Ask Doctor Dawn

← Ask Doctor Dawn4 sep · 47 min

Fall Vaccine Guide, Measles Outbreaks and SSPE Risk, Oral PCSK9 Blocker Inlicitide, Cancer Screening Criteria, and Prodromal Parkinson's Signs

Fall Vaccine Guide, Measles Outbreaks and SSPE Risk, Oral PCSK9 Blocker Inlicitide, Cancer Screening Criteria, and Prodromal Parkinson's Signs4 sep47 min

Broadcast from KSQD, Santa Cruz on 9-03-2026:

With CDC vaccine guidance politically contested, major medical societies (AAFP, AAP, ACOG, IDSA) issued their own recommendations through the Vaccine Integrity Project. Dr. Dawn recommends flu shots in October for peak Thanksgiving antibodies, high-dose flu vaccine (not adjuvanted) for frail seniors, and COVID/flu/RSV given at the same visit—except delay COVID vaccination four to six months after recent infection. Pregnant women should receive RSV vaccine at 32-36 weeks, and infants under eight months entering their first RSV season need vaccination if the mother wasn't vaccinated. RSV is one-time only for adults 75+, or for high-risk 50-74-year-olds.

Measles is the most contagious human disease, transmissible through brief incidental contact (buses, taxis, carnival rides). Beyond acute mortality (one in 5,000 pre-vaccine), survivors face rare but catastrophic subacute sclerosing panencephalitis 10-40 years later—immune-mediated brain destruction comparable to Huntington's. Thirty percent of current outbreak cases are in adults reflecting decades of under-vaccination in certain communities, and pregnant unvaccinated mothers create a dangerous one-year window since the live vaccine cannot be given during pregnancy.

Inlicitide (brand name Lipithandra) is the first oral PCSK9 inhibitor for LDL reduction, priced at $315/month versus $600 for the injectable version. Dr. Dawn positions it strictly as a treatment—not preventive—drug for patients who've had a heart attack or equivalent event and cannot achieve target LDL on statins alone, with prior authorization typically successful given documented disease.

Updated cancer screening guidance from major societies: cervical cancer screening at 25 for HPV-vaccinated women (earlier if unvaccinated), annual mammograms from 45-54 then biennial, PSA screening starting at 50, and low-dose CT lung cancer screening at 50-80 for heavy smokers. Dr. Dawn pushes back on the 2018 Task Force downplaying of PSA screening, noting MRI-targeted transperineal biopsies have dramatically reduced false-positive complications. She also warns about rising male cancer diagnoses at later stages for stomach, lung, tongue, and throat cancers, and recommends the vinegar test for suspicious oral white spots.

Parkinson's disease develops through a decades-long prodromal phase before motor symptoms appear—by tremor onset, at least half the substantia nigra neurons are dead. Four early warning sig