iiinova — where your digital self keeps evolving

Pranab Chatterjee MD, PhD @pranab.stopamr.org · 25/03/2026

@floragraham.bsky.social I had no clue I was following you here! I joined Springer Nature recently and simply love your emails!

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 25/03/2026

One of my most visited bookmarks is when Paul Farmer @pih.org did his Reddit AMA. Just as a reminder to keep fighting the long defeat! www.reddit.com/r/IAmA/comme...

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 09/11/2025

Listening to this @nytimes.com episode covering SNAP benefits and the testimony from the interviewed people is simply heartbreaking. www.nytimes.com/2025/11/04/p...

nytimes.com

The Millions of Poor Americans at the Mercy of the Shutdown

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 07/10/2025

Fred Ramsdell has won the @nobelprize.bsky.social but may not know because he is off living his best life, hiking in Idaho. Be like Fred Ramsdell. Congratulations, Dr. Ramsdell!

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 26/09/2025

#CDC @altcdc.altgov.info finds alarming increase of New Delhi metallo-β-lactamase (not a fan of the NDM name!) producing carbapenem-resistant Enterobacterales (NDM-CRE) in lab testing & surveillance. This reverses previous declines in CRE. Read research: bit.ly/4nKi2Vo. #AMR #AntimicrobialResistance

bit.ly

Changes in Carbapenemase-Producing Carbapenem-Resistant Enterobacterales, 2019 to 2023 | Annals of Internal Medicine

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 20/09/2025

Sitting in a flight from LHR London for the past hour or so. We are almost 2 hours late and have no estimate of when we can fly. I just hope it’s safe to fly. At this point I’m less worried about being delayed and more concerned with getting to Delhi safely.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 29/08/2025

Also, the EIS Officer who investigated the diphtheria outbreak was Dr. Reimert Thorolf Ravenholt. A USAID legend, I’ve always wondered how Harry Potteresque his name is.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 29/08/2025

And I’m left wondering about how much has remained unchanged in the decades since these landmark investigations happened.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 29/08/2025

I’m re-reading Mark Pendergrast’s master piece: “Inside the Outbreaks: The Elite Medical Detectives of the Epidemic Intelligence Service”, and I’ve just reached the end of chapter 2, where the author talks about Diphtheria and zoonoses.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 27/08/2025

Thank you so much Dr. Pai! Still feels unreal. :-)

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 27/08/2025

Thank you! I still can’t believe it. Feels unreal.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 01/08/2025

I’m not sure if blogging is a thing anymore but I’ve decided to write more this year. And this is the account of how a random drive helped clear out the cobwebs in my mind. The Nocturnal Odyssey: Driving as a Pathway to Cognitive Restoration and Creative Insights: open.substack.com/pub/sceptice...

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 09/07/2025

Meanwhile over on the other side of the spectrum, the resident AI has gone … umm … yeah. Not good.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 05/07/2025

Re-reading this classic book at a time when it’s important to re-reimagine global health. The dismantling of the US supported apparatus will be a shock, but it’s my hope that it’ll also push us to reach a more sustainable, locally-led future.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 23/06/2025

Bats are viral superheroes with fascinating immune systems. Bats can host deadly viruses like Ebola, Nipah, and coronaviruses without getting sick. Their secret? A constantly “switched on” antiviral response and a finely tuned immune system that avoids the inflammation seen in other mammals.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 23/06/2025

Hanging out in style! These majestic fruit bats (also known as flying foxes) are enjoying a leafy snack while chilling upside down, because why not? Native to tropical regions, these gentle pollinators play a vital role in maintaining forest ecosystems by dispersing seeds and pollinating plants.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 22/06/2025

Meet the Northern Bald Ibis. Punk-rock plumage and a scimitar bill to match! Once widespread across Europe, North Africa & the Middle East, it’s now listed as endangered; breeding programs in Morocco, Turkey & Europe are driving a fragile comeback. Share, donate, advocate. Extinction isn’t an option

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 22/06/2025

Yellow-bellied Slider (Trachemys scripta scripta) drifting under a mirrored water surface. 🌿🐢 Hear the soundtrack? Ripples tapping pads, cicadas buzzing, and a Red-eyed Vireo swapping its cheery “question-and-answer” phrases from the canopy! Wetland meditation in full surround-sound. #nature #Turtle

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 20/06/2025

So @bhavnaseth.bsky.social and I thought it was a hummingbird fluttering over the milkweed, until we looked closer. Meet the Hummingbird Clearwing Moth (Hemaris thysbe), a master mimic that hovers and feeds just like its avian namesake. It is a vital native pollinator, drawn to nectar-rich plants.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 22/05/2025

The world’s priciest pizzas just became a billionaire’s meal. @bitcoin.bsky.social #btc #crypto Today marks 15 years since Laszlo Hanyecz purchased two pizzas for 10,000 bitcoins. Worth $1.12 billion today. #PizzaDay

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

21/ TL;DR: ✅ Covid boosters: now targeted ✅ RCTs required for low-risk groups ✅ Trust in vaccines needs rebuilding ✅ FDA finally walking the evidence-based walk Let’s hope it’s the beginning of a more measured era. 📄 @nejm.org article: www.nejm.org/doi/full/10.... #Covid19 #Vaccine #PublicHealth

nejm.org

An Evidence-Based Approach to Covid-19 Vaccination | NEJM

This article from the FDA compares broad U.S. recommendations on Covid vaccination with those from other countries and announces the adoption of an evidence-based approach to such recommendations.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

20/ Parallel to trials, we must invest in restoring vaccine confidence: clear risk communication, community outreach, and rebuilding trust in public health, especially in communities hit hardest by Covid and misinformation. #VaccineEquity #PublicHealth

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

19/ As the FDA shifts to evidence-based booster approvals, we must urgently launch RCTs per FDA guidance: ✅ include 50–64 yr-olds ✅ allow prior Covid infection ✅ follow ≥6 months, and ✅ measure real-world outcomes (symptomatic illness, hospitalization, death). #Covid19 #Vaccines #RCT #FDA

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

18/ Downsides? This framework assumes “risk” is static and easily classified. Social vulnerability, exposure risk, and inequities (e.g., multigenerational households, essential workers) aren’t fully captured by medical comorbidity lists. Oversimplification can cost lives. #HealthEquity #Covid

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

17/ This should encourage efforts to initiate pragmatic, rapid clinical trials - something we excelled in #ICMR during the early phase of the pandemic.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

16/ While the FDA’s new booster policy favors evidence-based rigor, delaying access to boosters for low-risk groups until RCTs are done could undermine protection for younger adults with long COVID risk or caretaking roles: filling evidence gaps shouldn’t justify inaction. #Covid19 #Vaccines

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

15/ Will this shift save the credibility of U.S. vaccine policy? Maybe it’s a start. Better than overt, unconditional vaccine denialism. But transparency, clear communication, and trust-building will remain essential. More so, as we face a future rife with inevitable pandemic risks.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

14/ It also recognizes that public health messaging must respect people's intelligence. Rejecting the idea that Americans can’t understand nuanced recommendations is key to rebuilding credibility. Given the resistance towards vaccine mandates, can clinical trial data help change people's beliefs?

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

13/ This move may help reverse growing vaccine hesitancy. By demanding gold-standard evidence and being transparent about benefit-risk uncertainty, the FDA is signaling a return to evidence-based medicine over blanket precautionism.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

12/ The policy says that it strikes a balance: ✅ Speedy access for high-risk groups ✅ Scientific rigor for low-risk populations ✅ Incentives for manufacturers to generate evidence ✅ Encourages public trust by being honest about what we don’t yet know

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

11/ The high-risk group is broad, per CDC: ✅ Obesity, diabetes, pregnancy ✅ Mental health (e.g., depression) ✅ Cancer, HIV, heart/lung/liver/kidney diseases ✅ Smoking, physical inactivity, immunosuppression An estimated ~100–200 million Americans still qualify for boosters.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

10/ Trials should begin with the 50–64 age group, where global expert consensus is still in flux (“equipoise”). ✅ Placebo-controlled design ✅ ≥6-month follow-up ✅ Inclusion of people with past Covid ✅ Primary outcome: symptomatic Covid ✅ Key secondaries: severe illness, hospitalization, death

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

9/ This policy highlights the scientific uncertainty around whether additional doses benefit low-risk individuals who’ve already had Covid multiple times and received multiple vaccine doses. That uncertainty must now be addressed with real-world data.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

8/ But for healthy people aged 6mo–64yr with no risk factors, the FDA now wants randomized controlled trial #RCT evidence on clinical outcomes like symptomatic illness, hospitalization, and death, not just antibody levels, before recommending future boosters.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

7/ The new FDA policy focuses on evidence generation and risk stratification. Here’s how it works: ✔️ Adults 65+ ✔️ Anyone 6mo+ with risk factors for severe Covid → Eligible for annual boosters based on antibody data (immunogenicity)

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

6/ At this point, I must say, I was reassured to read: “…a reluctance to vaccinate that is affecting even vital immunization programs such as that for measles–mumps–rubella (MMR) vaccination, which has been clearly established as safe and highly effective.” Reminder: #vaccineswork.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

5/ More worryingly, public trust in vaccines overall declined. This included drops in MMR vaccine uptake, jeopardizing programs that are proven to save lives. Results? The ongoing #measles #outbreak in the U.S.: a case of unintended consequences, perhaps.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

4/ In practice, the existing policy was poorly adhered to. Booster uptake in the U.S. had plummeted. ➡️ Less than 25% of Americans received boosters in the past two seasons. ➡️ <10% of children under 12 were vaccinated in 2024–25. ➡️ Even health care workers opted out: <1/3 got the 2023–24 booster.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

3/ Per the authors, the U.S. took a one-size-fits-all approach, recommending Covid boosters to everyone aged 6 months and older. This diverged sharply from Europe & Canada, where boosters were only recommended for older adults or those with high-risk conditions.

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

2/ Going forward, annual boosters will be targeted to high-risk groups, and evidence via randomized trials will be required before recommending boosters for healthy low-risk adults. #Vaccines #PublicHealth #RCT

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

1/ In what is bound to be one of the most widely read and discussed publications, the US FDA has announced a major shift in its COVID-19 vaccination policy. Vinay Prasad and Marty Makary’s words in @nejm.org: pubmed.ncbi.nlm.nih.gov/40392534/

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 21/05/2025

Yikes. Looks like @bitcoin.bsky.social just scaled its all time high levels! #crypto

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 20/05/2025

✅ One of the first RCTs to test how terminology shapes public attitudes + behavior on AMR. Co-designed with the public, nationally representative sample, strong methods, and actionable insights for better health comms. A win for #AMR #SciComm. (23)

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 20/05/2025

📊 Numbers tell part of the story. This study leans heavily quant, but even the authors say: we need deeper qualitative dives to unpack why certain terms resonate—and what people actually mean when they say they "get" AMR. #AMR #QualitativeResearch (22)

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Pranab Chatterjee MD, PhD @pranab.stopamr.org · 20/05/2025

🌍 The terminology tested (“Antibiotic Resistance,” “Superbugs,” etc.) was co-designed in London, UK. That’s great for local relevance—but may not translate globally. We need similar studies across different cultural and linguistic contexts. #GlobalHealth #AMR (21)

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