VACCINES AND IMMUNITY
“No More Needles,” by Stephani Sutherland, describes new nasal spray vaccines. It was very helpful to learn about mucosal immunity, an aspect of the immune system about which there has been very little press. But the article did not discuss the effect of nasal vaccines on immunocompromised or immunosuppressed individuals.
My wife is a heart-transplant recipient and is on a lifelong regimen of immunosuppressants. Recently we received an alert from her transplant team that transplant patients should not take FluMist, a spray vaccine against influenza that received U.S. Food and Drug Administration approval last September. It also said such patients shouldn’t be in the same room as another person receiving an inhaled dose of FluMist or have any contact with a person who has taken the vaccine for seven days. Why is this?
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ANDREW WRIGHT BASKING RIDGE, N.J.
THE EDITORS REPLY: FluMist is made with a weakened (attenuated) flu virus to stimulate immunity. A normally functioning immune system can keep that virus in check. A suppressed immune system, however, may not be able to stop the weakened virus from creating a real infection. People who have received an organ transplant usually have a suppressed immune system, so live, attenuated vaccines are not recommended for such individuals.
“We shouldn’t abandon the leap second out of a misguided quest for simplicity!” —Agatha Mallett, Via E-mail
SECOND OPINION
“Should We Abandon the Leap Second?,” by Mark Fischetti and Matthew Twombly, questions whether the leap seconds we add or subtract to time kept by our atomic clocks are worth the effort.
We should maintain the leap second. It is the basic link between UT1 (essentially mean solar time) and atomic clock time, also called international atomic time (TAI). Their combination, coordinated universal time (UTC), gives the advantages of both: accurately ticking seconds, as defined by the International System of Units, but still respecting the day-night cycle that is foundational to everyday human life.
Jumps in UTC turn out to be the only reasonable way to make this elegant and useful correspondence. Every alternative involves sacrifice: reduced accuracy, reduced human relevance or long-term failure. Moreover, removing the leap second would actually make computerized timekeeping much harder, not easier, so there is simply no reason to do it.
UTC is the sole time standard that is ideal for the needs of both humans and machines, and leap seconds are crucial to implement it. We shouldn’t abandon the leap second out of a misguided quest for simplicity!
AGATHA MALLETT VIA E-MAIL
BABY TALK
“The Evolution of Music,” by Allison Parshall, Duncan Geere and Miriam Quick [Graphic Science], notes three worldwide trends in song: they tend to be slower than speech and to have a higher and more stable pitch. It occurs to me that this pattern is the same one we see when adults “speak” to infants (at least in the Western world). If this is correct, is there a connection between song and the most basic infantile communication? And further, is this link the basis for the evolution of adult speech?
DENNIS MONASEBIAN ARMONK, N.Y.
PARSHALL REPLIES: Recent research does support the idea of infant-directed speech, or “baby talk,” sharing characteristics such as higher pitch and slower tempo across cultures. One could hypothesize that the same features that make baby talk attention-grabbing and appealing to infants also make adult song attention grabbing and appealing to adults, although it’s also possible that they evolved separately for different reasons.
FINDING HELP FOR ADDICTION
As someone who has struggled with addiction, I was very interested in Maia Szalavitz’s article on “The Traumatic Roots of Addiction” [October]. But I was dismayed by her portrayal of 12-step programs, particularly Alcoholics Anonymous (AA). To classify them as “social support” groups is not correct. AA’s meetings may provide social support, but that is not the basis of the program.
Further, Szalavitz comments on the rigidity of 12-step programs and people telling newcomers to “shut up and listen,” but this is not the case in AA. It is simply a suggested program of recovery. Some groups did decide to veer away from the established program and basically create their own. As noted in the article, AA has no opinion on outside matters, including therapy. Therapy in conjunction with AA has helped many people—and has made a difference in my life. One without the other would mean incomplete treatment. Whenever a given group tells me what I must do in a rigid way, I simply find another meeting. The program can work for anyone who wants it to.
“MIKE H.” VIA E-MAIL
SZALAVITZ REPLIES: It is not possible to write about 12-step programs without encountering pushback from members who claim misinterpretation. Research shows that participation in 12-step groups is most likely to be beneficial for people who attend them voluntarily and find them helpful. But because both the social support aspect and the steps themselves can be harmful to some (as I discuss), they should not be mandated. Still, 12-step participation is the foundation of most American addiction treatments. To help the majority of people with addiction who have suffered from childhood trauma get evidence-based care, this must change.
MOTIVATED DELAY
I have some responses to Javier Granados Samayoa and Russell Fazio’s fine article on procrastination [“How to Beat Procrastination”; Mind Matters], but I just haven’t been able to find time to jot them down. Perhaps I’ll do so next month.
TIM JOHNSON SARASOTA, FLA.
ULTRASOUND LESSONS FOR ADHD
I was intrigued by Lucy Tu’s Advances article on a study that enhanced mindfulness with ultrasound stimulation of the brain’s default mode network (DMN) [“Ultrasound Meditation”; October]. I recall a video by YouTube personality Jessica McCabe in which she talked to psychiatrist Edward Hallowell about how the DMN can act up and lead to rumination in people with attention deficit hyperactivity disorder (ADHD). They also discussed strategies for how to get the DMN to relax. I wonder if ultrasound stimulation would be a viable treatment for those of us whose brain wants to go full speed all the time or if lessons from studying ADHD could become useful in determining how ultrasound stimulation could be helpful.
“VIVIANA H.” VIA E-MAIL
ERRATA
“Better Measures,” by Cassandra Willyard [Innovations in Solutions for Health Equity], should have described creatinine as a molecule, not a protein.
“Defogging Data,” by Jyoti Madhusoodanan [Innovations in Solutions for Health Equity], should have said that the Office of Management and Budget defined the single Asian or Pacific Islander category in 1977 and that a 1997 revision to the standard required that group to be split into two categories. In addition, the article should have given Joseph Keaweʻaimoku Kaholokula’s full name and described him as a health disparities researcher.