Category: Health

By Kim Lewis, as told to Stephanie Watson

As a single mom, I did a lot of juggling. I had an active son and a job at a health and sports facility. I was busy. Making time for doctor appointments and taking care of myself weren’t high on my list. I learned the hard way how important it is to be proactive about my own health.

Just over 20 years ago, when I was 32, I got a cough that wouldn’t go away. I was having so much trouble breathing that I had to sleep upright in a recliner to get enough air into my lungs.

I kept going back to my doctor and telling him the cough wasn’t improving and I couldn’t breathe. He diagnosed me with all kinds of things — pneumonia, walking pneumonia, bronchitis. Finally, after the third or fourth visit, I told my doctor, “I think I need to see a lung specialist.”

The lung specialist immediately sent me to a hospital, where I fell into a coma. When I came out of it 3 days later, my doctors told me that I had inflammation of my heart muscle called myocarditis, which was caused by a virus. I was in heart failure.

A Scary Prognosis

The doctors told me I had 5 years to live. My son was 12 years old at the time. That meant I wouldn’t get to see him graduate from high school. It was horrifying to think about. He’s my whole world.

My son was my baby boy, but he had to grow up quickly. I was so sick that I needed him to take care of me. By the time he was 15, he had to drive me to the hospital if I got sick in the middle of the night. If my port came out, he would call the doctor and say, “Tell me what to do.” My heart failure put a lot of pressure on him.

Turning My Health Around

I knew I had to make drastic changes if I was going to get more time with my son. I started eating healthy. There was no more going to fast food windows for breakfast, lunch, or dinner. I was sitting down to heart-healthy meals. Instead of keeping snack cakes and candy bars on my countertop, I have bananas, apples, and oranges. I stock my fridge with bottles of water, not soda.

Exercise also became a priority. Rather than watching TV in the evening, I go for a walk. I teach a water fitness class 3 days a week and I play with my grandchildren to stay active. I make sure that I exercise and see my doctors. And I take a guideline-recommended heart failure treatment to help my heart pump blood more effectively.

I have these really amazing doctors who monitor me closely and take good care of me. They say I’m nothing short of a miracle. They don’t have an explanation for how much I’m able to do, but they think it’s a combination of healthy living, good medication, and weight loss.

What I Would Have Done Differently

If I could talk to my former self, I would tell her that she needs to take better care of her body. I can look back now and say I probably should have gone to the doctor more often. I should have been more physically active. And I should have had a salad with my slice of pizza instead of eating three slices of pizza.

I also should have asked for a second opinion when my doctor wrote off my symptoms. Had the doctors caught my heart failure sooner, I might not have had permanent damage. There’s a fine line between trusting your doctor and trusting your gut. If you’re not comfortable with what your doctor tells you, it’s OK to get a second opinion.

If I had it do over again, I definitely would have prioritized my health. I’ve met a lot of other heart failure survivors who also put their health on the back burner while they took care of everything else. I should have put my health on the front burner and taken care of me.

A New Outlook on Life

Coming so close to death made me appreciate life more. I appreciate the holidays, dinner with friends, sunrises and sunsets, and the sound of rain. I appreciate family gatherings. I have a very large family here in Tennessee. We get together about four times a year. I’m tickled every time I get to see them.

I feel like life is more precious now. I know that I was given a second chance. After being told that I had 5 years to live, I’ve made it more than 20 years. Every day is a gift.

By Katherine Romano, as told to Hallie Levine

Let’s face it, a diagnosis of heart failure is hard. But it’s even harder to navigate during a global pandemic. I speak from experience: I was diagnosed with heart failure in October 2020, right after I had a massive heart attack. As a nurse, I knew how to take care of others. But I found it harder to take care of myself. Here are three things I’ve learned about life with heart failure in a post-quarantine world.

Don’t Delay Medical Care

I began to have classic heart attack symptoms while I was cleaning my house — agonizing upper back pain that radiated to my left arm, nausea, and shortness of breath. I was hesitant to go to the emergency room during the pandemic. But as soon as I got there, I realized I’d made the right decision. I was dizzy, vomiting, and everything hurt from waist up. 

The doctors told me that I was having a massive heart attack, but I didn’t believe them. I was young, only 63, with normal cholesterol and blood pressure, and no family history of heart disease. When they wheeled me in a stretcher to the catherization lab for two stents, I was more worried about the fact that my mask had fallen off and I couldn’t find it (they ended up covering my face with a sheet).

That’s not to say being in a hospital during the pandemic wasn’t scary. It was. A few days later, I was diagnosed with heart failure due to damage from the heart attack. Here I was, in the ICU, grappling with my new diagnosis while hearing the sounds of ventilators all around me.

I was transferred to a heart center about an hour away, where I stayed for a few weeks. I wanted the support of my family and friends, but the visiting rules were so restricted because of COVID-19 I told them to just stay home. It was hard and scary doing it alone, but somehow, I did it.

Once I was discharged from the hospital, I went through a 12-week cardiac rehabilitation program. Once again, it was scary to be doing this during COVID, but I kept reminding myself that the center had taken all necessary safety precautions, including wiping down machines after each use and requiring masks. Sure, there was some risk involved, but I knew that if I did the cardiac rehab, I’d be much less likely to end up in the hospital again.

Become Active — Again

During the pandemic, my exercise routine fell by the wayside. I no longer went to my twice-a-week Zumba class in person, and I just didn’t feel motivated to try it online. Let’s just say the diagnosis of my heart failure was the kick in the butt I needed to get restarted.

Unfortunately, heart failure makes you tired. You get short of breath easily, and activities that you once enjoyed, like walking, seem very hard. As a result, it’s very easy to waste away and become depressed. I forced myself to walk outside twice a week and to return to in-person Zumba.

But there are so many people with heart failure now who aren’t getting any activity at all. You don’t think about the exercise when you walk around the mall, for example. But now, since the pandemic changed the way we all live, people aren’t doing that anymore: They order things online, or go into a store for exactly what they need, then leave.

Put Yourself First

 While this is a rule that applies all the time, it’s become even more important during the COVID-19 pandemic. For years, I’d been the caretaker of my husband, Ted, after he had a major heart attack in 2011. For the next 6 years, I focused only on him, and let things like doctor’s appointments fall by the wayside. The big joke was we’d go on a family vacation and I’d remember all of his medications, but forget my own underwear. 

After his death, I began to take care of myself again and caught up on all the medical visits and tests I’d put off for so long, like a mammogram andv a colonoscopy. Still, during the pandemic, I let myself become isolated. I limited my interactions with my children and grandchildren, as the kids still saw their friends, and I’d stopped doing activities I’d enjoyed, like going out to dinner or going to concerts.

We know so much now about how social isolation is bad for the heart. I try my best now to stay connected with people. I still don’t socialize in large groups, but I see my family as much as I can. I now never miss my grandson’s outdoor baseball games, for example. I also make sure I video chat with close friends regularly. That human contact is so invaluable to our hearts.

Oct. 8, 2022 — The U.S. Centers for Disease Control and Prevention says it will start updating COVID-19 case and death counts on a weekly instead of a daily basis starting Oct. 20.
“To allow for additional reporting flexibility, reduce the reporting burden on states and jurisdictions, and maximize surveillance resources, CDC is moving to a weekly reporting cadence for line level and aggregate case and death data,” the CDC said Thursday.
The CDC is still providing daily data on COVID hospitalizations, using information from the Centers for Medicare and Medicaid Services. It’s unknown if that will change when the National Healthcare Safety Network takes responsibility for the collection of COVID hospital data mid-December, the CDC said.
The CDC has been publishing daily COVID data for more than two years. The CDC’s COVID community level ratings are already updated once a week, on Thursdays. State and local governments use community level ratings in deciding when and where citizens should be advised to wear masks.
The change is another sign of a de-escalation in COVID response as the major pandemic statistics drop. The New York Times reported that on Oct. 7 the United States was averaging 40,186 new COVID cases a day (a 26% drop over two weeks), 26,994 COVID-related hospitalizations (an 11% drop), and 380 COVID-related deaths (an 11% drop). Health experts say the case counts are actually higher because many home testing results are not reported to health agencies.
Earlier this week, the CDC announced it would no longer maintain a list of travel advisories for foreign countries because “fewer countries are testing or reporting COVID-19 cases,” The New York Times reported. Instead, the CDC will publish health notices when only for “a concerning Covid-19 variant” in a particular nation.
Anthony Fauci, the White House chief medical advisor, said Tuesday that COVID cases may rise this winter, especially if a new COVID variant emerges.
“Although we can feel good that we’re going in the right direction, we can’t let our guard down,” Fauci said in a discussion hosted by the USC Annenberg Center for Health Journalism. “We are entering into the winter months, where no matter what the respiratory disease is, there’s always a risk of an uptick.”
 

Oct. 7, 2022 – Where do teens and young adults go to talk about sex, sexual health, and sexually transmitted diseases? 

The obvious – routine medical checkups, hanging out with friends or partners – are possibly becoming less common than social media platforms for information and advice. And it appears that researchers and doctors  alike are starting to pay close attention by meeting users where they are – both to observe and take part in real-time exchanges around sexual health topics that occur in more leveled, stigma-free playing fields. 

For patients and doctors, it’s a win-win situation, one that provides a chance to address and prevent the spread of STD misinformation and, at the same time, help to reverse skyrocketing rates of some of these infections in younger people. 

Ina Park, MD, an STD doctor and professor of family and community medicine at the University of California, San Francisco, School of Medicine, says that almost all of her and her colleagues’ patients – especially within a certain age range – are on social media. 

“Many have had negative experiences when they’ve disclosed their sexual practices to their clinicians, when they felt that they were being judged for how many sexual partners they had, or [felt] that getting an STD meant getting punished for bad behavior” she says. 

This is especially true of sexual minority youth (LGBTQ), whose clinical encounters are all too often marred by doctors who lack an understanding of gender identity issues, or by those who aren’t comfortable discussing sexual health and STDs with their patients.

Perhaps this explains, at least in part, why platforms like Reddit and its smaller, moderated community forums, known as subreddits, are getting more popular. At last count, there were more than 3.4 million subreddits dedicated to specific topics, including the ‘Ask Me Anything (AMA)’ STD subreddit (r/STD), which does regular online question-and-answer sessions on sexual health and STDs among a community of 23,000 active users.

Discovering and Leveraging r/STD

In 2019, a group of researchers from the University of California, San Diego, did a small study to find out if people were getting medical diagnoses on social media platforms. They chose STDs as a case study, in part because these infections were getting more common.

“Our goal was to introduce the concept of crowd diagnosis, where you go to obtain a diagnosis on social media for a clinical outcome from your peers,” explains John Ayers, PhD, vice chief of innovation in the Division of Infectious Diseases and Global Public Health at UCSD and one of the study’s authors.

“When we looked at the data, we saw that 100s of people were going on Reddit and a large plurality were posting pictures, and asking for a diagnosis of sexually transmitted diseases,” he says.

The team’s findings were published later that year in JAMA and highlighted that 58% of roughly 17,000 posts were requests for a crowd diagnosis, 31% of which also included an image of physical signs of infection. Only 20% of posts asking for a crowd diagnosis were made to obtain a second option after receiving a diagnosis from a doctor. 

Ayers says the main takeaway is that many doctors have a “field of dreams” perspective, “you know, if we build it, they will come. But they’re not coming, so why don’t we go and help them where they already are?”

He also explains that it’s not enough to simply discover that a phenomenon exists (people going online to get a diagnosis), but that by discovering or revealing a problem (possible misinformation), doctors have a chance to intervene.

That is exactly what the American Sexual Health Association (ASHA) aimed to explore when it when it hopped onto an r/STD AMA forum armed with two experts – Park and a sexologist – and hosted a discussion about STDs. Their goal was to learn what types of information people were seeking, and ultimately drive sexually active people to seek testing through its Yes Means Test public awareness campaign.

The session generated 254 comments, and Park and her co-host addressed 42 questions, most commonly on STD transmission (24%) and STD testing (22%). Other common questions focused on sexual difficulties (15%) and sexuality (15%), although the AMA also included posts discussing contraception, partner communication, research, prevention, and treatment.

If scores and click-throughs indicate outcomes, then The ASHA AMA resulted in the best possible results. The session received a 5 out of 5 Reddit AMA score (the benchmark is 4), three community awards, and a click-through rate back to the ASHA site (and its STD testing campaign) of 45% (which surpassed the 10% Reddit benchmark).

Not All That Glitters Is Gold 

Reddit AMAs don’t come without risk, and it’s best for those who want STD information to be aware of the pitfalls and red flags.

“One of the things to think about is that an approach like the subreddit adds to the false narrative that STDs in particular have to be symptomatic to be problematic, which we know is not the case,” explains Dennis Li, an assistant professor of psychiatry and behavioral sciences, and sexual and gender minority health and well-being, at Northwestern Feinberg School of Medicine in Chicago. 

“We also have to be careful not to misdiagnose and potentially cause harm,” he says, emphasizing that many young people – especially those with equity issues – don’t have experience in navigating health systems or reputable websites for information. 

Ayers concurs.

“One of the outcomes in our study was people saying that they had a positive HIV test and were asked to come back and get a confirmatory test,” he explains. “But then someone in the community said don’t worry about it; you’re OK.”

So, “it’s OK to seek out advice but look for confirmation of that advice,” he says. “Make sure to follow [up] with a physician or go to a forum where you can actually engage with a physician.” 

Although she took part in the ASHA AMA session, Park has strong words of caution for people seeking advice on social platforms, especially when it comes to Reddit, which carries with it the baggage of hosting a lot of trolls.

“Reddit has the highest risk in terms of accepting advice because oftentimes, the person responding back to you is anonymous. They can say that their credentials are x, y, and z, but you really don’t have any way of proving that” Park says. 

“You don’t know who’s answering your question.”

Personally, she says that she uses her real name, on the few Reddit forums she’s taken part in as well as on her Instagram page, where she shares STD information.

Park also cautions users to avoid someone trying to sell something, as the information is, by nature, likely to be somewhat biased. Like Ayers, she recommends taking the information and verifying it before making health decisions. 

Reputable sources include ASHA, the CDC, Scarleteen (an LGBTQ-positive, graphic-forward site), Planned Parenthood, and, of course, WebMD.

Health Experts Call for New Prevention Strategies 

In September, the CDC held the 2022 STD Prevention Conference, resulting in an Associated Press news report that warned of an out-of-control “STD situation” in the U.S. In addition to dire news about rising infection rates for STDs such as gonorrhea, the CDC also reported that 2021 syphilis cases reached a high not seen since 1948 and that HIV cases were likewise on the rise.

The key takeaway from this conference was that prevention is key, especially among at-risk populations like young people, men who have sex with men, Black and Hispanic Americans, Indigenous Americans, and women.

According to Li, testing should be the best outcome.

“What online resources can really help with is reducing stigma around testing, getting people comfortable asking questions to a medical or health care provider, and helping to bolster trust in the medical system – not just trusting that people are doing the right thing, but trust that you’ll be taken care of in a way that respects you as a person,” he says. 

Li sees sites like Reddit as bridging the gap between doing things on one’s own and knowing when to go to a qualified health professional.

But there may be a need for doctors to take the leap onto social media, if only to start following user accounts and learning what people are talking about. 

By doing so, “we can minimize the harm,” says Ayers. 

Oct. 7, 2022 — Exploring the woods, hiking, summer camp, and regular trips to the dog park were all normal activities growing up in New Jersey. Meghan Bradshaw described herself as a healthy, active young girl with an affinity for the great outdoors. But things changed when she began having sporadic, unrelated health problems like exhaustion, dizzy spells, and body aches. After seeing a wide variety of medical specialists to uncover the root of these issues, her lab results were always inconclusive.  

Unbeknown to Bradshaw and her doctors, her illness stemmed from a parasite. Bradshaw had contracted Lyme disease, a bacterial infection that can come from the bite of a blacklegged tick — also known as a deer tick — if it stays attached to your body for 36 to 48 hours. Symptoms can include memory loss, joint pain, drooping muscles on one or both sides of your face, and tingling or numbness of your body parts. 

Bradshaw’s health continued to worsen as she bounced from the East Coast to the West Coast in her early 20s for work as a retail manager at Nordstrom. It wasn’t until she took a job promotion in Nashville that her illness became debilitating and left her bedridden. She could no longer perform everyday tasks like holding a toothbrush or washing dishes. 

Bradshaw’s knees began filling up with fluid. Her doctor diagnosed her with rheumatoid arthritis, which is the closest thing he could think of to explain her “mystery” illness. She had to have her hips replaced at 26 years old.

“It [the disease] was deteriorating every joint in my body,” Bradshaw, now 29, says. “I was a shell of myself. It was terrifying.” 

One specialist referred Bradshaw to a functional medicine doctor, who began asking questions about her upbringing. Upon discovering Bradshaw was from New Jersey, where blacklegged ticks are extremely common, her doctor asked a question that changed everything. 

“Have you ever been tested for Lyme disease?” 

Bionic Woman

Fast forward a few years. Bradshaw has now had 16 of her joints reconstructed and eight joint replacements, all because of the late detection of Lyme disease. She is preparing to have both elbows replaced, along with her second surgery on each hand, all of which should be completed within the next year. Hopefully then, she’ll “catch a break.” But there will likely be more surgeries down the road to replace her joint replacements, she says. 

Bradshaw’s experience is extremely rare for Lyme disease patients, says Glenn Gaston, MD, an orthopedic surgeon at OrthoCarolina in Charlotte. Only a small number of Lyme disease patients develop arthritis, especially if it’s treated early, says Gaston, who operated on Bradshaw’s hands. If a patient does get arthritis, it usually only affects one joint, which is often the knee.

“I have never even heard or read in a textbook a case to the degree of Meghan’s, of having to have multiple joint replacements and multiple surgeries, particularly at such a young age,” Gaston says.

When asked why Bradshaw’s Lyme disease diagnosis remained a mystery for so long, Gaston says the disease can be hard to detect.

“The biggest reason I see for delayed detection and treatment of Lyme disease is primarily because it’s not often in the forefront of the minds of clinicians, particularly depending on where a patient lives,” he says. “If they live in Connecticut, which is where Lyme disease comes from (Lyme, Connecticut), it’s more plausible that they’re going to think about it early. The further you get from the epicenter of the diagnosis, the less physicians think about it in their differential.” 

If you remove the tick before 48 hours, you likely won’t get the disease. Ticks can be as small as a poppyseed, so spotting them can be hard. But one major sign of a tick bite is a rash that looks like a bull’s eye. If you catch it early, Lyme disease can be treated and cured with antibiotics. But with late detection (like Bradshaw’s), treatment and recovery become much more difficult. Good news: A vaccine to treat Lyme disease is currently in phase III clinical trials with drugmakers Pfizer and Valneva. 

Dwelling on what life could have been like if, early on, doctors had asked questions about her upbringing has been one of the most difficult things for Bradshaw to come to grips with. 

“I have severe medical trauma and I relive it every 3 months after another traumatic surgery,” she says. “It’s constantly going through the grief cycle.” 

Bradshaw is often nicknamed the “bionic woman,” which she finds endearing.

“I use humor as a coping mechanism,” she says. “I have to laugh about it. Because if I don’t laugh, I cry, and this is healthier for me.”

Newfound Purpose

Great health care is one major source of gratitude for Bradshaw. Her surgeries and medical care have racked up over $1 million dollars of medical costs, of which her insurance covered the majority, and she paid the rest out of pocket. Bradshaw often speaks publicly about the lack of access to quality health care for certain marginalized communities, like LGBTQ+ individuals, immigrant groups, and people of color.  

“I’m very fortunate I’ve had access to improvement of my conditions,” she says. “A lot of people don’t have a means to an end.”

While it could be easy to become angry, or even resentful, for her late diagnosis, Bradshaw has shifted her focus toward tick-borne disease awareness advocacy, which has been “very healing” for her.

“I can look in hindsight and see all of the things that were wrong in my path and in this experience,” she says. “I’m like, ‘Here is how it should be. And here’s how we can fix it.’ I want to be apart of that.” 

Bradshaw recently co-founded a nonprofit organization, Tick JEDI Coalition (JEDI stands for “juvenile educational defense initiative”) that strives to put tick safety education into mainstream health science curricula. 

“Children should be learning this [tick safety] as a fundamental life skill, the same way they learn about handwashing,” she says.

Meghan’s Tips

To help avoid late detection of Lyme disease, or any other illness, Bradshaw gives these tips. 

You know your body better than anyone.

“Doctors are incredibly brilliant, talented, and knowledgeable about many things. But at the end of the day, everyone is still human. There may be times that you have something that is beyond the scope of their knowledge. If the doctor you see is not the right fit, and you are able to access care elsewhere, do your research and find someone who may be a good fit.”

Utilize patient support groups.

“I think there’s a lot you can learn from other individuals and their experiences, both good and bad things. I found them incredibly helpful in my own experience.”

Have a support person.

“There have been many times, especially at the beginning of my journey, where I was so emotionally distraught dealing with these things. My parents were there to take notes and take in everything for me. Have a support person because it’s hard to do these things alone.”

Editor’s note: Here’s more information on Lyme disease .

Oct. 7, 2022 — Monkeypox cases in the U.S. disproportionately affect Black Americans, with rates five times higher than among white peers, according to a new report from the Kaiser Family Foundation.

Hispanic Americans, Native Hawaiians and Pacific Islanders also have significantly higher rates of reported monkeypox cases.

“Disparities in cases persist among Black and Hispanic people, a pattern also seen with HIV and COVID-19,” KFF wrote.

The analysis was based on CDC data for 68% of monkeypox cases reported in the U.S. as of Sept. 23. Monkeypox case rates are:

• 14.4 per 100,000 people among Black Americans
• 10 per 100,000 people among Native Hawaiians and Pacific Islanders
• 8.3 per 100,000 people among Hispanic Americans
• 3 per 100,000 people among Asian Americans
• 2.8 per 100,000 people among American Indians and Alaska Natives
• 2.6 per 100,000 people among white Americans

Overall, Black Americans account for the largest share of monkeypox cases, and both Black and Hispanic Americans account for a larger share of cases. About 70% of cases are among people of color, while people of color account for 40% of the U.S. population.

The monkeypox outbreak in the U.S. appears to be slowing down, KFF wrote, reaching a peak in August and declining in September. However, new cases among Black Americans began to exceed those among white Americans in early August. Although those cases are now declining, the numbers continue to remain higher.

In addition, Black and Hispanic Americans have received smaller shares of monkeypox vaccines, the report found. As of Sept. 27, 51% of first doses have gone to white Americans, although they represent 30% of cases. In contrast, Black Americans have received 13% of first doses despite accounting for about 35% of cases. Similarly, Hispanic Americans have received 22% of first doses, while they account for 30% of cases.

“The lower shares of vaccinations among these groups may in part explain why they have had higher numbers of new cases and complicate efforts to address disparities moving forward,” KFF wrote.

The U.S. has reported 26,385 monkeypox cases during the current outbreak, according to the latest CDC data. More than 70,000 cases and 27 deaths have been reported worldwide.

KFF noted the ongoing challenge of tracking the outbreak due to data limitations around testing and vaccination. For instance, race and ethnicity data is missing for 32% of reported cases and 9% of vaccinations. Without data, researchers aren’t able to conduct an analysis of disparities across multiple factors, such as race and ethnicity, sex, gender identity, and risk.

“As has been seen with HIV and COVID-19, underlying structural inequities place people of color at increased risk for public health threats, and focused efforts will be key to minimizing and preventing further disparities going forward,” KFF wrote. “While the federal government has begun piloting efforts to reach communities of color with MPX vaccines in order to address disparities, it is unclear if such efforts will be enough to stave off further disproportionate impact, and much will also depend on what state and local jurisdictions do.”

Oct. 7, 2022 — More than 2.5 million middle school and high school students in the U.S. use e-cigarettes, according to a new study from the CDC and FDA.

The 2022 National Youth Tobacco Survey, conducted between January and May, showed that 14% of high school students and 3.3% of middle school students used nicotine devices at least once during the past 30 days. A year ago, the survey showed that 11.3% of high school students and 2.8% of middle school students reported vaping in the past month.

The numbers remain below 2019 data, which showed that more than 25% of high school students vaped. Even still, anti-tobacco and anti-vaping groups have urged federal regulators to eliminate flavored vaping products that are popular among teens. 

In this year’s survey, 85% of teens who vaped said they used flavored e-cigarettes. The most used flavors were fruit (69%); candy, desserts, or sweets (38%); mint (29%); and menthol (27%).

“It is unacceptable that over 2.5 million kids still use e-cigarettes when there is a clear solution to the problem — eliminate all flavored e-cigarettes,” Matthew Myers, president of Campaign for Tobacco-Free Kids, told USA Today.

The FDA has banned flavored vaping products derived from tobacco. However, users have increasingly turned to synthetic nicotine products, which are often disposable and sold in a variety of flavors, the newspaper reported.

In 2022, teens reported several different favorite brands, in contrast to 2019, when JUUL was the most recognized brand. Among those who currently vape, 14.5% said their usual brand was Puff Bar, followed by 12.5% for Vuse, 5.5% for Hyde, and 4% for SMOK. In addition, nearly 22% said their usual brand wasn’t among the 13 listed in the survey.

About 28% of youth reported using e-cigarettes daily, and 42% reported using them on 20 or more days during the past 30 days.

In addition, about 55% of teen vapers said they use disposable e-cigarettes. About 25% use prefilled or refillable pods, and 7% use tanks or mod systems. Another 23% said they didn’t know what type of device they used.

“This study shows that our nation’s youth continue to be enticed and hooked by an expanding variety of e-cigarette brands delivering flavored nicotine,” Deirdre Lawrence Kittner, director of the CDC’s Office on Smoking and Health, said in a statement.

“Our work is far from over,” she said. “It’s critical that we work together to prevent youth from starting to use any tobacco product — including e-cigarettes — and help all youth who do use them, to quit.”