Scientists identify four ways our bodies respond to COVID-19 vaccines

A Japanese study reveals a group who lose vaccine protection faster than others—even if they start with stronger antibody levels.

Nagoya University

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How COVID-19 vaccine responses change across individuals

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Credit: Kyoko Kojima

Two healthcare workers get COVID-19 vaccinations on the same day. Both show strong antibody responses initially, but six months later one stays healthy while the other contracts the virus. A new study published in Science Translational Medicine could help explain this difference.

Researchers tracked individuals’ antibody levels after vaccinations and identified four distinct patterns of immune response after the first booster vaccination. Notably, the group that started with the highest antibody levels but experienced a faster decline were infected earlier. People with lower blood levels of IgA(S) antibodies, which protect the nose and throat, were also at higher risk. The findings suggest that monitoring how antibody levels change over time could assist in identifying individuals at greater risk of infection. 

Led by scientists from Nagoya University in Japan, the research team measured antibody levels in 2,526 people over 18 months to see how vaccine responses changed between the first vaccination and later booster shots. They developed a mathematical classification system for COVID-19 vaccine responses using long-term tracking and AI-based computer analysis, becoming the first to systematically identify and characterize the “rapid-decliner” group. 

The researchers found that immune responses fell into four clear patterns: some people maintained high antibody levels over time (durable responders), others started with strong levels but lost them quickly (rapid-decliners), a third group produced few antibodies that also declined rapidly (vulnerable responders), and the rest fell in between (intermediate responders).  

Immunity that peaks early and then drops 

According to Shingo Iwami, senior author and professor at Nagoya University’s Graduate School of Science, the results for the rapid-decliner group were surprising. “In spite of their impressive initial immune response, they caught COVID-19 sooner than other groups, while durable responders maintained protection for longer periods. One-time blood tests for IgG antibodies, the antibody type we used for classification, couldn't detect this risk. Only by tracking changes over months did we see the pattern,” he explained. 

A breakthrough or subsequent infection refers to infections that occur after vaccination because the virus overcomes the immune protection that vaccines provide. The researchers found that people whose antibodies declined faster, either because they started low or dropped quickly (vulnerable responders and rapid-decliners), were slightly more likely to get breakthrough infections earlier. 

After booster vaccinations, 29% of participants fell into the durable responder category, 28% were vulnerable responders, and 19% were rapid-decliners. The remaining participants showed intermediate patterns. The differences in breakthrough infection rates between groups were modest—5.2% for durable responders and 6% for vulnerable and rapid-decliners. 

Breakthrough infections linked to IgA(S) antibody levels 

The study also revealed that participants who experienced breakthrough infections had lower levels of IgA(S) antibodies in their blood several weeks after vaccination. These antibodies protect the nose and throat and are our first line of defense against respiratory viruses.  

Importantly, the researchers found a strong correlation between blood IgA(S) levels and nasal IgA(S) levels, suggesting that blood tests can reliably indicate the strength of immune protection in airways. As a result, measuring blood IgA(S) levels after vaccination may help identify individuals at higher risk for breakthrough infection, especially among vulnerable groups. 

While these results provide a foundation for future research, Professor Iwami emphasized the importance of identifying the underlying biological mechanisms responsible for the rapid decline in antibody levels in order to develop more effective vaccination strategies. Previous research points to factors such as age, genetic variation, vaccine-specific characteristics, and environmental influences, including sleep habits, stress levels, and medications being taken at the same time.  

“This is the first time we’ve been able to clearly group how people respond to COVID-19 vaccines,” Professor Iwami noted. “Identifying the rapid-decliner pattern is especially important—it helps explain why some people may need boosters sooner than others. This could potentially contribute to better, more personalized vaccination strategies. However, whether antibody testing can be used widely depends on cost, accuracy, and if the benefits are worthwhile compared to current strategies. More research is needed to understand its full potential.” 

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Journal

Science Translational Medicine

DOI

10.1126/scitranslmed.adv4214 

Article Title

Longitudinal antibody titers measured after COVID-19 mRNA vaccination can identify individuals at risk for subsequent infection

Article Publication Date

17-Sep-2025

Researchers tracked dynamics of antibody levels between initial COVID-19 vaccinations and booster shots to understand why vaccine protection varies between individuals.





Blood samples taken from 2,526 participants over 18 months were analyzed using mathematical models and machine learning to classify antibody response patterns.






Four antibody response patterns were identified, with breakthrough infections linked to lower IgA(S) antibody levels.

Predicting the risk of subsequent infection after COVID-19 vaccination


Credit
©Kana Ariga

Major report tackles Covid’s cardiovascular crisis head-on

University of East Anglia

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Regular Covid vaccinations should continue worldwide to reduce cardiac risks associated with the virus - according to new research from the University of East Anglia.

A major report published today sets out ways of tackling the ‘profound and lasting impact’ of Covid and long Covid on cardiovascular health.

It makes recommendations for diagnosing, treating and preventing serious heart and blood vessel complications linked to the virus.

As well as continuing vaccination programmes, the report recommends structured cardiac rehabilitation - to prevent long-term problems after infection and boost long Covid recovery.

The clinical consensus statement is authored by a group of experts from across Europe, led by Prof Vassilios Vassiliou from UEA and the Norfolk and Norwich University Hospital on behalf of the European Society of Cardiology (ESC).

Millions suffering

Prof Vassiliou, from UEA’s Norwich Medical School, said: “The Covid pandemic has had a profound and lasting impact on our health, with complications emerging during acute illness and recovery.

“Millions of people around the world are suffering with serious cardiovascular problems caused by Covid infection and long Covid.

“A lack of clear evidence-based guidance on how to reduce this suffering and prevent further harm means that patients are not receiving the care they need, and some are turning to unproven or unsafe treatments.

“We wanted to change that.”

Almost one billion people are known to have been infected with Covid worldwide, although the true number is believed to be far higher.

Research shows that Covid patients, especially those who needed hospital treatment, have a higher risk of cardiovascular disease, including heart attack, stroke and death from cardiovascular disease.

Around 100 million people are currently living with long Covid, and about five per cent of these have cardiac long Covid, with symptoms including angina (chest pain), breathlessness, arrhythmia (abnormal heart rhythm), heart failure, fatigue and dizziness.

Long Covid can also lead to autonomic dysfunction where the nerves that normally control heart rate, breathing and body temperature do not work properly.

How the research happened

The team reviewed all existing research on the virus and cardiovascular disease, including the effects of an acute infection, long Covid and Covid vaccination.

They used this research to agree a set of recommendations for how to treat or prevent the damaging cardiovascular effects of Covid.

The report includes advice to continue vaccinating against Covid-19, as people who are fully vaccinated are far less likely to suffer cardiac complications or long Covid, even if they come down with the virus.  

It also sets out how to diagnose and treat the symptoms brought on by Covid, such as shortness of breath, chest pain and fainting.

Cardiac rehabilitation vital

In particular, the paper recommends structured cardiac rehabilitation programmes, including specialised physiotherapy, to prevent longer term problems from developing following infection and to aid recovery from long Covid.

Prof Vassiliou said: “Covid doesn’t just affect the lungs. It can also damage the heart and blood vessels, both during the acute infection and for months afterward. This means chest pain, breathlessness, palpitations, or fatigue may be signs of cardiac long Covid.

“If you already have heart disease, Covid raises your risk of serious complications both immediately and long after infection. In both cases, rehabilitation can protect your heart and support recovery.

“Our report provides unified, practical recommendations for prevention, rehabilitation, and long-term care, while also identifying critical research gaps to ensure strategies continue to evolve with emerging evidence.”

Finally, the experts call for equal access to cardiac rehabilitation programmes, especially for people living in rural locations.

“At present, the capacity of rehabilitation services across much of Europe is insufficient to accommodate both conventional cardiac patients and those with cardiac long Covid,” said Prof Vassiliou.

“There are also significant regional variations. Targeted financial investment and resource allocation are therefore required to expand service capacity and ensure equitable access.

“Unfortunately, even now, cardiac long Covid continues to affect the quality of life for many patients. We need to ensure patients have equitable access to rehabilitation services, support primary prevention through vaccination and lifestyle programmes, and fund research into long Covid and cardiovascular outcomes.

“Health systems must be prepared for the ongoing burden, not just the acute infection.”

‘Cardiovascular Disease Prevention and Management in COVID-19. A Clinical Consensus Statement of the European Association of Preventive Cardiology, the European Association of Cardiovascular Imaging, the Association of Cardiovascular Nursing & Allied Professions, the European Association of Percutaneous Cardiovascular Interventions, and the Heart Failure Association of the ESC’ is published in the European Journal of Preventive Cardiology

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Journal

European Journal of Preventive Cardiology

Method of Research

Systematic review

Subject of Research

People

Article Title

Cardiovascular Disease Prevention and Management in COVID-19. A Clinical Consensus Statement of the European Association of Preventive Cardiology, the European Association of Cardiovascular Imaging, the Association of Cardiovascular Nursing & Allied Professions, the European Association of Percutaneous Cardiovascular Interventions, and the Heart Failure Association of the ESC

Article Publication Date

18-Sep-2025

 

Music training can help the brain focus

Karolinska Institutet

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Cassia Low Manting

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Credit: Karolinska Institutet

Musical people find it easier to focus their attention on the right sounds in noisy environments. This is shown in a new study from Karolinska Institutet published in the journal Science Advances. The results suggest that music training can be used to sharpen attention and cognition.

Being able to focus on a conversation in a room full of noise is a complex task for the brain. In a new study, researchers have investigated how music training affects the brain's ability to focus attention on specific sounds.

The results show that musical people are better at using so-called top-down attention—a conscious control of focus—while being less sensitive to so-called bottom-up attention—distracting sounds (see fact box).

“Our results suggest that music training strengthens the brain's ability to focus under distracting conditions,” says lead author Cassia Low Manting, a researcher at the Department of Clinical Neuroscience, Karolinska Institutet.

In the study, participants listened to two melodies with different pitches simultaneously, and their task was to follow the pitch changes in one of them. Using a method called frequency tagging, the researchers were able to measure the brain's response to each melody separately. In two experiments with 28 and 20 participants, respectively, the researchers manipulated both conscious (top-down) and automatic (bottom-up) attention.

The results showed that people with high musical ability had stronger brain signals linked to conscious attention and weaker signals linked to automatic distractions.

"It's interesting to see how music training not only improves hearing but also the brain's ability to maintain attention over time. This may have applications in education and rehabilitation, where music can be used as a tool to improve attention and cognitive control," says Cassia Low Manting.

The researchers emphasize that the results cannot prove a causal link between music training and improved attention, but they do support the idea that music can have beneficial effects on the brain's cognitive functions.

The study is a collaboration between Karolinska Institutet and the Massachusetts Institute of Technology. It has been funded by the Knut and Alice Wallenberg Foundation and the Swedish Foundation for Strategic Research. The researchers state that there are no conflicts of interest.

Publication: “How musicality enhances top-down and bottom-up selective attention: Insights from precise separation of simultaneous neural responses”, Cassia Low Manting, Dimitrios Pantazis, John Gabrieli, Daniel Lundqvist, Science Advances, online September 17, 2025, doi: 10.1126/sciadv.adz0510

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Journal

Science Advances

DOI

10.1126/sciadv.adz0510 

Subject of Research

People

Article Title

How musicality enhances top-down and bottom-up selective attention: Insights from precise separation of simultaneous neural responses

Article Publication Date

17-Sep-2025

 

Decoding plants’ language of light

MSU researchers have discovered a new and unexpected way that plants regulate their growth — one that links development to a plant’s ability to sense light

Michigan State University

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By growing arabidopsis mutants under high light conditions, researchers were able to identifiy a mutation for a specific gene called UVR8.

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Credit: MSU Grotewold Lab

Researchers have revealed a previously unknown way plants shape their growth in response to light — a breakthrough that could better equip crops to handle environmental stress.   

In a first-of-its-kind finding, the team discovered how a compound that’s involved in plant metabolism can actually "reprogram” an unrelated light-sensing protein.  

This unexpected interaction, which was reported in the journal Nature Communications, is an exciting step toward more fully understanding plant physiology. 

“In the future, this mechanism could be exploited to fine-tune plant growth, development and stress responses,” Erich Grotewold said, a Michigan State University Research Foundation Professor and an author of the latest study. 

“This could lead to crops with improved tolerance to light stress and more efficient use of light energy, without relying solely on environmental modifications,” he added. 

As much as plants need their sunshine, there can always be too much of a good thing. In fact, harsh light can lead to damage similar to a sunburn.  

To shield themselves, plants produce a variety of natural “sunscreen” molecules called flavonoids and pigments. Like similar specialized molecules that defend against pests or attract pollinators, these compounds give plants an evolutionary edge in their environment.  

Originally, Grotewold and his team were examining mutant variants of the model plant Arabidopsis which couldn’t produce an important flavonoid enzyme.  

During their experiments, the researchers noticed that one type of mutant had serious growth problems when exposed to a certain kind of light — even though wild type specimens and other mutants appeared healthy under the same conditions. 

They discovered the culprit was a compound called naringenin chalcone, or NGC.  

Usually, this molecule is produced as part of the metabolic process that creates flavonoids. However, because the mutant was missing a key enzyme along that pathway, NGC began building up in the plant’s cells. 

Once they knew what molecular component was causing these growth defects, the team turned their attention to the bigger biochemical mystery: exactly why? 

By creating thousands of varied Arabidopsis mutants and raising them under stressful light conditions, the scientists were able identify a handful of plants that appeared to grow without defects.  

The one element these successful specimens had in common was a mutation for a specific gene called UVR8, which is a protein that usually senses UV light. 

Through a series of biochemical experiments, Grotewold’s lab revealed that NGC physically interacts and "reprograms" UVR8, activating it to send growth-regulating signals even without the presence of UV light. 

Until now, such a link wasn’t known to be possible.  

“We were surprised to discover that naringenin chalcone, a metabolic intermediate, could directly modulate the function of a light-sensing protein like UVR8,” Nan Jiang explained, the study’s lead author and a former Grotewold Group researcher who’s now assistant professor at the University of Hawai‘i at Mānoa.  

“This kind of cross-talk between specialized metabolism and photoreceptor signaling opens up an entirely new way of thinking about how plants integrate metabolic status with environmental perception.” 

In plant physiology, you might think of UVR8 as an actor in a play and NGC as a backstage crewmember. NGC helps keep the show running smoothly, while UVR8 only responds to a specific cue — a particular sort of light called UV-B. 

With these findings, it appeared that the backstage crew member was suddenly directing the star of the production. 

As luck would have, Grotewold didn’t have to look far to learn more about UVR8. Just down the hall in MSU’s Department of Biochemistry and Molecular Biology was colleague Robert Last, who years earlier had isolated the protein for the very first time. 

“Two decades ago, UVR8 was the last type of photoreceptor in plants we didn’t know about — a photoreceptor for ultraviolet-B light,” Last said, a University Distinguished Professor. “To see this new, unexpected interaction is wild and cool.” 

The team’s latest discoveries are reshaping what we know of the complex chemical choreography that occurs between a plant’s light-sensing machinery and its own growth. 

As for the purpose of this surprising molecular relationship, Grotewold sees it as a way for plants to more effectively fold light signaling into their development. 

“If you treat a plant with UV light and nothing else, it’s nearly lethal — but if you increase that UV intensity by a hundred times in the context of white light, the plant knows exactly how to deal with it,” Grotewold explained. 

“That’s what we think NGC is doing — helping integrate light signaling with developmental signaling.”  

Looking ahead, these discoveries are helping expand the horizon for light-focused plant modification. By modifying a plant's ability to sense light and produce specific compounds, crops could be made to grow more efficiently in low-light or harsh environments, or even better respond to harmful pathogens.  

“This work reveals a novel layer of regulatory complexity,” Jiang said. “It suggests that plants can use small molecules not just as end-products or defense compounds, but also as signaling messengers that fine-tune key physiological responses like growth and development.” 

During their experiments, researchers noticed that one type of Arabidopsis mutant had serious growth problems when exposed to a certain kind of light, even though wild type specimens and other mutants appeared healthy under the same conditions.

Credit

MSU Grotewold Lab

Journal

Nature Communications

DOI

10.1038/s41467-025-63010-3 

Article Title

Flavonoid pathway intermediates implicate UVR8 in functions beyond canonical UV-B signaling

 

UNC Greensboro study finds ticks carrying Lyme disease moving into western NC

New data on NC tick distribution notes dramatic increase in Blue Ridge Mountains

University of North Carolina at Greensboro

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Dr. Gideon Wasserman searching for Lyme-bearing ticks in the mountains of western North Carolina.

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Credit: UNCG/University Communications

GREENSBORO, NC (xx/xx/2025) - North Carolina is experiencing a surge in Lyme disease cases, and a new surveillance study from UNC Greensboro (UNCG) reveals that the primary vector of the bacteria that cause Lyme disease, the blacklegged tick (Ixodes scapularis), has been spreading into areas previously considered low risk.

“Currently, 16 states, mostly in the Northeast, mid-Atlantic, and upper Midwest, account for 95% of the reported LD cases,” says Dr. Gideon Wasserberg, a biology professor at UNCG and one of the research project leaders. “However, low-incidence states to the south and west, including North Carolina, have experienced an increase in the number of reported Lyme disease cases since the early 2010s.”

With funding from Centers for Disease Control, administered by the North Carolina Department of Health and Human Services, researchers from UNCG, North Carolina State University, and Appalachian State Universityconducted a five-year, statewide survey of blacklegged ticks and the pathogens they often carry.

“Our data shows a range expansion of these ticks into more counties in the Blue Ridge Mountains and the western Piedmont region and a dramatic increase in their densities in this area as a whole,” said Wasserberg. “These findings are consistent with increasing reports of human Lyme disease cases in these areas.” 

Eastern Piedmont and the Coastal Plain, where blacklegged ticks and human Lyme disease cases have been historically noted, saw little change in tick density in comparison. 

In the new study, ticks from the Blue Ridge Mountains were also more likely to carry Borrelia burgdorferi, the bacteria responsible for most cases of Lyme disease, compared to ticks from the Piedmont and Coastal Plain. 

“Our analyses indicate that these ticks and the bacteria they carry moved into the Blue Ridge Mountains of North Carolina from southwestern Virginia over the last 10 years, travelling along the Appalachian Mountains,” says Wasserberg.

The researchers say the findings have important implications for public health.

“Enhanced surveillance, increased public awareness, and updated guidance for healthcare providers are crucial to mitigate risk.” said Dr. Reuben Garshong, the lead author of the newly published article in PLOS One. Now a research scientist at the New Jersey Department of Health, Garshong participated in much of the study as a doctoral student in Wasserberg’s lab at UNCG.

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DOI

10.1016/j.psychsport.2025.102847 

Method of Research

Observational study

Subject of Research

Animals

Article Title

Expanding range of Ixodes scapularis Say (Acari: Ixodidae) and Borrelia burgdorferi infection in North Carolina counties, 2018–2023

New York City's medical specialist advantage may be an illusion, new NYU Tandon research shows

Study reveals that America's largest cities offer more types of doctors but fewer specialists per capita, challenging assumptions about urban healthcare access

NYU Tandon School of Engineering

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New York City offers nearly every type of medical specialist but provides fewer specialty healthcare providers per capita than smaller cities, according to a new study that challenges conventional assumptions about urban healthcare advantages and reveals a troubling paradox across America's largest metropolitan areas.

The research, published in Nature Cities, analyzed data from 1.4 million healthcare providers across 75 medical specialties in 898 metropolitan and micropolitan areas. The innovative approach combines urban scaling theory—which examines how city characteristics change with population size—with network science and economic geography to examine healthcare access in unprecedented detail.

Rather than treating healthcare as a single entity, the researchers examined each medical specialty separately, revealing that 88% exhibit what they call "sublinear scaling," meaning larger cities have proportionally fewer specialists per resident than smaller ones.

"We're discovering that the healthcare advantages of living in big cities may be an illusion when it comes to specialized care," explains lead researcher Maurizio Porfiri. "We all assume residents of large metropolitan areas have better access to healthcare than residents of smaller cities, but this is really true only for primary care services. Our findings suggest this assumption breaks down completely for medical specialists. A small city may not offer all the specialties of large cities, but in what it offers it may outperform them.”

Porfiri is an NYU Tandon Institute Professor with appointments in the Departments of Mechanical and Aerospace Engineering (MAE), Biomedical Engineering (BME), Civil and Urban Engineering (CUE), and Technology Management and Innovation (TMI). He also serves as Director of the NYU Center for Urban Science + Progress (CUSP).

The study represents the latest application of Porfiri's urban scaling methodology, which he has previously used to analyze gun violence patterns and the relationship between city living, ADHD and obesity. His research uses Scale-Adjusted Metropolitan Indicators (SAMIs) to control for population differences and reveal how cities deviate from expected patterns.

The study found that while cities like New York and Chicago offer nearly all examined specialties (NYC has 74 — missing only anesthesiology assistants — and Chicago has all 75), residents may face longer wait times and specialists higher patient loading.

In contrast, smaller cities may lack certain specialties entirely—73 of the 75 specialties showed significant associations between availability and population size—but those that exist serve fewer patients per provider. For example, Marshfield, Wisconsin provides 16.8 specialists per 1,000 residents compared to New York's 4.7 per 1,000.

Among the most underrepresented specialties in large cities per capita are addiction medicine, preventive medicine, osteopathic manipulative medicine, and micrographic dermatologic surgery.

Addiction medicine shows the starkest disparity, with large cities providing dramatically fewer specialists per resident than smaller areas. These fields showed the strongest sublinear scaling, meaning residents of major metropolitan areas have significantly fewer of these specialists available relative to their population size compared to smaller cities.

The research identifies two mechanisms driving this paradox: higher patient loads overwhelming specialists in large cities, and economic clustering that concentrates medical expertise in dense hospital networks, creating geographic inequalities.

“The findings have serious implications as the U.S. population ages. The study found sublinear scaling in geriatric specialties like urology and gerontology, suggesting major metropolitan areas may be unprepared for growing elderly populations,” said Tian Gan, a NYU Tandon mechanical engineering PhD student in the urban science track, and the paper’s lead author.

Geographic patterns reveal stark regional disparities. The highest specialist concentrations cluster in the Midwest—Minnesota alone claims two of the top five cities—while all five cities with the lowest access are in the South.

Not all specialties follow this pattern. Several key specialties—including anesthesiology, internal medicine, and clinical psychology—actually have more providers per capita in large cities, reflecting higher urban demand for these services.

The research provides a framework for understanding healthcare distribution that moves beyond the traditional urban-rural dichotomy. Rather than viewing cities as uniformly advantaged, policymakers must consider the complex interplay between diversity and provision of medical services.

Along with Porfiri and Gan, the paper's additional author is Tanisha Dighe, NYU Tandon MS student in applied urban science and information. The study was supported by National Science Foundation grants.

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APPENDIX: Medical Specialist Availability by City

CITIES WITH THE MOST MEDICAL SPECIALISTS (Cities offering all specialty types)

1. Chicago-Naperville-Elgin, IL-IN: 75 specialties
2. Houstone-Pasadena-The Woodlands, TX: 75 specialties
3. Atlanta-Sandy Springs-Roswell, GA: 75 specialties
4. Washington-Arlington-Alexandria, DC-VA-MD-WV: 75 specialties
5. Miami-Fort Lauderdale-West Palm Beach, FL: 75 specialties

CITIES WITH THE FEWEST MEDICAL SPECIALISTS (Fewest specialty types available)

1. Monroe, LA: 5 specialties
2. Zapata, TX: 6 specialties
3. Raymondville, TX: 6 specialties
4. Synder, TX: 11 specialties
5. Andrews, TX: 11 specialties

CITIES WITH THE HIGHEST CONCENTRATION OF SPECIALISTS OVERALL (All non-primary-care specialists combined per 1,000 residents)

1. Rochester, Minnesota: 21.1 specialists (home to Mayo Clinic)
2. Marshfield, Wisconsin: 16.8 specialists
3. Sunbury, Pennsylvania: 16.3 specialists
4. Easton, Maryland: 15.7 specialists
5. Albert Lea, Minnesota: 15.4 specialists

CITIES WITH THE LOWEST CONCENTRATION OF SPECIALISTS OVERALL (Fewest specialists per 1,000 residents)

1. Monroe, Louisiana: 0.1 specialists
2. Virginia Beach-Norfolk, Virginia: 0.4 specialists
3. Danville, Virginia: 0.8 specialists
4. Rio Grande City-Roma, Texas: 1.0 specialists
5. Bonham, Texas: 1.0 specialists

SPECIALTIES MOST UNDERREPRESENTED IN MAJOR METROS, 1M+ POPULATION

(Scaling exponents - how fast they grow with population growth )

1. Addiction Medicine (0.305) - Most underrepresented
2. Preventive Medicine (0.331)
3. Osteopathic Manipulative Medicine (0.351)
4. Micrographic Dermatologic Surgery (0.379)
5. Maxillofacial Surgery (0.398)
6. Marriage and Family Therapist (0.400)
7. Nuclear Medicine (0.408)
8. Advanced Heart Failure and Transplant Cardiology (0.446)
9. Certified Clinical Nurse Specialist (0.457)
10. Sleep Medicine (0.457)

SPECIALTIES MOST OVERREPRESENTED IN MAJOR METROS

(Scaling exponents - - how fast they grow with population growth)

1. Anesthesiology (1.154) - Most overrepresented
2. Internal Medicine (1.100)
3. Physical Therapy (1.089)
4. Clinical Psychology (1.069)
5. Physician Assistant (1.057)
6. Obstetrics/Gynecology (1.050)
7. Neurology (1.039)
8. Psychiatry (1.031)
9. Gastroenterology (1.022)

NYC SPECIALIST COUNTS (74 out of 75 research specialties)

Missing only: Anesthesiology Assistant

Top 10:

1. Nurse Practitioner: 8,977
2. Internal Medicine: 8,194
3. Physical Therapy: 7,515
4. Physician Assistant: 6,224
5. Clinical Social Worker: 4,842
6. Anesthesiology: 3,637
7. Family Practice: 3,259
8. Diagnostic Radiology: 2,843
9. Emergency Medicine: 2,545
10. Psychiatry: 2,465

Notable underrepresented specialties (bottom 5):

1. Maxillofacial Surgery: 40
2. Micrographic Dermatologic Surgery: 25
3. Preventive Medicine: 21
4. Marriage and Family Therapist: 18
5. Addiction Medicine: 16

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Journal

Nature Cities

DOI

10.1038/s44284-025-00326-7 

Method of Research

Data/statistical analysis

Subject of Research

Not applicable

Article Title

Trade-off between diversity and provision of specialized healthcare in US cities

Article Publication Date

17-Sep-2025