Study: Covid-19 shots don't affect fertility, but the disease might

Vaccines for the coronavirus don't affect the fertility of men or women, but the virus "could cause short-term fertility problems in men," Robert Preidt reports for HealthDay News.

The study debunks a fear that has been an obstacle to vaccination for some people who want to have children.

"Many reproductive-aged individuals have cited concerns about fertility as a reason for remaining unvaccinated," said lead study author Amelia Wesselink, a research assistant professor of epidemiology at the Boston University School of Public Health.

"Wesselink's team analyzed data from more than 2,100 American and Canadian women and their male partners in an ongoing study of women trying to conceive," Preidt reports. Senior researcher Lauren Wise, a BU epidemiology professor, said the study's large sample and diverse population make it strong.

"The researchers found that the Pfizer-BioNTech, Moderna and Johnson & Johnson vaccines had no effect on male or female fertility," Preidt reports. However, men infected with Covid-19 may have a temporary decline in their fertility, the investigators found."

The study, published Jan. 20 in the American Journal of Epidemiology, supports previous research linking Covid-19 infection in men with reproductive dysfunction, including poor sperm quality. The researchers said the findings should ease concerns prompted by anecdotal reports of women having menstrual cycle changes after getting a coronavirus vaccination.

Legislature tosses health departments and mental-health centers a budget lifeline; bills on disposal of opioids become law

By Al Cross
Kentucky Health News

FRANKFORT, Ky. – As it wrapped up its business, the Kentucky General Assembly threw a financial lifeline to health departments and mental-health centers, passed a telehealth bill without an amendment favored by insurance companies, and overrode the governor's veto of a drug-disposal bill.

Budget: In a revision of the budget it passed earlier, the legislature froze for one year the pension contributions of health departments and 11 of the state's 14 community mental health centers, which were facing increases in pension payments of 49.5 to 83.4 percent, averaging 69 percent.

That would have been a double whammy with the 6.25 percent across-the-board cut proposed by Gov. Matt Bevin and included in the budget, which is likely to force cuts in personnel and services.

Bevin could veto the revision bill, but he suggested Friday evening that it was making the budget better. And he indicated that he would still have to make cuts because the budget will be unbalanced. Legislative leaders have disputed that.

Home care for the disabled: In a rare gain among programs, the budget adds $10.5 million to the General Fund to generate an extra $24.6 million in federal Medicaid money each fiscal year for the Supports for Community Living program, which enables developmentally and intellectually disabled Kentuckians to receive care in homes rather than health-care facilities.

The money will "raise reimbursement rates to SCL service providers who have not seen an increase since 2004, even as costs have risen 27 percent through inflation since that time," says the Kentucky Center for Economic Policy. "The stagnant payment rates have contributed to a 45 percent turnover rate among providers and a 41 percent decrease in services offered to intellectually and developmentally disabled Kentuckians."

Telehealth: By a vote of 65-20, he House gave final passage to SB 112, aimed at increasing access to health care and saving money by requiring the state to develop policies on health care by telecommunication –including a reimbursement model, with similar expectations for the public insurance market. The House did not consider an insurance-company floor amendment filed by Rep. Jim Gooch, R-Providence, that would have removed a key provision, requiring telehealth visits to be paid for at same level as regular visits unless otherwise negotiated. Bevin could still veto the bill.

Drug disposal: The legislature overrode Bevin's veto of House Bill 148, sponsored by Rep. Addia Wuchner, R-Florence, to shift ownership of controlled substances from deceased hospice patients to the hospice for disposal. Bevin's veto message said the bill was contrary to federal law and U.S. Drug Enforcement Agency policy, but Senate President Robert Stivers cited a DEA memo that cleared the way for the bill.

Bevin allowed to become law without his signature Senate Bill 6, sponsored by Sen. Alice Forgy Kerr, R-Lexington, to make pharmacists tell customers how to safely dispose of unused opioids and other controlled substances, and either provide or offer to sell them a product designed to neutralize drugs for disposal, or provide on-site disposal. More than 70 percent of all opioid addictions result from misuse of prescription drugs.

Other health bills: In the days before the legislature reconvened to consider vetoed bills and pass others, Bevin signed several health-related bills into law, including:

SB 5, sponsored by Sen. Max Wise, R-Campbellsville, to put the Medicaid program in charge of reimbursement rates for pharmacists. Rates are now set by pharmacy benefit managers, firms hired by managed-care organizations (mainly insurance-company subsidiaries). The bill sets reporting requirements for PBMs and MCOs and the $1.7 billion a year they get from the state. It also would allow the Medicaid program to approve contracts and fees between MCOs, PBMs and pharmacists.

HB 463, sponsored by Rep. Michael Meredith, R-Brownsville, to prohibit PBMs from requiring clients to make a co-payment that is higher than a lesser cash-payment amount, and keep them from penalizing a pharmacy for telling patients if that option is available. It is called the "clawback" bill, because PBMs "claw back" the difference between the higher co-pay and the lower price of the drug.

SB 71, sponsored by Sen. Steve Meredith, R-Leitchfield, would require the inclusion of abstinence only education in any sex-ed classes taught in Kentucky. Kentucky has no comprehensive sexual health education standards; the state Department of Education is reviewing proposed rules.

Failed bills: Health-related bills that were poised for passage but did not make it included SB 95, sponsored by Kerr, to require health insurers to cover standard fertility preservation services for patients who have become infertile by means of surgery, radiation, chemotherapy or any other medical treatment affecting reproductive organs and processes; and SB 149, sponsored by Sen. Julie Raque Adams, R-Louisville, chair of the Senate Health and Welfare Committee, to establish an advisory council for palliative care, given to make patients with incurable illnesses more comfortable.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Study indicates fast food contains industrial chemicals linked to health problems such as infertility, diabetes and allergies

People who eat a lot of fast food have higher levels of chemicals that "have been linked to a number of adverse health outcomes, including higher rates of infertility," especially among men, Roberto Ferdman reports for The Washington Post.

Researchers at George Washington University in Washington, D.C., say the connection could have "great public health significance," Ferdman writes. "Specifically, the team found that people who eat fast food tend to have significantly higher levels of certain phthalates, which are commonly used in consumer products such as soap and makeup to make them less brittle. . . . The danger, the researchers believe, isn't necessarily a result of the food itself, but rather the process by which the food is prepared."

Here's how the study was done: Researchers analyzed diet and urinalysis data for nearly 9,000 people, collected as part of federal nutrition surveys in 2003-2010. "Food eaten at or from restaurants without waiters or waitresses was considered fast food. Everything else — food eaten at sit-down restaurants and bars or purchased from vending machines — was not," Ferdman writes. "The first thing the researchers found was that roughly one-third of the participants said they had eaten some form of fast food over the course of the day leading up to the urine sample collection," which fits with government estimates.

People who said they had eaten fast food in the previous 24 hours "tended to have much higher levels of two separate phthalates," Ferdman reports. Those who said they ate only a little fast food had levels 15 and 25 percent higher than those who said they had eaten none. "For people who reported eating a sizable amount, the increase was 24 percent and 39 percent, respectively. And the connection held true even after the researchers adjusted for various factors about the participants' habits and backgrounds that might have contributed to the association between fast-food consumption and phthalate levels."

The study was reported in Environmental Health Perspectives, a peer-reviewed journal funded by the National Institutes of Health.

"There is little consensus on the harms of phthalates, which are widely used in commerce and give materials such as food packaging added flexibility, except that exposure to them is widespread," Ferdman writes, citing the federal Centers for Disease Control and Prevention. "But there is growing concern that the chemicals could pose a variety of risks, particularly when observed in the sort of levels seen in the study."

Noting several other studies, such as those linking the chemicals to diabetes and allergies, Ferdman reports, "Many governments have moved to limit exposure to the industrial chemicals. Japan disallowed the use of vinyl gloves in food preparation for fear that their use was compromising health. The European Union, which limits the use of the chemical, has been nudging manufacturers to replace it. And the United States restricted its use in toys."

So, why do people who eat fast food seem to have much higher levels of these chemicals? That is unclear, Ferdman writes, "but it's easy enough to guess: the sheer amount of processing that goes into food served at quick-service restaurants. The more machinery, plastic, conveyor belts, and various forms of processing equipment that food touches, the more likely the food is to contain higher levels of phthalates. And fast food tends to touch a good deal more of these things than, say, the food one purchases at a local farmers' market."

Ferdman concludes, "It certainly seems as though eating fast food is more toxic than avoiding it, and not for the obvious reasons." He quotes Marion Nestle, the Paulette Goddard professor of nutrition and food studies at New York University: "Traditional fast food was never meant to be daily fare, and it shouldn’t be," said  "It’s too high in calories and salt and, as we now know, the chemicals that get into our food supply through industrial food production."

A couple's journey with infertility; similar tale likely in your town

Laura Ungar of The Courier-Journal follows the story of Kelly and James Durst, who turned to in vitro fertilization when they had trouble conceiving a child.

The Dursts are "among the 12 percent of reproductive-age couples in the United States who couldn't conceive without help," Ungar reports.

In April 2010, they gave birth to son Cooper, one of more than 675,000 babies born in the U.S. through assisted reproduction techniques since 1985. "He is literally the light of our lives," Kelly said. "He's why we try to make things better each day."

Ungar follows the Dursts' journey to have a second child, this time using the frozen embryos that were created at the time of Cooper's conception. The embryos will be placed in Kelly's womb.

Given the growing prevalence of assisted reproduction techniques, stories like the Dursts' can likely be found in nearly every community and make for a compelling read. (Read more)