
FDA requires updated warning about rare heart risk with COVID shots
The Food and Drug Administration said Wednesday it has expanded existing warnings on the two leading COVID-19 vaccines about a rare heart side effect mainly seen in young men.
Myocarditis, a type of heart inflammation that is usually mild, emerged as a complication after the first shots became widely available in 2021. Prescribing information from both Pfizer and Moderna already advises doctors about the issue.
In April, the FDA sent letters to both drugmakers asking them to update and expand the warnings to add more detail about the problem and to cover a larger group of patients. While the FDA can mandate label changes, the process is often more of a negotiation with companies.
Specifically, the new warning lists the risk of myocarditis as 8 cases per 1 million people who got the 2023-2024 COVID shots between the ages of 6 months and 64 years old. The label also notes that the problem has been most common among males ages 12 to 24. The previous label said the problem mostly occurs in 12- to 17-year-olds.
The FDA's labeling change appears to conflict with some prior findings of scientists elsewhere in the U.S. government.
The Centers for Disease Control and Prevention previously concluded there was no increased risk of myocarditis detected in government vaccine injury databases for COVID-19 shots dating back to 2022. Officials also noted that cases tend to resolve quickly and are less severe that those associated with COVID-19 infection itself, which can also cause myocarditis.
The FDA announcement came as new vaccine advisers appointed by Health Secretary Robert F. Kennedy Jr. met to debate the continuing use of COVID-19 vaccines for key groups, including pregnant women and children. It's the first meeting of the CDC advisory panel since Kennedy abruptly dismissed all 17 members of the group, naming a new panel that includes several members with a history of anti-vaccine statements.
The FDA's label update is the latest step by officials working under Kennedy to restrict or undercut use of vaccines. FDA Commissioner Marty Makary and a top deputy recently restricted annual COVID-19 shots to seniors and other Americans at higher risk from the virus. They've also suggested seasonal tweaks to match the latest circulating virus strains are new products that require extra testing.
Outside experts said the new warning is the wrong approach.
'They are right to suggest that we need to consider myocarditis risks associated with the vaccine, but what they propose is exactly the wrong solution,' said Dr. Robert Morris of the University of Washington. 'We should be investigating who is prone to myocarditis to see if we can predict and mitigate that risk.'
Makary and several other recent FDA appointees gained prominence during the pandemic by suggesting the federal government exaggerated the benefits of COVID-19 boosters and downplayed serious side effects, including myocarditis.
Before joining the government, Makary and two of his current FDA deputies wrote a 2022 paper that said mandating booster shots in young people would cause more vaccine-related injuries than prevented hospitalizations from COVID-19 infections. The conclusion was contradicted by many leading vaccine and public health experts at the time, including at the CDC.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

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Telegraph
2 hours ago
- Telegraph
Poor sleep and no routine – the seven things that make ADHD worse
From forgotten appointments and lost keys to emotional ups and downs, poor sleep and chronic procrastination, living with ADHD can feel like being on a rollercoaster with no end in sight. While these daily struggles are frustrating, they rarely happen in isolation, and many things can make them worse. Research shows that those with ADHD often live with co-occurring mental health conditions such as anxiety and depression, as well as other neurodevelopmental disorders like autism or dyslexia. There's also a higher risk of addiction, which can further intensify symptoms. Medication can be transformative – but it doesn't work for everyone, and the wrong dose can be counterproductive. Yet alongside these more clinical drivers, experts point to a range of lifestyle and environmental triggers that can quietly make ADHD worse: inconsistent routines, poor sleep and diet, digital overload, even hormonal shifts in perimenopause. The good news is some of these are within your control. 'I commonly use this idea of being on and off track. Because ADHD is a disorder of dysregulation, many things can knock you off that track,' says Dr James Kustow, a consultant psychiatrist specialising in ADHD and author of How to Thrive with Adult ADHD. Here's what can make ADHD worse – and what might help. Lack of routine and structure Because of executive dysfunction struggles, routine is especially important for those with ADHD. 'ADHD can feel like you're a ship being blown around because every day is like Groundhog Day. You don't have a great sense of the past or future, so you need things in the present to anchor you, to make you feel safe and present, to stabilise the ship,' says Dr Kustow. Prioritising and decision making are often difficult, so without any external structure, there is a danger of drift or not being productive or efficient. 'Then you might miss deadlines, or not pay your bills, and suddenly you're in firefighting mode and all sense of balance goes out of the window,' says Dr Kustow. What to do: Build in consistency to your week with anchor points like a regular hobby, work periods or exercise class, with some flexibility for variation and novelty. Make sure there are fixed, scheduled activities (EG: 'Monday is yoga night, 'take pills after brushing teeth') and habits that repeat on a rolling basis. Plan out your days into blocks, making sure to allow time for meals and meal prep, morning and evening routines, work, social time and downtime. Poor sleep Struggling with sleep is a bit of a hallmark of ADHD, and one of the 'signs we look for in assessments,' says Dr Fleur-Michelle Coiffat, a consultant clinical psychologist who specialises in neurodiversity. ADHD-ers often have disrupted circadian rhythms, struggling to get to sleep or waking at odd hours. Poor sleep also worsens ADHD symptoms like focus, anxiety and impulsivity. ADHD is often called a 'dopamine disorder'. Lower levels of this neurotransmitter drive people to seek stimulation, like scrolling social media or watching TV late, which keeps the mind switched on. What to do: Dr Coiffat recommends a pre-sleep routine to relax the mind and body. 'Put down your devices, dim the lighting, and do calm activities like a bath, reading or gentle stretches.' She also suggests exercise to counter restlessness. 'If you don't burn off energy during the day, it can make you restless at night – including hyperactivity of the mind,' she adds. Journaling can help. 'Get your thoughts down on paper, but limit it to 10 minutes, so you don't start to get anxious,' she says. Meditation may also help quieten and slow down the mind. A negative mindset From comments like 'you're lazy', 'disorganised' and 'unmotivated', people with ADHD have often had a lifetime of absorbing negative messages and as a result often struggle with shame and lack of self-confidence. 'This can lead to withdrawal, people might think nobody likes them, or they'll say the wrong thing, or that they don't fit in or can't manage a task. But social interaction with trusted friends, family and colleagues can help with these negative thoughts,' says Dr Coiffat. Emotional dysregulation is often a key marker of ADHD, and many experts talk about 'rejection sensitivity dysphoria', where people are extremely sensitive to criticism and perceived rejection. What to do: 'Communication is important, it might be as simple as asking someone to adjust how they give feedback, or how they respond to emails,' says Dr Coiffat. Dr Kustow advises nurturing a growth, rather than a fixed, mindset. 'When faced with a setback, think about what you can learn from it, and how adversity makes you stronger. Also, it's important to address the self-esteem challenges of ADHD with support scaffolds – spiritual, social, family and therapeutic,' he adds. Poor diet leading to blood sugar crashes Many ADHD-ers reach for sugar, caffeine and energy drinks as well as processed foods to give them a short-term hit. This can lead to issues like overeating or skipping meals, which is why they have higher rates of obesity and binge-eating disorder. 'Reaching for sugar hits can be addictive, and get you into a vicious cycle. If your blood sugar levels are spiking, that will heighten issues with attention, focus and restlessness. A lot of people with ADHD, and I do this myself, are often so focused on something or using all their brain capacity just to get through the day that they forget to eat, which also leads to a crash,' says Dr Coiffat. What to do: Keep blood sugar consistent by eating regularly and healthily. Try to keep simple snacks like a handful of nuts on hand. Avoid sugar and simple carbohydrates like white flour and rice, and include sufficient protein in every meal, as protein helps stabilise blood sugar. Get 'hits' from other sources like live music, exercise, and cold water swimming. An over-stimulating environment People with ADHD can thrive on a certain degree of novelty and stimulation, as monotonous tasks can cause shutdown, zoning out or restlessness. However, it's a fine balance as chronic stress and anxiety can also intensify ADHD symptoms, leading to potential increased impulsivity, difficulty concentrating, problems with emotional regulation, performance at work and burnout. People can vary quite widely here. Many might struggle with a 9-5, desk-based job in an open plan office with a lot of potential for noise and distractibility. However, for others, the noise and routine could be helpful. 'There can be a struggle to get in for 9am because of their sleep rhythms, then there is the sensory overload of a journey on public transport in rush hour. The monotony of a desk job that involves little interaction can exacerbate physical and mental restlessness,' says Dr Kustow. However, many with ADHD are also on the autistic spectrum. 'I have a patient who loves archiving, because it's just bringing order into things, but that would be extremely boring for someone who doesn't have that combination,' he adds. Social media and excessive screen use are often a problem as ADHD-ers crave stimulation and the dopamine hits of excessive scrolling, but this can also exacerbate problems with concentration. What to do: In the workplace, it's important to limit screen time and schedule regular screen and meal breaks, as well as time to move around and get outside. 'Jobs that involve creativity, project work, variety and problem solving can be more suitable', says Dr Kustow. But take time to understand your individual needs. Toxins and environmental stressors This is an emerging area, but people with ADHD may be more likely to have allergies, autoimmunity and inflammation, says Dr Kustow. 'Some have more sensitive immune systems, with hypermobility, allergies or chronic illness.' He highlights mould. 'If you're in a mouldy home and struggling with brain function, they may be connected. Some evidence is anecdotal, but toxins may trigger inflammation in sensitive individuals,' he adds. What to do: If you are someone with ADHD who suffers from allergies and has poor immunity, it might be worth trying to reduce toxins in the areas that you have control over. You can gradually buy less toxic versions of cleaning products, both for your body and home, makeup, and natural, pesticide-free foods. Hormonal shifts like perimenopause and menopause Hormonal shifts can make ADHD worse, and also 'unmask' previously undiagnosed ADHD. Perimenopausal women are now one of the largest groups seeking diagnosis. 'During perimenopause, oestrogen levels become dysregulated and start going down, which also reduces dopamine. A woman with ADHD in their 40s may notice that their ADHD might worsen, and they might need higher doses of medication or HRT. Then there are the people who never got a diagnosis because they just about managed, but then suddenly it gets worse because of hormonal shifts and their ADHD is unmasked,' says Dr Kustow. What to do: Adjusting ADHD medication can be helpful, as can HRT. Some doctors might prescribe an antidepressant. Does ADHD get worse with age? ADHD is a neurodevelopmental condition, so it doesn't fundamentally change with age, although the way it manifests can evolve as a response to life events and physical changes. Children are more likely to be hyperactive than adults, and adults may have more issues with time management and organisation. 'In a minority, it can improve and resolve, but most will be stable but find that symptoms may get aggravated at different points in life, as demands change over time, including increasing life responsibilities, hormonal shifts, accumulated stress and physical decline. The demands of retirement are quite different from sitting at a desk doing complex calculations, for example, and symptoms may respond accordingly,' explains Dr Kustow. Dr James Kustow is the author of How to Thrive with Adult ADHD: 7 Pillars for Focus, Productivity and Balance. How to Thrive with Adult ADHD by Dr James Kustow is out now. All artwork by Nicholas Stevenson.


Daily Mail
2 hours ago
- Daily Mail
The GP dismissed my common gut problem nine times...it was stomach cancer and now I have a year to live
A previously 'fit-and-healthy', mother has shared her anguish after what doctors repeatedly dismissed as heartburn turned out to be incurable stomach cancer. Georgia Gardiner, 28, from Leeds in West Yorkshire, has now been told she may have as little as a year to live. She was eventually diagnosed with linitis plastica—a rare and aggressive form of stomach cancer—on June 13. The disease has already spread to the tissues surrounding the internal organs close to the stomach as well the lymph nodes near her lungs, meaning it's in the advanced— and final—stages. She said she is angry medics didn't take her initial symptoms, which included stomach pain, seriously. The mother-of-one says if they had, her cancer may have been spotted earlier in a potentially more treatable stage. Ms Gardiner's heartbreaking ordeal began when she suddenly started having stomach pains so severe that she 'couldn't keep food down'. As her condition worsened, the former 'massive foodie' lost her appetite completely. 'My body was just rejecting everything. Then I was experiencing pains in my upper stomach. It was really intense, it was a sharp constant pain,' she recalled. Despite going back and forth to her doctors 'six and nine' times, she kept getting told it was related to heartburn and was given basic anti-acid reflux medication. It wasn't until months later when she was finally referred for an endoscopy, which involves a camera being put down the throat, to investigate the problem. This showed worrying signs that she may have stomach cancer. Further tests confirmed she had disease and that it had already spread to the other organs. This meant the disease was already at stage-four, the final and most serious stage. Medics then told her she may only have a year to live—which she said left her in 'complete shock'. 'I said, "am I going to die? I can't die, I have a two-year-old son". My fiancé Callum just went green,' she said. 'When they said it was incurable, I went into a complete shock state. I didn't speak or leave the house for three days—my whole world just crumbled,' she said. The keen horse rider—who had been previously 'fit-and-healthy'— said she had no idea why she had developed stomach cancer, having no family history of the disease. She is now urging others to always push their GP for action if they experience worrying symptoms. 'If someone else had this type of cancer and they can catch it at an earlier stage by making doctors do the correct tests, then at least I know that I've helped somebody then,' she said. Ms Gardiner said she is now focusing on trying to spend as much time as possible with her son Arlo while she can. 'The thing that breaks me is how much I'm going to miss out on Arlo's life. He's everything to me,' she said. While she and Callum had planned to get married in a couple of years the couple are now rushing this forward. A fundraiser has been launched to help pay for any future treatment and making memories with her family. About 6,500 patients in Britain and 30,000 in the US are diagnosed with stomach cancer each year. The disease kills about 4,000 Britons and 11,000 Americans per annum. While stomach cancer can develop at any age, it is far more common among older adults. Just half (49 per cent) of all cases of the disease diagnosed each year are among the over 75s. If caught in its earliest stages, the majority of stomach cancer patients (65 per cent) will survive a decade after their diagnosis according to charity Cancer Research UK. However, for stage four patients, 10-year survival drops to just one in five. The deadly disease is preventable in over half of cases with potential cause including smoking and obesity. Symptoms of stomach cancer include heartburn or acid reflex, problems swallowing, nausea, vomiting, burping, and feeling full very quickly after eating. Others include loss of appetite, unintentional weight loss, a lump on your tummy, a pain on the top of your tummy, and fatigue. It comes amid an explosion of cancers in young people, which has baffled experts. In 2023, a US study found that cancers of all types were on the rise for younger women—but curiously not men. While for women they increased overall by more than four per cent, for young men there was a dip of almost five per cent.


The Guardian
4 hours ago
- The Guardian
Patients dying of sepsis because medics too slow to spot it, warns NHS watchdog
Sepsis is causing thousands of deaths a year, a charity has said, as the NHS's safety watchdog warned that doctors and nurses are too often slow to identify and treat it. 'The recognition of sepsis remains an urgent and persistent safety risk', despite previous reports highlighting the large number of deaths it causes when diagnosed too late, according to the Health Services Safety Investigations Body. Too often, relatives were ignored when they raised concerns about the condition of a loved one who later died of sepsis, the HSSIB said on Thursday. It urged NHS trusts and staff in England to learn from mistakes which the UK Sepsis Trust estimates play a key role in as many as 10,000 avoidable deaths every year UK-wide. Sepsis develops when an infection goes untreated and the body's immune response starts to target its own tissues and organs. Doctors refer to that process as 'organ dysfunction'. It causes more deaths than lung cancer and is the second biggest killer in England after heart disease, NHS England says. However, it is very hard to diagnose as many of its symptoms – such as confusion, breathlessness and blotchy skin – are also found with other conditions and there is no single sign or diagnostic test to identify it. The report from HSSIB is the latest in a series from bodies including the Parliamentary and Health Service Ombudsman (PHSO) and Care Quality Commission to reveal the large number of patients who die every year after NHS staff take too long to diagnose it. 'There have been initiatives to improve the recognition and timely treatment of sepsis over the last 20 years, yet it has persisted as a safety risk,' HSSIB said. It published reports of three cases involving patients – named only as Barbara, Ged and Lorna – for whom a delay in spotting sepsis had severe consequences. Two of the patients died and the third had to have her leg amputated below the knee after starting on antibiotics too late. The three incidents 'show a consistent pattern of issues around the early recognition and treatment of sepsis', said Melanie Ottewill, HSSIB's senior safety investigator. 'The experiences of Barbara, Ged and Lorna show the devastating consequences of sepsis. They also highlight the imperative of listening to families when they express concerns about their loved one and tell us about changes in how they are.' Lorna was admitted to hospital in England on 5 July last year with severe abdominal pain and a high heart rate. It took 30 hours before a doctor identified her sepsis and gave her antibiotics. However, her condition deteriorated and she died the next day. 'Lorna's family expressed concerns that they were unable to advocate for her wellbeing and that their concerns about how unwell she was were not always heard,' HSSIB said. Dr Ron Daniels, the founder and chief medical officer of the UK Sepsis Trust, said that since the success of hospitals in England in 2016-19 at identifying and promptly treating sepsis, the NHS's performance 'has slipped backwards considerably'. That is because a financial incentive offered to hospitals, to screen anyone who might have sepsis and give them antibiotics within an hour – the approach recommended by the National Institute for Health and Care Excellence – ended. 'The quality of care has returned to its pre-2016 level – that is, a postcode lottery in patients' chances of their sepsis being spotted. I'm appalled,' Daniels said. 'We estimate that of the 48,000 people a year who die of sepsis, at least 10,000 more lives could be saved if the NHS prioritised sepsis as an urgent clinical issue.' Rebecca Hilsenrath, chief executive of the PHSO, said: 'These reports highlight what we have been saying about sepsis for over a decade. Lessons are not being learned, recommendations from reports are not being implemented and mistakes are putting people at risk.' The NHS's culture needs to be one that is 'open, accepts mistakes and learns from them' in order to reduce the huge toll of avoidable death, she added.