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1 in 7 Parents Avoided Vaccine Talk With Child’s Doctor During the Pandemic

Roughly one in seven parents did not discuss vaccines with their child’s primary care provider in the last 2 years, according to the C.S. Mott Children’s Hospital National Poll on Children’s Health.

Results of the nearly 1,500 respondents showed that 82% of parents discussed school-required vaccines with their child’s primary care provider during the pandemic, 68% discussed the influenza vaccine, and 57% discussed the COVID-19 vaccine.

Meanwhile, 15% of parents did not have any conversation about vaccines for their children with the primary care provider, and 3% avoided going to the doctor altogether so they didn’t have to have the conversation.

“Things are turned upside down,” said the poll’s co-director Sarah Clark, MPH, of C.S. Mott Children’s Hospital at University of Michigan Health in Ann Arbor, in a press statement. “Parents shouldn’t feel afraid of raising these conversations; they should go in with the expectation they are going to have a good conversation and go away with the information they need.”

“When parents delay or skip visits altogether, they are not prioritizing their child’s well-being,” Clark added. “Children won’t receive screening for medical or mental health problems, and parents will not receive information or guidance about how to keep their child healthy and safe.”

Clark says some blame might be placed on misinformation and division over vaccines circulating during the pandemic. Furthermore, visits to the doctor were frequently disrupted because of COVID precautions.

“This may have affected how often parents were talking with their child’s regular provider,” Clark said. “Without that trusted source of vaccine information and guidance, families may turn to other sources that may be less accurate.”

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Countdown to Thanksgiving – Let’s Vax Up America!

Let’s work together to help Vax Up America. Holiday gatherings and travel are around the corner. Public health experts are predicting another wave of COVID infections as the weather turns colder and people spend more time indoors.

Protect your friends, loved ones, and members of your community by encouraging them to get an updated COVID vaccine. If it’s been more than two months since your primary vaccine series or last dose, and you’re 5 years old or older, you are eligible for your updated COVID vaccine.

Updated vaccines protect against both the original COVID virus and Omicron. Vaccines offer you the best protection against the worst outcomes of COVID. Spread the word by sharing this news on your social media channels and in conversation with your friends and family around the holiday season and find your updated vaccine at vaccines.gov. Together, We Can Do This.

Thank you for your partnership to help Vax Up America!

Increased Respiratory Virus Activity, Especially Among Children, Early in the 2022-2023 Fall and Winter

Summary
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory about early, elevated respiratory disease incidence caused by multiple viruses occurring especially among children and placing strain on healthcare systems. Co-circulation of respiratory syncytial virus (RSV), influenza viruses, SARS-CoV-2, and others could place stress on healthcare systems this fall and winter. This early increase in disease incidence highlights the importance of optimizing respiratory virus prevention and treatment measures, including prompt vaccination and antiviral treatment, as outlined below.

Background
Many respiratory viruses with similar clinical presentations circulate year-round in the United States and at higher levels in fall and winter. In the past 2 years, respiratory disease activity has been dominated by SARS-CoV-2, and seasonal circulation of other respiratory viruses has been atypical or lower than pre-COVID-19 pandemic years. Currently, the U.S. is experiencing a surge and co-circulation of respiratory viruses other than SARS-CoV-2. CDC is tracking levels of respiratory syncytial virus (RSV), influenza, and rhinovirus/enterovirus (RV/EV) that are higher than usual for this time of year, especially among children, though RV/EV levels may have plateaued in recent weeks. SARS-CoV-2 also continues to circulate in all U.S. states.

RSV
CDC surveillance has shown an increase in RSV detections and RSV-associated emergency department visits and hospitalizations in all but two U.S. Department of Health and Human Services (HHS) regions (regions 4 and 6), with some regions already near the seasonal peak levels typically observed in December or January. This year, rates of RSV-associated hospitalizations began to increase during late spring and continued to increase through the summer and into early fall. Preliminary data from October 2022 show that weekly rates of RSV-associated hospitalizations among children younger than 18 years old are higher than rates observed during similar weeks in recent years. While RSV activity appears to be plateauing in some places, the timing, intensity, and severity of the current RSV season are uncertain.

Influenza
CDC has been tracking early and increasing influenza activity in recent weeks. The highest levels of influenza activity have been found in the southeast and south-central parts of the country. The most common viruses identified to date have been influenza A(H3N2) viruses, with most infections occurring in children and young adults. Cumulative influenza-associated hospitalization rates for children (age 0–4 years and 5–17 years) and all ages combined are notably higher compared to the same time periods during previous seasons since 2010–2011. Although the timing, intensity, and severity of the 2022–2023 influenza season are uncertain, CDC anticipates continued high-level circulation of influenza viruses this fall and winter.

SARS-CoV-2
CDC data are available to monitor COVID-19 community levels, which are based on hospitalization and case data and can be used to track SARS-CoV-2 activity. SARS-CoV-2 activity is expected to increase in the winter as has been observed in previous years. Rates of COVID-19-associated hospitalizations among all age groups including children have decreased since August, but rates in infants younger than 6 months remain higher than in other pediatric age groups and higher than in all adult age groups except those 65 years and older. CDC expects continued high-level circulation of SARS-CoV-2 this fall and winter.

Recommendations for Healthcare Providers
CDC recommends that healthcare providers offer prompt vaccination against influenza and COVID-19 to all eligible people aged 6 months and older who are not up to date. Vaccination can prevent hospitalization and death associated with influenza and SARS-CoV-2 viruses.

Influenza vaccines have been updated for the current season (1). Of influenza A(H3N2) viruses that have been analyzed in the United States since May 2022, most A(H3N2) viruses are genetically and antigenically closely related to the updated A(H3N2) vaccine component. These data suggest influenza vaccination this season should offer protection against the predominant A(H3N2) viruses to date.

Currently approved SARS-CoV-2 bivalent mRNA booster doses for use in patients 5 years of age and older offer protection against both the ancestral SARS-CoV-2 virus and the currently predominant Omicron BA.4 and BA.5 subvariants that cause COVID-19. Emerging evidence suggests that COVID-19 vaccination provides some protection against multisystem inflammatory syndrome in children (MIS-C) and against post-COVID-19 conditions, and that vaccination among persons with post–COVID-19 conditions might help reduce their symptoms (2).

To prevent RSV-associated hospitalizations, eligible high-risk children should receive palivizumab treatment in accordance with AAP guidelines. In brief, children eligible for palivizumab include infants prematurely born at less than 29 weeks gestation, children younger than 2 years of age with chronic lung disease or hemodynamically significant congenital heart disease, and children with suppressed immune systems or neuromuscular disorders.

While vaccination is the primary means for preventing influenza and COVID-19, antiviral medications are important adjuncts used to treat illness in persons with severe illness and those at increased risk for complications. Both influenza and COVID-19 antiviral medications are most effective in reducing complications when treatment is started as early as possible after symptom onset.

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Epidemiologic and Clinical Features of Children and Adolescents Aged <18 Years with Monkeypox — United States, May 17–September 24, 2022

Summary

What is already known about this topic?

Data on epidemiologic and clinical characteristics of monkeypox in persons aged ≤12 years (children) and adolescents during the ongoing 2022 monkeypox outbreak are limited.

What is added by this report?

During May 17–September 24, 2022, Monkeypox virus (MPXV) infections in children and adolescents aged <18 years were rare, representing 0.3% of all U.S. cases; none resulted in critical illness or death. Younger children typically acquired MPXV infection after skin-to-skin contact with a household member with monkeypox during caregiving activities; adolescents were most frequently exposed through male-to-male sexual contact.

What are the implications for public health practice?

Additional monkeypox cases in children and adolescents might be prevented through strengthened vaccination efforts and education around preventive measures and sexual health.

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Safety Monitoring of Bivalent COVID-19 mRNA Vaccine Booster Doses Among Persons Aged ≥12 Years — United States, August 31–October 23, 2022

Summary

What is already known about this topic?

CDC recommended bivalent COVID-19 booster vaccination for persons aged ≥12 years in August 2022; approximately 22.6 million bivalent booster doses were administered during August 31–October 23, 2022.

What is added by this report?

Early safety findings from v-safe and the Vaccine Adverse Event Reporting System for bivalent booster doses administered to persons aged ≥12 years during the first 7 weeks of vaccine availability are similar to those previously described for monovalent vaccine booster vaccines.

What are the implications for public health practice?

Adverse events reported after a bivalent booster dose appear consistent with those reported after a monovalent booster and are less common and less serious than health impacts associated with COVID-19 illness.

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Routine Vaccination Coverage — Worldwide, 2021

Summary

What is already known about this topic?

High routine childhood vaccination coverage achieved during 2015–2019 declined globally for most vaccines during 2019–2021 because of COVID-19 pandemic disruptions.

What is added by this report?

In 2021, the estimated global coverage with 3 doses of diphtheria-tetanus-pertussis–containing vaccine as well as the first dose of measles-containing vaccine decreased to 81%, the lowest level since 2008. Globally, 25.0 million children were unvaccinated or incompletely vaccinated in 2021, 5.9 million more than in 2019.

What are the implications for public health practice?

Reversing declining vaccination trends and addressing immunity gaps, as well as extending previous gains in vaccination coverage beyond prepandemic levels, requires targeted and context-specific approaches that prioritize routine vaccination as an essential health service and improve access to vaccination across the life span.

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Epidemiologic Features of the Monkeypox Outbreak and the Public Health Response — United States, May 17–October 6, 2022

Summary

What is already known about this topic?

An earlier analysis of 2,891 U.S. monkeypox cases found that up to 99% occurred in men, 94% of whom reported male-to-male sexual contact.

What is added by this report?

CDC’s emergency response focused on surveillance, laboratory testing, medical countermeasures, and education. A total of 26,384 U.S. monkeypox cases were reported during May 17–October 6, 2022. Among 59% of persons with data on gender and recent sexual or close intimate contact, 70% reported recent male-to-male sexual contact. Black and Hispanic persons continue to be disproportionately affected.

What are the implications for public health practice?

Public health monkeypox prevention efforts, including vaccination, should continue to prioritize gay, bisexual, and other men who have sex with men, Black and Hispanic persons, and persons who are immunocompromised.

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Interim Recommendations from the Advisory Committee on Immunization Practices for the Use of Bivalent Booster Doses of COVID-19 Vaccines — United States, October 2022

Summary

What is already known about this topic?

In the United States, COVID-19 monovalent booster vaccination was previously recommended, but related protection decreased after the emergence of Omicron subvariants.

What is added by this report?

In fall 2022, CDC recommended a bivalent mRNA COVID-19 vaccine booster dose for persons aged ≥5 years, administered ≥2 months after completing the primary series or after receipt of a monovalent booster dose.

What are the implications for public health practice?

Bivalent COVID-19 vaccine booster doses might improve protection against SARS-CoV-2 Omicron sublineages and, along with completion of a primary series in persons who remain unvaccinated, are important to protect against COVID-19, particularly among those persons who are at increased risk for severe illness and death.

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COVID-19–Associated Hospitalizations Among U.S. Infants Aged <6 Months — COVID-NET, 13 States, June 2021–August 2022

Summary

What is already known about this topic?

Infants aged <6 months, who are ineligible for vaccination, have high COVID-19–associated hospitalization rates compared with other pediatric age groups.

What is added by this report?

Although population-based COVID-19–associated hospitalization rates among infants aged <6 months increased in the Omicron variant–predominant periods compared with the Delta variant–predominant period, indicators of the most severe disease among hospitalized infants aged <6 months did not.

What are the implications for public health practice?

Pregnant women should stay up to date with COVID-19 vaccination to help protect themselves and infants too young to be vaccinated. Nonpharmaceutical measures should be used to help protect infants ineligible for vaccination.

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HHS announces initiative to help uninsured and underinsured Americans access COVID-19 monoclonal antibody treatment

Efforts will help smooth transition of outpatient treatment bebtelovimab to commercial marketplace 

The U.S. Department of Health and Human Services (HHS) today announced a new effort to help uninsured and underinsured Americans access the COVID-19 monoclonal antibody treatment bebtelovimab even after the product became available on the commercial market last month. 

Bebtelovimab received FDA emergency use authorization in February 2022. Since then, the U.S. government has purchased more than 750,000 doses of the product. Throughout the pandemic, bebtelovimab, along with other COVID-19 therapeutics, have been provided to states and territories for free. While the federal government has always expected that bebtelovimab and other COVID-19 therapeutics would ultimately transition to the commercial market, the timeline to make the transition for bebtelovimab has accelerated without additional funding from Congress. As a result, the federal procurement and distribution of bebtelovimab began to phase out and the product became available on the commercial market on August 17. 

HHS is making 60,000 doses of the product available to support the bebtelovimab product replacement initiative. Through this new initiative, which is effective immediately, health care providers who use a commercially procured dose of bebtelovimab to treat an uninsured or underinsured patient may be eligible to have the dose replaced for free by HHS. Health care providers can use their own established methods for determining uninsured or underinsured status, such as eligibility criteria for existing programs for which a patient may already be eligible. At the current rate of use, the additional doses purchased for this initiative are expected to be available through September 2023. 

Approximately 8% of Americans are not covered by a government insurance program such as Medicare or Medicaid or by private insurance. The Medicare and Medicaid programs fully cover all costs for bebtelovimab treatment, and the therapeutic is likely to be covered under most private health insurance plans. 

Bebtelovimab is available under emergency use authorization from the U.S. Food and Drug Administration as a treatment product to reduce hospitalization and death among patients who have a positive COVID-19 test and are at high risk for progression to severe COVID-19 and for whom alternative COVID-19 treatment options approved or authorized by the FDA are not accessible or clinically appropriate. 

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