Bulletin Today
Researchers look into trends in routine childhood vaccination coverage
An analysis published June 24, 2025, in The Lancet suggests the Immunization Agenda 2030—the WHO’s campaign to bolster global childhood vaccination rates—will not achieve its goals in the next 5 years.
Pediatric uptake of key vaccines recommended by WHO has declined in recent years due to the COVID-19 pandemic, health inequities, and other factors. Modeling based on 2023 data from the Global Burden of Diseases, Injuries, and Risk Factors Study indicates that—with the possible exception of three doses of diphtheria, tetanus, and pertussis vaccine—the target of 90% worldwide coverage will fall out of reach.
To move closer to the goal, the authors emphasize that current strategies will need to take on greater urgency.
The researchers said the findings underscore the crucial need for targeted, equitable immunization strategies.
“Strengthening primary health care systems, addressing vaccine misinformation and hesitancy, and adapting to local contexts are essential to advancing coverage,” they wrote.
Priority must be assigned, they added, to marginalized populations and subnational regions if global immunization goals are to be reached. ■
Can a low salt diet help patients with T2D reduce BP?
For adults with T2D, a Dietary Approaches to Stop Hypertension (DASH)–style diet with lower sodium helped patients achieve a clinically meaningful reduction in BP, according to new research published in JAMA Internal Medicine on June 9, 2025.
For the study, 102 adults with T2D, a systolic BP of 120 to 159 mm Hg, and a diastolic BP of less than 100 mm Hg were randomized to a sequence of four diets, each for 5 weeks: the DASH4D diet with lower sodium, the DASH4D diet with higher sodium, a comparison diet with lower sodium, and a comparison diet with higher sodium.
The DASH4D diet is optimized for those with T2D since it features lower carbohydrates, higher unsaturated fats, and lower potassium than the original DASH diet.
The DASH4D diet with lower sodium reduced systolic BP by 4.6 mm Hg and diastolic BP by 2.3 mm Hg compared with the comparison diet with higher sodium.
There were few adverse events with each diet.
The findings highlight the BP-reducing benefits of the DASH4D diet combined with sodium reduction for patients with T2D, the researchers report, noting that “the observed effects on [BP] may contribute to a meaningful reduction in the risk of BP-related outcomes.” ■
ASHP releases latest survey on hospital pharmacy practice
The American Society of Health-System Pharmacists’ latest survey on pharmacy practice in hospital settings highlights some key issues facing today’s hospital pharmacists—and they should come as no surprise. These include workforce shortages, drug shortages, financial constraints, and regulatory issues.
The survey, conducted in 2024, noted that pharmacists routinely provide clinical services to a majority of inpatients in more than 75% of hospitals. General medical-surgical units are the most common assignment, followed by critical care, oncology, cardiology, and infectious disease/antimicrobial stewardship.
According to the data, 18.5% of hospitals allow pharmacists to independently prescribe medication. Technicians have taken on more advanced duties, too, but the survey notes there is mixed progress toward ASHP Practice Advancement Initiative 2030 goals. In addition, more than four out of five pharmacy directors indicated there was a shortage of experienced technicians, while about three in five said there were insufficient clinical specialists and clinical coordinators. ■
FDA expands labeling for children taking extended-release ADHD meds
FDA has learned from trial data that children aged 6 years and younger are more likely to experience weight loss and other adverse events than older minors who take extended-release stimulants for ADHD.
Even though extended-release stimulants are not approved for pediatric patients younger than age 6, FDA is mandating a change in labeling for the products, as they often are prescribed off-label to this population.
Going forward, prescribing information on extended-release ADHD medications must include a Limitation of Use section to reflect the unfavorable benefit–risk profile for children younger than age 6 years who take extended-release stimulants for the management of ADHD.
Manufacturers of products that already bear a Limitation of Use section will have to update the labeling so the messaging is consistent.
In addition to expanding safety warnings, FDA is raising public awareness of this risk among patients, guardians, and health care professionals. ■
Cannabis use could be risk factor for CVD
New research highlights the increased risk of major adverse cardiovascular events among cannabis users. The meta-analysis, published in the BMJ journal Heart on June 17, 2025, included 24 observational studies from 2016 to 2023. Researchers found that the estimated risk ratio for acute coronary syndrome was 1.29, 1.20 for stroke, and 2.10 for cardiovascular death. In addition, they report that four additional papers published since the study period yielded similar results.
“These findings should encourage investigating cannabis use in all patients presenting with serious cardiovascular disorders,” the researchers reported.
All but five of the papers included in the meta-analysis controlled for tobacco use, an important factor since tobacco use is common among cannabis users. ■
Interventions can safely reduce number of meds prescribed to older adults
Efforts to address potentially inappropriate prescribing in older adults can safely reduce the number of medications they take, according to new research published in JAMA Network Open on June 27, 2025.
The systematic review and meta-analysis included 118 randomized clinical trials with more than 417,000 primary care patients aged 65 years and older residing in the community or in long-term care facilities.
Overall, interventions to reduce potentially inappropriate prescribing correlated with fewer medications prescribed, equivalent to about 0.5 fewer medications per person. But the researchers found no meaningful differences in additional outcomes, including nonserious adverse drug reactions, injurious falls, quality of life, medical visits, emergency department admissions, hospitalizations, or all-cause mortality.
“Future studies should continue to assess the effects of [potentially inappropriate prescribing] interventions, and they should report negative effects of inappropriate medications using standardized criteria and terminology to facilitate the combining of future data and ensure the capture of important health outcomes, including quality of life, hospitalization, and mortality,” the authors wrote. ■