Category: 8. Health

WATCH TIME: 5 minutes | Captions are auto-generated and may contain errors.

The 4th Annual Women in Neurology Conference, held October 24–26, 2025, at the Cheyenne Mountain Resort in Colorado Springs, is weekend event where women neurologists can gather for connection, growth, and relaxation, both professionally and personally. Hosted by the Women Neurologists Group (WNG), this conference is designed to empower women in all stages of their neurology careers, from residency to retirement. The meeting offers a combination of expert-led educational sessions, wellness experiences, and opportunities to connect with colleagues.

In collaboration with the WNG, NeurologyLive^® held a Roundtable discussion with 2 of the conference’s program co-chairs, Jill M. Farmer, DO, MPH, and Kathrin LaFaver, MD, FAAN, DipABLM, who work in treating patients with movement disorders. Throughout the Roundtable, Farmer, owner and founder at Boro Neurology, and LaFaver, neurologist in the Department of Neurology at Saratoga Hospital Medical Group, discuss the mission of WNG and provide an overview of this year’s program for the 4th Annual Women in Neurology Conference.

In this fourth and final episode of the roundtable discussion, Farmer and LaFaver talked about the evolving landscape for women in neurology, emphasizing both challenges and opportunities in the field. The duo of experts discussed the importance of mentorship, career flexibility, and embracing innovations such as direct-care models and artificial intelligence. Additionally, the 2 women neurologists highlighted that the WNG aims to fosters community, share professional experiences. Furthermore, they noted that the upcoming conference is expanding to invite nurse practitioners and physician assistants, with the goal of strengthening collaboration and support for all neurology professionals.

Transcript edited for clarity. Click here to register for the 4th Annual Women in Neurology Conference.

Isabella Ciccone, MPH: My question for both of you is, where do you see women in neurology heading in the future, whether it’s this group, this conference, personally with you and your colleagues? How do you see the conference helping to address any challenges that women face in their practice?

Kathrin LaFaver, MD, FAAN, DipABLM: Well, I think there are many challenges currently in medicine, as I think we all realize, and health care is really a bit of a crossroads. For physicians who are in employed positions, there’s a lot of time crunches and lower reimbursements from insurance companies, just as one example, and increased administrative burdens. These frustrations with one’s career—because we all enter this field out of passion, feeling passionate about what we do and wanting to help people—can become challenges when we have to navigate things we weren’t necessarily expecting as we entered this profession. I think what this means for the field going forward is that these challenges can help us find new solutions.

Actually, Farmer is one of the groundbreaking pioneers in forging your own path. She changed from an employed position to now being her own boss, which will be one of the topics at the conference, and moved away from an insurance-based model to a more direct-care neurology practice. There are a lot of other opportunities as well. One of the talks I didn’t mention before is actually about artificial intelligence (AI) opportunities in medicine. So, we’re very excited about that speaker.

So, of course, we often mention the challenges, but there are also many opportunities. My hope is that through connecting with the leaders in the field and with people who are at the forefront of technological changes, we can all find ways to move forward. We transform our practices in a way that continues to provide career satisfaction, serves patients effectively, and moves the field of neurology forward.

Jill M. Farmer, DO, MPH: I agree 100%, and my leap into direct specialty care was shepherded by yet another member of the WNG who had done it previously, was a big advocate for it, and served as a wonderful mentor and guide. Again, one of the powerful ways that the connections in this group can have far-reaching impact.

I would like to see the group thrive and grow but not lose touch with its essence. We had thought about trying to get a website together and put it on other platforms, in other ways, shapes, and forms, to help with its growth and outreach. That was honestly just very hard for a group of essentially volunteer admins with full-time jobs and full-time lives outside of this to accomplish. We decided, if it’s not broke, don’t fix it. We’ll keep our home as it is, continue with the style of the group, and continue with its focus of championing a community. Through that, we hope to grow and bring in more members to share their stories and learn from experiences. But this isn’t necessarily going to become something that takes on a life of its own like other groups—becoming a brand or something like that. That’s not our goal. We want to keep it true to its roots.

Kathrin LaFaver, MD, FAAN, DipABLM: With that being said, we are also on LinkedIn now. We have a bit of a public face on Twitter—or X, I guess. One thing I did want to mention is that the group itself has traditionally been for physicians only. However, for this year’s conference, we are inviting nurse practitioners (NP) and physician assistants (PA) working in neurology to attend and learn. Part of this is really trying to embrace that our field is changing, and we need our colleagues in these professions to help manage the patient load better. We’re hoping that many of our NP and PA colleagues will join us, enjoy learning neurology updates, and connect. So that’s another opportunity we’re providing this year.

Isabella Ciccone, MPH: Thank you, and I hope that you have a great turnout this year!

Jill M. Farmer, DO, MPH: Thank you very much. So do we!

Kathrin LaFaver, MD, FAAN, DipABLM: Thanks for the opportunity. We’re very much looking forward to connecting in Colorado!

Click here to learn more about the WNG.

For more than a century, the humble fruit fly has paved the way for many critical scientific breakthroughs.

This tiny insect helped researchers figure out that X-rays can cause genetic mutations. That genes are passed on from parent to child through chromosomes. That a gene called period helps our bodies keep time — and that disruptions to that internal clock can lead to jet lag and increased risk for neurological and metabolic diseases.

Those discoveries, along with nearly 90,000 other studies, are part of a key online database called FlyBase that researchers routinely use to help them more quickly design new experiments. These tests explore the underlying causes of disease and could help with the development of new treatments. Science builds on prior insights, and a handy repository of past advances serves as kindling for future discoveries.

The website receives about 770,000 page views each month from scientists working around the world on developing personalized therapies for rare cancers, modeling human neurodegenerative diseases and screening drug candidates for conditions like Alzheimer’s.

Now, that critical resource is on the brink of layoffs that endanger its future and ability to make research more efficient.

This spring, the Trump administration, as part of its broader $2.2 billion funding cuts at Harvard University, rescinded a grant used to maintain FlyBase.

“I use FlyBase every single day. It’s so essential,” said Celeste Berg, a professor of genome sciences at the University of Washington, who is not part of the team that operates FlyBase. “What we know about human genes and how they function comes almost completely from model systems like drosophila.”

Humans share about 60% of our genes with fruit flies, also known by their scientific name Drosophila melanogaster.

FlyBase’s now-uncertain future highlights just how interconnected and interdependent research efforts are and how the effects of funding cuts to one institution can ripple worldwide. More than 4,000 labs use FlyBase.

Harvard was receiving about $2 million a year in federal funding to maintain FlyBase, which was the vast majority of the website’s total operating budget. But the University of New Mexico, Indiana University and the University of Cambridge in England are partners that help Harvard manage FlyBase and are beneficiaries, too.

“This is not just affecting Harvard,” said Brian Calvi, a professor of biology at Indiana University, who is part of the FlyBase management team. “The ripple effect is to the international biomedical research community.”

Harvard’s Faculty of Arts and Sciences rescued FlyBase with interim funding, but that support will cease in October, according to Norbert Perrimon, a professor of developmental biology at Harvard Medical School.

A judge earlier this month ordered the Trump administration to restore funding to Harvard researchers who lost grants, but money has not begun to flow to FlyBase, Perrimon said. The administration has promised to appeal the decision, which could halt the flow of funds.

The White House did not respond to a request for comment. The U.S. Department of Health and Human Services, which oversees the National Institutes of Health, declined to comment.

The Transmitter, a neuroscience news site, first reported about layoffs at FlyBase. The Harvard Crimson reported about the Harvard Faculty of Arts and Sciences’ decision not to continue with interim funding.

Calvi said the FlyBase grant provided full or partial salary for eight people at Harvard, three at Indiana, five at Cambridge and one at the University of New Mexico. Both Indiana and Cambridge were able to secure funds to keep their portion of the program operating into next year. The New Mexico position ended in August.

FlyBase, which has been operating since 1992, has received federal support for more than three decades. It curates and summarizes research papers, organizes findings about particular genes, and catalogs information about fruit flies that have been modified genetically to tease apart how certain genes guide normal development.

Fruit flies are among the most important animal models for biomedical research because scientists have been able to map their genomes and brains. They’re also relatively easy and cheap to handle.

Berg, the genome sciences professor and avid FlyBase user, studies human development and how cells form organs. FlyBase allows her to search and identify genes of interest for experiments. She then tests how changing the expression of those genes affects the arrangement of cells.

Every year, thousands of fruit fly papers are added to FlyBase and summarized. Without FlyBase, Berg said researchers and clinicians would struggle to keep up and could miss key connections about particular genes.

Researchers with the Undiagnosed Diseases Network use FlyBase to help identify whether genetic mutations in children could be contributing to rare and unexplained diseases. The scientists identify genetic variants in these patients and then compare those mutations to past research of those genes in flies.

FlyBase is now crowdfunding support on its website.

“Given the importance of FlyBase to the broader U.S. and international scientific research community, we are hopeful other institutions and other stakeholders at Harvard will support those efforts,” said James Chisholm, a spokesman for Harvard Faculty of Arts and Sciences, adding that several Harvard departments were “actively working to identify and secure additional funding to safeguard FlyBase’s operations.”

Two Harvard-based staffers have already been laid off from their work at FlyBase, and another six are scheduled for layoffs later in September and in early October, Perrimon said.

“If we cannot retain the key personnel, it’s going to be very difficult to get back those people who have knowledge to keep the databases running,” Perrimon said. “That would be the point of no return for FlyBase.”

The funding disruption is also threatening plans to move FlyBase’s data to a new long-term home called the Alliance of Genome Resources. Fruit flies are among several common “model organisms,” along with rats, mice and worms, that are used in laboratories and lay the groundwork for understanding human biology.

The National Institutes of Health has spent about $5 million a year since 2017 to merge several databases, including FlyBase, WormBase and the Mouse Genome Database, among a handful of others. Each contains information that human health researchers can cross-reference to study genes important for human health more efficiently.

“If you’re studying human genes and you have to study everything that’s known, you have to go to all of these [websites] and learn the system,” said Paul Sternberg, a professor of biology at the California Institute of Technology, who is leading the Alliance effort. “We want one-stop shopping.”

The Alliance’s budget expired June 30, and Sternberg said he is awaiting a funding renewal decision from NIH himself. He said the funding disruption at FlyBase represents a new, unexpected obstacle to making research findings more useful and easier to scour.

“We need to do this fast, but when you’re losing staff and energy, that’s what makes it dicey,” Sternberg said. “Don’t throw extra roadblocks. That’s all we ask.”

FlyBase had planned to merge with the Alliance in 2029. Now, Calvi and others are pushing for a speedier merger, before FlyBase’s financial runway runs out. The donations the organization is seeking are meant to help pay for that.

“So far it’s less than $100,000,” Calvi said of the organization’s crowdfunding efforts. “We probably need a million.”

CT coronary angiography (CTCA) has revealed that coronary artery disease (CAD) can occur in the absence of typical risk factors such as hypertension, hyperlipidemia, diabetes, and smoking, researchers have reported.

A team led by Seiyon Sivakumar, MD, of Monash University in Melbourne, Australia, found that “in patients undergoing clinically indicated CTCA, patients without [risk factors] exhibited a similar degree of coronary inflammation to those with [them], despite having a lower plaque burden and stenosis severity.”

Clinicians have made progress in preventing CAD by targeting modifiable risk factors, the team explained, but the incidence of CAD occurring in the absence of these factors has increased, prompting a need to identify biomarkers and mechanisms for this kind of CAD so that effective treatment strategies can be developed.

To this end, Sivakumar and colleagues assessed coronary inflammation in patients with typical risk factors and those without, tracking pericoronary adipose tissue (PCAT) attenuation, a new, specific biomarker of coronary inflammation that can be quantified on CTCA. The group conducted a study that included 309 patients who underwent serial CTCAs for suspected stable CAD between 2010 and 2016 at Monash Health in Melbourne, Australia. It tracked PCAT attenuation around the proximal right coronary artery (PCAT_RCA) using semiautomated software and assessed plaque using the segment involvement score and segment stenosis score. Finally, the investigators assessed coronary artery diameter stenosis severity using the Coronary Artery Disease – Reporting and Data System (CAD-RADS) classification.

Of the total patient cohort, 26.9% did not have cardiovascular disease risk factors. Those study participants with these risk factors were more frequently on statins, angiotensin-converting enzyme inhibitor/angiotensin receptor blockers, and aspirin.

The team reported the following:

• Patients without risk factors had a similar PCAT_RCA mean attenuation compared to those with the risk factors (Hounsfield units, or HU, of -77.5 vs. -78.4, respectively; p = 0.481) — despite having a lower coronary plaque burden and stenosis severity.
• The mean segment involvement score and segment stenosis score were 18.7% and 39.5% lower, respectively, in patients without risk factors than in those with them (SIS of 1.78 vs. 2.72, p = 0.01, and SSS of 2.22 vs. 3.67, p = 0.004).
• Patients with risk factors were more likely to have obstructive CAD than patients without them (odds ratio of 2.8; p = 0.006).

“In patients undergoing clinically indicated CTCA, patients without [risk factors] exhibited a similar degree of coronary inflammation to those with [them], despite having a lower plaque burden and stenosis severity,” the group noted.

The study offers “early mechanistic insights into why patients without [risk factors] still develop CAD and subsequent cardiovascular events,” according to the team.

“Further research is needed to validate these findings,” the group concluded. “If confirmed, the therapeutic target of inflammation could be explored further in patients without [risk factors].”

The complete study can be found here.

Acute lymphoblastic leukemia (ALL) can be a devastating disease, with approximately 30% of patients dying five years after their diagnosis. The blood cancer is most common in children and young people and originates from lymphocyte over-proliferation within the bone marrow. ALL usually requires an intensive and cytotoxic chemotherapy regimen to overcome.

Discoveries in emerging drug modalities could not only improve the risk of adverse events but could also deliver improved survival rates for cancer and other serious diseases. For example, siRNA therapy can silence disease-related genes by targeting a particular mRNA sequence for degradation – opening doors for treating diseases like ALL.

However, of the five siRNA therapies approved by the US Food and Drug Administration, none are indicated for hematological cancers despite clinical need. BioXconomy spoke to Mohammad Nasrullah, pharmaceutical sciences PhD candidate at the University of Alberta, about the potentials of siRNA therapy for ALL and other blood cancers. His recent paper in Advanced Healthcare Materials – coming on the heels of his presentation at TIDES USA this year – explores the efficacy of lipopolymer nanoparticles (LPNPs) to deliver siRNA therapies to ALL cells in mouse models.

Related:Emerging therapeutics at ‘tipping point’ in heart disease

Balancing payloads

“We saw a void in the market,” explained Nasrullah. “There is no siRNA therapy for malignancies and there is no siRNA therapy for blood cancers. Blood cells are hard to transfect. So to overcome this issue, we began to design our lipopolymer.”

He and his team at the University of Alberta set out to design LPNPs that could get siRNAs to the right tissue. The first step was to find a way to avoid preferential hepatic accumulation of the drug, a recurring problem in lipid nanoparticle (LNP) drug delivery systems. Nasrullah and his colleagues attempted to solve this issue by conjugating the lipid to polyethyleneimine.

“Polyethyleneimine is a polymer that is very well-known for delivering nucleic acid payloads,” Nasrullah said. “At high molecular weights, they are very efficient but are not well tolerated and show some cellular toxicity. At lower weights, however, the efficiency goes down.”

“This is when we began to theorize ways of taking low molecular weight polyethyleneimine, which is safe, and improving its efficacy. We conjugated the low molecular weight [version] with different lipids, screening over 100 candidates until we identified PEI-C, which we reported in our paper.”

Fusion frenzy

Nasrullah’s team targeted a potent oncogene fusion responsible for an aggressive ALL subtype with poor prognosis in infant, pediatric, and adult cases, known as KMT2A:AFF1. The KMT2A gene, when functioning correctly, is a transcriptional coactivator essential for hematopoiesis, but when fused with transcription elongation factor AFF1, it gives rise to several malignancies.

Related:Deep brain penetration by oligos enables Alzheimer’s, Parkinson’s treatment

The aim of the study was to selectively silence this fusion site ex vivo in human peripheral blood mononuclear cells and mouse bone marrow stromal cells using siRNA. They set out to compare engineered PEI-C to leading commercial reagent, RNAiMAX – and were astonished at the results.

“We showed that compared to RNAiMAX, our PEI-C lipid polymer nanoparticle outperformed,” commented Nasrullah. “In bone marrow stromal cell, the RNAiMAX showed around 20% siRNA uptake, whereas our PEI-C performed at 60%.”

He also highlighted siRNA uptakes of up to 93% utilizing the PEI-C lipopolymer versus 12.2% with RNAiMAX in SEM cells. Further molecular analysis confirmed effective silencing of the KMT2A:AFF1 fusion as well as downregulation of BCL2, a proto-oncogene.

The team then moved on to in vivo models to test their systems. They found that their LPNP approach achieved successful targeting of leukemia-associated organ systems in mouse models. When delivered intravenously, siRNA distribution was significantly higher in extrahepatic tissues such as the spleen, bone marrow, and lungs, all of which were higher than those in the liver.

Related:siRNA backbone modifications boost therapeutic potential, study finds

They also observed that their LPNP-siRNAs led to increased cancer cell apoptosis and reduced ALL burden. Most excitingly, the siRNA against the KMT2A::AFF1 fusion improved overall survival – ALL mice treated with LPNP-delivered siRNA lived around ten days longer than the control group.

Patients in mind

With this preclinical success in hand, the researchers hope human trials won’t be far behind.

“Our ultimate goal is to get to clinical trials in two years, but the next step is performing this in primary patient cells,” explained Nasrullah. “Based on the preliminary data, we’re positive. We hope to translate our academic successes into commercial investment.”

But there are still barriers to cross with siRNA therapy. One significant hurdle in the safety of these treatments, including off-target induced toxicity that can limit effective delivery of the siRNA payload.

Nasrullah believes LPNPs may also be able to offer a solution.

“The biggest adverse event for this kind of therapy is immunogenicity,” he noted. “That’s why when we use siRNA therapy for patients, we also have to use an immunosuppressing agent. This is a big challenge for lipid nanoparticles, but when testing our lipopolymer in human blood cells, there was not much stimulation of pro-inflammatory cytokines.”

So what could the future look like for LPNPs, and the siRNA therapies they can deliver?

“We are now collecting primary cells from all different forms of leukemia and have recently also had successes in targeting lung cancer and breast cancer,” commented Nasrullah.

“In the next ten years, siRNA therapy and chemotherapy will co-exist, but in 20–25 years conventional chemotherapy will most likely be completely replaced.”

Beyond leukemia, BioXconomy has reported on siRNA treatment of colorectal cancer, vision loss, kidney disease, heart disease, neurodegenerative disorders, and neurological conditions. Now, Nasrullah and his team’s breakthrough lipopolymer adds to other innovations in the field of therapeutic RNAi. Their contribution could be the key to further unlocking the potential of siRNAs. In the next two decades, the harsh side effects and adverse events of chemotherapy may indeed be a thing of the past.

Quotes have been lightly edited for clarity.

Telomere damage drives T cell exhaustion. Antioxidants restored their cancer-fighting strength in mice.

Tumor environments place heavy stress on immune cells that fight cancer. Limited oxygen, elevated acidity, and other harsh conditions overload mitochondria, the cell’s energy producers, which contributes to T cell fatigue and worsens cancer outcomes.

A new study in Immunity, led by researchers at the University of Pittsburgh, showed in mice that these conditions prompt mitochondria to release reactive oxygen species (ROS). These molecules travel to the nucleus and damage telomeres, ultimately pushing T cells into a dysfunctional state.

“The really exciting part about this research is that by preventing damage to telomeres via a targeted antioxidant, we can rescue T cell function,” said lead author Dayana Rivadeneira, assistant professor in the Pitt Department of Immunology and UPMC Hillman Cancer Center. “This opens the door to novel therapies to improve the effectiveness of cancer immunotherapies.”

Unexpected mitochondrial connection

Rivadeneira and senior author Greg Delgoffe, a professor in the Pitt Department of Immunology and UPMC Hillman, did not originally plan to investigate telomeres. Their initial focus was on how mitochondrial damage influences T cell performance. A collaboration with Patricia Opresko, professor in the Pitt Department of Pharmacology and Chemical Biology, and the late Marcel Bruchez, professor of biological sciences and chemistry at Carnegie Mellon University, expanded the study to include telomeric damage.

To explore this, the team engineered mice with a genetic system that produces highly localized oxidative damage at either telomeres or mitochondria when exposed to far-red light.

“What we found was remarkable,” said Delgoffe. “Whether we damaged the mitochondria or the telomeres, we got the same result: dysfunctional T cells. There is crosstalk between the engine of the cell and the brains of the cell, the mitochondria, and the nucleus. This is something we didn’t necessarily appreciate, at least in the immune system.”

“When you damage the mitochondria, one of the first thing that gets damaged is the telomeres,” Rivadeneira added. “And, likewise, when you damage the telomeres, they talk back to the mitochondria to initiate a program that tells the cell to shut down and become exhausted.”

Antioxidant therapy to restore function

Because ROS — highly reactive oxygen molecules that cause cellular damage — were responsible for telomeric damage, Delgoffe and Rivadeneira hypothesized that ROS-neutralizing antioxidants could protect or restore T cell function.

To neutralize ROS specifically at telomeres, they took mouse T cells and tethered an antioxidant protein to another protein that resides at telomeres. When they infused these T cells into mice with an aggressive form of melanoma, the animals had much better survival and smaller tumors than those given regular T cells.

Potential for CAR-T therapy

According to the researchers, this antioxidant approach could be applied to CAR-T therapy, which involves taking a patient’s T cells and genetically engineering them to better recognize cancer cells before reinfusing them.

“This research is highly translatable because this approach could easily be incorporated into standard CAR-T protocol,” said Delgoffe. “While you’re genetically engineering T cells to improve cancer-fighting capability, you could also make them bulletproof against oxidative damage.”

Now, the researchers are working to develop a similar telomere-specific antioxidant approach for modifying human T cells, which they eventually hope to test in clinical trials.

In her newly launched lab, Rivadeneira also plans to investigate more broadly how telomere health influences the immune system and cancer outcomes. One area of interest is understanding how chemotherapy alters T cell function by damaging telomeres and whether this could influence whether patients respond to immunotherapy.

Reference: “Oxidative-stress-induced telomere instability drives T cell dysfunction in cancer” by Dayana B. Rivadeneira, Sanjana Thosar, Kevin Quann, William G. Gunn, Victoria G. Dean, Bingxian Xie, Angelina Parise, Andrew C. McGovern, Kellie Spahr, Konstantinos Lontos, Ryan P. Barnes, Marcel P. Bruchez, Patricia L. Opresko and Greg M. Delgoffe, 9 September 2025, Immunity.
DOI: 10.1016/j.immuni.2025.08.008

Funding: NIH/National Institutes of Health, Cancer Research Institute, Mark Foundation For Cancer Research

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Dear Doctors: I suggest you talk about the benefits of a whole-food, plant-based diet for people with Type 2 diabetes. The results are marvelous, and I think the people with diabetes could be cured.

Dear Reader: Plant-based diets date back thousands of years. The ancient Greek philosopher Pythagoras is considered by many to be the father of vegetarianism. For him, it was a moral and ethical decision. In the early 1800s, driven by social and cultural changes, the focus shifted to improved health and well-being. Today, a growing body of research links a plant-based diet to a wide range of benefits. These include reduced inflammation, improved cardiovascular health, lower rates of heart disease, improved gut health and lower rates of certain cancers. And, as you’ve pointed out, improved blood sugar control.

For those who aren’t familiar, Type 2 diabetes is a chronic and progressive condition. This condition first impairs the body’s response to insulin. Over time, the condition also affects production of the hormone by the pancreas. This leads to elevated blood glucose levels. Elevated blood glucose can cause serious health problems if left untreated. It can cause nerve damage, kidney disease, impaired vision, tissue damage, heart disease and an increased risk of heart attack or stroke. Currently, there is no cure for Type 2 diabetes. Even if it can’t be cured, it can be successfully managed. A plant-based — or even plant-forward — diet can play a key role.

Studies have found that a plant-based diet can have dual benefits. For people living with Type 2 diabetes, it can greatly improve blood sugar control. It’s also been found that a plant-based diet can significantly reduce the risk of developing the disease. A study of 113,000 adults in Great Britain analyzed their health data. The study found that people with diets highest in fresh fruit and vegetables, legumes and grains lowered their risk of developing Type 2 diabetes by 25%. A separate review of more than 60 studies and research papers on the possible benefits of a plant-based diet corroborated these findings.

Eating a plant-based or plant-forward diet involves meals and snacks that contain a generous amount of fiber. Fiber is a crucial nutrient that is notably scarce in the modern American diet. A high-fiber diet slows down how the body breaks down glucose and absorbs it. This can lead to improved insulin response. Subbing out processed foods for fresh fruit and vegetables, beans, grains and legumes reduces simple carbs and added sugars that can contribute to insulin resistance and poor blood glucose control. A plant-based diet also lowers systemic inflammation, improving overall health outcomes.

Like we said, Type 2 diabetes cannot be cured. But for some people, adopting a plant-based or plant-forward diet can lessen or even eliminate the reliance on medications. However, it’s important to remember that diabetes is a silent disease. If you want to adopt a plant-based diet, work closely with your doctor as you track the resulting blood glucose response. Never change, reduce or eliminate medications without medical guidance.

(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

“If a patient attests to having one of these conditions or situations that places you at higher risk of severe illness from COVID-19, they are eligible for the vaccine under current FDA guidelines,” says Amy Thibault, a CVS Health spokesperson.

Yet confusion remains. For example, the American College of Obstetricians and Gynecologists considers pregnancy a high-risk condition that increases the odds of COVID-19 complications, but last spring Health and Human Services Secretary (HHS) Robert F. Kennedy Jr. announced the removal of pregnant women from the vaccine recommendation list.

Kennedy also removed healthy children from the list, including those ages 6 to 23 months, whom the American Academy of Pediatrics (AAP) considers to be at high risk for COVID-19 complications. The AAP strongly recommends that all children in this age group get the updated shot, including those who live in a household with someone who is at high risk.

Most American Adults Qualify for a Vaccine Under the New Guidelines

If you want a COVID vaccine and you don’t think you have any of the above conditions, you may still qualify due to a condition or situation that puts you at higher risk, says Thibault. “Consult your pharmacist or medical provider if you need help,” she says.

And if that still doesn’t work, it’s likely that you can find a healthcare professional who can write a prescription anyway, says David Wohl, MD, an infectious disease doctor and professor of medicine at UNC Health in Chapel Hill, North Carolina.

“Most clinicians totally understand the benefits of the updated COVID-19 vaccines and are eager to help. This does place a tremendous burden on clinics that are fielding calls and issuing prescriptions,” says Dr. Wohl.

Pharmacies in Different States Have Different Rules

Pharmacies administer the vast majority of COVID vaccines in the United States. But pharmacy rules are state-specific, and not all states allow pharmacists to give shots outside of CDC recommendations without a prescription.

That’s why some pharmacies currently require prescriptions for people under 65, while others allow self-attestation of a high-risk condition (meaning you say you have a qualifying condition, and the pharmacist takes your word for it).

CVS pharmacies can administer COVID-19 vaccines without a prescription in 40 states, says Thibault, excluding:

• Arizona
• District of Columbia
• Florida
• Georgia
• Louisiana
• Maine
• North Carolina
• Oregon
• Utah
• Virginia
• West Virginia

“Once ACIP acts on the updated COVID-19 vaccines, or states take additional action to authorize pharmacy dispensing prior to ACIP recommendations, we’ll be able to offer the FDA-approved COVID-19 vaccines without a prescription in the remaining states,” says Thibault.

However, confusion about the vaccines means that even people who should clearly qualify for the COVID-19 vaccine without a prescription, like seniors, may face roadblocks. “Even people who are considered by the more restrictive approval of the vaccines to qualify are being told by pharmacies to get a doctor’s prescription,” says Wohl, who practices in North Carolina.

“Last night I was texted about two people in their seventies who were turned away from a local pharmacy for this reason,” he says.

Want to Get the Vaccine at Your Pharmacy? Check First

To get vaccinated for COVID-19, check with your pharmacy beforehand to see what they require, says Wohl. “If you only have to attest that you are eligible, then go. But if they require a prescription, contact your clinician, who can send an electronic prescription or just have you come into the clinic to get the shot,” he says.

For people without a regular doctor, local health departments may be the best bet. Many still run vaccine clinics and, in some cases, offer transportation for those who need it.

Will Insurance Cover the Latest COVID Shots?

This year’s insurance coverage is murkier than in past rollouts. Insurers generally follow CDC vaccine committee recommendations, and those haven’t been finalized yet. In the meantime, some plans may cover the vaccine, some may require a copay, and others may not cover the shot at all.

“Our understanding is that the COVID-19 vaccine is covered by most insurance plans at no cost for eligible patients. Patients should check with their insurer to determine whether the updated COVID-19 vaccine is covered by their individual health plan,” says Thibault.

“Individual health plans and plan sponsors will be prepared to make coverage decisions informed by science, the latest medical evidence, and data. This process will be evidence-based, evaluate multiple sources of data, including but not limited to ACIP, and will be informed by customer needs,” said Stow.

“Call your pharmacy ahead of time and ask if you should expect a copay for the COVID vaccine. If your usual pharmacy isn’t sure or tells you that you’ll be charged, you can try another pharmacy to see if they are using a different policy,” says Caitlin Donovan, senior director at the Patient Advocate Foundation, a nonprofit that provides healthcare case management services and financial aid.

Help paying for shot is available through the following resources:

• PfizerRxPathways.com offers assistance for eligible uninsured adults.
• Moderna partners with Project HOPE and Direct Relief to distribute free shots through community health centers.
• The Patient Advocate Foundation provides co-pay relief for eligible families.
• Local health departments may still provide free or low-cost options.

Bottom Line: How to Get a COVID-19 Vaccine

Getting vaccinated this year may take persistence. Here’s how to make it easier:

• Call more than one pharmacy to compare requirements and availability.
• Check your state health department website for local clinics and eligibility updates.
• Ask your doctor about prescriptions if needed.
• Call your insurance company to inquire about coverage beforehand, and bring your insurance card and a list of medications or diagnoses with you to the pharmacy.

When Is the Best Time to Get a COVID-19 Shot?

Both Wohl and Thibault agree that getting a COVID-19 vaccine now is a good idea — if you can get one.

“Wastewater shows a surge in SARS-CoV-2 [the virus that causes COVID-19 infection] in the water. Many people are getting sick,” says Wohl.

Wastewater testing looks for pieces of the COVID-19 virus in sewage, which people shed when they use the bathroom. By tracking whether those levels go up or down, public health officials can spot illness trends in the community, often before case counts rise.

Wohl says there’s also a chance that the ACIP, which has recently gone through significant member turnover, may whittle down the list of conditions that qualify for the COVID-19 vaccines for people under 65, he says.

Get it while you can, says Thibault. “It is hard to time this just right. I generally favor October, so that my antibody levels are higher during the holidays. But I am concerned access to these vaccines will become more restricted,” she says.

Why Vaccination Still Matters

Most people who wound up in the hospital because of COVID-19 had not received the updated vaccine.

Some children have compromised immune systems or illnesses that prevent them from getting vaccines. Increasingly, however, families are citing “religious” or “personal” reasons for forgoing vaccination.

That kind of excuse has been repeatedly encouraged by Kennedy, who says vaccination is a “personal choice.”

HHS has notified schools and clinics that receive federal money from the Vaccines for Children Program, which provides free shots for uninsured or underinsured kids, that they would be required to recognize any “religious and conscience-based exemptions to vaccine mandates.”

Bill Winfrey, vice president of policy and strategic initiatives at Saint Louis Integrated Health Network — a nonprofit that works to tackle health disparities — believes doubts about vaccine safety sown by the “most trusted health officials in the country” are partly to blame.

“In a situation of doubt, it’s just easier to be inactive. It’s easier to say, ‘Well, if there’s any question, I’m just not going to do it,’” he said.

For most of the nearly 20% of kindergartners who haven’t had their full schedule of shots, their families have never requested an exemption; the children are simply inadequately immunized.

‘Measles can be deadly’

Kimberly Jones, a mother of five living in a vibrant, diverse area south of St. Louis’ downtown area, was careful to make sure her four older children were fully vaccinated. Any shot their pediatrician recommended, she had the children get them on schedule. They were all healthy.

Her view on vaccines, however, changed when her youngest child, 4-year-old Za’riyah, stopped meeting typical developmental milestones around the time the little girl got her first MMR shot in 2023.

Za’riyah’s since been diagnosed with autism. Though there’s no scientific evidence linking the MMR vaccine to disorders like autism, Jones, 44, said the dramatic increase in autism spectrum disorder diagnoses over the past two decades makes her question whether the shots have changed somehow.

“I no longer trust any vaccines, old or new,” Jones said.

Boleyjack of Saint Louis Public Schools said more parents have shared their worries about autism and vaccines in recent years.

“I usually just use my own personal story to say, ‘You know what? I have a child with autism. I strongly do not believe that his autism was caused from immunization,’” she said. “There’s no research to back it up.”

Some have changed their minds. Others haven’t. “And that’s fine,” she said. “I just want them to have accurate information.”

Boleyjack’s goal for the coming school year is to hit an 80% vaccination rate within the public schools — still far below herd immunity, but an improvement — by educating parents and increasing school-based access to vaccines and general health care.

“Measles can be deadly,” she said. “That’s what’s scary about it.”

‘Do you have a gun in your home?’

For St. Louis parents Emily Pratt, 39, and her husband, Ryan Pratt, 41, the declining vaccination rates are a cause for alarm.

Their young daughter, Lucy, has a rare autoimmune disease called juvenile dermatomyositis, or JDM, that leaves her almost defenseless against even minor illnesses. She’s on medication to suppress her overactive immune system from attacking her body.

That means Lucy has little to no ability to fight off even a common cold.

“We have four kids. If one of them brings a cold home, they’re better in three days,” Emily Pratt said. But Lucy “has a cold for two weeks. She gets sicker than typical kids.”