AMA Update covers a range of health care topics affecting the lives of physicians, residents, medical students and patients. From private practice and health system leaders to scientists and public health officials, hear from the experts in medicine on COVID-19, medical education, advocacy issues, burnout, vaccines and more. 

What's the new long COVID study? How bad is this year's flu? How many measles vaccines do you need? What food has been recalled? When to get RSV vaccine pregnancy?

AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia, JD, MPH, discusses the ongoing flu season, 2025 measles outbreak news, a new study on long COVID in women, uptake of maternal RSV vaccines, as well as food recalls and financial challenges faced by rural health care facilities. AMA Chief Experience Officer Todd Unger hosts.

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Speaker

• Andrea Garcia, JD, MPH, vice president, science, medicine & public health, American Medical Association

Garcia: As of this recording, the number of cases linked to that outbreak in West Texas has grown to 90. That is up from 48 cases when we talked last week. And given how contagious measles is, that number will likely continue to rise. 

Unger: Hello and welcome to the AMA Update video and podcast. Today is our weekly look at public health issues facing physicians and patients across the country with the AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia. I'm Todd Unger, AMA's chief experience officer. And if you're one of the tens of thousands of people who've recently joined us on our YouTube channel, I'd like to say welcome, and we hope you enjoy the video. Andrea, if you can believe it, we crossed 200,000 subscribers on our YouTube channel. So we've got a lot of audience out there. Welcome back. 

Garcia: Thanks, great to be here and lots to talk about today. 

Unger: Well, last week we talked about the number of flu cases, one of the worst flu seasons that we've seen in recent memory. I think you said, last time, that 29 million people had the flu as of last week. I think that number has grown. One of those people, unfortunately, includes my mother, who is recovering right now. So let's talk a little bit about the flu situation. How's this week looking? 

Garcia: Well, flu activity does continue to be elevated, but we are luckily starting to see some signs of improvement. For the week ending February 15, 26.9% of tests came back positive for flu, and that is down from 31.6% the week before. Additionally, emergency department visits for the flu fell to 6.4% which is down from more than 8% two weeks ago. So we are trending in the right direction, but it's important to remember that respiratory illness levels are still high nationwide, according to the CDC data. 

As of Friday, nine states are still listed as having very high levels of respiratory virus activity. And just as a reminder, as long as flu is still circulating, people are recommended to get vaccinated against the virus if they haven't already. As always, this is something that we'll continue to keep a close eye on and share updates as these trends change. 

Unger: I think before our conversation, you mentioned we were up to about 33 million cases. But it's good that some of these trends are having some positive movement, I should say. Last week, we also talked about the measles outbreak happening in Texas. I know that's something that people are very concerned about. Andrea, what's the latest on that? 

Garcia: Well, Todd, as of this recording, the number of cases linked to that outbreak in West Texas has grown to 90. That is up from 48 cases when we talked last week. And given how contagious measles is, that number will likely continue to rise. We know the Texas Department of Health is posting updates on Tuesdays and Fridays. Previously, all the reported cases have been in unvaccinated individuals or individuals whose vaccination status is unknown. There are now five cases of measles in people who said they had received at least a dose of the vaccine. 

We're waiting for more details to emerge around those cases, though some may have received the vaccine recently, and we know it does take a couple of weeks for that vaccine to be effective. As for the number of people who've been hospitalized with measles, that number is now 16, which is up from 13 the week before. 

Unger: So serious business here with the measles. And, Andrea, you mentioned that where more states were involved in Texas, how about the cases outside of that state? 

Garcia: Yeah, last week there were three cases in Lea County, New Mexico, which does border the county where we're seeing most of these cases in Texas. That number of cases in Lea County has now risen to nine, with four of those cases being in children. And as we previously discussed, this outbreak coincides with higher than ever vaccine exemption rates among children in the U.S. We know measles is one of the most contagious diseases known to humans, which is why it's especially important to be vaccinated against it. 

Unger: I was very surprised about what you said last week, just in terms of somebody with measles comes in the room and you're not vaccinated, the odds are very high that that will spread. And speaking of vaccination, the measles outbreak has a lot of people wondering if they need a vaccine booster. I'm advanced age at this point. I don't remember whether I had anything along the way since my childhood. What do patients need to know about that? 

Garcia: Well, Todd, many of us received the measles vaccination as children, but you might not have your vaccination record or might not have access to them. So in addition to your vaccine record, presumptive evidence of immunity for measles can be established through either laboratory evidence of immunity, which is a titer test for antibodies, laboratory confirmation of disease. So you've had measles before, or if you were born before 1957, when we know measles was really widespread. If you don't have written documentation of measles immunity, the recommendation is to get vaccinated with the MMR vaccine. 

CDC notes that there is no harm in getting another dose of MMR vaccine. If you do know that you've had two doses of MMR vaccine, you do not need a booster dose. 

Unger: All right, excellent. Thank you so much for that update, Andrea. I'd like to shift gears now and ask you about an article that ran in the Washington Post last week that said that women are at a higher risk of developing long COVID. Been a while since we talked about long COVID. Andrea, what can you tell us about that? 

Garcia: That article was about a study that came out of the long COVID research initiative, funded by the NIH. It was published in JAMA Network™ Open, and it looked at more than 12,000 individuals and found that women had a 31% higher risk of developing long COVID than men. The trend was most significant in women between the ages of 40 and 54, who were not yet menopausal. That group was 45% more likely to develop long COVID. 

However, women in that age range who had previously experienced menopause and younger women showed no significant difference in their risk of developing long COVID. This potentially points to the role that hormone levels play in long COVID. And the author of that study noted that hormones involved in menopause, fertility and pregnancy may even be protective factors against long COVID. This needs to be studied further, but it does help to deepen our understanding of long COVID and inform potential treatment options. 

Unger: The numbers that you mentioned there, the differences are pretty stunning between men and women on that, and in the age groups that you specified. Obviously, there's just so much more to understand in regard to long COVID. Andrea, Thank you for that update. I know it's not making headlines as much as it once was, but there are a lot of people out there who are struggling with long COVID, and we'll continue to follow the updates there. There was some positive news on the respiratory virus front. 

Last week, a study in JAMA Network™ Open showed strong results for the uptake of the maternal RSV vaccine. Andrea, walk us through those findings. 

Garcia: Yeah, so this was a cohort study. It showed that among 647 pregnant individuals in the study, 64% received Pfizer's maternal RSV vaccine. And there were several factors that were associated with higher uptake of the vaccine, those included a person's age and having no prior pregnancy or children. It's also worth noting that those who had received the COVID-19 vaccine were much more likely to also receive the RSV vaccine. 

And then the study also looked at the uptake of nirsevimab, which is that monoclonal antibody given to infants to protect against RSV. Among the pregnant individuals who did not receive the RSV maternal vaccine or standard prenatal vaccine, there were over 40% of their babies who did receive nirsevimab. So between the maternal RSV vaccine and nirsevimab, RSV protection exceeded 80% in the study, with the exception of the first month. I think it's great to see such high uptake in the first year that these immunizations were available. 

Unger: It really is. And for parents who've experienced the RSV situation, a lot of benefit to taking those steps. Andrea, turning to a different topic than what we've been covering before is food recalls. And a new report showed that the number of recalls was actually down last year, but there were more widespread and deadly instances. So let's talk a little bit more about that. 

Garcia: Well, that's right, Todd. And this was according to a report from the Public Interest Research Group Education Fund. There were 300 food recalls in 2024 and 1,400 illnesses related to those recalls. Compared to 2023, food recalls were down 5% last year, but the number of illnesses was up 25%. So produce did cause the highest number of hospitalizations, with cucumbers alone leading to more than a third of all hospitalizations. And that was mostly due to a salmonella outbreak in June. 

We can't really draw conclusions from the number of food recalls alone. However, one issue that the report calls out is the lag time between the initial illness from contaminated foods, the product recall, and then when consumers learn about those recalls. 

Unger: Gosh, I knew there was a reason I didn't really love cucumbers. But Andrea, is there anything else that people can do to learn about the recalls earlier in the process? 

Garcia: Well, for the most up to date information, people should sign up to receive alerts directly from FDA and USDA. Your state and local health departments can also be good sources of information on foodborne outbreaks, and grocery stores can also be another great resource. Many of them have a page on their website with the latest information about recalls. There are even apps out there now that can help people stay on top of these alerts. Physicians also have a role here. They should report cases of foodborne illness to their local health department. 

We know that prompt reporting of foodborne diseases helps recognize outbreaks and can help stem further transmission of the disease. And we'll, of course, continue to keep an eye on recalls and do our part to help spread the word. 

Unger: All right. I have found those updates to be extremely helpful, so thank you for that. Before we go, Andrea, I would like to ask you about something different, and that is about a new study on the financial challenges facing practices, especially in rural areas. What were some of the key findings there? 

Garcia: Well, unfortunately, many of the findings in the study come as no surprise to us here at the AMA. It showed that 46% of rural hospitals are operating with negative margins and 432 hospitals are at a risk of closing. Rural hospitals in Connecticut were the most impacted. All three of them are operating in the red. And then the next two states with the highest percentage of rural hospitals in the red are Kansas and Washington. 

Like the AMA has been doing for years, this report called out the recent Medicare payment cuts as the major contributor to the financial challenges that are facing rural practices. Over the last 15 years, 182 rural hospitals have either closed their doors or converted to an operating model that doesn't provide inpatient care. 

Unger: We've been talking a lot about the impact that these successive cuts in Medicare payments have been happening and why it's so important to transform the Medicare payment system. But it doesn't just affect doctors, it affects patients. Andrea, tell us a little bit more about that impact. 

Garcia: Yeah, Todd it is hugely disruptive to patients, and it further compounds access to care challenges that we know are facing rural communities. If people want to learn more about the impact that Medicare payment cuts are having on physicians and patients and what the AMA is doing about it, they should visit fixmedicarenow.org. 

Unger: Well, thank you so much, Andrea, for that overview. And as always, we really appreciate you being here and keeping us up to date. If you found this discussion valuable, you can support more programming like it by becoming an AMA member at ama-assn.org/join. You can find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Stay healthy. Take care.

Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.

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