iiinova — where your digital self keeps evolving

Reposted by Alasdair Munro

Shaun Lintern @shaunlintern.bsky.social · 27/09/2026

Does the shingles vaccine reduce the risk of developing dementia? The science isn't as solid as some claim, but private vaccinations are soaring. Was great to speak to @apsmunro.bsky.social to understand where we are at on the evidence: www.thetimes.com/article/f980...

thetimes.com

Sales of £460 shingles jab double after claims it wards off dementia

The middle-aged are lining up at Boots for the Shingrix vaccine but experts urge caution over studies claiming it can reduce the risk of dementia by up to 20%

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Alasdair Munro @apsmunro.bsky.social · 11/09/2026

Piperacillin/tazobactam (Tazocin, Zosyn etc) is ultimately a drug for Pseudomonas aeruginosa Are you worried about Pseudomonas? Pip/taz is a great choice Not worried about Pseudomonas? You don’t need pip/taz, there is almost certainly a better option

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Alasdair Munro @apsmunro.bsky.social · 06/09/2026

Wondering how to keep kids immune systems healthy as we enter the school year? We reviewed the evidence on diet, supplements and exercise for @pidjournal.bsky.social Tldr: the same things that makes kid healthy in general keep their immune system healthy too - no need for supplements

alasdairmunro.substack.com

How to “boost” children's immunity

Can non-pharmaceutical methods help improve kids resilience to infection?

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Reposted by Alasdair Munro

gadwall.bsky.social @gadwall.bsky.social · 17/08/2026

A calm and devastating critique

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Alasdair Munro @apsmunro.bsky.social · 17/08/2026

My piece on the new White House Executive Order on childhood vaccines The document is based on an inappropriate premise, flies in the face of existing science, and would achieve the opposite of its own stated aims It is a catastrophic failure at vaccine policy

alasdairmunro.substack.com

Executive Vaccine Order: Home run or Own goal?

Is the White House statement a welcome shake up or unnecessary blunder?

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Reposted by Alasdair Munro

Gerald Evans @skepticaliddoc.bsky.social · 12/08/2026

Read the well-written opinion piece cited in this post; a brilliant example of logical thinking. Well done Alasdair.

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Alasdair Munro @apsmunro.bsky.social · 12/08/2026

Despite negative RCTs, I don’t think air filters are useless I think the magnitude of their likely effect was grossly oversold by many advocates - writing cheques the trials could not cash Misalignment of expectations has caused a lot of confusion

alasdairmunro.substack.com

Engineers vs RCTs

Are trials of masks and air filters essential or RCT fetishization?

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Alasdair Munro @apsmunro.bsky.social · 06/08/2026

Given all the interest in air cleaning following the recent negative RCT… Here is an old post explaining why cleaning air is not comparable to cleaning water It’s a good thing to do, but we need to be realistic about what it can achieve

alasdairmunro.substack.com

Air is not “the new poop”, Covid is not cholera

Equating the transmission of waterborne and airborne pathogens is beguiling but wrong

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Reposted by Alasdair Munro

Robert Dingwall @rwjdingwall.bsky.social · 04/08/2026

As usual @apsmunro.bsky.social is a model of good sense More Fuss About Filters open.substack.com/pub/alasdair...

open.substack.com

More Fuss About Filters

A new RCT of air filtration devices gets heads spinning...again

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Alasdair Munro @apsmunro.bsky.social · 30/07/2026

Huge numbers of neonates get long courses of IV antibiotics for suspected early onset sepsis, despite an incidence of only 0.5-1% New evidence shows these courses can stop earlier and babies can go home sooner Practice needs to change ASAP #Peds #PedsID 🧪

open.substack.com

Switching or Stopping: Antibiotics for neonates with suspected sepsis

Two studies shine light on a previously difficult to research topic

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Reposted by Alasdair Munro

George Davey Smith @mendelrandom.bsky.social · 22/07/2026

Does the (live) shingles vaccine protect against dementia? Fergus Hamilton and colleagues provide important evidence in a new preprint using hospital data from the whole of England in a regression discontinuity design from which we *don't* show evidence of a meaningful protective effect /cont

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Alasdair Munro @apsmunro.bsky.social · 17/07/2026

The JCVI announced they are now recommending the MenB vaccination for adolescents in the UK, which many people (including me!) will be very pleased about How did this change come about? The story is fascinating, and perhaps not without controversy...

alasdairmunro.substack.com

MenB, teenagers, and the price of peace of mind

The JCVI changes its position on recommending adolescent vaccination against MenB

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Alasdair Munro @apsmunro.bsky.social · 17/07/2026

alasdairmunro.substack.com

MenB, teenagers, and the price of peace of mind

The JCVI changes its position on recommending adolescent vaccination against MenB

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Alasdair Munro @apsmunro.bsky.social · 14/07/2026

ICYMI my latest post looks at a common cause of concern for parents - infection related rashes! Why do they happen and when should you worry? Join me to find out all this and more! #Peds #PedsID 🧪

open.substack.com

Making Rash Decisions

When to worry about rashes when a child is sick

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Reposted by Alasdair Munro

Alasdair Munro @apsmunro.bsky.social · 10/07/2026

My latest post looks at a common cause of concern for parents - infection related rashes! Why do they happen and when should you worry? Join me to find out all this and more!

alasdairmunro.substack.com

Making Rash Decisions

When to worry about rashes when a child is sick

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Alasdair Munro @apsmunro.bsky.social · 10/07/2026

My latest post looks at a common cause of concern for parents - infection related rashes! Why do they happen and when should you worry? Join me to find out all this and more!

alasdairmunro.substack.com

Making Rash Decisions

When to worry about rashes when a child is sick

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Reposted by Alasdair Munro

Tim Morris @timpmorris.bsky.social · 07/07/2026

Oh no you’re way behind Jack (Can’t believe you made me dig out ttespoof.pdf)

Spoof paper titled ‘Extending target trial approaches to case series,
case reports and opinions shared on facebook’

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Reposted by Alasdair Munro

Health Research | Southampton @uhsftresearch.bsky.social · 07/07/2026

Five-year-old Isla is a star today on BBC South Today 📺🤩 She and mum, Jennifer, are taking part in a major new clinical trial, funded by @nihr.bsky.social and co-led by @uhsft.bsky.social, to improve care for children and young people with severe acute asthma. Watch BBC One in the South at 6.30pm

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Reposted by Alasdair Munro

Jonathan Ryder, MD @jonathanrydermd.bsky.social · 24/06/2026

@apsmunro.bsky.social does actually discuss this study and its limitations in quite a bit of detail in this fascinating blog reviewing this question. An interesting issue with study design and more questions than answers I think alasdairmunro.substack.com/p/the-truth-...

alasdairmunro.substack.com

The truth about the shingles vaccine and dementia

Ground breaking intervention or senseless hype?

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Reposted by Alasdair Munro

Michael Plank @michaelplanknz.bsky.social · 23/06/2026

Great article by @apsmunro.bsky.social on the dementia - shingles vaccine question. TLDR - The shingles vaccine is excellent at preventing shingles, but the evidence for a protective effect against dementia is pretty weak alasdairmunro.substack.com/p/the-truth-...

alasdairmunro.substack.com

The truth about the shingles vaccine and dementia

Ground breaking intervention or senseless hype?

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Reposted by Alasdair Munro

Andrew Starr @ajsta.bsky.social · 23/06/2026

tl;dr Despite what you've likely seen on socials the old Shingles vax probably isn't protective against dementia. Still good for shingle tho..

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Reposted by Alasdair Munro

Andrew Tan @andrewtanyongyi.bsky.social · 23/06/2026

"Then they looked at dementia, and found …. nothing. A complete null result, stable across sensitivity analyses, with no bias they could find to explain the gap with Wales."

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Alasdair Munro @apsmunro.bsky.social · 23/06/2026

Huge developments this past week in the question over whether the old, live-attenuated shingles vaccine prevents dementia The messaging around this topic from much of the Sci-Com field has been atrocious What is the truth?

alasdairmunro.substack.com

The truth about the shingles vaccine and dementia

Ground breaking intervention or senseless hype?

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Reposted by Alasdair Munro

Steven Tong @steventong.bsky.social · 16/06/2026

Great post @apsmunro.bsky.social! Doing more is such a natural reaction. But even 'benign' interventions may likely be harmful when tested properly. I'm yet to know of a trial for sepsis where adding antibiotics has been beneficial (outside of TB where we do it to prevent emergence of resistance).

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Alasdair Munro @apsmunro.bsky.social · 15/06/2026

My new post looks at two antimicrobials which have been routinely used and even recommended in guidelines despite a lack of RCT evidence In the last few weeks they’ve both been shown to have no benefit, and worse, high probability of harm - killing patients A lesson we keep failing to learn

substack.com

When doing more harms patients

Oseltamivir and adjunctive Clindamycin may have been increasing mortality

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Reposted by Alasdair Munro

pertussis hater, MPH @gamer-epi.bsky.social · 15/06/2026

Interesting read that I would like to discuss with some ID peeps I know to hear their thoughts 👀👀

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Reposted by Alasdair Munro

Dr Vanessa @hpsvanessa.bsky.social · 15/06/2026

Reminder that the big, trumpeted, wellcome trust-funded trial intended to be the FIRST EVIDENCE of a link between teen mental health and social media has been running for, uh, 3 months and doesn't finish unitil next summer. Evidence based policy, innit. www.bbc.co.uk/news/article...

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Reposted by Alasdair Munro

Kai Kupferschmidt @kakape.bsky.social · 15/06/2026

New Ebola situation report is out (there was none yesterday) and numbers are still rising shockingly fast: 782 confirmed cases now (+72 in the last 24 hours) That includes 181 confirmed deaths. Follow-up of contacts is back down to 56,5%. Not good. insp.cd/sitrep-n30-m...

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Reposted by Alasdair Munro

Norma @looftsabine.bsky.social · 15/06/2026

OMG "This is a firm reminder that “we must do more for the sickest” is a human reflex, not an evidence base. The discipline of waiting for a trial, rather than acting on what feels right, is the thing that actually protects patients." "More to follow when both papers are out in full."

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Alasdair Munro @apsmunro.bsky.social · 15/06/2026

substack.com

When doing more harms patients

Oseltamivir and adjunctive Clindamycin may have been increasing mortality

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Reposted by Alasdair Munro

Health Research | Southampton @uhsftresearch.bsky.social · 05/06/2026

An AI-designed ‘universal’ coronavirus vaccine trialled at @uhsft.bsky.social @southamptoncrf.bsky.social could help protect against future viruses before they emerge 👇 Experts say this could potentially save millions of lives and avoid costly lockdowns. 🔗 research.uhs.nhs.uk/news/new-ai-...

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Reposted by Alasdair Munro

Alasdair Munro @apsmunro.bsky.social · 02/06/2026

The Ebola outbreak has been extremely fast moving, and the news has been mostly terrible News of potential trials of vaccines and therapeutics does lend some hope - but these are some way off Catch up on the latest developments with me and what it all means here

alasdairmunro.substack.com

Ebola outbreak goes from bad to worse

A dire situation, but perhaps a glimmer of hope is on the horizon

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Reposted by Alasdair Munro

Judith ter Schure @judithterschure.bsky.social · 02/06/2026

Indeed! Randomization + routinely collected data go back to Richard Peto's call for 'large and simple trials' that inspired the hugely succesfull RECOVERY trial in COVID-19. Nicely summarized important points.

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Reposted by Alasdair Munro

Florian Naudet @floriannaudet.bsky.social · 02/06/2026

2/ Emphasising the role of randomisation. Randomisation is entirely compatible with the use of routinely collected data. Importantly, the source of the data does not compensate for weaknesses in study design, and "real-world evidence" is no substitute for rigorous methodology...

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Reposted by Alasdair Munro

Anthony England @ebolaphone.bsky.social · 02/06/2026

"There have been reports of family members retrieving bodies from quarantine." -- all very normal, sadly. Same happened in 2014. The locals do a lot to make it worse, unfortunately :( Fingers crossed on getting it stopped ASAP & vaccine candidates

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Alasdair Munro @apsmunro.bsky.social · 02/06/2026

alasdairmunro.substack.com

Ebola outbreak goes from bad to worse

A dire situation, but perhaps a glimmer of hope is on the horizon

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Reposted by Alasdair Munro

Alasdair Munro @apsmunro.bsky.social · 26/05/2026

New piece on arguments on the weight of evidence, following a post by @adamjkucharski.bsky.social We don't always need gold standard, sometimes aluminium standard is enough But when we disagree, it's not usually about the standard of evidence or science It's about decision thresholds and values

alasdairmunro.substack.com

How much evidence is enough?

My thoughts on Adam Kucharski's recent piece on "Aluminium" grade evidence

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Alasdair Munro @apsmunro.bsky.social · 26/05/2026

alasdairmunro.substack.com

How much evidence is enough?

My thoughts on Adam Kucharski's recent piece on "Aluminium" grade evidence

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Reposted by Alasdair Munro

Marc Veldhoen @marcveld.bsky.social · 20/05/2026

It is as if OC43, NL63, HKU1 and 229E did not accept SC2 into the same timeframe. It will be interesting to see if this years SC2 peak is again earlier, from middel September to possibly August, or it may have found the best spot and middle of September is where it settles? 4/4

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Kai Kupferschmidt @kakape.bsky.social · 19/05/2026

The contrast between the number of media requests I got when rich people on a cruise were facing a deadly, but contained outbreak versus now that some of the poorest people in the world are facing a deadly and devastating epidemic is just so so stark and it just really annoys the hell out of me.

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Reposted by Alasdair Munro

Seb Schmoller @schmoller.net · 19/05/2026

Very informative Ebola explainer by @apsmunro.bsky.social with an update on the current outbreak in the east of the Democratic Republic of the Congo: open.substack.com/pub/alasdair...

open.substack.com

Not now, Ebola

Another viral haemorrhagic fever outbreak. This one is more serious.

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Alasdair Munro @apsmunro.bsky.social · 19/05/2026

My new post looks at the latest in the Ebola outbreak We didn't need another VHF outbreak right now - and this one is much worse - Why is Ebola both interesting and terrifying? - What makes this outbreak different? - What does the future likely hold?

alasdairmunro.substack.com

Not now, Ebola

Another viral haemorrhagic fever outbreak. This one is more serious.

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Reposted by Alasdair Munro

Isaac Bogoch @isaacbogoch.bsky.social · 12/05/2026

1/ We are living in an era of emerging zoonotic infections. While hantavirus is the focus today, preventing epidemics requires sustained investment in the tools needed to prevent, rapidly detect & respond to biological threats, whether natural, accidental, or deliberate.

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Alasdair Munro @apsmunro.bsky.social · 09/05/2026

Looking for something to read this weekend? I’m running a trial for a hantavirus vaccine Catch up on the outbreak with me, including: - timeline of events - what we’ve learnt so far - why this isn’t the next pandemic No ivermectin banter I’m afraid 🤷‍♂️

open.substack.com

Hantavirus Cruise Ship Update: This is not the next pandemic

Significant and reassuring updates in the outbreak investigation

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Kai Kupferschmidt @kakape.bsky.social · 08/05/2026

UK has published its guidelines by the way for people who were on the ship: "The ship is expected to dock in Tenerife on Sunday ... British Passengers and ship crew not displaying any symptoms of hantavirus will be escorted by UK Government staff to an airport and given free passage back to the UK."

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Adam Kucharski @adamjkucharski.bsky.social · 08/05/2026

Lots of posts using the 2020 NEJM superspreading event paper as estimate of typical hantavirus transmissibility. Reminder that superspreading events are by definition an outlier. If you want to estimate transmissibility you need to look at ALL infections, not just cherry pick tail of distribution.

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Alasdair Munro @apsmunro.bsky.social · 08/05/2026

My update on the hantavirus cruise ship outbreak The news has developed at pace, with significant case and genomic updates in the past few days What we know for sure: - This is not the next pandemic - Hantavirus is under researched - We need investment in public health agencies to keep us safe

alasdairmunro.substack.com

Hantavirus Cruise Ship Update: This is not the next pandemic

Significant and reassuring updates in the outbreak investigation

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Jason Nickerson @jwnickerson.bsky.social · 05/05/2026

Hantavirus is, thankfully rare - that means that most clinicians have never encountered a case or have much knowledge of the disease. Here’s a solid summary from an infectious disease expert actually working on hantavirus. If you’re curious, start here.

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