An ancient man’s remains were hacked apart and kept in a garage

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This week I’ve been working on a story about a brain of glass. About five years ago, archaeologists found shiny black glass fragments inside the skull of a man who died in the Mount Vesuvius eruption of 79 CE. It seems they are pieces of brain, turned to glass.

Scientists have found ancient brains before—some are thought to be at least 10,000 years old. But this is the only time they’ve seen a brain turn to glass. They’ve even been able to spot neurons inside it.

The man’s remains were found at Herculaneum, an ancient city that was buried under meters of volcanic ash following the eruption. We don’t know if there are any other vitrified brains on the site. None have been found so far, but only about a quarter of the city has been excavated.

Some archaeologists want to continue excavating the site. But others argue that we need to protect it. Further digging will expose it to the elements, putting the artifacts and remains at risk of damage. You can only excavate a site once, so perhaps it’s worth waiting until we have the technology to do so in the least destructive way.

After all, there are some pretty recent horror stories of excavations involving angle grinders, and of ancient body parts ending up in garages. Future technologies might eventually make our current approaches look similarly barbaric.

The inescapable fact of fields like archaeology or paleontology is this: When you study ancient remains, you’ll probably end up damaging them in some way. Take, for example, DNA analysis. Scientists have made a huge amount of progress in this field. Today, geneticists can crack the genetic code of extinct animals and analyze DNA in soil samples to piece together the history of an environment.

But this kind of analysis essentially destroys the sample. To perform DNA analysis on human remains, scientists typically cut out a piece of bone and grind it up. They might use a tooth. But once it has been studied, that sample is gone for good.

Archaeological excavations have been performed for hundreds of years, and as recently as the 1950s, it was common for archaeologists to completely excavate a site they discovered. But those digs cause damage too.

Nowadays, when a site is discovered, archaeologists tend to focus on specific research questions they might want to answer, and excavate only enough to answer those questions, says Karl Harrison, a forensic archaeologist at the University of Exeter in the UK. “We will cross our fingers, excavate the minimal amount, and hope that the next generation of archaeologists will have new, better tools and finer abilities to work on stuff like this,” he says.

In general, scientists have also become more careful with human remains. Matteo Borrini, a forensic anthropologist at Liverpool John Moores University in the UK, curates his university’s collection of skeletal remains, which he says includes around 1,000 skeletons of medieval and Victorian Britons. The skeletons are extremely valuable for research, says Borrini, who himself has investigated the remains of one person who died from exposure to phosphorus in a match factory and another who was murdered.

When researchers ask to study the skeletons, Borrini will find out whether the research will somehow alter them. “If there is destructive sampling, we need to guarantee that the destruction will be minimal, and that there will be enough material [left] for further study,” he says. “Otherwise we don’t authorize the study.”

If only previous generations of archaeologists had taken a similar approach. Harrison told me the story of the discovery of “St Bees man,” a medieval man found in a lead coffin in Cumbria, UK, in 1981. The man, thought to have died in the 1300s, was found to be extraordinarily well preserved—his skin was intact, his organs were present, and he even still had his body hair.

Normally, archaeologists would dig up such ancient specimens with care, using tools made of natural substances like stone or brick, says Harrison. Not so for St Bees man. “His coffin was opened with an angle grinder,” says Harrison. The man’s body was removed and “stuck in a truck,” where he underwent a standard modern forensic postmortem, he adds.

“His thorax would have been opened up, his organs [removed and] weighed, [and] the top of his head would have been cut off,” says Harrison. Samples of the man’s organs “were kept in [the pathologist’s] garage for 40 years.”

If St Bees man were discovered today, the story would be completely different. The coffin itself would be recognized as a precious ancient artifact that should be handled with care, and the man’s remains would be scanned and imaged in the least destructive way possible, says Harrison.

Even Lindow man, who was discovered a mere three years later in nearby Manchester, got better treatment. His remains were found in a peat bog, and he is thought to have died over 2,000 years ago. Unlike poor St Bees man, he underwent careful scientific investigation, and his remains took pride of place in the British Museum. Harrison remembers going to see the exhibit when he was 10 years old. 

Harrison says he’s dreaming of minimally destructive DNA technologies—tools that might help us understand the lives of long-dead people without damaging their remains. I’m looking forward to covering those in the future. (In the meantime, I’m personally dreaming of a trip to—respectfully and carefully—visit Herculaneum.)

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Some believe an “ancient-DNA revolution” is underway, as scientists use modern technologies to learn about human, animal, and environmental remains from the past. My colleague Antonio Regalado has the details in his recent feature. The piece was published in the latest edition of our magazine, which focuses on relationships.

Ancient DNA analysis made it to MIT Technology Review’s annual list of top 10 Breakthrough Technologies in 2023. You can read our thoughts on the breakthroughs of 2025 here. 

DNA that was frozen for 2 million years was sequenced in 2022. The ancient DNA fragments, which were recovered from Greenland, may offer insight into the environment of the polar desert at the time.

Environmental DNA, also known as eDNA, can help scientists assemble a snapshot of all the organisms in a given place. Some are studying samples collected from Angkor Wat in Cambodia, which is believed to have been built in the 12th century.

Others are hoping that ancient DNA can be used to “de-extinct” animals that once lived on Earth. Colossal Biosciences is hoping to resurrect the dodo and the woolly mammoth.

From around the web

Next-generation obesity drugs might be too effective. One trial participant lost 22% of her body weight in nine months. Another lost 30% of his weight in just eight months. (STAT)

A US court upheld the conviction of Elizabeth Holmes, the disgraced founder of the biotechnology company Theranos, who was sentenced to over 11 years for defrauding investors out of hundreds of millions of dollars. Her sentence has since been reduced by two years for good behavior. (The Guardian)

An unvaccinated child died of measles in Texas. The death is the first reported as a result of the outbreak that is spreading in Texas and New Mexico, and the first measles death reported in the US in a decade. Health and Human Services Secretary Robert F. Kennedy Jr. appears to be downplaying the outbreak. (NBC News)

A mysterious disease with Ebola-like symptoms has emerged in the Democratic Republic of Congo. Hundreds of people have been infected in the last five weeks, and more than 50 people have died. (Wired)

Towana Looney has been discharged from the hospital three months after receiving a gene-edited pig kidney. “I’m so grateful to be alive and thankful to have received this incredible gift,” she said. (NYU Langone)

8,000 pregnant women may die in just 90 days because of US aid cuts

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

Yesterday marks a month since the inauguration of Donald Trump as the 47th US president. And what a month it has been. The Trump administration wasted no time in delivering a slew of executive orders, memos, and work notices to federal employees.

On February 18, Trump signed an executive order that seeks to make IVF more accessible to people in the US. In some ways, the move isn’t surprising—Trump has expressed his support for the technology in the past, and even called himself “the father of IVF” while on the campaign trail last year.

Making IVF more affordable and accessible should give people more options when it comes to family planning and reproductive freedom more generally. But the move comes after a barrage of actions by the new administration that are hitting reproductive care hard for people around the world. On January 20, his first day in office, Trump ordered a “90-day pause in United States foreign development assistance” for such programs to be assessed. By January 24, a “stop work” memo issued by the State Department brought US-funded aid programs around the world to a halt.  

Recent estimates suggest that more than 8,000 women will die from complications related to pregnancy and childbirth over the next 90 days if the funding is not reinstated.

On January 24 Trump also reinstated the global gag rule—a policy that requires nongovernmental organizations receiving US health funding to agree that they will not offer abortion counseling and care. This move alone immediately stripped organizations of the funding they need to perform their work. MSI Reproductive Choices, which offers support for reproductive health care in 36 countries, lost $14 million as a result, says Anna Mackay, who manages donor-funded programs at the organization. “Over 2 million women and girls would have received contraceptive services with that money,” she says.

The US Agency for International Development (USAID) had a 2025 budget of $42.8 billion to spend on foreign assistance, which covers everything from humanitarian aid and sanitation to programs promoting gender equality and economic growth in countries around the world. But the “stop work” memo froze that funding for 90 days.

The impacts were felt immediately and are still rippling out. Clinical trials were halted. Jobs were lost. Health programs were shut down.

“I think this is going to have a devastating impact on the global health architecture,” says Thoai Ngo at Columbia University’s Mailman School of Public Health. “USAID is the major foreign funder for global health … I’m afraid that there isn’t [another government] that can fill the gap.”

Reproductive health care is likely to lose out as affected governments and health organizations try to reorganize their resources, says Ngo: “In times of crisis … women and girls tend to be deprioritized in terms of access to health and social services.”

Without information on and access to a range of contraceptive options, unintended pregnancies result. These have the potential to limit the freedoms of people who become pregnant. And they can have far-reaching economic impacts, since access to contraception can improve education rates and career outcomes.

And the health consequences can be devastating. Unintended pregnancies are more likely to be ended with abortions—potentially unsafe ones. Maternal death rates are high in regions that lack adequate resources. A maternal death occurred every two minutes in 2020.

“It’s difficult to overstate how catastrophic this freeze has been over the last several weeks,” says Amy Friedrich-Karnik, director of federal policy at the Guttmacher Institute, a research and policy organization focused on global sexual and reproductive health and rights. “Every single day that the freeze is in place, there are 130,000 women who are being denied contraceptive care,” she says.

The Guttmacher Institute estimates that should USAID funding be frozen for the full 90 days, around 11.7 million women and girls would lose access to contraceptive care, and 4.2 million of them would experience unintended pregnancies. Of those, “8,340 will die from complications during pregnancy and childbirth,” says Friedrich-Karnik.

“By denying people access to contraception, not only are you denying them tools for their bodily autonomy—you are really risking their lives,” she says. “Thousands more women will die down the road.”

“USAID plays such a central role in supporting these life-saving programs,” says Ngo. “The picture is bleak.”

Even online sources of information on contraceptives are being affected by the funding freeze. Ben Bellows is a chief business officer at Nivi, a digital health company that develops chatbots to deliver health information to people via WhatsApp. “Two million users have used the bot,” he says.

He and his team have been working on a project to deliver information on contraceptive options and family planning to women in India, and they have been looking to incorporate AI into their bot. The project was funded by a company that, in turn, is funded by USAID. Like the funding, the work is “frozen,” says Bellows.

“We’ve slowed [hiring] and we’ve slowed some of the tech development because of the freeze [on USAID],” he says. “It’s bad [for] the individuals, it’s bad [for] the companies that are trying to operate in these markets, and it’s bad [for] public health outcomes.”

Reproductive health and freedoms are also likely to be affected by the Trump administration’s cuts to federal agencies. The National Institutes of Health and the Centers for Disease Control and Prevention have been in the administration’s crosshairs, as has the Food and Drug Administration.

After all, the FDA regulates drugs and medical devices in the US, including contraceptives. The CDC collects and shares important data on sexual and reproductive health. And the NIH supports vital research on reproductive health and contraception.

The CDC also funds health programs in low-income countries like Ethiopia. Following Trump’s executive order, the country’s ministry of health terminated the contracts of more than 5,000 health workers whose salaries were supported by the CDC as well as USAID.

“That’s midwives and nurses working in rural health posts,” says Mackay. “We’re turning up to support these staff and provide them with sexual reproductive health training and make sure they’ve got the contraceptives, and there’s just no one at the facility.”

So, yes, it is great news if the Trump administration can find a way to make IVF more accessible. But, as Mackay points out, “it’s increasing reproductive choice in one direction.”

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Last November, two years after Roe v. Wade was overturned, 10 US states voted on abortion rights. Seven of them voted to extend and protect access.

My colleague Rhiannon Williams reported on the immediate aftermath of the decision that reversed Roe v. Wade.

Fertility rates are falling around the world, in almost every country. IVF is great, but it won’t save us from a looming fertility crisis. Gender equality and family-friendly policies are much more likely to be effective. 

Decades of increasingly successful IVF treatments have caused millions of embryos to be stored in cryopreservation tanks around the world. In some cases, they can’t be donated, used, or destroyed and appear to be stuck in limbo “forever.”

Ever come across the term “women of childbearing age”? The insidious idea that women’s bodies are, above all else, vessels for growing children has plenty of negative consequences for us all. But it has also set back scientific research and health policy. 

There are other WhatsApp-based approaches to improving access to health information in India. Accredited social health activists in the country are using the platform to counter medical misinformation and superstitions around pregnancy.

From around the web

The US Food and Drug Administration assesses the efficacy and toxicity of experimental medicines before they are approved. It should also consider their “financial toxicity,” given that medical bills can fall on the shoulders of patients themselves, argue a group of US doctors. (The New England Journal of Medicine)

Robert F. Kennedy Jr., the new US secretary of health and human services, has vowed to investigate the country’s childhood vaccination schedule. During his confirmation hearing a couple of weeks ago, he promised not to change the schedule. (Associated Press)

Some scientists have been altering their published work without telling anyone. Such “stealth corrections” threaten scientific integrity, say a group of researchers from Europe and the US. (Learned Publishing)

The US Department of Agriculture said it accidentally fired several people who were working on the federal response to the bird flu outbreak. Apparently the agency is now trying to hire them back. (NBC News)

Could your next pet be a glowing rabbit? This startup is using CRISPR to “level up” pets. Their goal is to eventually create a real-life unicorn. (Wired)

A woman made her AI voice clone say “arse.” Then she got banned.

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

Over the past couple of weeks, I’ve been speaking to people who have lost their voices. Both Joyce Esser, who lives in the UK, and Jules Rodriguez, who lives in Miami, Florida, have forms of motor neuron disease—a class of progressive disorders that result in the gradual loss of the ability to move and control muscles.

It’s a crushing diagnosis for everyone involved. Jules’s wife, Maria, told me that once it was official, she and Jules left the doctor’s office gripping each other in floods of tears. Their lives were turned upside down. Four and a half years later, Jules cannot move his limbs, and a tracheostomy has left him unable to speak.

“To say this diagnosis has been devastating is an understatement,” says Joyce, who has bulbar MND—she can still move her limbs but struggles to speak and swallow. “Losing my voice has been a massive deal for me because it’s such a big part of who I am.”

AI is bringing back those lost voices. Both Jules and Joyce have fed an AI tool built by ElevenLabs recordings of their old voices to re-create them. Today, they can “speak” in their old voices by typing sentences into devices, selecting letters by hand or eye gaze. It’s been a remarkable and extremely emotional experience for them—both thought they’d lost their voices for good.

But speaking through a device has limitations. It’s slow, and it doesn’t sound completely natural. And, strangely, users might be limited in what they’re allowed to say.

Joyce doesn’t use her voice clone all that often. She finds it impractical for everyday conversations. But she does like to hear her old voice and will use it on occasion. One such occasion was when she was waiting for her husband, Paul, to get ready to go out.

Joyce typed a message for her voice clone to read out: “Come on, Hunnie, get your arse in gear!!” She then added: “I’d better get my knickers on too!!!”

“The next day I got a warning from ElevenLabs that I was using inappropriate language and not to do it again!!!” Joyce told me via email (we communicated with a combination of email, speech, text-to-voice tools, and a writing board). She wasn’t sure what had been inappropriate, exactly. It’s not as though she’d used any especially vile language—just, as she puts it, “normal British banter between a couple getting ready to go out.”

Joyce assumed that one of the words she’d used had been automatically flagged up by “the prudish American computer,” and that once someone from the ElevenLabs team had assessed the warning, it would be dismissed.

“Well, apparently not, because the next day a human banned me!!!!” says Joyce. She says she felt mortified. “I’d just got my voice back and now they’d taken it away from me … and only two days after I’d done a presentation to my local MND group telling them how amazing ElevenLabs were.”

Joyce contacted ElevenLabs, who apologized and reinstated her account. But it’s still not clear why she was banned in the first place. When I first asked Sophia Noel, a company representative, about the incident, she directed me to the company’s prohibited use policy.

There are rules against threatening child safety, engaging in illegal behavior, providing medical advice, impersonating others, interfering with elections, and more. But there’s nothing specifically about inappropriate language. I asked Noel about this, and she said that Joyce’s remark was most likely interpreted as a threat.

ElevenLabs’ terms of use state that the company does not have any obligation to screen, edit, or monitor content but add that it may “terminate or suspend” access to its services when content is “reasonably likely, in our sole determination, to violate applicable law or [the user] Terms.” ElevenLabs has a moderation tool that “screens content to ensure it aligns with our Terms of Service,” says Dustin Blank, head of partnerships at the company.

The question is: Should companies be screening the language of people with motor neuron disease?

After all, that’s not how other communication devices for people with this condition work. People with MND are usually advised to “bank” their voices as soon as they can—to record set phrases that can be used to create a synthetic voice that sounds a bit like them, albeit a somewhat robotic-sounding version. (Jules recently joked that his sounded like “a Daft Punk song at quarter speed.”)

Banked voices aren’t subject to the same scrutiny, says Joyce’s husband, Paul. “Joyce was told … you can put whatever [language] you want in there,” he says. Voice banking wasn’t an option for Joyce, whose speech had already deteriorated by the time she was diagnosed with MND. Jules did bank his voice but doesn’t tend to use it, because the voice clone sounds so much better. 

Joyce doesn’t hold a grudge—and her experience is far from universal. Jules uses the same technology, but he hasn’t received any warnings about his language—even though a comedy routine he performs using his voice clone contains plenty of curse words, says his wife, Maria. He opened a recent set by yelling “Fuck you guys!” at the audience—his way of ensuring they don’t give him any pity laughs, he joked. That comedy set is even promoted on the ElevenLabs website.

Blank says language like that used by Joyce is no longer restricted. “There is no specific swear ban that I know of,” says Noel. That’s just as well. 

“People living with MND should be able to say whatever is on their mind, even swearing,” says Richard Cave of the MND Association in the UK, who helps people with MND set up their voice clones. “There’s plenty to swear about.”

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You can read more about how voice clones are re-creating the voices of people with motor neuron disease in this story.

Researchers are working to create realistic avatars of people with strokes and amyotrophic lateral sclerosis that can be controlled via a brain implant. Last year, two such individuals were able to use these devices to speak at a rate of around 60 to 70 words per minute—half the rate of typical speech, but more than four times faster than had previously been achieved using a similar approach. 

Other people with ALS who are locked in—completely paralyzed but cognitively able—have used brain implants to communicate, too. A few years ago, a man in Germany used such a device to ask for massages and beer, and to tell his son he loved him. 

Several companies are working on creating hyperrealistic avatars. Don’t call them deepfakes— they prefer to think of them as “synthetic media,” writes my former colleague Melissa Heikkilä, who created her own avatar with the company Synthesia.

ElevenLabs’ tool can be used to create “humanlike speech” in 32 languages. Meta is building a model that can translate over 100 languages into 36 other languages.

From around the web

Covid-19 conspiracy theorists—some of whom believe the virus is an intentionally engineered bioweapon—will soon be heading US agencies. Some federal workers are worried they may be out for revenge against current and former employees. (Wired)

Cats might have spread bird flu to humans—and vice versa. That’s according to data from the US Centers for Disease Control and Prevention, which published the finding but then abruptly removed it. (The New York Times)

And a dairy worker is confirmed to have been infected with a second strain of bird flu that more recently spilled over from birds to cows. The person’s only symptom was conjunctivitis. (Ars Technica)

Health officials in states with abortion bans are claiming that either few or zero abortions are taking place. The claims are “ludicrous,” according to doctors in those states. (KFF Health News)

A judge in the UK has warned women against accepting sperm donations from a man who claims to have fathered more than 180 children in several countries. Robert Charles Albon, who calls himself Joe Donor, has subjected a female couple to a “nightmare” of controlling behavior, the judge said. (The Guardian)

How the tiny microbes in your mouth could be putting your health at risk

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

This week I’ve been working on a piece about teeth. Well, sort of teeth. Specifically, lab-grown bioengineered teeth. Researchers have created these teeth with a mixture of human and pig tooth cells and grown them in the jaws of living mini pigs.

“We’re working on trying to create functional replacement teeth,” Pamela Yelick of Tufts University, one of the researchers behind the work, told me. The idea is to develop an alternative to titanium dental implants. Replacing lost or damaged teeth with healthy, living, lab-grown ones might be a more appealing option than drilling a piece of metal into a person’s jawbone.

Current dental implants can work well, but they’re not perfect. They don’t attach to bones and gums in the same way that real teeth do. And around 20% of people who get implants end up developing an infection called peri-implantitis, which can lead to bone loss.

It is all down to the microbes that grow on them. There’s a complex community of microbes living in our mouths, and disruptions can lead to infection. But these organisms don’t just affect our mouths; they also seem to be linked to a growing number of disorders that can affect our bodies and brains. If you’re curious, read on.

The oral microbiome, as it is now called, was first discovered in 1670 by Antonie van Leeuwenhoek, a self-taught Dutch microbiologist. “I didn’t clean my teeth for three days and then took the material that had lodged in small amounts on the gums above my front teeth … I found a few living animalcules,” he wrote in a letter to the Royal Society at the time.

Van Leeuwenhoek had used his own homemade microscopes to study the “animalcules” he found in his mouth. Today, we know that these organisms include bacteria, archaea, fungi, and viruses, each of which comes in lots of types. “Everyone’s mouth is home to hundreds of bacterial species,” says Kathryn Kauffman at the University of Buffalo, who studies the oral microbiome.

These organisms interact with each other and with our own immune systems, and researchers are still getting to grips with how the interactions work. Some microbes feed on sugars or fats in our diets, for example, while others seem to feed on our own cells. Depending on what they consume and produce, microbes can alter the environment of the mouth to either promote or inhibit the growth of other microbes.

This complex microbial dance seems to have a really important role in our health. Oral diseases and even oral cancers have been linked to an imbalance in the oral microbiome, which scientists call “dysbiosis.” Tooth decay, for example, has been attributed to an overgrowth of microbes that produce acids that can damage teeth. 

Specific oral microbes are also being linked to an ever-growing list of diseases of the body and brain, including rheumatoid arthritis, metabolic disease, cardiovascular diseases, inflammatory bowel disease, colorectal cancer, and more.

There’s also growing evidence that these oral microbes contribute to neurodegenerative disease. A bacterium called P. gingivalis, which plays a role in the development of chronic periodontitis, has been found in the brains of people with Alzheimer’s disease. And people who are infected with P. gingivalis also experience a decline in their cognitive abilities over a six-month period.

Scientists are still figuring out how oral microbes might travel from the mouth to cause disease elsewhere. In some cases, “you swallow the saliva that contains them … and they can lodge in your heart and other parts of the body,” says Yelick. “They can result in a systemic inflammation that just happens in the background.”

In other cases, the microbes may be hitching a ride in our own immune cells to journey through the bloodstream, as the “Trojan horse hypothesis” posits. There’s some evidence that Fusobacterium nucleatum, a bacterium commonly found in the mouth, does this by hiding in white blood cells. 

There’s a lot to learn about exactly how these tiny microbes are exerting such huge influence over everything from our metabolism and bone health to our neurological function. But in the meantime, the emerging evidence is a good reminder to us all to look after our teeth. At least until lab-grown ones become available.

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You can read more about Yelick’s attempt to grow humanlike teeth in mini pigs here.

The gut microbiome is even more complex than the one in our mouths. Some scientists believe that people in traditional societies have the healthiest collections of gut microbes. But research on the topic has left some of the people in those groups feeling exploited. 

Research suggests our microbiomes change as we age. Scientists are exploring whether maintaining our microbiomes might help us stave off age-related disease.

The makeup of a gut microbiome can be assessed by analyzing fecal samples. This research might be able to reveal what a person has eaten and help provide personalized dietary advice.

There are also communities of microbes living on our skin. Scientists have engineered skin microbes to prevent and treat cancer in mice. Human trials are in the works.

From around the web

Argentina has declared that it will withdraw from the World Health Organization, following a similar move from the US. President Javier Milei has criticized the WHO for its handling of the covid-19 pandemic and called it a “nefarious organization.” (Al Jazeera)

Dairy cows in Nevada have been infected with a form of bird flu different from the one that has been circulating in US dairy herds for months. (The New York Times)

Staff at the US Centers for Disease Control and Prevention have been instructed to withdraw pending journal publications that mention terms including “transgender” and “pregnant people.” But the editors of the British Medical Journal have said they “will not retract published articles on request by an author on the basis that they contained so-called banned words.” “Retraction occurs in circumstances where clear evidence exists of major errors, data fabrication, or falsification that compromise the reliability of the research findings. It is not a matter of author request,” two editors have written. (BMJ)

Al Nowatzki had been chatting to his AI girlfriend, Erin, for months. Then, in late January, Erin told him to kill himself, and provided explicit instructions on how to do so. (MIT Technology Review)

Is our use of the internet and AI tools making us cognitively lazy? “Digital amnesia” might just be a sign of an aging brain. (Nature)

How measuring vaccine hesitancy could help health professionals tackle it

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

This week, Robert F. Kennedy Jr., President Donald Trump’s pick to lead the US’s health agencies, has been facing questions from senators as part of his confirmation hearing for the role. So far, it’s been a dramatic watch, with plenty of fiery exchanges, screams from audience members, and damaging revelations.

There’s also been a lot of discussion about vaccines. Kennedy has long been a vocal critic of vaccines. He has spread misinformation about the effects of vaccines. He’s petitioned the government to revoke the approval of vaccines. He’s sued pharmaceutical companies that make vaccines. 

Kennedy has his supporters. But not everyone who opts not to vaccinate shares his worldview. There are lots of reasons why people don’t vaccinate themselves or their children.

Understanding those reasons will help us tackle an issue considered to be a huge global health problem today. And plenty of researchers are working on tools to do just that.

Jonathan Kantor is one of them. Kantor, who is jointly affiliated with the University of Pennsylvania in Philadelphia and the University of Oxford in the UK, has been developing a scale to measure and assess “vaccine hesitancy.”

That term is what best captures the diverse thoughts and opinions held by people who don’t get vaccinated, says Kantor. “We used to tend more toward [calling] someone … a vaccine refuser or denier,” he says. But while some people under this umbrella will be stridently opposed to vaccines for various reasons, not all of them will be. Some may be unsure or ambivalent. Some might have specific fears, perhaps about side effects or even about needle injections.

Vaccine hesitancy is shared by “a very heterogeneous group,” says Kantor. That group includes “everyone from those who have a little bit of wariness … and want a little bit more information … to those who are strongly opposed and feel that it is their mission in life to spread the gospel regarding the risks of vaccination.”

To begin understanding where individuals sit on this spectrum and why, Kantor and his colleagues scoured published research on vaccine hesitancy. They sent surveys to 50 people, asking them detailed questions about their feelings on vaccines. The researchers were looking for themes: Which issues kept cropping up?

They found that prominent concerns about vaccines tend to fall into three categories: beliefs, pain, and deliberation. Beliefs might be along the lines of “It is unhealthy for children to be vaccinated as much as they are today.” Concerns around pain center more on the immediate consequences of the vaccination, such as fears about the injection. And deliberation refers to the need some people feel to “do their own research.”

Kantor and his colleagues used their findings to develop a 13-question survey, which they trialed in 500 people from the UK and 500 more from the US. They found that responses to the questionnaire could predict whether someone had been vaccinated against covid-19.

Theirs is not the first vaccine hesitancy scale out there—similar questionnaires have been developed by others, often focusing on parents’ feelings about their children’s vaccinations. But Kantor says this is the first to incorporate the theme of deliberation—a concept that seems to have become more popular during the early days of covid-19 vaccination rollouts.

Nicole Vike at the University of Cincinnati and her colleagues are taking a different approach. They say research has suggested that how people feel about risks and rewards seems to influence whether they get vaccinated (although not necessarily in a simple or direct manner).

Vike’s team surveyed over 4,000 people to better understand this link, asking them information about themselves and how they felt about a series of pictures of sports, nature scenes, cute and aggressive animals, and so on. Using machine learning, they built a model that could predict, from these results, whether a person would be likely to get vaccinated against covid-19.

This survey could be easily distributed to thousands of people and is subtle enough that people taking it might not realize it is gathering information about their vaccine choices, Vike and her colleagues wrote in a paper describing their research. And the information collected could help public health centers understand where there is demand for vaccines, and conversely, where outbreaks of vaccine-preventable diseases might be more likely.

Models like these could be helpful in combating vaccine hesitancy, says Ashlesha Kaushik, vice president of the Iowa Chapter of the American Academy of Pediatrics. The information could enable health agencies to deliver tailored information and support to specific communities that share similar concerns, she says.

Kantor, who is a practicing physician, hopes his questionnaire could offer doctors and other health professionals insight into their patients’ concerns and suggest ways to address them. It isn’t always practical for doctors to sit down with their patients for lengthy, in-depth discussions about the merits and shortfalls of vaccines. But if a patient can spend a few minutes filling out a questionnaire before the appointment, the doctor will have a starting point for steering a respectful and fruitful conversation about the subject.

When it comes to vaccine hesitancy, we need all the insight we can get. Vaccines prevent millions of deaths every year. One and half million children under the age of five die every year from vaccine-preventable diseases, according to the children’s charity UNICEF. In 2019, the World Health Organization included “vaccine hesitancy” on its list of 10 threats to global health.

When vaccination rates drop, we start to see outbreaks of the diseases the vaccines protect against. We’ve seen this a lot recently with measles, which is incredibly infectious. Sixteen measles outbreaks were reported in the US in 2024.

Globally, over 22 million children missed their first dose of the measles vaccine in 2023, and measles cases rose by 20%. Over 107,000 people around the world died from measles that year, according to the US Centers for Disease Control and Prevention. Most of them were children.

Vaccine hesitancy is dangerous. “It’s really creating a threatening environment for these vaccine-preventable diseases to make a comeback,” says Kaushik. 

Kantor agrees: “Anything we can do to help mitigate that, I think, is great.”

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In 2021, my former colleague Tanya Basu wrote a guide to having discussions about vaccines with people who are hesitant. Kindness and nonjudgmentalism will get you far, she wrote.

In December 2020, as covid-19 ran rampant around the world, doctors took to social media platforms like TikTok to allay fears around the vaccine. Sharing their personal experiences was important—but not without risk, A.W. Ohlheiser reported at the time.

Robert F. Kennedy Jr. is currently in the spotlight for his views on vaccines. But he has also spread harmful misinformation about HIV and AIDS, as Anna Merlan reported.

mRNA vaccines have played a vital role in the covid-19 pandemic, and in 2023, the researchers who pioneered the science behind them were awarded a Nobel Prize. Here’s what’s next for mRNA vaccines.

Vaccines are estimated to have averted 154 million deaths in the last 50 years. That number includes 146 million children under the age of five. That’s partly why childhood vaccines are a public health success story.

From around the web

As Robert F. Kennedy Jr.’s Senate hearing continued this week, so did the revelations of his misguided beliefs about health and vaccines. Kennedy, who has called himself “an expert on vaccines,” said in 2021 that “we should not be giving Black people the same vaccine schedule that’s given to whites, because their immune system is better than ours”—a claim that is not supported by evidence. (The Washington Post)

And in past email exchanges with his niece, a primary-care physician at NYC Health + Hospitals in New York City, RFK Jr. made repeated false claims about covid-19 vaccinations and questioned the value of annual flu vaccinations. (STAT)

Towana Looney, who became the third person to receive a gene-edited pig kidney in December, is still healthy and full of energy two months later. The milestone makes Looney the longest-living recipient of a pig organ transplant. “I’m superwoman,” she told the Associated Press. (AP)

The Trump administration’s attempt to freeze trillions of dollars in federal grants, loans, and other financial assistance programs was chaotic. Even a pause in funding for global health programs can be considered a destruction, writes Atul Gawande. (The New Yorker)

How ultraprocessed is the food in your diet? This chart can help rank food items—but won’t tell you all you need to know about how healthy they are. (Scientific American)

The US withdrawal from the WHO will hurt us all

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

On January 20, his first day in office, US president Donald Trump signed an executive order to withdraw the US from the World Health Organization. “Ooh, that’s a big one,” he said as he was handed the document.

The US is the biggest donor to the WHO, and the loss of this income is likely to have a significant impact on the organization, which develops international health guidelines, investigates disease outbreaks, and acts as an information-sharing hub for member states.

But the US will also lose out. “It’s a very tragic and sad event that could only hurt the United States in the long run,” says William Moss, an epidemiologist at Johns Hopkins Bloomberg School of Public Health in Baltimore.

Trump appears to take issue with the amount the US donates to the WHO. He points out that it makes a much bigger contribution than China, a country with a population four times that of the US. “It seems a little unfair to me,” he said as he prepared to sign the executive order.

It is true that the US is far and away the biggest financial supporter of the WHO. The US contributed $1.28 billion over the two-year period covering 2022 and 2023. By comparison, the second-largest donor, Germany, contributed $856 million in the same period. The US currently contributes 14.5% of the WHO’s total budget.

But it’s not as though the WHO sends a billion-dollar bill to the US. All member states are required to pay membership dues, which are calculated as a percentage of a country’s gross domestic product. For the US, this figure comes to $130 million. China pays $87.6 million. But the vast majority of the US’s contributions to the WHO are made on a voluntary basis—in recent years, the donations have been part of multibillion-dollar spending on global health by the US government. (Separately, the Bill and Melinda Gates Foundation contributed $830 million over 2022 and 2023.)

There’s a possibility that other member nations will increase their donations to help cover the shortfall left by the US’s withdrawal. But it is not clear who will step up—or what implications it will have to change the structure of donations.

Martin McKee, a professor of European public health at the London School of Hygiene and Tropical Medicine, thinks it is unlikely that European members will increase their contributions by much. China, India, Brazil, South Africa, and the Gulf states, on the other hand, may be more likely to pay more. But again, it isn’t clear how this will pan out, or whether any of these countries will expect greater influence over global health policy decisions as a result of increasing their donations.

WHO funds are spent on a range of global health projects—programs to eradicate polio, rapidly respond to health emergencies, improve access to vaccines and medicines, develop pandemic prevention strategies, and more. The loss of US funding is likely to have a significant impact on at least some of these programs.

“Diseases don’t stick to national boundaries, hence this decision is not only concerning for the US, but in fact for every country in the world,” says Pauline Scheelbeek at the London School of Hygiene and Tropical Medicine.“With the US no longer reporting to the WHO nor funding part of this process, the evidence on which public health interventions and solutions should be based is incomplete.”

“It’s going to hurt global health,” adds Moss. “It’s going to come back to bite us.”

There’s more on how the withdrawal could affect health programs, vaccine coverage, and pandemic preparedness in this week’s coverage.

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This isn’t the first time Donald Trump has signaled his desire for the US to leave the WHO. He proposed a withdrawal during his last term, in 2020. While the WHO is not perfect, it needs more power and funding, not less, Charles Kenny, director of technology and development at the Center for Global Development, argued at the time.

The move drew condemnation from those working in public health then, too. The editor in chief of the medical journal The Lancet called it “a crime against humanity,” as Charlotte Jee reported.

In 1974, the WHO launched an ambitious program to get lifesaving vaccines to all children around the world. Fifty years on, vaccines are thought to have averted 154 million deaths—including 146 million in children under the age of five. 

The WHO has also seen huge success in its efforts to eradicate polio. Today, wild forms of the virus have been eradicated in all but two countries. But vaccine-derived forms of the virus can still crop up around the world.

At the end of a round of discussions in September among WHO member states working on a pandemic agreement, director-general Tedros Adhanom Ghebreyesus remarked, “The next pandemic will not wait for us, whether from a flu virus like H5N1, another coronavirus, or another family of viruses we don’t yet know about.” The H5N1 virus has been circulating on US dairy farms for months now, and the US is preparing for potential human outbreaks.

From around the web

People with cancer paid $45,000 for an experimental blood-filtering treatment, delivered at a clinic in Antigua, after being misled about its effectiveness. Six of them have died since their treatments. (The New York Times)

The Trump administration has instructed federal health agencies to pause all external communications, such as health advisories, weekly scientific reports, updates to websites, and social media posts. (The Washington Post)

A new “virtual retina,” modeled on human retinas, has been developed to study the impact of retinal implants. The three-dimensional model simulates over 10,000 neurons. (Brain Stimulation)

Trump has signed an executive order stating that “it is the policy of the United States to recognize two sexes, male and female.” The document “defies decades of research into how human bodies grow and develop,” STAT reports, and represents “a dramatic failure to understand biology,” according to a neuroscientist who studies the development of sex. (STAT)

Attention, summer holiday planners: Biting sandflies in the Mediterranean region are transmitting Toscana virus at an increasing rate. The virus is a major cause of central nervous system disorders in the region. Italy saw a 2.6-fold increase in the number of reported infections between the 2016–21 period and 2022–23. (Eurosurveillance)

Deciding the fate of “leftover” embryos

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

Over the past few months, I’ve been working on a piece about IVF embryos. The goal of in vitro fertilization is to create babies via a bit of lab work: Trigger the release of lots of eggs, introduce them to sperm in a lab, transfer one of the resulting embryos into a person’s uterus, and cross your fingers for a healthy pregnancy. Sometimes it doesn’t work. But often it does. For the article, I explored what happens to the healthy embryos that are left over.

I spoke to Lisa Holligan, who had IVF in the UK around five years ago. Holligan donated her “genetically abnormal” embryos for scientific research. But she still has one healthy embryo frozen in storage. And she doesn’t know what to do with it.

She’s not the only one struggling with the decision. “Leftover” embryos are kept frozen in storage tanks, where they sit in little straws, invisible to the naked eye, their growth paused in a state of suspended animation. What happens next is down to personal choice—but that choice can be limited by a complex web of laws and ethical and social factors.

These days, responsible IVF clinics will always talk to people about the possibility of having leftover embryos before they begin treatment. Intended parents will sign a form indicating what they would like to happen to those embryos. Typically, that means deciding early on whether they might like any embryos they don’t end up using to be destroyed or donated, either to someone else trying to conceive or for research.

But it can be really difficult to make these decisions before you’ve even started treatment. People seeking fertility treatment will usually have spent a long time trying to get pregnant. They are hoping for healthy embryos, and some can’t imagine having any left over—or how they might feel about them.

For a lot of people, embryos are not just balls of cells. They hold the potential for life, after all. Some people see them as children, waiting to be born. Some even name their embryos, or call them their “freezer babies.” Others see them as the product of a long, exhausting, and expensive IVF journey.

Holligan says that she initially considered donating her embryo to another person, but her husband disagreed. He saw the embryo as their child and said he wouldn’t feel comfortable with giving it up to another family. “I started having these thoughts about a child coming to me when they’re older, saying they’ve had a terrible life, and [asking] ‘Why didn’t you have me?’” she told me.

Holligan lives in the UK, where you can store your embryos for up to 55 years. Destroying or donating them are also options. That’s not the case in other countries. In Italy, for example, embryos cannot be destroyed or donated. Any that are frozen will remain that way forever, unless the law changes at some point.

In the US, regulations vary by state. The patchwork of laws means that one state can bestow a legal status on embryos, giving them the same rights as children, while another might have no legislation in place at all.

No one knows for sure how many embryos are frozen in storage tanks, but the figure is thought to be somewhere between 1 million and 10 million in the US alone. Some of these embryos have been in storage for years or decades. In some cases, the intended parents have deliberately chosen this, opting to pay hundreds of dollars per year in fees.

But in other cases, clinics have lost touch with their clients. Many of these former clients have stopped paying for the storage of their embryos, but without up-to-date consent forms, clinics can be reluctant to destroy them. What if the person comes back and wants to use those embryos after all?

“Most clinics, if they have any hesitation or doubt or question, will err on the side of holding on to those embryos and not discarding them,” says Sigal Klipstein, a reproductive endocrinologist at InVia Fertility Center in Chicago, who also chairs the ethics committee of the American Society for Reproductive Medicine. “Because it’s kind of like a one-way ticket.”

Klipstein thinks one of the reasons why some embryos end up “abandoned” in storage is that the people who created them can’t bring themselves to destroy them. “It’s just very emotionally difficult for someone who has wanted so much to have a family,” she tells me.

Klipstein says she regularly talks to her patients about what to do with leftover embryos. Even people who make the decision with confidence can change their minds, she says. “We’ve all had those patients who have discarded embryos and then come back six months or a year later and said: ‘Oh, I wish I had those embryos,’” she tells me. “Those [embryos may have been] their best chance of pregnancy.”

Those who do want to discard their embryos have options. Often, the embryos will simply be exposed to air and then disposed of. But some clinics will also offer to transfer them at a time or place where a pregnancy is extremely unlikely to result. This “compassionate transfer,” as it is known, might be viewed as a more “natural” way to dispose of the embryo.

But it’s not for everyone. Holligan has experienced multiple miscarriages and wonders if a compassionate transfer might feel similar. She wonders if it might just end up “putting [her] body and mind through unnecessary stress.”

Ultimately, for Holligan and many others in a similar position, the choice remains a difficult one. “These are … very desired embryos,” says Klipstein. “The purpose of going through IVF was to create embryos to make babies. And [when people] have these embryos, and they’ve completed their family plan, they’re in a place they couldn’t have imagined.”

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Our relationship with embryos is unique, and a bit all over the place. That’s partly because we can’t agree on their moral status. Are they more akin to people or property, or something in between? Who should get to decide their fate? While we get to the bottom of these sticky questions, millions of embryos are stuck in suspended animation—some of them indefinitely.

It is estimated that over 12 million babies have been born through IVF. The development of the Nobel Prize–winning technology behind the procedure relied on embryo research. Some worry that donating embryos for research can be onerous—and that valuable embryos are being wasted as a result.

Fertility rates around the world are dropping below the levels needed to maintain stable populations. But IVF can’t save us from a looming fertility crisis. Gender equality and family-friendly policies are much more likely to prove helpful. 

Two years ago, the US Supreme Court overturned Roe v. Wade, a legal decision that protected the right to abortion. Since then, abortion bans have been enacted in multiple states. But in November of last year, some states voted to extend and protect access to abortion, and voters in Missouri supported overturning the state’s ban.

Last year, a ruling by the Alabama Supreme Court that embryos count as children ignited fears over access to fertility treatments in a state that had already banned abortion. The move could also have implications for the development of technologies like artificial uteruses and synthetic embryos, my colleague Antonio Regalado wrote at the time.

From around the web

It’s not just embryos that are frozen as part of fertility treatments. Eggs, sperm, and even ovarian and testicular tissue can be stored too. A man who had immature testicular tissue removed and frozen before undergoing chemotherapy as a child 16 years ago had the tissue reimplanted in a world first, according to the team at University Hospital Brussels that performed the procedure around a month ago. The tissue was placed into the man’s testicle and scrotum, and scientists will wait a year before testing to see if he is successfully producing sperm. (UZ Brussel)

The Danish pharmaceutical company Novo Nordisk makes half the world’s insulin. Now it is better known as the manufacturer of the semaglutide drug Ozempic. How will the sudden shift affect the production and distribution of these medicines around the world? (Wired)

The US has not done enough to prevent the spread of the H5N1 virus in dairy cattle. The response to bird flu is a national embarrassment, argues Katherine J. Wu. (The Atlantic)

Elon Musk has said that if all goes well, millions of people will have brain-computer devices created by his company Neuralink implanted within 10 years. In reality, progress is slower—so far, Musk has said that three people have received the devices. My colleague Antonio Regalado predicts what we can expect from Neuralink in 2025. (MIT Technology Review)

How the US is preparing for a potential bird flu pandemic

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

This week marks a strange anniversary—it’s five years since most of us first heard about a virus causing a mysterious “pneumonia.” A virus that we later learned could cause a disease called covid-19. A virus that swept the globe and has since been reported to have been responsible for over 7 million deaths—and counting.

I first covered the virus in an article published on January 7, 2020, which had the headline “Doctors scramble to identify mysterious illness emerging in China.” For that article, and many others that followed it, I spoke to people who were experts on viruses, infectious disease, and epidemiology. Frequently, their answers to my questions about the virus, how it might spread, and the risks of a pandemic were the same: “We don’t know.”

We are facing the same uncertainty now with H5N1, the virus commonly known as bird flu. This virus has been decimating bird populations for years, and now a variant is rapidly spreading among dairy cattle in the US. We know it can cause severe disease in animals, and we know it can pass from animals to people who are in close contact with them. As of this Monday this week, we also know that it can cause severe disease in people—a 65-year-old man in Louisiana became the first person in the US to die from an H5N1 infection.

Scientists are increasingly concerned about a potential bird flu pandemic. The question is, given all the enduring uncertainty around the virus, what should we be doing now to prepare for the possibility? Can stockpiled vaccines save us? And, importantly, have we learned any lessons from a covid pandemic that still hasn’t entirely fizzled out?

Part of the challenge here is that it is impossible to predict how H5N1 will evolve.

A variant of the virus caused disease in people in 1997, when there was a small but deadly outbreak in Hong Kong. Eighteen people had confirmed diagnoses, and six of them died. Since then, there have been sporadic cases around the world—but no large outbreaks.

As far as H5N1 is concerned, we’ve been relatively lucky, says Ali Khan, dean of the college of public health at the University of Nebraska. “Influenza presents the greatest infectious-disease pandemic threat to humans, period,” says Khan. The 1918 flu pandemic was caused by a type of influenza virus called H1N1 that appears to have jumped from birds to people. It is thought to have infected a third of the world’s population, and to have been responsible for around 50 million deaths.

Another H1N1 virus was responsible for the 2009 “swine flu” pandemic. That virus hit younger people hardest, as they were less likely to have been exposed to similar variants and thus had much less immunity. It was responsible for somewhere between 151,700 and 575,400 deaths that year.

To cause a pandemic, the H5N1 variants currently circulating in birds and dairy cattle in the US would need to undergo genetic changes that allow them to spread more easily from animals to people, spread more easily between people, and become more deadly in people. Unfortunately, we know from experience that viruses need only a few such changes to become more easily transmissible.

And with each and every infection, the risk that a virus will acquire these dangerous genetic changes increases. Once a virus infects a host, it can evolve and swap chunks of genetic code with any other viruses that might also be infecting that host, whether it’s a bird, a pig, a cow, or a person. “It’s a big gambling game,” says Marion Koopmans, a virologist at the Erasmus University Medical Center in Rotterdam, the Netherlands. “And the gambling is going on at too large a scale for comfort.”

There are ways to improve our odds. For the best chance at preventing another pandemic, we need to get a handle on, and limit, the spread of the virus. Here, the US could have done a better job at limiting the spread in dairy cows, says Khan. “It should have been found a lot earlier,” he says. “There should have been more aggressive measures to prevent transmission, to recognize what disease looks like within our communities, and to protect workers.”

States could also have done better at testing farm workers for infection, says Koopmans. “I’m surprised that I haven’t heard of an effort to eradicate it from cattle,” she adds. “A country like the US should be able to do that.”

The good news is that there are already systems in place for tracking the general spread of flu in people. The World Health Organization’s Global Influenza Surveillance and Response System collects and analyzes samples of viruses collected from countries around the world. It allows the organization to make recommendations about seasonal flu vaccines and also helps scientists track the spread of various flu variants. That’s something we didn’t have for the covid-19 virus when it first took off.

We are also better placed to make vaccines. Some countries, including the US, are already stockpiling vaccines that should be at least somewhat effective against H5N1 (although it is difficult to predict exactly how effective they will be against some future variant). The US Administration for Strategic Preparedness and Response plans to have “up to 10 million doses of prefilled syringes and multidose vials” prepared by the end of March, according to an email from a representative.

The US Department of Health and Human Services has also said it will provide the pharmaceutical company Moderna with $176 million to create mRNA vaccines for pandemic influenza—using the same quick-turnaround vaccine production technology used in the company’s covid-19 vaccines.

Some question whether these vaccines should have already been offered to dairy farm workers in affected parts of the US. Many of these individuals have been exposed to the virus, a good chunk of them appear to have been infected with it, and some of them have become ill. If the decision had been up to Khan, he says, they would have been offered the H5N1 vaccine by now. And we should ensure they are offered seasonal flu vaccines in order to limit the risk that the two flu viruses will mingle inside one person, he adds.

Others worry that 10 million vaccine doses aren’t enough for a country with a population of around 341 million. But health agencies “walk a razor-thin line between having too much vaccine for something and not having enough,” says Khan. If an outbreak never transpires, 340 million doses of vaccine will feel like an enormous waste of resources.

We can’t predict how well these viruses will work, either. Flu viruses mutate all the time, and even seasonal flu vaccines are notoriously unpredictable in their efficacy. “I think we’ve become a little bit spoiled with the covid vaccines,” says Koopmans. “We were really, really lucky [to develop] vaccines with high efficacy.”

One vaccine lesson we should have learned from the covid-19 pandemic is the importance of equitable access to vaccines around the world. Unfortunately, it’s unlikely that we have. “It is doubtful that low-income countries will have early access to [a pandemic influenza] vaccine unless the world takes action,” Nicole Lurie of the Coalition for Epidemic Preparedness Innovations (CEPI) said in a recent interview for Gavi, a public-private alliance for vaccine equity.

And another is the impact of vaccine hesitancy. Making vaccines might not be a problem—but convincing people to take them might be, says Khan. “We have an incoming administration that has lots of vaccine hesitancy,” he points out. “So while we may end up having … vaccines available, it’s not very clear to me if we have the political and social will to actually implement good public health measures.”

This is another outcome that is impossible to predict, and I won’t attempt to do so. But I am hoping that the relevant administrations will step up our defenses. And that this will be enough to prevent another devastating pandemic.

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Bird flu has been circulating in US dairy cows for months. Virologists are worried it could stick around on US farms forever.

As the virus continues to spread, the risk of a pandemic continues to rise. We still don’t really know how the virus is spreading, but we do know that it is turning up in raw milk. (Please don’t drink raw milk.)

mRNA vaccines helped us through the covid-19 pandemic. Now scientists are working on mRNA flu vaccines—including “universal” vaccines that could protect against multiple flu viruses.

The next generation of mRNA vaccines is on the way. These vaccines are “self-amplifying” and essentially tell the body how to make more mRNA. 

Maybe there’s an alternative to dairy farms of the type that are seeing H5N1 in their cattle. Scientists are engineering yeasts and plants with bovine genes so they can produce proteins normally found in milk, which can be used to make spreadable cheeses and ice cream. The cofounder of one company says a factory of bubbling yeast vats could “replace 50,000 to 100,000 cows.”

From around the web

My colleagues and I put together an annual list of what we think are the breakthrough technologies of that year. This year’s list includes long-acting HIV prevention medicines and stem-cell treatments that actually work. Check out the full list here.

Calico, the Google biotech company focused on “tackling aging,” has released results from the trial of a drug to treat amyotrophic lateral sclerosis (ALS). The drug failed. (STAT) 

Around the world, birth rates are falling. The more concerned nations become about this fact, the greater the risk to gender rights, writes Angela Saini. (Wired)

Brooke Eby, a 36-year-old with ALS, is among a niche group of content creators documenting their journeys with terminal illness on social media platforms like TikTok. “I’m glad that I’m sharing my journey. I wish someone had come before me and shared, start to finish …,” she said. “I’m just going to post all this, because maybe it’ll help someone who’s like a year behind me in their progression.” (New York Times)

Do we each have 30 trillion genomes? A growing understanding of genetic mutations that occur in adults is changing the way doctors diagnose and treat disease. (The Atlantic)

Why childhood vaccines are a public health success story

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

Later today, around 10 minutes after this email lands in your inbox, I’ll be holding my four-year-old daughter tight as she receives her booster dose of the MMR vaccine. This shot should protect her from a trio of nasty infections—infections that can lead to meningitis, blindness, and hearing loss. I feel lucky to be offered it.

This year marks the 50-year anniversary of an ambitious global childhood vaccination program. The Expanded Programme on Immunization was launched by the World Health Organization in 1974 with the goal of getting lifesaving vaccines to all the children on the planet.

Vaccines are estimated to have averted 154 million deaths since the launch of the EPI. That number includes 146 million children under the age of five. Vaccination efforts are estimated to have reduced infant mortality by 40%, and to have contributed an extra 10 billion years of healthy life among the global population.

Childhood vaccination is a success story. But concerns around vaccines endure. Especially, it seems, among the individuals Donald Trump has picked as his choices to lead US health agencies from January. This week, let’s take a look at their claims, and where the evidence really stands on childhood vaccines.

WHO, along with health agencies around the world, recommends a suite of vaccinations for babies and young children. Some, such as the BCG vaccine, which offers some protection against tuberculosis, are recommended from birth. Others, like the vaccines for pertussis, diphtheria, tetanus, and whooping cough, which are often administered in a single shot, are introduced at eight weeks. Other vaccinations and booster doses follow.

The idea is to protect babies as soon as possible, says Kaja Abbas of the London School of Hygiene & Tropical Medicine in the UK and Nagasaki University in Japan.

The full vaccine schedule will depend on what infections pose the greatest risks and will vary by country. In the US, the recommended schedule is determined by the Centers for Disease Control and Prevention, and individual states can opt to set vaccine mandates or allow various exemptions.

Some scientists are concerned about how these rules might change in January, when Donald Trump makes his return to the White House. Trump has already listed his picks for top government officials, including those meant to lead the country’s health agencies. These individuals must be confirmed by the Senate before they can assume these roles, but it appears that Trump intends to surround himself with vaccine skeptics.

For starters, Trump has selected Robert F. Kennedy Jr. as his pick to lead the Department of Health and Human Services. Kennedy, who has long been a prominent anti-vaxxer, has a track record of spreading false information about vaccines.

In 2005, he published an error-laden article in Salon and Rolling Stone linking thimerosal—an antifungal preservative that was previously used in vaccines but phased out in the US by 2001—to neurological disorders in children. (That article was eventually deleted in 2011. “I regret we didn’t move on this more quickly, as evidence continued to emerge debunking the vaccines and autism link,” wrote Joan Walsh, Salon’s editor at large at the time.)

Kennedy hasn’t let up since. In 2015, he made outrageous comments about childhood vaccinations at a screening of a film that linked thimerosal to autism. “They get the shot, that night they have a fever of a hundred and three, they go to sleep, and three months later their brain is gone,” Kennedy said, as reported by the Sacramento Bee. “This is a holocaust, what this is doing to our country.”

Aaron Siri, the lawyer who has been helping Kennedy pick health officials for the upcoming Trump administration, has petitioned the government to pause the distribution of multiple vaccines and to revoke approval of the polio vaccine entirely. And Dave Weldon, Trump’s pick to direct the CDC, also has a history of vaccine skepticism. He has championed the disproven link between thimerosal and autism.

These arguments aren’t new. The MMR vaccine in particular has been subject to debate, controversy, and conspiracy theories for decades. All the way back in 1998, a British doctor, Andrew Wakefield, published a paper suggesting a link between the vaccine and autism in children.

The study has since been debunked—multiple times over—and Wakefield was found to have unethically subjected children to invasive and unnecessary procedures. The paper was retracted 12 years after it was published, and the UK’s General Medical Council found Wakefield guilty of serious professional misconduct. He was struck off the medical register and is no longer allowed to practice medicine in the UK. (He continues to peddle false information, though, and directed the 2016 film Vaxxed, which Weldon appeared in.)

So it’s remarkable that his “study” still seems to be affecting public opinion. A recent Pew Research Center survey suggests that four in 10 US adults worry that “not all vaccines are necessary,” and while most Americans think the benefits outweigh any risks, some are still concerned about side effects. Views among Republicans in particular seem to have shifted over the years. In 2019, 82% supported school-based vaccine requirements. That figure dropped to 70% in 2023.

The problem is that we need more than 70% of children to be vaccinated to reach “herd immunity”—the level needed to protect communities. For a super-contagious infection like measles, 95% of the population needs to be vaccinated, according to WHO. “If [coverage drops to] 80%, we should expect outbreaks,” says Abbas.

And that’s exactly what is happening. In 2023, only 83% of children got their first dose of a measles vaccine through routine health services. Nearly 35 million children are thought to have either partial protection from the disease or none at all. And over the last five years, there have been measles outbreaks in 103 countries.

Polio vaccines—the ones whose approval Siri sought to revoke—have also played a vital role in protecting children, in this case from a devastating infection that can cause paralysis. “People were so afraid of polio in the ‘30s, ‘40s, and ‘50s here in the United States,” says William Moss, an epidemiologist at Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland. “When the trial results of [the first] vaccine were announced in the United States, people were dancing in the streets.”

That vaccine was licensed in the US in 1955. By 1994, polio was considered eliminated in North and South America. Today, wild forms of the virus have been eradicated in all but two countries.

But the polio vaccine story is not straightforward. There are two types of polio vaccine: an injected type that includes a “dead” form of the virus, and an oral version that includes “live” virus. This virus can be shed in feces, and in places with poor sanitation, it can spread. It can also undergo genetic changes to create a form of the virus that can cause paralysis. Although this is rare, it does happen—and today there are more cases of vaccine-derived polio than wild-type polio.

It is worth noting that since 2000, more than 10 billion doses of the oral polio vaccine have been administered to almost 3 billion children. It is estimated that more than 13 million cases of polio have been prevented through these efforts. But there have been just under 760 cases of vaccine-derived polio.

We could prevent these cases by switching to the injected vaccine, which wealthy countries have already done. But that’s not easy in countries with fewer resources and those trying to reach children in remote rural areas or war zones.

Even the MMR vaccine is not entirely risk-free. Some people will experience minor side effects, and severe allergic reactions, while rare, can occur. And neither vaccine offers 100% protection against disease. No vaccine does. “Even if you vaccinate 100% [of the population], I don’t think we’ll be able to attain herd immunity for polio,” says Abbas. It’s important to acknowledge these limitations.

While there are some small risks, though, they are far outweighed by the millions of lives being saved. “[People] often underestimate the risk of the disease and overestimate the risk of the vaccine,” says Moss.

In some ways, vaccines have become a victim of their own success. “Most of today’s parents fortunately have never seen the tragedy caused by vaccine-preventable diseases such as measles encephalitis, congenital rubella syndrome, and individuals crippled by polio,” says Kimberly Thompson, president of Kid Risk, a nonprofit that conducts research on health risks to children. “With some individuals benefiting from the propagation of scary messages about vaccines and the proliferation of social media providing reinforcement, it’s no surprise that fears may endure.”

“But most Americans recognize the benefits of vaccines and choose to get their children immunized,” she adds. Now, that is a sentiment I can relate to.

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A couple of years ago, the polio virus was detected in wastewater in London, where I live. I immediately got my daughter (who was only one year old then!) vaccinated. 

Measles outbreaks continue to spring up in places where vaccination rates drop. Researchers hope that searching for traces of the virus in wastewater could help them develop early warning systems. 

Last year, the researchers whose work paved the way for the development of mRNA vaccines were awarded the Nobel Prize. Now, scientists are hoping to use the same technology to treat and vaccinate against a host of diseases.

Most vaccines work by priming the immune system to respond to a pathogen. Scientists are also working on “inverse vaccines” that teach the immune system to stand down. They might help treat autoimmune disorders.

From around the web

A person in the US is the first in the country to have become severely ill after being infected with the bird flu virus, the US Centers for Disease Control and Prevention shared on December 18. The case was confirmed on December 13. The person was exposed to sick and dead birds in backyard flocks in Louisiana. (CDC) 

Gavin Newsom, the governor of California, declared a state of emergency as the bird flu virus moved from the Central Valley to Southern California dairy herds. Since August, 645 herds have been reported to be infected with the virus. (LA Times)

Pharmacy benefit managers control access to prescription drugs for most Americans. These middlemen were paid billions of dollars by drug companies to allow the free flow of opioids during the US’s deadly addiction epidemic, an investigation has revealed. (New York Times)

Weight-loss drugs like Ozempic have emerged as blockbuster medicines over the past couple of years. We’re learning that they may have benefits beyond weight loss. Might they also protect organ function or treat kidney disease? (Nature Medicine)

Doctors and scientists have been attempting head transplants on animals for decades. Can they do it in people? Watch this delightful cartoon to learn more about the early head transplant attempts. (Aeon)

Donating embryos for research is surprisingly complex

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.

There’s a new film about IVF out on Netflix. And “everyone in the field [of reproductive medicine] has watched it,” according to one embryologist I spoke to recently. Joy is a lovely watch about the birth of the field, thanks to the persistent efforts of Robert Edwards, Jean Purdy, and Patrick Steptoe in the face of significant opposition.

The team performed much of their key research during the 1960s and ’70s. And Louise Brown, the first “test tube baby” (as she was called at the time), was born in 1978. It’s remarkable to think that within 40 years of that milestone, another 8 million babies had been born through IVF. Today, it is estimated that over 12 million babies have resulted from IVF, and that the use of reproductive technology accounts for over 2% of births in the US.

IVF is a success story for embryo research. But today, valuable embryos that could be used for research are being wasted, say researchers who gathered at a conference in central London earlier this week.

The conference was organized by the Progress Educational Trust, a UK-based charity that aims to provide information to the public on genomics and infertility. The event marked 40 years since the publication of the Warnock Report, which followed a governmental inquiry into infertility treatment and embryological research. The report is considered to be the first to guide recognition of the embryo’s “special” status in law and helped establish regulation of the nascent technology in the UK.

The report also endorsed the “14-day rule,” which limits the growth of embryos in a lab to this two-week point. The rule, since adopted around the world, is designed to prevent scientists from growing embryos to the point where they develop a structure called the primitive streak. At this point, the development of tissues and organs begins, and the embryo is no longer able to split to form twins. 

The embryos studied in labs have usually been created for IVF but are no longer needed by the people whose cells created them. Those individuals might have completed their families, or they might not be able to use the embryos because their circumstances have changed. Sometimes the embryos have genetic abnormalities that make them unlikely to survive a pregnancy.

These embryos can be used to learn more about how humans develop before birth, and to discover potential treatments for developmental disorders like spina bifida or heart defects, for example. Research on embryos can help reveal clues about our fundamental biology, and provide insight into pregnancy and miscarriage.

A survey conducted by the Human Fertility and Embryology Authority, which regulates reproductive technology in the UK, found that the majority of patients would rather donate their embryos to research than allow them to “perish,” Geraldine Hartshorne, director of the Coventry Centre for Reproductive Medicine, told the audience.

Despite this, the number of embryos donated for research in the UK has dropped steeply over the last couple of decades, from 17,925 in 2004 to 675 in 2019—a surprising decline considering that the number of IVF cycles performed increased steadily over the same period. 

There are a few reasons why embryos aren’t making it into research labs, says Hartshorne. Part of the problem is that most IVF cycles happen at clinics that don’t have links with academic research centers.

As things stand, embryos tend to be stored at the clinics where they were created. It can be difficult to get them to research centers—clinic staff don’t have the time, energy, or head space to manage the paperwork legally required to get embryos donated to specific research projects, said Hartshorne. It would make more sense to have some large, central embryo bank where people could send embryos to donate for research, she added.

A particular problem is the paperwork. While the UK is rightly praised for its rigorous approach to regulation of reproductive technologies, which embryologists around the globe tend to describe as “world-leading,” there are onerous levels of bureaucracy to contend with, said Hartshorne. “When patients contact me and say ‘I’d like to give my embryos or my eggs to your research project,’ I usually have to turn them away, because it would take me a year to get through the paperwork necessary,” she said.

Perhaps there’s a balance to be struck. Research on embryos has the potential to be hugely valuable. As the film Joy reminds us, it can transform medical practice and change lives.

“Without research, there would be no progress, and there would be no change,” Hartshorne said. “That is definitely not something that I think we should aspire to for IVF and reproductive science.”

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Scientists are working on ways to create embryos from stem cells, without the use of eggs or sperm. How far should we allow these embryo-like structures to develop? 

Researchers have implanted these “synthetic embryos” in monkeys. So far, they’ve been able to generate a short-lived pregnancy-like response … but no fetuses.

Others are trying to get cows pregnant with synthetic embryos. Reproductive biologist Carl Jiang’s first goal is to achieve a cow pregnancy that lasts 30 days. 

Several startups are using robots to fertilize eggs with sperm to create embryos. Two girls are the first people to be born after robot-assisted fertilization, says the team behind the work. 

From around the web

Mexico’s Sinaloa cartel is recruiting young chemistry students from colleges to make fentanyl. Specifically, the students are being tasked with the often dangerous job of trying to synthesize precursor chemicals that must currently be imported. They also try to design stronger versions of the drug that are more likely to get users hooked. (New York Times)

Billionaire Greg Lindberg is running his own “baby project.” Having duped, misled, and paid off a series of egg donors and surrogates, the disgraced insurance tycoon currently has 12 children, nine of whom were born in the last five years or so. He is the sole parent caring for eight of them, despite facing significant jail time since being convicted of bribery and pleading guilty to money laundering and fraud conspiracy charges for crimes unrelated to the baby project. The scale of his project is an indictment of the US fertility industry. (Bloomberg Businessweek)

The UK government has agreed to a contract for more than 5 million doses of a vaccine designed to protect people from the H5 bird flu virus. The vaccine is being procured as part of pandemic preparedness plans and will be used only if the virus starts spreading among humans. (UK Health Security Agency)

Last week, MPs voted in favor of a bill to legalize assisted dying in England and Wales. In the past few months, the debate over the bill has included horror stories of painful deaths. Most deaths are “ordinary,” but we all stand to benefit from talking about, and understanding, what death involves. (New Statesman)

An unknown disease has killed 143 people in southwest Congo, according to local authorities. The number of infections continues to rise, and the situation is extremely worrying. (Reuters)

Brian Thompson, the 50-year-old CEO of US health insurance company UnitedHealthcare, was fatally shot in New York city on Wednesday. The New York Times is reporting that bullet casings found at the scene appear to have been marked with the words “delay” and “deny.” The words may refer to strategies used by insurance companies to avoid covering healthcare costs. (New York Times)