TWiV 1266: Clinical update with Dr. Daniel Griffin

Nov 1, 2025

Dr. Daniel Griffin, an infectious disease clinician, provides an insightful clinical update on various viral infections. He discusses how mRNA vaccines may enhance cancer therapies and reveals new meta-analysis findings on COVID-19, RSV, and influenza vaccines. Dr. Griffin also highlights rising measles cases and H5N1 outbreaks in poultry. He addresses long COVID treatments, vaccine effectiveness against severe illness, and the limitations of wastewater surveillance for RSV, all while encouraging public health awareness.

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INSIGHT

Why Wastewater Misses RSV

Wastewater surveillance poorly captures RSV because the main affected group (infants) wear diapers, diverting viral material from sewage.
ER visit tracking by state gives earlier and more reliable RSV signal.

ADVICE

RSV mRNA Revaccination Restores Antibodies

Revaccination with Moderna mRNA-1345 at 12 months is immunogenic and well tolerated in adults 50+ and restores antibody titers.
Expect mild-to-moderate reactions and no new safety concerns in the studied cohort.

INSIGHT

England's RSV Program Strongly Protective

England's bivalent RSV pre-F program achieved very high vaccine effectiveness (72–89%) against hospital admissions and severe RSV outcomes in older adults.
Effectiveness remained robust across exacerbations of chronic lung, heart disease, and immunosuppression groups.

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In his weekly clinical update, Dr. Griffin and Vincent Racaniello ponder the nomination of Casey Means for Surgeon General by President Trump, how mRNA vaccines may enhance effectiveness of check point inhibitor cancer therapies, if viral infection associates with cardiac disease, H5N1 isolation from backyard birds and turkey farms, and the effectiveness of the COVID-19, RSV and influenza vaccines before Dr. Griffin deep dives into recent statistics on the measles epidemic, RSV, influenza and SARS-CoV-2 infections, the Wasterwater Scan dashboard, Johns Hopkins measles tracker, if revaccination with the mRNA RSV vaccine is effective, how effective today’s COVID-19 vaccine is for protection against severe disease following infection with current viral variants, where to find PEMGARDA, how to access and pay for Paxlovid, can you be retreated with Paxlovid, long COVID treatment center, where to go for answers to your long COVID questions, and contacting your federal government representative to stop the assault on science and biomedical research.

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Links for this episode

The Challenge of Malignancies in HIV-1, Beyond Immune Activation and Back to Decreased Immune Surveillance (Journal of AIDS & Clinical Research)
SARS-CoV-2 mRNA vaccines sensitize tumours to immune checkpoint blockade (Nature)
TWiV 1265: mRNA vaccines make cancer treatment great again (microbeTV: TWiV 1265)
Viral Infections and Risk of Cardiovascular Disease (Journal of the American Heart Association)
Confirmations of Highly Pathogenic Avian Influenza in Commercial and Backyard Flocks (USDA: Animal and Plant Health Inspection Service)
Three large turkey farms in Minnesota hit with H5N1 avian flu (CIDRAP)
Updated Evidence for Covid-19, RSV, and Influenza Vaccines for 2025–2026 (NEJM)
Wastewater for measles (WasterWater Scan)
Measles cases and outbreaks (CDC Rubeola)
Tracking Measles Cases in the U.S. (Johns Hopkins)
Weekly measles and rubella monitoring (Government of Canada)
Measles (WHO)
Get the FACTS about measles (NY State Department of Health)
Measles (CDC Measles (Rubeola))
Measles vaccine (CDC Measles (Rubeola))
Presumptive evidence of measles immunity (CDC)
Contraindications and precautions to measles vaccination (CDC)
Measles vaccine recommendations from NYP (jpg)
Adverse events associated with childhood vaccines: evidence bearing on causality (NLM)
Measles Vaccination: Know the Facts (ISDA: Infectious Diseases Society of America)
Deaths following vaccination: what does the evidence show (Vaccine)
Influenza: Waste water scan for 11 pathogens (WastewaterSCan)
US respiratory virus activity (CDC Respiratory Illnesses)
Respiratory virus activity levels (CDC Respiratory Illnesses)
Weekly surveillance report: Cliff notes (CDC FluView)
ACIP Recommendations Summary (CDC: Influenza)
Influenza Vaccine Composition for the 2025-2026 U.S. Influenza Season (FDA)
RSV: Waste water scan for 11 pathogens (WastewaterSCan)
Respiratory Diseases (Yale School of Public Health)
US respiratory virus activity (CDC Respiratory Illnesses)
RSV-Network (CDC Respiratory Syncytial virus Infection)
Vaccines for Adults (CDC: Respiratory Syncytial Virus Infection (RSV))
Economic Analysis of Protein Subunit and mRNA RSV Vaccination in Adults aged 50-59 Years (CDC: ACIP)
Safety, Tolerability, and Immunogenicity of Revaccination With mRNA-1345, an mRNA Vaccine Against RSV, Administered 12 Months Following a Primary Dose in Adults Aged ≥50 Years (CID)
Vaccine effectiveness of a bivalent respiratory syncytial virus (RSV) pre-F vaccine against RSV-associated hospital admission among adults aged 75–79 years in England (LANCET: Infectious Diseases)
Waste water scan for 11 pathogens (WastewaterSCan)
COVID-19 deaths (CDC)
Respiratory Illnesses Data Channel (CDC: Respiratory Illnesses)
COVID-19 national and regional trends (CDC)
COVID-19 variant tracker (CDC)
SARS-CoV-2 genomes galore (Nextstrain)
Antigenic and Virological Characteristics of SARS-CoV-2 Variant BA.3.2, XFG, and NB.1.8.1 (bioRxiV)
Association of 2024–2025 Covid-19 Vaccine with Covid-19 Outcomes in U.S. Veterans (NEJM)
Durability of 2024-2025 COVID-19 Vaccines Against JN.1 Subvariants (JAMA: Internal Medicine)
Where to get pemgarda (Pemgarda)
EUA for the pre-exposure prophylaxis of COVID-19 (INVIYD)
Infusion center (Prime Fusions)
CDC Quarantine guidelines (CDC)
NIH COVID-19 treatment guidelines (NIH)
Drug interaction checker (University of Liverpool)
Help your eligible patients access PAXLOVID with the PAXCESS Patient Support Program (Pfizer Pro)
Understanding Coverage Options (PAXCESS)
Infectious Disease Society guidelines for treatment and management (ID Society)
Molnupiravir safety and efficacy (JMV)
Convalescent plasma recommendation for immunocompromised (ID Society)
What to do when sick with a respiratory virus (CDC)
Managing healthcare staffing shortages (CDC)
Anticoagulation guidelines (hematology.org)
Daniel Griffin’s evidence based medical practices for long COVID (OFID)
Long COVID hotline (Columbia : Columbia University Irving Medical Center)
The answers: Long COVID
Reaching out to US house representative
Letters read on TWiV 1266
Dr. Griffin’s COVID treatment summary (pdf)
Timestamps by Jolene Ramsey. Thanks!

Intro music is by Ronald Jenkees

Send your questions for Dr. Griffin to daniel@microbe.tv

Content in this podcast should not be construed as medical advice.