Sexual health clinics in the United Kingdom today began offering vaccination against gonorrhea to patients at the highest risk of sexually transmitted infections (STIs).

Although there is currently no vaccine that specifically targets the Neisseria gonorrhoeae bacterium, the National Health Service (NHS) is now recommending an existing vaccine for meningococcal B disease (4CMenB) to gay and bisexual men who have a recent history of multiple sexual partners and a bacterial STI within the past 12 months. Multiple studies have shown that the 4CMenB vaccine, which protects against four serogroups of Neisseria meningitidis, also provides moderate cross-protection against N gonorrhoeae, with vaccine effectiveness ranging from 30% to 40%. 

NHS announced the vaccination program in May, based on a recommendation from the UK's Joint Committee on Vaccination and Immunisation. Researchers at Imperial College London have estimated that vaccinating those at highest risk of gonorrhea with the 4CMenB vaccine could avert more than 100,000 cases and save NHS more than £7.9 million over 10 years.

"This vaccine is already used to protect against Men B and is proven to be effective against gonorrhoea, preventing the spread of infection and reducing the rising rates of antibiotic-resistant strains," Amanda Doyle, NHS national director for primary care and community services, said in an NHS press release.

Surge in gonorrhea cases in the UK

The rollout of the vaccination program comes at a time when gonorrhea infections have been surging in the United Kingdom. The 85,000 gonorrhea cases reported in 2023 were three times the number reported in 2012 and the most since UK officials began tracking gonorrhea cases in 1918.

"Rolling out this world-leading gonorrhoea vaccination programme in sexual health clinics in England represents a major breakthrough in preventing an infection that has reached record levels," said UK Minister for Public Health and Prevention Ashley Dalton. "I strongly encourage anyone who is eligible to come forward for vaccination, to protect not only yourselves but also your sexual partners."

A new report in Open Forum Infectious Diseases details the significant increase of the Babesia season in New England since the 1980s, and the authors said warming trends in the region may lead to accelerating tick life cycles and increasing tick activity outside of the traditional summer months.

Babesiosis is parasitic disease primarily spread by blacklegged (deer) ticks, which infects red blood cells. While some have no symptoms, many people will experience flu-like symptoms and in severe cases, the disease can lead to hemolytic anemia if not treated. 

To measure incidence over time, the authors conducted a chart-review of cases seen at three Boston hospitals between May 1, 1993, and May 1, 2024. Of the 1,130 cases included in the study, 986 were probably acquired in Massachusetts, 43 in New Hampshire, 25 in Rhode Island, 8 in Maine, 6 in Connecticut, and 1 in Vermont.

Biggest increases in Maine, Vermont 

According to the authors, between 2011 and 2019, the incidence of babesiosis increased by 193% in Massachusetts, 338% in Connecticut, 1,422% in Maine, and 1,602% in Vermont.

Babesia diagnoses showed a strong correlation with each unit increase in time (year), resulting in an annual growth in cases of 14.2% (95% confidence interval [CI], 13.1% to 15.2%).

“We observed a significant expansion of the babesiosis season in the past 31 years with the mean number of months per year with cases rising from 2.2 before 2000 to 9.2 after 2015,” the authors concluded. 

Electronic health record data from 352 US outpatient facilities show a 20% increase in antibiotic prescribing per year from 2021 through 2023, researchers reported today in Antimicrobial Stewardship & Healthcare Epidemiology.

Using data from the Collaboration to Harmonize Antimicrobial Registry Measures database, researchers from Ferris State University assessed oral antibiotic prescribing at 352 outpatient facilities in the Midwest from January 2021 through June 2023. The primary outcome was the rate of antibiotic prescribing per 1,000 prescription-related outpatient visits, and secondary outcomes included prescribing patterns for selected diagnoses and the concordance of antibiotic prescriptions with published guidelines.

"By examining this trend, we aim to identify potential gaps in clinical practice and areas for intervention to enhance the judicious use of antibiotics," the study authors wrote.

Return to pre-pandemic healthcare use

Out of 6,795,023 prescription-related outpatient visits over the study period, 823,938 antibiotics prescriptions were issued, for an overall prescribing rate of 121.26 per 1,000 prescription-related visits.  The rate increased from 96.24 in the first quarter of 2021, to 114.80 in the same quarter of 2022 (a 19% increase) and further increased to 138.87 in the first quarter of 2023 (a 20% increase from 2022). Amoxicillin-clavulanate (12%), amoxicillin (12%), doxycycline (11%), and cephalexin (11%) were the most frequently prescribed antibiotics. 

Sinusitis and otitis media were the most common reasons for prescribing antibiotics among adults and children, respectively. Less than 60% of sinusitis-related prescriptions were antibiotic concordant. Duration concordance rates were less than 70% for sinusitis, urinary tract infections, cellulitis, and group A Streptococci (GAS) infections. The researchers also noted a significant increase in pediatric antibiotic prescriptions, with the prescription rates for otitis media rising by 152% in the last quarter of 2022 and for GAS by 165% in the first quarter of 2023.

The authors say the increase in antibiotic prescribing reflects a return to pre-COVID pandemic healthcare utilization patterns, and resurgence in infections as public health measures were relaxed. They add that the discrepancies in guideline concordance highlight the need for stronger antimicrobial stewardship.

"Future research should focus on understanding the factors influencing prescribing behaviors and developing targeted interventions to promote appropriate antibiotic use," they wrote.

About two-thirds (59%) of American adults polled in a new survey from the Kaiser Family Foundation said they had no intention of getting a seasonal COVID-19 vaccine for the upcoming cold and flu season. 

Of the adults polled, 23% said they will “probably not” get the vaccine, while 37% said they will “definitely not” get the shot. Earlier this year the Trump administration and Department of Health and Human Services Secretary Robert F. Kennedy, Jr. made sweeping changes to COVID-19 vaccine policy, with a seasonal booster no longer recommended for children, pregnant women, and adults with no underlying health conditions. 

Sharp political divide noted 

There was a distinct political divide among poll respondents, with Democrats and Republicans sharply divided on the question of whether Kennedy’s vaccine changes, including his replacement of the Centers for Disease Control and Prevention's (CDC) vaccine advisory committee members, will make the nation safer. 

About two in ten adults, including 41% of Republicans, think these changes will make people safer while about one-third of adults, including most Democrats (62%) and four in ten independents (41%) say they will make people less safe.

“About two in ten adults, including 41% of Republicans, think these changes will make people safer while about one-third of adults, including most Democrats (62%) and four in ten independents (41%) say they will make people less safe,” KFF said. Sixty percent of Republicans said they will not get the COVID-19 vaccine this Fall.

Thirty-one percent of respondents said they did not know if the changes will make the nation safer. And only 49% of poll respondents said they trust the Food and Drug Administration or the CDC to make sure vaccines are safe. 

A less noticeable divide was seen among racial and ethnic groups. Four in 10 Black adults and Hispanic adults say they plan to get the COVID-19 vaccine, as do 37% of white adults.

In another change to how the Centers for Disease Control and Prevention (CDC) vaccine advisory group operates, the Department of Health and Human Services (HHS) on July 31 sent a letter to members of about 30 nonvoting liaison groups from medical and public health organizations that bars their participation on work groups, CNN reported, based on a letter it obtained. 

The email called the liaison members special interest groups that are expected to be biased based on the constituencies they represent.

The liaison groups include organizations such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. The work groups have typically assisted with vaccine efficacy and safety reviews, considering the age-groups that would most benefit and weighing the costs and benefits. 

Work groups, which also include CDC staff, craft the wording of proposed recommendations for discussion and vote at Advisory Committee on Immunization Practices (ACIP) meetings. Liaison members don’t vote on the recommendations at the meetings but can ask questions and comment on presentations.

In early June, HHS Secretary Robert F. Kennedy Jr. removed all 17 members of the previous ACIP and replaced them with eight new members, including several who are vaccine skeptics or have little expertise in vaccine science. At its first meeting of the new group in July, the group revived long-discredited antivaccine boilerplate topics, including thimerosal as a vaccine additive and the cumulative effects of childhood vaccines.

ACIP’s charter notes about 30 specific groups that hold nonvoting seats on the ACIP. It also allows the HHS secretary to appoint other liaison members based on the committee’s needs. According to longstanding ACIP work group operating procedure rules, last updated in August 2018, liaison members and ex-officio members must sign an annual membership agreement and conflict-of-interest forms.

Groups sound alarm in joint statement 

A day after the HHS letter about the work group involvement was sent, members from eight liaison groups published a statement that said they were deeply disappointed and alarmed to be barred from reviewing scientific data and informing the development of vaccine recommendations. 

“To remove our deep medical expertise from this vital and once transparent process is irresponsible, dangerous to our nation’s health, and will further undermine public and clinician trust in vaccines,” the authors wrote, calling it a step backward for transparency and public health. The group included several major medical associations, including the Infectious Diseases Society of America.