultry developments, APHIS confirmed the virus on a commercial turkey farm in California's San Joaquin County that has 22,200 birds and in a backyard flock of 8 birds in Oregon's Klamath County.

APHIS testing also confirmed H5N1 in one more dairy cow herd, another in California, raising the national total to 957 and California's total to 736.

A meta-analysis of 31 studies suggests high rates of cervical infections with non-vaccine, high-risk human papillomavirus (HR-HPV) in women, regardless of vaccination status.

For the analysis, published last week in BMC Infectious Diseases, researchers in Brazil included observational studies that assessed the prevalence of cervical infection by HR-HPV type among vaccinated and unvaccinated women and were published up to July 14, 2023.

Worldwide, HPV is the most common sexually transmitted infection of the lower genital tract and the main cause of cervical cancer, the authors noted. It is also the fourth most common disease in women globally and the leading cause of death in 42 countries.

Three HPV vaccines have been licensed: bivalent (two-strain [2vHPV]), which targets HPV types 16/18 (Cervarix); quadrivalent (four-strain [4vHPV]), which targets types 6/11/16/18 (Gardasil); and nonavalent (nine-strain), which targets types 6/11/16/18/31/33/45/52/58 (Gardasil-9). 

Rates for some types lower in vaccinated women

Among the 59,035 women included in the analysis, 42% had received at least one dose of HPV vaccine. Of the 31 studies, 64.5% used 4vHPV, 32.3% used 2vHPV, and 3.2% used both. 

Further studies with vaccinated women are needed to understand the effects of vaccines on the distribution of non-vaccine HR-HPV types.

There was a high prevalence of non-vaccine HR-HPV types 31/33/45 (prevalence ratio [PR], 0.60), 31 (PR, 0.47), and 45 (PR, 0.38). While prevalence was high regardless of vaccination status, the rates of types 31/33/45, 47, and 45 were lower in vaccinated women, which the authors said suggests that the vaccines offer some cross-protection against these types.

"Further studies with vaccinated women are needed to understand the effects of vaccines on the distribution of non-vaccine HR-HPV types," the study authors concluded.