Quick takes: mRNA vaccine production equity, Powassan death in Maryland, COVID infection-prevention guidance

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  • The Bill and Melinda Gates Foundation yesterday announced $40 million in new funding to support mRNA vaccine production in Africa and other low- and middle-income locations. The support will advance access to the Quantoom Biosciences low-cost mRNA research and manufacturing platform, which was developed with an early-research Grand Challenges grant to its parent company, Univercells. Institutions currently tapped to receive the technology include the Pasteur Institute in Dakar, Senegal, and Biovac, which is based in South Africa. The Gates Foundation announced the funding at the Grand Challenges annual meeting in Dakar.
  • The Maryland Department of Health (MDH) recently announced its first Powassan virus death, which involved an individual who contracted the virus in Canada, according to a statement. Nilesh Kalyanaraman, MD, MDH’s deputy secretary for public health services, said officials don’t believe Powassan viruses pose a local transmission threat in Maryland, but they urged people to take measures to avoid ticks and areas known to have ticks.
  • The World Health Organization (WHO) yesterday published updated infection prevention and control (IPC) guidance for COVID-19 that combines technical guidance developed earlier with evidence-informed recommendations. It said the living guidelines include 15 statements on IPC measures in healthcare settings and one statement on mask fit in community settings. The WHO said the update is geared toward transitioning from critical emergency response activities to longer-term efforts to control the spread of COVID and a shift toward integrating IPC activities into routine systems.

Kids in state with flu vaccine mandate more likely to be vaccinated, study finds

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Vaccine BandAid on baby
FotoDuets / iStock

Children in a state with an influenza vaccine mandate during the 2020–2021 flu season were much more likely to be vaccinated than those in non-mandate states, according to a study published today in Pediatrics.

A Harvard-led research team analyzed health insurance enrollment and claims data from 71,333 children aged 6 months to 18 years in Massachusetts, New Hampshire, and Maine. Massachusetts instituted a flu vaccine mandate during the 2020-2021 season.

The team also used county-level community COVID-19 case counts from March 2020 to August 2020 to measure area COVID-19 severity. The average child age was 9.7 years, and 45% received flu vaccines in both the 2019–2020 and 2020–2021 flu seasons, 26% weren't vaccinated in either season, and 29% were vaccinated in only one season.

"Influenza vaccination uptake among children is suboptimal despite the clearly defined benefits of annual vaccination," the study authors wrote. "The coronavirus disease 2019 pandemic may have changed vaccination behaviors because of concerns about coronavirus disease 2019 exposure and new mandates for influenza vaccination for children."

Previously unvaccinated saw largest gains

Previously unvaccinated children in Massachusetts had a higher predicted probability of being vaccinated against flu than those in New Hampshire and Maine (47.7% vs 21.2%, respectively). Previously vaccinated children in Massachusetts were also more likely to receive a flu shot (78.2% vs 58.2%, respectively); the difference was 6.5 percentage points higher among the previously unvaccinated.

Strategies to improve uptake of influenza vaccination may have differential impact based on previous vaccination status and should account for community factors.

Previously vaccinated children in a county with the greatest COVID-19 severity had a lower predicted probability of being vaccinated against the flu than those in a county with the lowest COVID-19 severity (72.1% vs 77.3%, respectively).

The researchers said vaccinating schoolchildren against flu is the most effective way to reduce flu incidence and hospitalization, particularly in years of low vaccine efficacy. "Strategies to improve uptake of influenza vaccination may have differential impact based on previous vaccination status and should account for community factors," they wrote.

Study: Prenatal telehealth visits did not take off during pandemic

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During the first months of the pandemic, many healthcare providers pivoted to telehealth appointments as way to limit potential exposure to COVID-19, including obstetricians and gynecologists caring for pregnant patients. But a new study in JAMA Network Open shows most patients chose in-person visits from June to December 2020 out of personal preference, despite the availability of telehealth.

The study was based on data collected from the 2020 Pregnancy Risk Assessment Monitoring System (PRAMS) across 29 states or localities. Participants completed a survey about their healthcare access in 2020.

70% of patients chose in-person care

A total of 12,073 respondents gave birth between June and December 2020 and were asked if they used prenatal telehealth. If they did not, they were asked to supply a reason why. Of the 12,073 respondents, 7,686 said they never used prenatal telehealth, and 4,387 said they did.

Those in rural areas were less likely to use prenatal telehealth than urban respondent.

Seventy percent of those who did not use telehealth said they did so based on personal preference to be seen in person during pregnancy. Twenty-six percent said telehealth visits were not offered in their clinic, and 5% said there were technical barriers to accessing the services.

"Compared with respondents with private insurance, those with Medicaid had no adjusted difference in prenatal telehealth use, but uninsured respondents were 14.6 percentage points less likely to use prenatal telehealth," the authors wrote. "Those in rural areas were less likely to use prenatal telehealth than urban respondents."

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