In a recent study published in JAMA Network Open, researchers investigate the association between population-level coronavirus disease 2019 (COVID-19) mitigation strategies, including vaccination rates and face mask mandates, and the prevalence of symptomatic asthma among children.
Study:COVID-19 Vaccination and Parent-Reported Symptomatic Child Asthma Prevalence. Image Credit: SeventyFour / Shutterstock.com
Asthma was initially considered a significant risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and subsequent hospitalization caused by COVID-19. Health professionals were concerned that children with asthma would be particularly vulnerable during the pandemic.
Some of the different measures that promoted or enforced social distancing during the initial stages of the pandemic were found to reduce childrens emergency visits and hospitalizations related to asthma. Likewise, vaccination efforts in 2020 and 2021 significantly reduced the risk of being infected with SARS-CoV-2 for both children and adults.
Vaccination against COVID-19 can confer additional protective benefits, such as reductions in asthma symptoms. However, these potential benefits have not been studied. Furthermore, the relationship between exposure to illness caused by COVID-19, mitigation strategies, and symptomatic asthma among children remains unclear.
Using a cross-sectional design and publicly available data, researchers examined state-level trends and associations to better understand how public health measures during the COVID-19 pandemic may have influenced asthma symptomatology in children.
The analysis included data on the prevalence of asthma symptoms in children that parents reported through the National Survey of Childrens Health during 2018-2019 and 2020-2021. These data were collected at the state level.
Additional data included age-adjusted COVID-19 mortality rates from the United States Centers for Disease Control and Prevention (CDC) for 2020 and 2021, the proportion of the population aged five years or older who received the primary COVID-19 vaccination series, and state-level mask mandates in closed spaces until August 2021.
Changes in the state-level prevalence of childhood asthma symptoms, as reported by parents, were recorded between 2018-2019 and 2020-2021. Time trends in these symptoms were subsequently assessed using statistical tests, whereas trend associations with other state-level covariates were determined using pairwise linear regression and pairwise correlation analyses.
The average rate of childhood asthma symptoms declined significantly from 7.8% in 2018-2019 to 6.9% in 2020-2021, an overall decrease of 0.85 percentage points. Notably, this reduction occurred amid significant public health efforts to control COVID-19, such as widespread vaccination and mandatory face masks.
During the same period, the average COVID-19 death rate at the state level rose from 80.3 to 99.3 for every 100,000 people in 2020 and 2021, respectively. By December 2021, the average COVID-19 vaccination rate at the state level was 72.3%.
A linear regression analysis showed that for every 10-percentage point increase in the coverage of COVID-19 vaccinations, the rate of parent-reported childhood asthma symptoms decreased by 0.4 percentage points. However, no significant association was observed between asthma symptoms and COVID-19 death rates or face mask mandates at the state level.
State-level COVID-19 vaccination rates were negatively associated with COVID-19 death rates in 2021 but not 2020. Comparatively, mandates for face masks were positively associated with higher vaccination rates.
These findings suggest that higher vaccination rates may provide broader health benefits beyond preventing COVID-19 by potentially reducing the rate of asthma symptoms in children.
Higher COVID-19 vaccination rates were associated with reduced parent-reported childhood asthma symptoms, whereas state-level COVID-19 mortality and face mask mandates were not significantly correlated.
The study findings emphasize the importance of vaccination in mitigating health risks during pandemics. The widespread COVID-19 vaccination also appears to have broader health benefits, as it reduces the prevalence of childhood asthma symptoms.
Notable strengths of the current study include the use of comprehensive state-level data and the focus on population-level trends. However, a significant limitation is the lack of specific data on vaccination rates for children with asthma, which prevents a direct comparison of vaccinated and unvaccinated children.
Future research should further explore this relationship and assess whether sustained vaccination efforts against COVID-19 can continue to mitigate asthma symptoms in children. Ongoing public health strategies are also needed to address chronic conditions during pandemics and emphasize the role of vaccination in protecting vulnerable populations.
Summers nowadays bring not only anticipated sweltering heat waves, but also predicted seasonal surges in COVID-19 infections.
[1]
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[3]
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For the week ending July 6, positive COVID-19 tests crept up by 0.8 percent, COVID-related emergency room visits jumped by more than 23 percent, and hospitalizations increased by just over 13 percent.
Were seeing an anticipated summer bump, says William Schaffner, MD, an infectious disease specialist and a professor of preventive medicine and health policy at the Vanderbilt University School of Medicine in Nashville, Tennessee. COVID doesn't disappear during the summertime the way influenza does. If we look back over our past two years, weve had an increase during the summer months. It abates again in the fall, and then you get a real seasonal increase during the winter.
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COVID figures are trending up due to a constellation of factors, including more people congregating close together, more people traveling, and more people going indoors to escape extreme heat, says Peter Chin-Hong, MD, an infectious disease specialist and a professor of medicine at the University of California San Francisco School of Medicine.
A new suite of variants and waning vaccine immunity may also be contributing to the problem, adds Dr. Chin-Hong.
Since COVID-19 initially swept through the world over four years ago, the virus has rapidly mutated. Many versions of the virus have been able to escape the immune defenses people have built up through previous infection or vaccination, although newer versions of COVID-19 havent been causing as much serious illness as the versions that occurred early on in the pandemic.
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The highly transmissible LB.1 variant is closely related to the FLiRT strains but has an extra mutation. These top four variants are all descendants of the omicron variant JN.1, which now accounts for just over 7 percent of cases but made up more than half of infections at the end of March.
As the virus quickly changes, vaccine makers are trying to keep up and adjust their formulas to be more effective against circulating strains.
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Dr. Schaffner notes that at this point, it is highly unlikely that the fall vaccine can be adjusted any further to directly address a newly rising variant like LB.1. There is a finite period of time to make these vaccines, get them bottled up, and distribute them, he says. The current dominant strains, however, are all subvariants of the omicron family, so the anticipation is that these vaccines for the KP strains will provide antibodies that will protect against LB.1.
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With at least a mini COVID-19 wave happening now, people may wonder if they should wait for the new shots or take further protective action right away.
For Chin-Hong, the answer is pretty straightforward: Did you get the vaccine approved in the fall of 2023? If not, I would go ahead and get it, especially if you are older than 65 and immunocompromised, he says. Those 65 and older can also get another vaccine if four months have elapsed since the last one. That will still give you the ability to get the new vaccine with the flu shot in October or November.
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Treatments such as nirmatrelvir and ritonavir (Paxlovid) and remdesivir (Veklury) have also proved to prevent an infection from becoming serious.
Fortunately, the hospitals have not been overwhelmed as in previous years, attesting to the collective immunity in the population, says Chin-Hong. Still, some people are at risk of getting seriously ill: mainly those older than 75 or those who are very immunocompromised who have not gotten the latest vaccine or [been] prescribed Paxlovid or remdesivir when infected.
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Chin-Hong says hes seeing fewer symptoms that were common in 2020, like shortness of breath and loss of taste and smell, and that some people are experiencing nausea and diarrhea symptoms they may not realize can be linked to COVID-19.
Because COVID-19 symptoms are often similar to those of allergies (such as hay fever) or the common cold, doctors warn that the only way to know for sure is to take a COVID test especially if you are vulnerable to severe infection (if you are older, for instance, or are immunocompromised) and want to stave off serious disease with a course of Paxlovid. You should also test if you spend time with anyone at high risk whom you might infect.
Anecdotally, some people on social media are reporting a few fairly nasty effects from the currently circulating virus. A commentator for CNBC recently wrote on X:
Tested positive for COVID a few days ago. First three days of symptoms were worse than those of 2 years ago. Deep, lingering sore throat among them. Thank goodness for Paxlovid. Seems to be working. Mask up. The new variant appears to be making a bit of a summer surge.
Young girl using asthma inhaler. (Photo by Jeff Overs/BBC News & Current Affairs via Getty Images)
Higher Covid-19 vaccination rates are associated with protection against children experiencing symptomatic asthma, according to the findings of a new JAMA Network Open study. The researchers reported that for every increase of 10 percentage points in the coverage of Covid-19 vaccination, the prevalence of pediatric asthma symptoms decreased by 0.36 percentage points.
Asthma is one of the most common chronic illnesses among children in the United States, with about 4.7 million children experiencing symptoms each year, lead author Matthew M. Davis, Executive Vice-President, Enterprise Physician-in-Chief and Chief Scientific Officer of Nemours Childrens Health, said in a press release. Whether asthma is mild or severe, it affects childrens quality of life. So anything we can do to help kids avoid flare-ups is beneficial.
In 2020, healthcare providers and researchers observed that social distancing measures helped prevent children with asthma from being hospitalized or rushed to the emergency department. A year later in 2021, people had access to Covid-19 vaccines and they were widely administered to children and adults across the United States. Davis and colleagues conducted the study to investigate if the vaccines could be linked to some form of protection against symptomatic asthma.
We hypothesized that symptomatic asthma would be positively associated with population-level COVID-19 overall mortality (a proxy for SARS-CoV-2 exposure), and would be inversely associated with population-level completion of the COVID-19 primary vaccination series and with state face mask mandates, they wrote in the JAMA study.
The team analyzed state-level data of parent-reported asthma symptoms in their children from the National Survey of Childrens Health. They studied the data from 2018-2019 and then compared that to 2020-2021 data.
They found that the state-level prevalence of childhood asthma symptoms decreased from 7.77% in 2018-19 to 6.93% in 2020-21. The only bad news was that the Covid-19-related mortality rate increased from 80.3 per 100,000 people in 2020 to 99.3 in 2021. Community-level immunity in states with higher vaccination rates may have helped reduce childrens asthma risk, the authors stated.
In a press release, co-author Lakshmi Halasyamani, Chief Clinical Officer of Endeavor Health in Evanston, Illinois, said: Ongoing vaccination against COVID-19 may offer direct benefits for children with a history of asthma, but this must be confirmed with further research. It also raises the question of whether broader population-level COVID-19 vaccination among children and adults can help protect children with asthma, too.
However, a major limitation of the study is that state-level estimates of Covid-19 vaccination rates among children with a history of asthma were unavailable. Because of that, the researchers were not able to investigate differences in asthma symptoms among vaccinated and unvaccinated children. "These findings merit further assessment to determine whether childhood asthma symptom prevalence may be reduced by sustained vaccination efforts against SARS-CoV-2," the authors concluded.
According to the Centers for Disease Control and Prevention (CDC), the prevalence of pediatric asthma in the United States was 9.5% in 2011. But in 2021, the prevalence decreased to 6.5%. Male children are far more likely to be diagnosed with asthma than female children. The Asthma and Allergy Foundation of America reported that while 7% of male children have asthma, 5.4% of female children were diagnosed with the respiratory condition.
Accommodating a Christian nurses request for a religious exemption to a Covid-19 vaccination policy would have posed an undue hardship for the Oregon university behind the childrens hospital where she worked, a federal judge said.
Oregon Health & Science University demonstrated that it couldnt accommodate the nurses religion-based objections to the vaccine without posing an undue hardship during an earlier stage of the coronavirus pandemic, the US District Court for the District of Oregon said, granting summary judgment in favor of Oregons largest public hospital system.
Plaintiff Brittany MacDonald worked as a registered nurse at OHSUs Doernbecher Childrens Hospital ...
There were only four cases last year.
HARTFORD, Connecticut Officials announced Monday that 11 Connecticut residents have been diagnosed with mpox (formally known as monkey pox) so far this year.
The Connecticut Department of Public Health said 11 patients are between the ages of 20 and 50, and reside in Fairfield, New Haven, New London and Hartford counties.
Most of the patients have not been hospitalized said officials. In 2023, only four Connecticut residents were diagnosed with mpox and there were 145 cases in 2022. Additionally, there has never been a death in Connecticut associated with mpox.
Fortunately, we are in a far different place than we were in 2022 thanks to the availability of the mpox vaccine and greater awareness, said DPH Commissioner Manisha Juthani, MD. Mpox spreads through close prolonged contact with an infected person. This might include coming into contact with skin lesions, or bodily fluids, sharing clothes or other materials that have been used by an infected person, or inhaling respiratory droplets during prolonged face-to-face contact.
Juthani added that residents who are concerned about fever, swollen glands, and a new rash, should contact their health care provider. Although anyone can get and spread mpox, the current cases are primarily among gay, bisexual, and other men who have sex with men and their sexual partners. For those who have multiple or anonymous sex partners, their likelihood of mpox exposure is higher.
Vaccination is highly recommended for people who are at risk for mpox. Two doses of the vaccine are recommended to provide maximum protection. The CDC estimates that only one in three Connecticut residents at risk have received both doses of the vaccine. With continued mpox spread in the US and globally, people at risk should get vaccinated to protect their health and their communities. People who have received only one dose can still get a second dose, Vaccination is not recommended for people with current mpox symptoms or people who have already had mpox.
For those seeking additional information on the vaccine, please contact your health care provider or visit the DPH mpox page: ct.gov/dph/mpox
Doug Stewart is a Senior Digital Content Producer at FOX61 News. He can be reached atdstewart@fox61.com.
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AMA Update covers a range of health care topics affecting the lives of physicians, residents, medical students and patients. From private practice and health system leaders to scientists and public health officials, hear from the experts inmedicineon COVID-19, medical education, advocacy issues, burnout, vaccines and more.
Featured topic and speakers
Is a new COVID vaccine coming out? Which RSV vaccine is better? Are there new PCV vaccines? Which vaccines can be given together? When is the new flu shot available?
Our guest is Sandra Fryhofer, MD, AMAs liaison to the Advisory Committee on Immunization Practices (ACIP), and a member of ACIPs COVID-19 Vaccine Workgroup. AMA Chief Experience Officer Todd Unger hosts.
Unger: Hello and welcome to the AMA Update video and podcast. New vaccines with new recommendations were just voted on last week by the ACIP, the CDC's Advisory Committee on Immunization Practices. And back with us today to share all those details is the AMA's in-house vaccine expert and ACIP liaison, Dr. Sandra Fryhofer in Atlanta. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Fryhofer, thanks for joining us again today.
Dr. Fryhofer: Well, Todd, thanks for having me back.
Unger: Dr. Fryhofer, the ACIP met for three days in June. Why don't you take us through some of the highlights?
Dr. Fryhofer: Well, it was a packed few days. ACIP made new recommendations for RSV, flu, COVID and pneumococcal vaccines. There was also an update on where we stand on the H5N1 bird flu outbreak in dairy cows.
Unger: Well, let's get into some of that. Why don't we start by talking about the new vaccine recommendations? Dr. Fryhofer, you also serve on the ACIP's COVID vaccine workgroup. So let's start with COVID vaccines. What should we expect for the fall, and who should get the vaccine?
Dr. Fryhofer: ACIP recommends everyone six months and older get a dose of the updated 2024-2025 COVID vaccine. So again, this is a universal recommendation, just like for flu. But understand, even though COVID is waned, it remains deadlier than flu. And uptake of last year's updated COVID vaccine has been very disappointing. Only 22.5% of adults and 14% of children have received it. We certainly hope uptake will be better this fall. Most Americans now have at least some immunity against COVID, but immunity wanes with time. And as the virus keeps changing, these updated vaccines provide a way to incrementally boost our immunity and keep us protected.
Unger: Dr. Fryhofer, where did we land on the formula for the new fall COVID vaccine? I know there's been some debate on that.
Dr. Fryhofer: Well, finalizing the recipe for that new vaccine has been a little tricky because the virus keeps changing and mutating. And lately, as you know, the virus has been flipping and "FLiRT-ing." The FLiRT variants got this nickname from the location of their mutations. There's an F for L at one position, an R for T at another, and they include any variants starting with KP or JN that has the same set of mutations.
So when VRBPAC, FDA's independent advisory committee, met on June 5, JN.1 had been dominated. KP.2 was on the rise. VRBPAC recommended a monovalent JN.1 formula. And initially, FDA did too. But over the next week, FDA continued to monitor what was circulating and made a slight change. The preferred recipe for the new JN.1 lineage formula is a COVID vaccine based on the KP.2 strain.
Unger: All right, well, thank you for the update there on the vaccine. Can you remind uswe talk about risk, who is most at risk of adverse outcomes from COVID?
Dr. Fryhofer: Two-thirds of COVID hospitalizations are in those aged 65 and older. And hospitalization rates are highest in those 75 and older and also in infants under six months old. And these little babies are too young to be vaccinated themselves. But maternal vaccination during pregnancy can help protect them. So that's why that's so important. Hospitalization rates are also high in adults aged 65 to 75. And unfortunately, we're still seeing racial and ethnic disparities in hospitalizations. COVID-associated hospitalizations are highest in American Indian, Alaska Native and in Black populations.
Unger: How did the COVID hospitalizations and deaths in children compare with, let's say, other vaccine preventable childhood illnesses?
Dr. Fryhofer: More pediatric hospitalizations and deaths occur each year associated with COVID than with other vaccine preventable diseases at the time those recommendations were made for children in the United States. And this includes hepatitis A, chickenpox, invasive pneumococcal disease, rubella, rotavirus and meningitis.
Unger: Dr. Fryhofer, it's clear that these vaccines are lifesaving for so many people. Why do you think the uptake has been so low?
Dr. Fryhofer: Focus group studies say older patients, those 65 and older, are most concerned about getting COVID and having to be hospitalized. Younger adults in their 20s are most concerned that they may unknowingly spread COVID to others. For children, the main reason parents gave for not having their child get the vaccine is concern about vaccine side effects. Other reasons include thinking the vaccine is not effective, which is not true, and that their child is unlikely to get very sick from COVID and we know that's not true either. So we really need to dispel these myths.
Another key point that really stood out is the power of physician recommendation. Adults and children who received a health care provider recommendation to get the COVID vaccine were more likely to get vaccinated. So physician recommendation is so important. We have to recommend these vaccines to our patients.
Unger: That is so important. Let's switch gears and talk about something different, which is RSV. I hear there is a new RSV vaccine. Tell us more about that.
Dr. Fryhofer: Yes, there is a new one. Now, until June 2024, there were just two RSV vaccines on the market, one by Pfizer called ABRYSVOthat does not contain an adjuvant, and one by GSK called AREXVY that does. And CDC does use these brand names. But with FDA's recent approval of Moderna's new mRNA RSV vaccine, MRESVIA, we now have three RSV vaccines to prevent severe RSV in older adults. This is Moderna's second ever licensed product, and it uses the same messenger mRNA platform as their COVID vaccines. All three of these RSV vaccines are licensed for those 60 and older.
Unger: Well, Dr. Fryhofer, going into this meeting, RSV vaccines had been recommended, as you say, by ACIP, those 60 and older, but under shared clinical decision making. Can you talk a little bit about what this means and what does ACIP recommend now?
Dr. Fryhofer: Shared clinical decision making means you and your patient have to discuss and decide. And these conversations are pretty easy for primary care physicians because we know our patients. But not everyone who administers vaccines is comfortable having them. The new recommendation is more specific and has both age-based and risk-based components.
Unger: Is there still that element of shared clinical decision making thathas that gone away, or is that still in place?
Dr. Fryhofer: Shared clinical decision making no longer applies here. The age-based recommendation is for those 75 and older. And all adults age 75 and older should receive a single RSV vaccine dose. And if you already received a dose under the old recommendation, you don't need to get another one, at least for now. The risk-based recommendation applies to adults 60 up to 75. And for them, RSV vaccine is now recommended only for those with risk factors for severe RSV.
These risk factors include lung disease, heart disease, immune compromise, diabetes, obesity with a BMI of 40 or more, neurological conditions, neuromuscular conditions, chronic kidney disease, liver disorders and hematologic disorders. Also, frailty, as well as living in a nursing home or other long-term care facility are considered risk factors for severe RSV disease. So those 60 up to 75 without these risk factors are no longer recommended to receive it.
Unger: Thank you for that clarification. In terms of timing, what's the best time to get the RSV vaccine?
Dr. Fryhofer: The best time to get the RSV vaccine for the greatest benefit is late summer to early fall, so think August through October.
Unger: What about coadministration with other vaccines? We've talked about COVID. You mentioned flu, RSV. Is that still allowed?
Dr. Fryhofer: Yes. Coadministration of RSV vaccine with other adult vaccines, including flu, COVID, pneumococcal, Tdap and shingles vaccines is allowed and is acceptable.
Unger: I heard that the age indication for GSK's RSV vaccine, AREXVY, has been lowered to age 50. Did ACIP look at giving the vaccine to people in their 50s with risk factors for severe disease?
Dr. Fryhofer: Well, they did talk about it, but ACIP doesn't recommend it for people in their 50s, even for those at high risk for severe disease. Now, one of the main hesitations goes back to vaccine safety concerns. You may recall FDA's required post-marketing surveillance for GBS and atrial fibrillation from both manufacturers, and those vaccine surveillance studies are still ongoing. There's still many unanswered questions, and vaccine safety concerns were top of mind during ACIP deliberations. ACIP did clarify this is not a recommendation against use of RSV vaccines in adults in their 50s. It's because more information is needed to make a population-level policy recommendation.
Now, this may change as more is clarified about potential safety concerns. And there's still many other questions we have about RSV vaccinesdurability of protection, will a booster be needed, and if so, when? And will a booster restore the initial boost in immunity we get from that first shot? So there's much more we need to know about RSV vaccines.
Unger: Now, we've talked about RSV vaccination for adults 60, 75, and older. What about on the other end of the age range for babies? Is there anything new there?
Dr. Fryhofer: Yes. And as a reminder, we now have two new ways to protect little babies, a maternal RSV vaccine given to mom, but only the one by Pfizer called ABRYSVOthat doesn't have the adjuvant, and also a new long-acting monoclonal antibody, nirsevimab, given to baby. ACIP clarified that at this time, people who received a maternal RSV vaccine dose during a previous pregnancy are not recommended to receive additional doses during future pregnancies.
Now, this is different from what we do with Tdap. Tdap is recommended in each and every pregnancy to prevent pertussis in little babies. However, infants born to people who are vaccinated with RSV during a prior pregnancy should receive nirsevimab. These recommendations can be updated as additional data become available.
Unger: Is there anything new with the long-acting monoclonal antibody that's given to babies to prevent RSV?
Dr. Fryhofer: Yes. Nirsevimab really works well. A study published in March in MMWR showed nirsevimab is 90% effective at preventing RSV-associated hospitalization for infants in their first RSV season. And this is great news for families with little babies. Nirsevimab's recommended for infants up to eight months old during their first RSV season and for high-risk toddlers aged 8 to 19 months in their second RSV season. And you might remember last RSV season, nirsevimab supplies were limited and we had to prioritize doses. Fortunately, no supply shortages are expected for the upcoming season.
Unger: Dr. Fryhofer, there's also a new pneumococcal vaccine with a new ACIP recommendation. Can you tell us how this vaccine is different from other pneumococcal vaccines?
Dr. Fryhofer: A new PCV 21 pneumococcal vaccine has been FDA licensed for those aged 18 and older under an accelerated approval pathway. ACIP voted to recommend PCV 21 as an option for adults 19 and older, who currently have an indication to receive a dose of PCV. Now, there are two basic types of pneumococcal vaccines, polysaccharide vaccines, like PPSV 23, which do not produce memory B cells, and conjugate vaccines, which do trigger memory B cell production, and therefore induce long-term immunity. And these include PCV 15, PCV 20, and now PCV 21.
Unger: What's so special about this new PCV 21 vaccine? Or is it just PCV 20 plus one?
Dr. Fryhofer: No, it's not just PCV 20 plus one. What's unique about PCV 21 is it just didn't add additional coverage. It's 21 strains are different and include 11 unique serotypes not in PCV 20. Now, this is important because many of the cases we see in adult disease are caused by subtypes not covered in other FDA-approved pneumococcal vaccines. ACIP reviewed the evidence and says PCV 21 has greater coverage of the serotypes that cause invasive pneumococcal disease in adults as compared to PCV 20. IPD, invasive pneumococcal disease, includes bacteremic pneumonia, pneumococcal bacteremia and meningitis.
PCV 20 covers up to 58% of invasive disease in adults. PCV 21 provides much greater protection and covers up to 84% of the serotypes that cause invasive disease. PCV 21's additional protection from strains that cause invasive disease is very impressive, and it's licensed for both prevention of invasive pneumococcal disease and pneumococcal pneumonia.
Unger: Is there any downside to using PCV 21 compared to the older versions of PCV since it covers more strains?
Dr. Fryhofer: Well, PCV 21 does not cover serotype 4, which is a major cause of invasive disease in certain populations. Adults experiencing homelessness are 100 to 300 times more likely to report invasive disease due to serotype 4. And adults in Alaska, especially Alaskan Natives, have an 88-fold increase in serotype 4 invasive disease.
Fortunately, serotype 4 is covered by other pneumococcal vaccines, including PCV 15, PCV 20 and PPSV 23. So we haven't heard the end of this story. And even higher valency pneumococcal vaccines, including a 25 valent and a 31 valent version, are under development, so much more to come. I'm sure I'll be back talking to you more about pneumococcal vaccines.
Unger: Thank you for the update on that. Let's talk about the other thing that we're aware of for the fall, and of course, that's the seasonal flu vaccine. What's new there?
Dr. Fryhofer: Well, this coming fall, the seasonal flu vaccine's going trivalent. FDA's removed the Yamagata flu B strain because it no longer appears to be circulating. And new CPT codes are ready to go, thanks to AMA's CPT editorial team. ACIP also made a special off-label recommendation for people aged 18 through 64 who've had a solid organ transplant and are on immunosuppressive medications. These high-risk patients can now be given one of the higher dose flu vaccines, including fluzone high-dose and also the adjuvanted flu vaccine, which are FDA approved only for those 65 and older.
Unger: Well, Dr. Fryhofer, that is a lot of great information. I just want to say, thank you so much for being here and for that quick run through of the highlights from ACIP's June meeting. That wraps up today's episode. To support important public health information like this, I encourage you to become an AMA member. You can join at ama-assn.org/join. We'll be back soon with another AMA Update. And in the meantime, you can find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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A new strain of mpox that emerged in the Democratic Republic of the Congo (DRC) could become an international health threat if it isnt contained soon and while lessons from recent viral outbreaks offer a path forward, its unclear whether authorities will act quickly enough to rein in the virus.
The DRC has been grappling with a major outbreak of mpox, formerly known as monkeypox, since September 2023.
But it has reached a crisis level recently because the lethal new strain is spreading without sexual contact and may be evading diagnostic tests. Cases are also reaching record highs, and vaccines are not widely accessible.
About 9,600 suspected mpox cases have been reported in eight African countries this year, and more than 400 people have died. Children under 15 have accounted for most of the new infections and deaths in 2024.
Nearly all of the cases so far have been in the DRC, but health officials say the new strain may already have spread beyond its borders, and that overall cases are likely underreported due to spotty testing and surveillance.
Without mitigation measures, mpox could soon cause more illnesses and deaths, and spill beyond Central Africa.
There's every likelihood that the virus may be on the move, Dr Rosamund Lewis, the World Health Organization (WHO)s technical lead and emergency manager for mpox, told Euronews Health.
Mpox became a global crisis in 2022 when cases broke out among gay and bisexual men in Europe and North America.
This marked the first time that sustained transmission was identified outside of West or Central Africa, where the virus has been endemic for decades in some countries.
Mpox has now been detected in 116 countries. Since 2022, more than 27,000 cases have been confirmed in Europe, where the virus continues to spread among men who have sex with men.
While some people have no symptoms, mpox can cause fever, fatigue, and a rash that turns into painful skin lesions, and in extreme cases, it can lead to death. Its particularly dangerous for children, pregnant women, and people with compromised immune systems due to an advanced HIV infection.
The strain that caused the global outbreak in 2022 is called Clade II, which is typically found in West Africa and is far less deadly than Clade I, which is common in the DRC and has a case fatality rate of about 10 per cent.
The concerning new strain, an offshoot of Clade I, first emerged last year among miners and sex workers in the eastern DRC town of Kamituga.
Recently, the new strain has been found in internally displaced camps, Lewis said. It is spreading through close personal contact, not just through sex, meaning it affects a much wider group of people, making it much harder to track and contain.
Researchers say the new strain has pandemic potential.
If this outbreak is not controlled, it can definitely pose a risk for the rest of the globe, Nicaise Ndembi, a senior advisor to the director general of the Africa Centres for Disease Control and Prevention, told Euronews Health.
In 2022, health authorities got the global outbreak under control through targeted distribution of vaccines and antiviral treatments, as well as effective health messaging to at-risk communities that helped them make decisions that slowed the spread.
By February 2023, nearly 337,000 vaccine doses had been administered in the European Union, Iceland, Liechtenstein, and Norway.
But there have been barriers to this approach in the DRC and broader region, given the stigma associated with mpox and the lack of access to vaccines and treatments.
There are three mpox vaccines available globally, but the DRC just granted emergency authorisation to use two of them last week. The country has a weak system for approving medical products and the WHO doesnt recognise the DRCs medicines regulator as a stringent regulatory agency.
Dr Nelson Aghogho Evaborhene, a vaccinologist at the University of the Witwatersrand in South Africa, added that some countries lack the technical and financial resources needed to evaluate medicines, instead relying on WHO, other global health groups, and other countries regulators to determine vaccine safety and efficacy.
Domestic vaccine manufacturing is also almost nonexistent meaning the DRC, and indeed much of the region, are reliant on donated doses from other countries.
That prompted officials and researchers to warn that the public health response to mpox reflects a failure to heed lessons from the COVID-19 pandemic and the earlier mpox outbreak, when wealthier nations stockpiled vaccines for their own citizens.
There was a huge disparity for antivirals and for vaccines, Evaborhene said.
Its also unclear how effective the existing vaccines are against the new mpox strain, which appears to be evading diagnostic tests. Meanwhile, clinical trials are underway to test how well the vaccines work to protect children.
Ndembi said more research is needed, but that given the emergency situation, African officials should prioritise getting the existing vaccines out quickly in countries with mpox transmission.
With immunisations not yet widely available, Lewis said better disease surveillance, targeted public health messaging, and clinical care for infected patients would help get the outbreak in check.
She also said mpox testing and treatment should be incorporated into sexual health services because it can look like herpes or syphilis.
If youre talking about an adult who has acquired mpox through sexual transmission, then that person should have an HIV test, Lewis said.
While HIV isnt a risk factor for mpox, people with HIV are at higher risk of severe illness and death from mpox.
Ndembi said the current outbreak underscores the need for a strengthened, centralised public health infrastructure in Africa, as well as health workforce development, increased regional vaccine manufacturing, more domestic funding for health security, and greater collaboration with global health organisations and other countries.
The Africa CDC proposed this roadmap, called the New Public Health Order, in 2021 after the COVID-19 pandemic exposed staggering international health inequalities.
But it has been sluggish to get off the ground, and Ndembi said the continents medical regulatory pathways remain fragmented.
We learned the hard way during COVID, and we came to realise we need to reshape the global health architecture, Ndembi said. As those efforts slowly ramp up, the immediate solution here is going to be ensuring that we have access to the biomedical interventions for mpox.
Its extremely important at this particular juncture, Ndembi said.
Eligible Victorians, including those in Wyndham, are being urged to get vaccinated against mpox amid an increased risk of local transmission across the state.
Current records show 61 mpox (previously known as monkeypox) cases have been reported in Victoria since April 2024, with most cases acquired in Australia.
The virus is usually spread from person-to-person by prolonged physical or intimate contact with someone who has mpox, especially with skin rashes, lesions, sores or scabs.
Mpox can start with flu-like symptoms, such as fever, headaches and muscle aches and pains. It causes a rash or skin lesions and swollen lymph nodes.
Symptoms can occur up to 21 days after being exposed to mpox.
Since May 2022, there has been a large international outbreak of mpox that is predominantly impacting gay, bisexual and other men who have sex with men.
Victorian acting chief health officer Dr Christian McGrath said the recent uptick in cases in Victoria is cause for concern.
Mpox is not just a disease you can contract overseas it is spreading locally in Victoria and people at risk need to consider how to best protect themselves, he said.
In Victoria, gay, bisexual, and other men who have sex with men are most at risk in the current outbreak. However, anyone who has been in close, and usually prolonged, intimate contact with someone with mpox is at risk.
Dr McGrath said the best line of defence against mpox is to get vaccinated.
While mpox can still occur following vaccination, it significantly reduces the risk of transmission and disease severity, he continued.
Its vital that you have two doses of the vaccine for optimal protection.
Avoiding contact with infected people, considering limiting your number of sexual partners and maintaining good hygiene are also important for the prevention of mpox.
In Victoria, the mpox vaccine is available free-of-charge for people who are at risk.
For information on eligibility and where to get the mpox vaccine please visit betterhealth.vic.gov.au/mpox
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STATUS CODE: 500
Pete Zimmerman and Alix Martichoux
1 day ago
(WGN Radio) As the summer surge in COVID-19 cases and hospitalizations continues, an updated vaccine to protect against the virus is on the way.
An updated booster shot will be available to Americans this fall, the Centers for Disease Control and Prevention confirmed. The CDC advises everyone 6 months and older get the new booster as soon as its available, regardless of whether or not theyve been vaccinated before.
These are the top vaccine people in the country and their recommendation is that everyone eligible should get it, said Dr. Jeffrey Kopin, chief medical officer forNorthwestern Medicine Lake Forest Hospital.
The shots are expected to become available in August and September, the Associated Press reports.
The updated booster wont be a combination COVID-influenza vaccine, Kopin said. That shot wont be available until at least next year, he said.
Listen to Dr. Kopins full interview with WGN Radio below.
Health officials have told Americans to expect a yearly update to COVID-19 vaccines, just like they are recommended to get a new shot each fall to protect against the latest flu strains.
But many Americans arent heeding the CDCs advice.
As of last month, less than one-quarter of U.S. adults and 14% of children were up to date in their COVID shots. Surveys show shrinking percentages of Americans think COVID-19 is a major health threat to the U.S. population, and indicate that fewer doctors are urging patients to get updated vaccines.
CDC officials on Thursday presented recent survey information in which about 23% of respondents said they would definitely get an updated COVID-19 shot this fall, but 33% said they definitely would not.
About 1.2 million U.S. COVID-associated deaths have been reported since early 2020, according to the CDC. The toll was most intense in the winter of 2020-2021, when weekly deaths surpassed 20,000. About 1 out of every 100 Americans ages 75 and older were hospitalized with COVID in the last four years, CDC officials said Thursday.
The Associated Press contributed to this report.
