Alasdair Munro
@apsmunro.bsky.social
NIHR Academic Clinical Lecturer in Paediatric Immunology and Infectious Diseases
University of Southampton and Southampton Children’s Hospital UK
alasdairmunro.substack.com
University of Southampton and Southampton Children’s Hospital UK
alasdairmunro.substack.com
Reposted by Alasdair Munro
Respiratory PCR testing has exploded since the pandemic, but tests are expensive and sometimes used indiscriminately
We produced a statement for our regional paediatric network to help guide testing and improve diagnostic stewardship
#IDSky #PedsID
We produced a statement for our regional paediatric network to help guide testing and improve diagnostic stewardship
#IDSky #PedsID
Position Statement on Respiratory PCR testing in children
PIER Guideline for Position Statement on Respiratory PCR testing in children
www.piernetwork.org
November 18, 2025 at 6:25 PM
Reposted by Alasdair Munro
I get so confused when residents want to get the big panels in the primary care setting.
As you state in the guideline multiplex for when it will impact management! Which in primary care is almost never.
As you state in the guideline multiplex for when it will impact management! Which in primary care is almost never.
November 18, 2025 at 6:49 PM
I get so confused when residents want to get the big panels in the primary care setting.
As you state in the guideline multiplex for when it will impact management! Which in primary care is almost never.
As you state in the guideline multiplex for when it will impact management! Which in primary care is almost never.
Respiratory PCR testing has exploded since the pandemic, but tests are expensive and sometimes used indiscriminately
We produced a statement for our regional paediatric network to help guide testing and improve diagnostic stewardship
#IDSky #PedsID
We produced a statement for our regional paediatric network to help guide testing and improve diagnostic stewardship
#IDSky #PedsID
Position Statement on Respiratory PCR testing in children
PIER Guideline for Position Statement on Respiratory PCR testing in children
www.piernetwork.org
November 18, 2025 at 6:25 PM
Reposted by Alasdair Munro
Pleased to share my new post looking at the recent successes and turbulence in the development of therapeutics for infant RSV protection
Much progress made - but there’s more to do still!
#IDSky #PedsID 🧪
Much progress made - but there’s more to do still!
#IDSky #PedsID 🧪
Protecting babies against RSV
The last two years have changed the landscape of RSV disease prevention
open.substack.com
October 13, 2025 at 6:09 AM
Reposted by Alasdair Munro
"we haven't been able to give them the vaccine ... there hasn't been enough data for the regulators ... this trial is looking at getting this additional data that we need so that hopefully in the future we'll be able to offer the vaccine to children younger than two." - @apsmunro.bsky.social
Did you see @uhsft.bsky.social's @apsmunro.bsky.social on BBC South with @edwardjsault.bsky.social? 📺
While many people recover quickly, flu can be dangerous for young children.
A new trial is exploring whether the flu vaccine can be extended to younger toddlers.
🔗 bbc.co.uk/news/article...
While many people recover quickly, flu can be dangerous for young children.
A new trial is exploring whether the flu vaccine can be extended to younger toddlers.
🔗 bbc.co.uk/news/article...
October 18, 2025 at 3:39 AM
"we haven't been able to give them the vaccine ... there hasn't been enough data for the regulators ... this trial is looking at getting this additional data that we need so that hopefully in the future we'll be able to offer the vaccine to children younger than two." - @apsmunro.bsky.social
Reposted by Alasdair Munro
Did you see @uhsft.bsky.social's @apsmunro.bsky.social on BBC South with @edwardjsault.bsky.social? 📺
While many people recover quickly, flu can be dangerous for young children.
A new trial is exploring whether the flu vaccine can be extended to younger toddlers.
🔗 bbc.co.uk/news/article...
While many people recover quickly, flu can be dangerous for young children.
A new trial is exploring whether the flu vaccine can be extended to younger toddlers.
🔗 bbc.co.uk/news/article...
October 17, 2025 at 1:21 PM
Did you see @uhsft.bsky.social's @apsmunro.bsky.social on BBC South with @edwardjsault.bsky.social? 📺
While many people recover quickly, flu can be dangerous for young children.
A new trial is exploring whether the flu vaccine can be extended to younger toddlers.
🔗 bbc.co.uk/news/article...
While many people recover quickly, flu can be dangerous for young children.
A new trial is exploring whether the flu vaccine can be extended to younger toddlers.
🔗 bbc.co.uk/news/article...
Reposted by Alasdair Munro
"trials were immediately halted and a meeting ... convened on December 12th 2024. Despite the vaccine passing all the pre-clinical tests put in place to ensure the vaccines didn’t result in VAERD, it looks possible it may have happened anyway. ... the safety checks ... worked extremely well"
Pleased to share my new post looking at the recent successes and turbulence in the development of therapeutics for infant RSV protection
Much progress made - but there’s more to do still!
#IDSky #PedsID 🧪
Much progress made - but there’s more to do still!
#IDSky #PedsID 🧪
Protecting babies against RSV
The last two years have changed the landscape of RSV disease prevention
open.substack.com
October 13, 2025 at 11:45 AM
"trials were immediately halted and a meeting ... convened on December 12th 2024. Despite the vaccine passing all the pre-clinical tests put in place to ensure the vaccines didn’t result in VAERD, it looks possible it may have happened anyway. ... the safety checks ... worked extremely well"
Reposted by Alasdair Munro
Really nice summary - thanks @apsmunro.bsky.social
Pleased to share my new post looking at the recent successes and turbulence in the development of therapeutics for infant RSV protection
Much progress made - but there’s more to do still!
#IDSky #PedsID 🧪
Much progress made - but there’s more to do still!
#IDSky #PedsID 🧪
Protecting babies against RSV
The last two years have changed the landscape of RSV disease prevention
open.substack.com
October 13, 2025 at 6:16 AM
Really nice summary - thanks @apsmunro.bsky.social
Pleased to share my new post looking at the recent successes and turbulence in the development of therapeutics for infant RSV protection
Much progress made - but there’s more to do still!
#IDSky #PedsID 🧪
Much progress made - but there’s more to do still!
#IDSky #PedsID 🧪
Protecting babies against RSV
The last two years have changed the landscape of RSV disease prevention
open.substack.com
October 13, 2025 at 6:09 AM
Just remembered when I broke one of my golden rules and suggested testing for Mycoplasma serology last week
Saying it took just moments, but the shame will last a lifetime
Saying it took just moments, but the shame will last a lifetime
October 12, 2025 at 2:25 PM
Just remembered when I broke one of my golden rules and suggested testing for Mycoplasma serology last week
Saying it took just moments, but the shame will last a lifetime
Saying it took just moments, but the shame will last a lifetime
This morning I awoke to discover we had run out of coffee
In behaviours not at all indicative of addiction, I drove immediately to the nearest drive-through Costa in my pyjamas to obtain flat-whites for me and my wife
I have no regrets
In behaviours not at all indicative of addiction, I drove immediately to the nearest drive-through Costa in my pyjamas to obtain flat-whites for me and my wife
I have no regrets
October 12, 2025 at 7:00 AM
This morning I awoke to discover we had run out of coffee
In behaviours not at all indicative of addiction, I drove immediately to the nearest drive-through Costa in my pyjamas to obtain flat-whites for me and my wife
I have no regrets
In behaviours not at all indicative of addiction, I drove immediately to the nearest drive-through Costa in my pyjamas to obtain flat-whites for me and my wife
I have no regrets
Very please to say that for the first time in nearly a year, I have a new Substack post coming on Monday!
Looking at the successes and tribulations of novel therapeutics to protect infants from RSV
Looking forward to sharing ✍️
open.substack.com/pub/alasdair...
Looking at the successes and tribulations of novel therapeutics to protect infants from RSV
Looking forward to sharing ✍️
open.substack.com/pub/alasdair...
The Munro Report | Alasdair Munro | Substack
A newsletter with analysis on issues affecting science, medical research, child health and infectious diseases. Click to read The Munro Report, by Alasdair Munro, a Substack publication with thousands...
open.substack.com
October 11, 2025 at 6:19 PM
Very please to say that for the first time in nearly a year, I have a new Substack post coming on Monday!
Looking at the successes and tribulations of novel therapeutics to protect infants from RSV
Looking forward to sharing ✍️
open.substack.com/pub/alasdair...
Looking at the successes and tribulations of novel therapeutics to protect infants from RSV
Looking forward to sharing ✍️
open.substack.com/pub/alasdair...
Reposted by Alasdair Munro
Everything spoken about here is pretty widely accepted now
These are really important things for institutions to be demonstrating they accept, and have learnt from if we want to build back trust from the public
That includes us as health professionals
www.economist.com/culture/2025...
These are really important things for institutions to be demonstrating they accept, and have learnt from if we want to build back trust from the public
That includes us as health professionals
www.economist.com/culture/2025...
Covid-19 sent the world mad
The pandemic polarised voters and undermined trust in institutions
www.economist.com
September 10, 2025 at 2:23 PM
Everything spoken about here is pretty widely accepted now
These are really important things for institutions to be demonstrating they accept, and have learnt from if we want to build back trust from the public
That includes us as health professionals
www.economist.com/culture/2025...
These are really important things for institutions to be demonstrating they accept, and have learnt from if we want to build back trust from the public
That includes us as health professionals
www.economist.com/culture/2025...
Reposted by Alasdair Munro
It’s that time of year again. You know RSV is coming! But it could all be different with RSV vaccination. Listen to the brilliant Dr Simon Drysdale for hear the latest @ox.ac.uk @voices4vaccines.bsky.social #RCPCH #paedsround @apsmunro.bsky.social @mariekeemonts.bsky.social
Protecting infants with the maternal vaccine for RSV
Podcast Episode · The Paeds Round · 08/04/2025 · 28m
podcasts.apple.com
September 16, 2025 at 9:57 PM
It’s that time of year again. You know RSV is coming! But it could all be different with RSV vaccination. Listen to the brilliant Dr Simon Drysdale for hear the latest @ox.ac.uk @voices4vaccines.bsky.social #RCPCH #paedsround @apsmunro.bsky.social @mariekeemonts.bsky.social
Reposted by Alasdair Munro
On #WorldSepsisDay highlighting editorial (with @apsmunro.bsky.social )
"Time for paediatrics to screen out sepsis “screening”
www.bmj.com/content/381/...
(For example screening, by definition, requires patient to be asymptomatic. But many patients receiving a “sepsis screen” are symptomatic)
"Time for paediatrics to screen out sepsis “screening”
www.bmj.com/content/381/...
(For example screening, by definition, requires patient to be asymptomatic. But many patients receiving a “sepsis screen” are symptomatic)
Time for paediatrics to screen out sepsis “screening”
It is time to remove the term, “sepsis screen,” from the paediatric lexicon, argue these authors
Despite the success of vaccinations against organisms such as Haemophilus influenza type B and Neisser...
www.bmj.com
September 13, 2025 at 5:07 PM
On #WorldSepsisDay highlighting editorial (with @apsmunro.bsky.social )
"Time for paediatrics to screen out sepsis “screening”
www.bmj.com/content/381/...
(For example screening, by definition, requires patient to be asymptomatic. But many patients receiving a “sepsis screen” are symptomatic)
"Time for paediatrics to screen out sepsis “screening”
www.bmj.com/content/381/...
(For example screening, by definition, requires patient to be asymptomatic. But many patients receiving a “sepsis screen” are symptomatic)
This equates to 0.5 micromorts for each person receiving a vaccination course (usually several vaccines)
That is less than the mortality risk for a single day of skiing (0.7 micromorts)
That is less than the mortality risk for a single day of skiing (0.7 micromorts)
Covid vaccine deaths: the best data came out of Korea, which did autopsies on all post-vaccination sudden deaths.
The country identified 21 deaths out of 44 million vaccinees.
Yes people can die from the vaccine, but it’s incredibly rare.
mazer.substack.com/p/koreas-rea...
The country identified 21 deaths out of 44 million vaccinees.
Yes people can die from the vaccine, but it’s incredibly rare.
mazer.substack.com/p/koreas-rea...
Korea's reassuring vaccine data
Autopsy results reveal extremely rare sudden deaths
mazer.substack.com
September 12, 2025 at 6:53 PM
This equates to 0.5 micromorts for each person receiving a vaccination course (usually several vaccines)
That is less than the mortality risk for a single day of skiing (0.7 micromorts)
That is less than the mortality risk for a single day of skiing (0.7 micromorts)
Reposted by Alasdair Munro
Covid vaccine deaths: the best data came out of Korea, which did autopsies on all post-vaccination sudden deaths.
The country identified 21 deaths out of 44 million vaccinees.
Yes people can die from the vaccine, but it’s incredibly rare.
mazer.substack.com/p/koreas-rea...
The country identified 21 deaths out of 44 million vaccinees.
Yes people can die from the vaccine, but it’s incredibly rare.
mazer.substack.com/p/koreas-rea...
Korea's reassuring vaccine data
Autopsy results reveal extremely rare sudden deaths
mazer.substack.com
September 12, 2025 at 6:46 PM
Covid vaccine deaths: the best data came out of Korea, which did autopsies on all post-vaccination sudden deaths.
The country identified 21 deaths out of 44 million vaccinees.
Yes people can die from the vaccine, but it’s incredibly rare.
mazer.substack.com/p/koreas-rea...
The country identified 21 deaths out of 44 million vaccinees.
Yes people can die from the vaccine, but it’s incredibly rare.
mazer.substack.com/p/koreas-rea...
Everything spoken about here is pretty widely accepted now
These are really important things for institutions to be demonstrating they accept, and have learnt from if we want to build back trust from the public
That includes us as health professionals
www.economist.com/culture/2025...
These are really important things for institutions to be demonstrating they accept, and have learnt from if we want to build back trust from the public
That includes us as health professionals
www.economist.com/culture/2025...
Covid-19 sent the world mad
The pandemic polarised voters and undermined trust in institutions
www.economist.com
September 10, 2025 at 2:23 PM
Everything spoken about here is pretty widely accepted now
These are really important things for institutions to be demonstrating they accept, and have learnt from if we want to build back trust from the public
That includes us as health professionals
www.economist.com/culture/2025...
These are really important things for institutions to be demonstrating they accept, and have learnt from if we want to build back trust from the public
That includes us as health professionals
www.economist.com/culture/2025...
This reminds me that contrary to some thinking, social media doesn’t reduce exposure to alternative viewpoints (eg “bubble effect”)
It increases exposure - but only to the worst and most extreme versions of them, further convincing you that you’re right and “the others” are terrible idiots
It increases exposure - but only to the worst and most extreme versions of them, further convincing you that you’re right and “the others” are terrible idiots
Whereas traditional media caters to a range of views, with moderate positions well-represented, extreme views — of both left and right — are heavily over-represented on social media. on.ft.com/3HNwX1M
September 5, 2025 at 7:32 PM
This reminds me that contrary to some thinking, social media doesn’t reduce exposure to alternative viewpoints (eg “bubble effect”)
It increases exposure - but only to the worst and most extreme versions of them, further convincing you that you’re right and “the others” are terrible idiots
It increases exposure - but only to the worst and most extreme versions of them, further convincing you that you’re right and “the others” are terrible idiots
Reposted by Alasdair Munro
Whereas traditional media caters to a range of views, with moderate positions well-represented, extreme views — of both left and right — are heavily over-represented on social media. on.ft.com/3HNwX1M
September 5, 2025 at 7:16 PM
Whereas traditional media caters to a range of views, with moderate positions well-represented, extreme views — of both left and right — are heavily over-represented on social media. on.ft.com/3HNwX1M
Reposted by Alasdair Munro
We didn't randomize, and there was no allocation concealment or blinding, and we can't really be sure what intervention they got or how the outcomes were measured, but we emulated a trial by drawing a DAG.
August 31, 2025 at 3:21 PM
We didn't randomize, and there was no allocation concealment or blinding, and we can't really be sure what intervention they got or how the outcomes were measured, but we emulated a trial by drawing a DAG.
There are a lot of oral/enteral source infections where we add anaerobic cover to standard empirical antibiotics (usually cephalosporins - classic “cef and met” combo)
Is there actually any empirical evidence this is beneficial?
#IDSky
Is there actually any empirical evidence this is beneficial?
#IDSky
August 22, 2025 at 6:57 PM
There are a lot of oral/enteral source infections where we add anaerobic cover to standard empirical antibiotics (usually cephalosporins - classic “cef and met” combo)
Is there actually any empirical evidence this is beneficial?
#IDSky
Is there actually any empirical evidence this is beneficial?
#IDSky
Reposted by Alasdair Munro
Instructive thread by Alasdair explaining difference in covid vaccination policy in UK & EU vs US and the difference to flu vaccination. Refreshing to see nuance and the need for thinking in trade-offs which is a necessary element for building a sustainable and efficient public health policy.
You’ve missed the point
Not every seasonal vaccine requires an RCT (I don’t believe anyone is suggesting that currently)
The scenario for covid vaccines is unique as they were trialled on a background of ~zero population immunity
There is now substantial population immunity
Not every seasonal vaccine requires an RCT (I don’t believe anyone is suggesting that currently)
The scenario for covid vaccines is unique as they were trialled on a background of ~zero population immunity
There is now substantial population immunity
August 1, 2025 at 8:15 AM
Instructive thread by Alasdair explaining difference in covid vaccination policy in UK & EU vs US and the difference to flu vaccination. Refreshing to see nuance and the need for thinking in trade-offs which is a necessary element for building a sustainable and efficient public health policy.
Reposted by Alasdair Munro
The UK’s flagship health research programme promises breakthroughs, but beneath an NHS branded facade, critics are asking who really benefits from this vast database, heavily backed by industry and government.
@mgtmccartney.bsky.social and I investigate
www.bmj.com/content/390/...
@mgtmccartney.bsky.social and I investigate
www.bmj.com/content/390/...
July 30, 2025 at 7:07 PM
The UK’s flagship health research programme promises breakthroughs, but beneath an NHS branded facade, critics are asking who really benefits from this vast database, heavily backed by industry and government.
@mgtmccartney.bsky.social and I investigate
www.bmj.com/content/390/...
@mgtmccartney.bsky.social and I investigate
www.bmj.com/content/390/...
Reposted by Alasdair Munro
"What’s it like to have lived through both HIV and COVID as an ID doctor?"
A new intern asked me that last week.
I didn’t answer it fully then -- but I did here. #IDSky blogs.jwatch.org/hiv-id-obser...
A new intern asked me that last week.
I didn’t answer it fully then -- but I did here. #IDSky blogs.jwatch.org/hiv-id-obser...
Two Pandemics, Compared: Reflections on HIV and COVID-19
“Dr. Sax, what’s it like to have lived through two pandemics as an ID doctor?” The question came from a brand-new intern during afternoon sign-out. I took a breath — because wow, were they different. ...
blogs.jwatch.org
July 7, 2025 at 5:57 PM
"What’s it like to have lived through both HIV and COVID as an ID doctor?"
A new intern asked me that last week.
I didn’t answer it fully then -- but I did here. #IDSky blogs.jwatch.org/hiv-id-obser...
A new intern asked me that last week.
I didn’t answer it fully then -- but I did here. #IDSky blogs.jwatch.org/hiv-id-obser...