Free to die: Economic freedoms and influenza mortality.

Seasonal influenzas are annually responsible for hundreds of thousands of deaths worldwide, often because of insufficient care, which may depend on orientations of economic policy. Yet, the empirical evidence on the relations existing between policies based on different degrees of economic liberalism and flu mortality is still scarce. This paper contributes to filling the gap by proposing an empirical investigation into the effects of various dimensions of liberalism, proxied by the different components of the Fraser Index of Economic Freedom, on deaths from seasonal influenzas in a sample of 38 OECD countries observed from 1970 to 2018. A dynamic panel System-GMM estimator is used to alleviate endogeneity concerns, while alternative models, specifications and subsamples check the robustness of findings. Findings show that: a) not every component of economic freedom has an effect on flu mortality; b) more economic freedom not always means less or more deaths from flu. In particular, stronger protection of property rights and smaller government consumption are associated with higher flu mortality, which is instead lower when people and capital are freer to move. Such results give rise to policy considerations and contribute to inform policymakers about actions that can limit the mortality of a globally widespread disease like flu.

Radiation recall dermatitis induced by COVID-19 vaccination in breast cancer patients treated with postoperative radiation therapy.

BACKGROUND: and purpose: Radiation recall dermatitis is an adverse event predominantly due to systemic therapy administration after a previous radiation therapy course. Few case reports describe radiation recall dermatitis in breast cancer patients treated with postoperative radiation therapy following COVID-19 vaccination. In this study we investigated the incidence and severity of radiation recall dermatitis after COVID-19 vaccination in irradiated breast cancer patients. METHODS: Patients that received at least one COVID-19 vaccination dose during the year after the end of postoperative breast radiation therapy were included in this observational monocentric study. Local symptoms occurring inside the radiation field after vaccination were patient-reported and scored according to the PRO-CTCAE questionnaire. Descriptive data of radiation recall dermatitis incidence and severity, and potential risk factors were evaluated. RESULTS: A cohort of 361 patients with 756 administered COVID-19 vaccinations was analyzed. Breast symptoms were reported by 7.5% of patients, while radiation recall dermatitis was considered for 5.5%. The incidence of radiation recall dermatitis per single dose of vaccine was 2.6%, with a higher risk for the first dose compared to the second/third (4.4% vs 1%, p = 0.003), especially when administered within the first month after the end of irradiation (12.5% vs 2.2%, p = 0.0004). Local symptoms were generally self-limited and a few cases required anti-inflammatory drugs. CONCLUSIONS: Radiation recall dermatitis is an uncommon but not rare phenomenon in breast cancer patients that received COVID-19 vaccination within one year after breast irradiation. However, symptoms severity were generally low/mild and reversible. These findings can be useful for patient counseling.