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1rem

0:00 Burden of Community Acquired Pneumonia (CAP)

3:11 Strategies for Approaching Treatment Selection of CAP

6:00 Understanding Multidrug-Resistant Pathogens (MDR) and Antimicrobial Stewardship in CAP

10:52 Unmet Needs and Key Takeaways in CAP Management

An expert in infectious diseases shares treatment considerations and clinical strategies for the management of community acquired pneumonia (CAP).

Tailoring Therapies in Community Acquired Pneumonia in the Inpatient Setting

This interview and episode was recorded and produced prior to the November 16 announcement that 

Moderna's vaccine candidate mRNA-1273 was associated with 94.5% efficacy

 in preventing COVID-19 in preliminary phase 3 COVE trial data. Though the candidate and the mRNA platform is discussed throughout the podcast, more updated coverage of mRNA-1273 will be made available on ContagionLive.com throughout the coming weeks.

In matter of 2 weeks, a series of significant clinical, public health, and otherwise factors greatly influenced the current state of 

From promising preliminary phase 3 data from Pfizer and BioNTech, to record surges in new cases and hospitalizations across the US, and to a Presidential election laden with public health policy implications, the makeup of COVID-19 pandemic response is entirely different from what it was weeks ago.

It is only bound to change even more greatly in just a couple more weeks. Before the US Food and Drug Administration (FDA) is able to weigh on the potentially first COVID-19 vaccine to submit an Emergency Use Authorization (EUA) and kick off an unprecedented distribution and real-world monitoring process, it’s crucial to assess where things stand now, and what’s coming up.

This week’s Vaccine Race podcast features an interview with William Schaffner, MD, professor of Preventive Medicine and Medicine at the Vanderbilt University Medical Center.

Schaffner discusses his own impression of the new Pfizer preliminary data for candidate BNT162, whether the current US rate of 150,000-plus new daily cases could pressure the FDA to further expedite a vaccine, what vaccine distribution, storage, and immunization will entail, and what a new administration would (or would not) mean for COVID-19 response and vaccine development.

The Vanderbilt Professor of Preventive Medicine shares thoughts on the first potential COVID-19 vaccine, at a time of record new daily cases.

Vaccine Race: The Pfizer Vaccine with William Schaffner, MD

, as the global-scale infectious disease meeting has been forced to resort its comprehensive clinical agenda to a virtual format due to 

As an acknowledgement to the great burden of COVID-19—and in spirit with the meeting’s great collaborative efforts—the first 24 hours of the annual meeting are dedicated to discussions around the pandemic, titled “Chasing the Sun.”

 will provide around-the-clock IDWeek 2020 coverage over the next days, we kick off our content in a similar fashion: the second episode of our limited series podcast Vaccine Race.

In this episode, senior editor John Parkinson sits down with Mei Mei Hu, co-chief executive officer of vaccine development company Covaxx, and honorary member of Time Magazine’s Next 100 List of 2019.

Covaxx’s investigational COVID-19 vaccine, UB-612, is the first multitope peptide-based vaccine capable of activating both B-cells and T-cells.

about her company and its creation of this interesting candidate, and provided some firsthand insights into getting a vaccine through the development process.

Stay tuned for more IDWeek 2020 content, and a new Vaccine Race episode, throughout the week.

ID Week

A vaccine developer joins for a firsthand discussion on the development, research, and distribution process.

Vaccine Race: Mei Mei Hu on Developing, Researching a COVID-19 Vaccine

A preventable crisis, measles, makes a dangerous comeback.

Measles 2025: Looking Back and Moving Forward

A multi-prong approach reduces inappropriate antibiotic prescribing to outpatients with upper respiratory tract infection.

Bundle of Interventions Reduces Inappropriate Antibiotics for Upper Respiratory Tract Infection

NYC Health Department urges immediate medical attention for flu-like symptoms in affected ZIP codes in Central Harlem amid ongoing investigation.



3 Deaths and 67 Cases Reported in Legionnaires’ Disease Cluster in NYC

Clarametyx Biosciences said its investigational antibody therapy, CMTX-101, which is in a phase 1b/2a study, remains on track for full trial enrollment by the end of 2025. 

FDA Fast Tracks Antibody Therapy for Pulmonary Infections Including Cystic Fibrosis

In a continuing trend from the last several years, a record number of families are opting out of vaccines. 

CDC: Increased Childhood Vaccine Exemptions Lead to Further Decreases in Immunizations

COVID-19 Variants and Vaccine Decisions Heading Into Fall

As new COVID-19 variants circulate and the respiratory virus season approaches, families are once again facing decisions about prevention, especially with schools reopening. Sharon Nachman, MD, division chief of pediatric infectious diseases at Stony Brook Children’s Hospital, shared her perspective on what the latest variants mean for both children and adults and how families can prepare.

Currently, 2 dominant variants are being tracked: Stratus and Nimbus. According to Nachman, both are highly transmissible but not linked to more severe illness compared with earlier strains. “The Stratus variant and the Nimbus variant—those are two of the ones that we're seeing right now—actually are both equally good at infecting a host. They are not, however, associated with more severe illness like we've seen with other strains in the past. So you can easily catch it and you can easily spread it.”

She noted that tracking data shows an upward trend in these variants over the summer: “From May to June to now, in August, we are seeing climbing percentages of both Nimbus and Stratus.” Although hospitalizations have not risen at the same pace, symptoms are shifting. “As part of all the COVID-19 variants that we see, we have seen more sore throat, more hoarseness of throat—that kind of horrible complaint that ‘I can’t talk, I can’t swallow’—happening.”

Though the severity remains relatively mild for most, Nachman cautioned that this could change. “Can this change over the fall and winter? Absolutely it can,” she said. “These variants have many sites of mutation from the original strains that we had back in 2020 as well as in 2022 and 2023.” As she explained, widespread transmission fuels further mutation: “The more people that get it, the more they pass it, the more mutations that happen. So that means the fall and winter are going to be primed for us to see more infections and probably with different variants.”

One practical piece of advice remains consistent. “If you or your child has COVID-19, it would not be a bad idea to stay home until you're not coughing and [you do not] have fever,” she said. This minimizes the risk of passing the virus to others: “They're probably going to pass that variant to the next kid or the next adult—and on and on.”

On the topic of vaccination, Nachman emphasized education as the first step in addressing hesitancy. “Yes, there are several mRNA vaccines out there. mRNA vaccines do not have any mercury in them or thimerosal in them,” she explained. “If it's one vial, one person, there's no thimerosal, there's no preservative.”

She also reassured parents concerned about the safety of mRNA vaccines. “There's nothing live about this vaccine. The vaccine is not going to cause an infection in anyone,” she said. “By giving a COVID-19 vaccine, you turn on the machinery. Unfortunately, when you turn on the machinery, you feel under the weather. You may have some fever and some body aches, but that's because your body is a good immune machine and it's making antibodies.”

Vaccination decisions should take into account both individual and household risk. “We are especially concerned for the fall and winter for older populations as well as populations with underlying lung issues,” she said, noting these groups continue to face higher risks for severe illness and hospitalization.

Although children may typically experience milder symptoms, Nachman urged parents to think about the bigger picture. “In the past, people have said, ‘Oh, kids don't get so sick with COVID-19, they don't need a vaccine.’ As someone who worries about even one child getting sick, I tell families, ‘Think about who your kid is and who else is at home with you.’” For multigenerational households, she recommends considering how one child’s infection could affect more vulnerable relatives. “You may need to circle around that person and have everyone protected so that they're not going to bring it home to that individual.”

Sharon Nachman, MD, breaks down the latest on Stratus and Nimbus variants and what families should consider as schools resume.

Robert Hopkins Jr, MD, the medical director of the National Foundation for Infectious Diseases (NFID) discusses the importance of this and that more people forget to do so after key times or believe it is not needed. 

Handwashing: An Infection Prevention Method That We Forget? 

Handwashing often takes place after encounters with people, using the bathroom, or touching doors or other areas where the public has been utilizing. However, it can be quite a personal decision and one associated with people’s beliefs about germs.

A new survey commissioned by the National Foundation for Infectious Diseases (NFID) and released as part of its 2025 State of Handwashing Report, asked about people’s behaviors around handwashing. The results showed there is quite a bit of variability for when people wash their hands.

One of the takeaways from the report confirmed that many adults know how important it is to wash their hands, and yet it is easy to forget in everyday life.

For example, the report showed that 48% of US adults admit to forgetting or choosing not to wash their hands at key times, like after visiting grocery stores, restaurants, or coffee shops, or a healthcare setting (doctor’s office, pharmacy, clinic, or hospital). In addition, 1 out of 5 (20%) admit to not washing their hands, even though handwashing can help prevent approximately 80% of infectious diseases.

When it comes to the amount of time needed, a majority knew the correct cleaning method and time needed to kill germs.

“Sixty-two percent of the survey respondents correctly stated that washing your hands for 20 seconds with soap and water effectively reduces the spread of germs,” said Robert Hopkins Jr, MD, the medical director of NFID. “Only 13% believe that less than 20 seconds is enough, while 24% thought that you needed more time.”

Hopkins did point out some areas that can be problematic in terms of contracting or spreading germs. 

“Only 30% reported they're most likely to wash their hands after a cough or sneezing, which is a concern, especially given what we know about how easily we spread respiratory disease by droplets,” he said.

He did note men and women do differ a bit in terms of handwashing strategies.
Hopkins said that 34% of men surveyed were more likely to forget to wash their hands; whereas, 27% of women forget. Additionally, 34% of women were more likely to use alternatives, like hand sanitizers, than men ( 23%).

Along with the report, NFID has launched its Hands In For Handwashing campaign to raise awareness about the importance of handwashing to help stop the spread of infectious diseases.

“The campaign is to raise awareness about the importance of hand washing— really to help stop the spread of infectious diseases. We want to encourage everyone to wash their hands as 1 component of an effort to stay healthy and avoid infections. About 80% of infectious diseases are spread by dirty hands,” Hopkins said.

Hopkins says hand washing is one component of an infection prevention strategy that should also include vaccination as well as other elements.

As part of the campaign, NFID is also going out on the road with a Clean Hands Caravan, that includes a mobile handwashing station to make it easier for people to wash their hands in places where germs can spread.

For its next stops, Hopkins says the caravan will be at the World Barbecue Cooking Contest in Memphis from May 14 to 17, and at the Atlanta Jazz Festival from May 24 to 26.

To learn more about the campaign or read the handwashing report, go 

Reference
1.New National Survey Finds Nearly Half of US Adults Admit to Not Washing Their Hands at Key Moments. NFID press release. May 5, 2025. Accessed May 5, 2025.
https://www.nfid.org/new-national-survey-finds-nearly-half-of-us-adults-admit-to-not-washing-their-hands-at-key-moments/

Robert Hopkins Jr, MD, the medical director of the National Foundation for Infectious Diseases discusses the results of the organization's new survey and the surprising findings that many people forget to wash their hands after key times or believe it is not needed. 

Pertussis also known as whooping cough, has seen more cases last year and on track for another record year for cases. Sharon Nachman, MD, provides clinical insights for presentation, treatment and vaccination. 

Pertussis Another Vaccine-Preventable Disease Seeing a Major Resurgence

Pertussis (whooping cough) is a bacterial infection caused by the bacterium 

, and is spread through respiratory droplets when an infected person coughs or sneezes.

In the US, there were 35,435 reported cases of pertussis last year—the highest number in more than a decade. For comparison, there were 7,063 cases in 2023.

Through the first 3 months of 2025, there was about 6,600 cases already, which is almost 4 times the number reported during the same period last year.

Sharon Nachman, MD, chief of pediatric infectious diseases at Stony Brook Children's Hospital, says the initial clinical presentation of pertussis looks much like other respiratory illnesses.

“You feel sick; you have a fever, runny nose, cough, fatigue, and it's only after that initial early stage that you start coughing a week or two later,” Nachman said. “So we really don’t know you have pertussis when you’ve got those early symptoms. That means you're going back to school; you're going to work; your child’s going to daycare, and they have the sniffles, a sore throat, and some aches.”

She says that pain relievers such as acetaminophen and ibuprofen may make patients feel better, but over time, the fever continues and the whooping cough begins—by which time, it’s too late for early intervention.

“By then, it’s actually too late for antibiotics to make a difference. People also think that antibiotics are going to get rid of your cough. But the cough is toxin-mediated, which means that while you kill the bacteria that started this whole process, you don’t get rid of the toxin,” Nachman said. “And that toxin is just dangerous for your lungs and takes weeks and weeks to clear. But the damage is done. The reason we use antibiotics—believe it or not—is not just to stop more bacteria from producing toxin, but also to stop you from being infectious. And that’s really important, because the last thing we want is for you to infect more and more people.”

Pertussis is highly contagious. “It can go on to infect between 12 and 17 unvaccinated people when you come into close contact with someone who has pertussis,” Nachman said. “If you’ve not been vaccinated and you’re traveling to a country where we see a lot of pertussis, and you're in a crowd, you are highly likely to come back with pertussis.”

Although pertussis can affect people of all ages, it is most common in infants and young children who have not been fully vaccinated. Babies under one year old are at the greatest risk for severe complications and mortality. Last year, 10 people died from pertussis, and 6 of them were under the age of one.

Because of the burden pertussis places on the youngest population, Nachman stresses the importance of vaccination—starting with pregnant mothers and continuing with babies.

“We give it to pregnant women so that they will make a good antibody response and help protect their infants, particularly those who are born at full term,” Nachman said. “We give it to infants at 2, 4, and 6 months, and then again at 12 to 15 months, because we know that an infant who gets pertussis has the worst outcome. They basically do the worst—and, in fact, some of those infants do die.”

"If you're getting this subunit vaccine, over time your antibodies can wane, particularly if you're not being exposed to the disease," Nachman said. “So we want to give you a booster so that you remember how to make these antibodies, and when you see a pertussis case, you don’t get infected. And we give pertussis vaccines about every 10 years or so to children. This way, we know they’re safe in those ages that are most at risk.”

Throughout her career as a pediatrician, Nachman has seen some of the debilitating and life-altering effects that pertussis can cause.

“Children with pertussis cough so much that they can have bleeding on their face, in their eyes, and in their lungs—and that is quite scary to see.”

She also says some pertussis patients can develop chronic lung issues, including asthma.

“We don’t have good numbers on how many of those children with asthma had pertussis as the inciting event that led to their asthma. Asthma is a diagnosis we make later—not in those first few months of life—and unless you know to link the two and have tested for pertussis in that first year, we can’t say how often it happens. But in prospective data, those kids who had pertussis and were followed by our pulmonary colleagues—far too often, we’re seeing kids with chronic lung disease among those who got this infection early.”

References
1.About Whooping Cough. CDC. April 2, 2024. Accessed May 14, 2025. 
https://www.cdc.gov/pertussis/about/index.html
2. 2024 Provisional Pertussis Surveillance Report. CDC. February 3, 2025. Accessed May 14, 2025. 
https://www.cdc.gov/nndss/infectious-disease/weekly-and-annual-disease-data-tables.html
3. Dyer O. Whooping cough: Cases soar in US. 

. 2025;389:r704. Published 2025 Apr 8. doi:10.1136/bmj.r704



Pertussis, also known as whooping cough, saw more cases last year than in the last decade, and it is on track for another record year for cases. Sharon Nachman, MD, provides clinical insights for presentation, treatment, and vaccination. 

Pertussis: Another Vaccine-Preventable Disease Seeing a Major Resurgence

Paul Offit, MD, offers a glimpse of when the outbreak might end as well as where we are with herd immunity, the MMR vaccine’s efficacy, and insights on breakthrough cases. 

When Will the Measles Outbreak End? 

The Johns Hopkins Bloomberg School of Public Health’s Center for Outbreak Response Innovation has a 

. Much like they did during the COVID-19 pandemic, and were tracking cases of the virus, the institution is tracking measles cases across all states.

As of today, May 13, there are 1,014 cases of measles across 31 jurisdictions in the US according to the Hopkins tracker.

For comparison, in 2024, there were 285 cases across 33 jurisdictions.

According to the Centers for Disease Control and Prevention (CDC) there have been 14 outbreaks (defined as 3 or more related cases) reported in 2025. In 2024, there were 16 outbreaks reported during 2024.

One of the bigger questions around the outbreak is when will it end? Paul Offit, MD, the director of the Vaccine Education Center and an attending physician in the Division of Infectious Diseases at Children's Hospital of Philadelphia (CHOP), is a veteran of the 1990-1991 Philadelphia measles outbreak where his hospital and the other children’s hospital in Philadelphia were overwhelmed with cases. During that outbreak, there were more than 1400 cases, with a majority in unvaccinated children, and led to 9 children dying.

 And, Offit says if his past experience is any indicator, there is a seasonality to measles and does believe there will be an end in sight soon.

“The measles epidemic now will die down because it's essentially a winter disease, and by mid-spring, it's gone. That's what happened in Philadelphia,” Offit said. We basically didn't see any more measles beyond mid-May, so I think we're getting there. My sense is that the incidence of measles is starting to decline. But, if we continue to choose not to vaccinate our children, it'll be back again next winter.”

The measles vaccine is highly effective with 1 dose of the MMR vaccine being shown to be 93% effective, and with 2 doses, being 97% effective.

“The measles vaccine is so good that all you need is immunological memory, because measles is a long incubation period disease. From the time when you're exposed to the time that you develop symptoms—2 weeks, sometimes as long as 3 weeks—that's plenty of time for those memory cells to become antibody secreting cells, and protect you even against mild disease,” Offit said.

In terms of herd immunity, he believes it may be gone in the US.

“I think we're there,” Offit said. “I've talked to people on the ground who have told me that if you look at the death rate, you look at the doubling rate, and you look at the hospitalization rate, it's probably at least 3000 cases, and maybe as many as 5000 cases in the US. So I think we've already exceeded where we were in 2019 where we had 1200 cases. I think that we are no doubt going to soon lose our status as a country that eliminated measles.”

Although rare, breakthrough infections are being reported, and Offit says for those who are vaccinated, cases are typically very mild.

“People who are vaccinated that nonetheless develop symptoms are invariably mild, because the vaccine is so remarkably effective, even as a single dose, it's effective at preventing all manner of illness, mild, moderate, or severe disease.”



This is the second segment of a 2-part interview with Offit. In the 

, he discussed if measles has become a binary choice for families between vaccination and treatment.

References
1.Measles Outbreak Response. Johns Hopkins. May 13, 2025. Accessed May 13, 2025.
https://cori.centerforhealthsecurity.org/resources/measles-outbreak-response
2.

Measles Cases and Outbreaks. CDC. May 9, 2025. Accessed May 13, 2025.


https://www.cdc.gov/measles/data-research/index.html

 1990–1991 Philadelphia measles outbreak. Wikipedia. Accessed May 13, 2025.
https://en.wikipedia.org/wiki/1990%E2%80%931991_Philadelphia_measles_outbreak

Paul Offit, MD, offers some insights on the state of measles today where some families are opting to believe treatment is a better option than vaccination. He also discusses the potential toxicity of vitamin A treatment, as well as the limitations of supportive treatment for the disease.      

Has Measles Become a Binary Choice Between Trying to Treat the Disease Vs Prevention? 

Health and Human Services Secretary Robert F Kennedy Jr is reported to have asked the Centers for Disease Control and Prevention (CDC) to develop new guidance for treating measles with therapies and vitamins.

Paul Offit, MD, the director of the Vaccine Education Center and an attending physician in the Division of Infectious Diseases at Children's Hospital of Philadelphia (CHOP), says this idea creates a binary choice for parents who may believe it is better to treat for measles than to prevent the respiratory disease altogether.

“I think what RFK Jr did—maybe inadvertently—but he set it up as a binary choice. I mean, it's for people who are thinking about their child with measles or someone who might get measles…vitamin A sounds like a safer alternative than injecting yourself with a vaccine that contains 3 live, attenuated viruses. Vitamin A sounds far more benign,” Offit said. “The problem is by creating that or setting it up as a potential binary choice, then people may forego measles vaccination, thinking I'll just treat it with vitamin A. And then the child continues to do worse, and they give them more vitamin A and more vitamin A—and that’s what’s being seen.” 

Paul Offit, MD, offers insights on the state of measles today where some families are opting to believe treatment is a better option than vaccination. He also discusses the potential toxicity of vitamin A treatment, as well as the limitations of supportive treatment for the disease.      

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