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Seven days in medicine: 13-19 July
BMJ 2022; 378 doi: https://doi.org/10.1136/bmj.o1784 (Published 20 July 2022)
Cite this as: BMJ 2022;378:o1784
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Over 50s to get autumn vaccine booster
The UK government accepted the advice of the Joint Committee on Vaccination and Immunisation to offer an autumn covid booster to over 50s, care home staff and residents, frontline health and care workers, unpaid carers, people in clinical risk groups aged 5-49 years, and household contacts of immunosuppressed people. Those eligible for a flu vaccine will also be expanded to everyone aged 50 or over, primary school children and secondary school pupils in years 7-9, as well as people in clinical risk groups, unpaid carers, and household contacts of immunosuppressed people.

Mesothelioma
NICE recommends life extending treatment[/b]
The UK National Institute for Health and Care Excellence published final draft guidance recommending nivolumab (Opdivo) with ipilimumab (Yervoy) as a first line treatment for unresectable malignant pleural mesothelioma in adults.2 Most cases of this rare and aggressive form of cancer are linked to occupational exposure to asbestos. It is estimated that more than 600 people in England could benefit from the intravenous treatment. Clinical trial results show that on average people having nivolumab plus ipilimumab survive for four months longer than those having chemotherapy, the current standard first line treatment.

Supplemental oxygen
Study shows racial inequalities in administration
A cohort study of 3069 patients in an intensive care unit in the US found that Asian, black, and Hispanic patients received significantly less supplemental oxygen for a given average haemoglobin oxygen saturation than white patients. The research, published in JAMA Internal Medicine,3 found that the differences were associated with pulse oximeter performance. The data were from 2008 to 2019 and so there were no patients with covid-19. However, the researchers said hidden hypoxaemia may contribute to racial and ethnic inequalities in care seen in the pandemic.
Alcohol
Young people face higher health risks than older adults
A new analysis from the Global Burden of Diseases study found that 59.1% of people who consumed unsafe amounts of alcohol in 2020 were aged 15-39, with three quarters of them male. For adults over 40, consuming a small amount of alcohol (one to two small glasses of red wine) can provide some health benefits, such as reducing the risk of cardiovascular disease, said the study. The authors wrote in the Lancet that alcohol consumption recommendations should be based on age and location, with the strictest guidelines targeted at men and boys under 40.5

Learning disabilities
Report highlights avoidable deaths
People with a learning disability continue to have a much shorter life expectancy than the wider general public, with six in 10 dying before age 65, compared with one in 10 in the general population, said the sixth annual report of the learning from life and death reviews programme (LeDeR).7 People with epilepsy and from ethnic minority backgrounds were more likely to die younger. Around half of all deaths of people with a learning disability were deemed to be avoidable, compared with less than a quarter in the general population.

Vaccination
Childhood rates decline globally, figures show
Coverage of the third dose of diphtheria-tetanus-pertussis (DTP3), a marker for immunisation coverage, fell worldwide from 86% in 2019 to 81% in 2021, the lowest since 2008. The latest estimates from the World Health Organization and Unicef show that 25 million children were unvaccinated or undervaccinated in 2021, with 18 million not receiving any vaccines. Many factors contributed to the decline, including an increased number of children living in conflict and fragile settings, increased vaccine misinformation, and covid-19 related issues such as service and supply chain disruptions.

G Mohan