How an Idaho vaccine advocacy org plans its annual goals
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The start of a new year means many nonprofits and community health workers are busy setting goals and reflecting on what’s worked and what hasn’t. For those engaged in vaccine outreach, it also means reflecting on the tools and tactics that help them communicate better with their communities about why vaccines matter.
Across the country, childhood vaccination rates have declined since the COVID-19 pandemic, resulting in a resurgence of preventable diseases like pertussis.
Also known as whooping cough, pertussis has surged in states like Idaho, said Karen Jachimowski Sharpnack, executive director of the Idaho Immunization Coalition, in a conversation with PGN about the organization’s 2025 priorities.
Sharpnack shared how spikes in infectious respiratory illnesses can create opportunities to listen better and understand the nuances of the communities they serve.
Here’s more of what Sharpnack said.
[Editor’s note: The contents of this interview have been edited for length and clarity.]
PGN: Whooping cough cases are up in your state. Can you share an example of how your organization is responding?
Karen Jachimowski Sharpnack: If you look at Treasure Valley and Northern Idaho, the majority of those cases have been reported, and it’s like five times as much as we had the previous year.
So, two things that the Coalition is doing in response: First, we put out radio public service announcements throughout those particular areas about what whooping cough is, how contagious it is, and what you should do if you think your child or anyone you know has it.
Second, we are contacting every school superintendent, principal, school nurse, with a letter from us at the Coalition [to warn about] the whooping cough outbreaks in schools right now. Here’s what the symptoms are, here’s what you can do, and then here’s how you can protect yourself and your families.
It doesn’t mean the health district wouldn’t do it, or the Department of Health and Welfare can’t do it. But from our standpoint, at least we are bringing an awareness to the schools that this is happening.
PGN: How does your organization decide when outreach is needed? How do you take a pulse of your communities’ vaccine attitudes?
K.J.S.: We consistently hold listening sessions. We do them in English and Spanish if we need to, and we go around—and I’m talking about the southern part of the state—and bring people together.
We’ve done adults, we’ve done teenagers, we’ve done college students, we’ve done seniors, we’ve done all age groups.
So, we’ll bring eight or 10 people together, and we’ll spend a couple of hours with them. We feed them and we also pay them to be there. We say, ‘We want to hear from you about what you’re hearing about vaccines, what your views are if you’re vaccinated.’ Anytime, by the way, they can get up and leave and still get paid.
We want to hear what they’re hearing on the ground. And these sessions are extremely informational. For one, we learn about the misinformation that goes out there, like immediately. And two, we’re able to then focus [on how to respond]. If we’re hearing this, what kind of media campaign do we need to get together?
PGN: How do these listening sessions inform your work?
K.J.S.: So, a couple times a year we also pay a professional poller to do a poll. And when we get those results we check them against our listening sessions. We want to see: Are we on target? Are we ahead?
We just finished putting a one-pager together for legislators, so we’re ready to go with the new [legislative] session. We do this poll every year in August-September to know how Idahoans are feeling about vaccines. We get the results in October, because we’re getting ready for the next year.
We actually poll 19-to-64-year-olds, really honing in on questions like, ‘Do you believe vaccines are safe and effective?’ ‘Do you believe that school vaccination rules should still be in place?’
And what’s pretty cool is that two-thirds of Idahoans still believe vaccines are safe and effective, want to keep school rules in place, and believe that the infrastructure systems that we have in place for our vaccine registry should remain the same. Those are important to hear, so this is really good information that we can pull out and do something with.
PGN: Like what?
K.J.S.: Here’s the bottom line. It takes money to do this work, so you have to be able to say what you are going to do with the results.
Doing a poll costs anywhere from $15,000 to $35,000. This is an expensive investment, but we know that the polling is so important to us, along with the time that I have my staff go out and do the listening sessions and get feedback.
We take those results to educate, to talk to our legislators, and advocate for vaccines. We actually do these high-level media campaigns around the state. So, we are actually doing something with the polling. We’re not just sharing the results out.
And then we actually ask, what can we do to make a change? What are we hearing that we need to focus on?
That’s why it’s really important, because we are actually pushing this out for 2025. We know where we’re going in 2025 programmatically with marketing, and we know where we’re going with advocacy work.
We’re not guessing. We’re actually listening to people. And then we’re making really concrete decisions on how we’re going to move the organization forward to be able to help our communities.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Are Electrolyte Supplements Worth It?
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When To Take Electrolytes (And When We Shouldn’t!)
Any sports nutrition outlet will sell electrolyte supplements. Sometimes in the form of sports drinks that claim to be more hydrating than water, or tablets that can be dissolved in water to make the same. How do they work, and should we be drinking them?
What are electrolytes?
They’re called “electrolytes” because they are ionized particles (so, they have a positive or negative electrical charge, depending on which kind of ion they are) that are usually combined in the form of salts.
The “first halves” of the salts include:
- Sodium
- Potassium
- Calcium
- Magnesium
The “second halves” of the salts include:
- Chloride
- Phosphate
- Bicarbonate
- Nitrate
It doesn’t matter too much which way they’re combined, provided we get what we need. Specifically, the body needs them in a careful balance. Too much or too little, and bad things will start happening to us.
If we live in a temperate climate with a moderate lifestyle and a balanced diet, and have healthy working kidneys, usually our kidneys will keep them all in balance.
Why might we need to supplement?
Firstly, of course, you might have a dietary deficiency. Magnesium deficiency in particular is very common in North America, as people simply do not eat as much greenery as they ideally would.
But, also, you might sweat out your electrolytes, in which case, you will need to replace them.
In particular, endurance training and High Intensity Interval Training are likely to prompt this.
However… Are you in a rush? Because if not, you might just want to recover more slowly:
❝Vigorous exercise and warm/hot temperatures induce sweat production, which loses both water and electrolytes. Both water and sodium need to be replaced to re-establish “normal” total body water (euhydration).
This replacement can be by normal eating and drinking practices if there is no urgency for recovery.
But if rapid recovery (<24 h) is desired or severe hypohydration (>5% body mass) is encountered, aggressive drinking of fluids and consuming electrolytes should be encouraged to facilitate recovery❞
Source: Fluid and electrolyte needs for training, competition, and recovery
Should we just supplement anyway, as a “catch-all” to be sure?
Probably not. In particular, it is easy to get too much sodium in one’s diet, let alone by supplementation.And, oversupplementation of calcium is very common, and causes its own health problems. See:
To look directly to the science on this one, we see a general consensus amongst research reviews: “this is complicated and can go either way depending on what else people are doing”:
- Trace minerals intake: risks and benefits for cardiovascular health
- Electrolyte minerals intake and cardiovascular health
Well, that’s not helpful. Any clearer pointers?
Yes! Researchers Latzka and Mountain put together a very practical list of tips. Rather, they didn’t put it as a list, but the following bullet points are information extracted directly from their abstract, though we’ve also linked the full article below:
- It is recommended that individuals begin exercise when adequately hydrated.
- This can be facilitated by drinking 400 mL to 600 mL of fluid 2 hours before beginning exercise and drinking sufficient fluid during exercise to prevent dehydration from exceeding 2% body weight.
- A practical recommendation is to drink small amounts of fluid (150-300 mL) every 15 to 20 minutes of exercise, varying the volume depending on sweating rate.
- During exercise lasting less than 90 minutes, water alone is sufficient for fluid replacement
- During prolonged exercise lasting longer than 90 minutes, commercially available carbohydrate electrolyte beverages should be considered to provide an exogenous carbohydrate source to sustain carbohydrate oxidation and endurance performance.
- Electrolyte supplementation is generally not necessary because dietary intake is adequate to offset electrolytes lost in sweat and urine; however, during initial days of hot-weather training or when meals are not calorically adequate, supplemental salt intake may be indicated to sustain sodium balance.
Source: Water and electrolyte requirements for exercise
Bonus tip:
We’ve talked before about the specific age-related benefits of creatine supplementation, but if you’re doing endurance training or HIIT, you might also want to consider a creatine-electrolyte combination sports drink (even if you make it yourself):
Where can I get electrolyte supplements?
They’re easy to find in any sports nutrition store, or you can buy them online; here’s an example product on Amazon for your convenience
You can also opt for natural and/or homemade electrolyte drinks:
Healthline | 8 Healthy Drinks Rich in Electrolytes
Enjoy!
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See what other 10almonds subscribers are asking!
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It’s Q&A Day at 10almonds!
Q: I would be interested in learning more about collagen and especially collagen supplements/powders and of course if needed, what is the best collagen product to take. What is collagen? Why do we need to supplement the collagen in our body? Thank you PS love the information I am receiving in the news letters. Keep it up
We’re glad you’re enjoying them! Your request prompted us to do our recent Research Review Monday main feature on collagen supplementation—we hope it helped, and if you’ve any more specific (or other) question, go ahead and let us know! We love questions and requests
Q: Great article about the health risks of salt to organs other than the heart! Is pink Himalayan sea salt, the pink kind, healthier?
Thank you! And, no, sorry. Any salt that is sodium chloride has the exact same effect because it’s chemically the same substance, even if impurities (however pretty) make it look different.
If you want a lower-sodium salt, we recommend the kind that says “low sodium” or “reduced sodium” or similar. Check the ingredients, it’ll probably be sodium chloride cut with potassium chloride. Potassium chloride is not only not a source of sodium, but also, it’s a source of potassium, which (unlike sodium) most of us could stand to get a little more of.
For your convenience: here’s an example on Amazon!
Bonus: you can get a reduced sodium version of pink Himalayan salt too!
Q: Can you let us know about more studies that have been done on statins? Are they really worth taking?
That is a great question! We imagine it might have been our recent book recommendation that prompted it? It’s quite a broad question though, so we’ll do that as a main feature in the near future!
Q: Is MSG healthier than salt in terms of sodium content or is it the same or worse?
Great question, and for that matter, MSG itself is a great topic for another day. But your actual question, we can readily answer here and now:
- Firstly, by “salt” we’re assuming from context that you mean sodium chloride.
- Both salt and MSG do contain sodium. However…
- MSG contains only about a third of the sodium that salt does, gram-for-gram.
- It’s still wise to be mindful of it, though. Same with sodium in other ingredients!
- Baking soda contains about twice as much sodium, gram for gram, as MSG.
Wondering why this happens?
Salt (sodium chloride, NaCl) is equal parts sodium and chlorine, by atom count, but sodium’s atomic mass is lower than chlorine’s, so 100g of salt contains only 39.34g of sodium.
Baking soda (sodium bicarbonate, NaHCO₃) is one part sodium for one part hydrogen, one part carbon, and three parts oxygen. Taking each of their diverse atomic masses into account, we see that 100g of baking soda contains 27.4g sodium.
MSG (monosodium glutamate, C₅H₈NO₄Na) is only one part sodium for 5 parts carbon, 8 parts hydrogen, 1 part nitrogen, and 4 parts oxygen… And all those other atoms put together weigh a lot (comparatively), so 100g of MSG contains only 12.28g sodium.
Q: Thanks for the info about dairy. As a vegan, I look forward to a future comment about milk alternatives
Thanks for bringing it up! What we research and write about is heavily driven by subscriber feedback, so notes like this really help us know there’s an audience for a given topic!
We’ll do a main feature on it, to do it justice. Watch out for Research Review Monday!
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Beat Food Addictions!
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When It’s More Than “Just” Cravings
This is Dr. Nicole Avena. She’s a research neuroscientist who also teaches at Mount Sinai School of Medicine, as well as at Princeton. She’s done a lot of groundbreaking research in the field of nutrition, diet, and addition, with a special focus on women’s health and sugar intake specifically.
What does she want us to know?
Firstly, that food addictions are real addictions.
We know it can sound silly, like the famous line from Mad Max:
❝Do not, my friends, become addicted to water. It will take hold of you and you will resent its absence!❞
As an aside, it is actually possible to become addicted to water; if one drinks it excessively (we are talking gallons every day) it does change the structure of the brain (no surprise; the brain is not supposed to have that much water!) causing structural damage that then results in dependency, and headaches upon withdrawal. It’s called psychogenic polydipsia:
But back onto today’s more specific topic, and by a different mechanism of addiction…
Food addictions are dopaminergic addictions (as is cocaine)
If you are addicted to a certain food (often sugar, but other refined carbs such as potato products, and also especially refined flour products, are also potential addictive substances), then when you think about the food in question, your brain lights up with more dopamine than it should, and you are strongly motivated to seek and consume the substance in question.
Remember, dopamine functions by expectation, not by result. So until your brain’s dopamine-gremlin is sated, it will keep flooding you with motivational dopamine; that’s why the first bite tastes best, then you wolf down the rest before your brain can change its mind, and afterwards you may be left thinking/feeling “was that worth it?”.
Much like with other addictions (especially alcohol), shame and regret often feature strongly afterwards, even accompanied by notions of “never again”.
But, binge-eating is as difficult to escape as binge-drinking.
You can break free, but you will probably have to take it seriously
Dr. Avena recommends treating a food addiction like any other addiction, which means:
- Know why you want to quit (make a list of the reasons, and this will help you stay on track later!)
- Make a conscious decision to genuinely quit
- Learn about the nature of the specific addiction (know thy enemy!)
- Choose a strategy (e.g. wean off vs cold turkey, and decide what replacements, if any, you will use)
- Get support (especially from those around you, and/but the support of others facing, or who have successfully faced, the same challenge is very helpful too)
- Keep track of your success (build and maintain a streak!)
- Lean into how you will better enjoy life without addiction to the substance (it never really made you happy anyway, so enjoy your newfound freedom and good health!)
Want more from Dr. Avena?
You can check out her column at Psychology Today here:
Psychology Today | Food Junkie ← it has a lot of posts about sugar addiction in particular, and gives a lot of information and practical advice
You can also read her book, which could be a great help if you are thinking of quitting a sugar addiction:
Sugarless: A 7-Step Plan to Uncover Hidden Sugars, Curb Your Cravings, and Conquer Your Addiction
Enjoy!
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From Lupus To Arthritis: New Developments
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This week’s health news round-up highlights some things that are getting better, and some things that are getting worse, and how to be on the right side of both:
New hope for lupus sufferers
Lupus is currently treated mostly with lifelong medications to suppress the immune system, which is not only inconvenient, but also can leave people more open to infectious diseases. The latest development uses CAR T-cell technology (as has been used in cancer treatment for a while) to genetically modify cells to enable the body’s own immune system to behave properly:
Read in full: Exciting new lupus treatment could end need for lifelong medication
Related: How to Prevent (Or Reduce The Severity Of) Inflammatory Diseases
It’s in the hips
There are a lot of different kinds of hip replacements, and those with either delta ceramic or oxidised zirconium head with a highly cross-linked polyethylene liner/cup have the lowest risk of need for revision in the 15 years after surgery. This is important, because obviously, once it’s in there, you want it to be able to stay in there and not have to be touched again any time soon:
Read in full: Study identifies hip implant materials with the lowest risk of needing revision
Related: Nobody Likes Surgery, But Here’s How To Make It Much Less Bad
Sooner is better than later
Often, people won’t know about an unwanted pregnancy in the first six weeks, but for those who are able to catch it early, Very Early Medical Abortion (VEMA) offers a safe an effective way of doing so, with success rate being linked to earliness of intervention:
Read in full: Very early medication abortion is effective and safe, study finds
Related: What Might A Second Trump Presidency Look Like for Health Care?
Increased infectious disease risks from cattle farms
Many serious-to-humans infectious diseases enter the human population via the animal food chain, and in this case, bird flu becoming more rampant amongst cows is starting to pose a clear threat to humans, so this is definitely something to be aware of:
Read in full: Bird flu infects 1 in 14 dairy workers exposed; CDC urges better protections
Related: With Only Gloves To Protect Them, Farmworkers Say They Tend Sick Cows Amid Bird Flu
Herald of woe
Gut health affects most of the rest of health, and there are a lot of links between gut and bone health. In this case, an association has been found between certain changes in the gut microbiome, and subsequent onset of rheumatoid arthritis:
Read in full: Changes in gut microbiome could signal onset of rheumatoid arthritis
Related: Stop Sabotaging Your Gut
Take care!
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No, taking drugs like Ozempic isn’t ‘cheating’ at weight loss or the ‘easy way out’
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Hundreds of thousands of people worldwide are taking drugs like Ozempic to lose weight. But what do we actually know about them? This month, The Conversation’s experts explore their rise, impact and potential consequences.
Obesity medication that is effective has been a long time coming. Enter semaglutide (sold as Ozempic and Wegovy), which is helping people improve weight-related health, including lowering the risk of a having a heart attack or stroke, while also silencing “food noise”.
As demand for semaglutide increases, so are claims that taking it is “cheating” at weight loss or the “easy way out”.
We don’t tell people who need statin medication to treat high cholesterol or drugs to manage high blood pressure they’re cheating or taking the easy way out.
Nor should we shame people taking semaglutide. It’s a drug used to treat diabetes and obesity which needs to be taken long term and comes with risks and side effects, as well as benefits. When prescribed for obesity, it’s given alongside advice about diet and exercise.
How does it work?
Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for short, work better.
GLP-1 gets secreted by cells in your gut when it detects increased nutrient levels after eating. This stimulates insulin production, which lowers blood sugars.
GLP-1 also slows gastric emptying, which makes you feel full, and reduces hunger and feelings of reward after eating.
GLP-1 receptor agonist (GLP-1RA) medications like Ozempic help the body’s own GLP-1 work better by mimicking and extending its action.
Some studies have found less GLP-1 gets released after meals in adults with obesity or type 2 diabetes mellitus compared to adults with normal glucose tolerance. So having less GLP-1 circulating in your blood means you don’t feel as full after eating and get hungry again sooner compared to people who produce more.
GLP-1 has a very short half-life of about two minutes. So GLP-1RA medications were designed to have a very long half-life of about seven days. That’s why semaglutide is given as a weekly injection.
What can users expect? What does the research say?
Higher doses of semaglutide are prescribed to treat obesity compared to type 2 diabetes management (up to 2.4mg versus 2.0mg weekly).
A large group of randomised controlled trials, called STEP trials, all tested weekly 2.4mg semaglutide injections versus different interventions or placebo drugs.
Trials lasting 1.3–2 years consistently found weekly 2.4 mg semaglutide injections led to 6–12% greater weight loss compared to placebo or alternative interventions. The average weight change depended on how long medication treatment lasted and length of follow-up.
Higher doses of semaglutide are prescribed for obesity than for type 2 diabetes. fcm82/Shutterstock Weight reduction due to semaglutide also leads to a reduction in systolic and diastolic blood pressure of about 4.8 mmHg and 2.5 mmHg respectively, a reduction in triglyceride levels (a type of blood fat) and improved physical function.
Another recent trial in adults with pre-existing heart disease and obesity, but without type 2 diabetes, found adults receiving weekly 2.4mg semaglutide injections had a 20% lower risk of specific cardiovascular events, including having a non-fatal heart attack, a stroke or dying from cardiovascular disease, after three years follow-up.
Who is eligible for semaglutide?
Australia’s regulator, the Therapeutic Goods Administration (TGA), has approved semaglutide, sold as Ozempic, for treating type 2 diabetes.
However, due to shortages, the TGA had advised doctors not to start new Ozempic prescriptions for “off-label use” such as obesity treatment and the Pharmaceutical Benefits Scheme doesn’t currently subsidise off-label use.
The TGA has approved Wegovy to treat obesity but it’s not currently available in Australia.
When it’s available, doctors will be able to prescribe semaglutide to treat obesity in conjunction with lifestyle interventions (including diet, physical activity and psychological support) in adults with obesity (a BMI of 30 or above) or those with a BMI of 27 or above who also have weight-related medical complications.
What else do you need to do during Ozempic treatment?
Checking details of the STEP trial intervention components, it’s clear participants invested a lot of time and effort. In addition to taking medication, people had brief lifestyle counselling sessions with dietitians or other health professionals every four weeks as a minimum in most trials.
Support sessions were designed to help people stick with consuming 2,000 kilojoules (500 calories) less daily compared to their energy needs, and performing 150 minutes of moderate-to-vigorous physical activity, like brisk walking, dancing and gardening each week.
STEP trials varied in other components, with follow-up time periods varying from 68 to 104 weeks. The aim of these trials was to show the effect of adding the medication on top of other lifestyle counselling.
Trial participants also exercised for 150 minutes a week. Elena Nichizhenova/Shutterstock A review of obesity medication trials found people reported they needed less cognitive behaviour training to help them stick with the reduced energy intake. This is one aspect where drug treatment may make adherence a little easier. Not feeling as hungry and having environmental food cues “switched off” may mean less support is required for goal-setting, self-monitoring food intake and avoiding things that trigger eating.
But what are the side effects?
Semaglutide’s side-effects include nausea, diarrhoea, vomiting, constipation, indigestion and abdominal pain.
In one study these led to discontinuation of medication in 6% of people, but interestingly also in 3% of people taking placebos.
More severe side-effects included gallbladder disease, acute pancreatitis, hypoglycaemia, acute kidney disease and injection site reactions.
To reduce risk or severity of side-effects, medication doses are increased very slowly over months. Once the full dose and response are achieved, research indicates you need to take it long term.
Given this long-term commitment, and associated high out-of-pocket cost of medication, when it comes to taking semaglutide to treat obesity, there is no way it can be considered “cheating”.
Read the other articles in The Conversation’s Ozempic series here.
Clare Collins, Laureate Professor in Nutrition and Dietetics, University of Newcastle
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Tasty Hot-Or-Cold Soup
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Full of fiber as well as vitamins and minerals, this versatile “serve it hot or cold” soup is great whatever the weather—give it a try!
You will need
- 1 quart low-sodium vegetable stock—ideally you made this yourself from vegetable offcuts you kept in the freezer until you had enough to boil in a big pan, but failing that, a large supermarket will generally be able to sell you low-sodium stock cubes.
- 2 medium potatoes, peeled and diced
- 2 leeks, chopped
- 2 stalks celery, chopped
- 1 large onion, diced
- 1 large carrot, diced, or equivalent small carrots, sliced
- 1 zucchini, diced
- 1 red bell pepper, diced
- 1 tsp rosemary
- 1 tsp thyme
- ¼ bulb garlic, minced
- 1 small piece (equivalent of a teaspoon) ginger, minced
- 1 tsp red chili flakes
- 1 tsp black pepper, coarse ground
- ½ tsp turmeric
- Extra virgin olive oil, for frying
- Optional: ½ tsp MSG or 1 tsp low-sodium salt
About the MSG/salt: there should be enough sodium already from the stock and potatoes, but in case there’s not (since not all stock and potatoes are made equal), you might want to keep this on standby.
Method
(we suggest you read everything at least once before doing anything)
1) Heat some oil in a sauté pan, and add the diced onion, frying until it begins to soften.
2) Add the ginger, potato, carrot, and leek, and stir for about 5 minutes. The hard vegetables won’t be fully cooked yet; that’s fine.
3) Add the zucchini, red pepper, celery, and garlic, and stir for another 2–3 minutes.
4) Add the remaining ingredients; seasonings first, then vegetable stock, and let it simmer for about 15 minutes.
5) Check the potatoes are fully softened, and if they are, it’s ready to serve if you want it hot. Alternatively, let it cool, chill it in the fridge, and enjoy it cold:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Eat More (Of This) For Lower Blood Pressure
- Our Top 5 Spices: How Much Is Enough For Benefits? ← 5/5 in our recipe today!
- Monosodium Glutamate: Sinless Flavor-Enhancer Or Terrible Health Risk?
Take care!
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