News Scan for Sep 24, 2021

COVID-19 vaccine hesitancy
Medicare and excess pandemic deaths
Less foodborne illness
Salmonella outbreak expands
H1N2v flu case in Ohio

COVID-19 vaccine hesitancy has decreased, survey says

Of 1,061 people who were hesitant about receiving the COVID-19 vaccine at the end of 2020, 32% were at least partially vaccinated by spring 2021, and 37% said they were likely to be, according to a research letter published today in JAMA Network Open.

The researchers surveyed 3,439 people from Aug 9 to Dec 8, 2020, of whom 1,061 said they were vaccine hesitant. While follow-up from Mar 2 to Apr 21, 2021, showed that most people in this subgroup were either vaccinated (32%) or said they were likely to be (37%), 32% said they were unlikely to be vaccinated.

Of the 2,378 people who were not hesitant at baseline, 54% had received at least one dose at follow-up, while 39% said they were likely to be, and 7% changed their mind and said they were unlikely to be vaccinated.

Baseline willingness was associated with at least a college undergraduate degree (76% vs 65%), and at follow-up, 54% of this group were vaccinated, compared with 43% who had less education. While Hispanic people's vaccine willingness was similar to White people's (71% vs 69%), at follow-up, they were still less vaccinated (31% vs 51%).

"Changes in hesitancy have not alleviated health inequities in vaccines received, and further studies are needed to explore the reasons why vaccine hesitancy is changing over time by group," write the researchers.

A sensitivity analysis of those who were initially vaccine hesitant and eligible at the time of follow-up showed that 51% were at least partially vaccinated, 22% said they were likely to be vaccinated, and 27% said they were unlikely to be vaccinated.
Sep 24 JAMA Netw Open study


Medicare eligibility not tied to excess pandemic deaths

Medicare, for which most US adults become eligible around age 65, was not associated with excess deaths in 2020, according to a study published today in JAMA Health Forum. US mortality data from those 61 to 69 years old from March to December, 2015 to 2020, showed no discontinuities in the researchers' model.

Similar results were found when the researchers tightened their age range around 65 years and when they altered the model relationship between age and death counts. The percent change in total death counts in the 2020 period compared with those from 2015 to 2019 was 28.1% or 30.6%, depending on whether Datavant or National Center for Health Statistics data were used, respectively.

"These null findings may reflect the influence of state and federal policies that directed payments to hospitals for COVID-19 treatment and eliminated cost sharing for COVID-19 testing, both of which aimed to broaden access to COVID-19 testing and treatment," they conclude. "This cross-sectional regression discontinuity analysis found that entry into Medicare was not associated with the likelihood of death during the COVID-19 pandemic."
Sep 24 JAMA Health Forum study


Foodborne illnesses decreased in 2020, study finds

Foodborne illnesses decreased by 26% in 2020 compared with the average from 2017-19, according to a report today in Morbidity and Mortality Weekly (MMWR).

In 2020, the Centers for Disease Control and Prevention's FoodNet surveillance system, which covers 10 US states and about 15% of the US population, identified 18,462 infections—26% lower than the 2017-19 average—including 4,788 hospitalizations and 118 deaths.

Campylobacter had the highest incidence (14.4 infections per 100,000 people), followed by Salmonella (13.3), and Shiga toxin-producing Escherichia coli (3.6). All eight FoodNet-tracked pathogens had lower incidences, except for Yerisinia and Cyclospora.

The researchers speculated that pandemic-related behaviors, such as more handwashing, less international travel, and restaurant closures, may have contributed to the decrease in foodborne illnesses, but they note that changes in healthcare delivery and healthcare-seeking behaviors may have caused underreporting. While they also note that lab-testing practice changes may have had an effect, they found that the proportion of infections diagnosed by culture, compared with culture-independent diagnostic tests, was stable in 2020.

"The incidences of Salmonella Infantis, Cyclospora, and Yersinia infections, which had previously been increasing, did not change, possibly because of continuing prepandemic factors that led to rising incidences during previous years," the researchers write. "The stable incidences despite the pandemic suggest that they might have increased otherwise. As pandemic-related restrictions are lifted, illnesses caused by these pathogens and by Hadar, the one Salmonella serotype with increasing incidence, should be closely monitored."

All outbreak-associated Hadar cases were connected to one multistate outbreak involving backyard poultry contact, according to the data; more than one-third had to be hospitalized.
Sep 24 MMWR study


Salmonella outbreak from mystery food source climbs to 279 cases

A Salmonella Oranienburg outbreak tied to a still-unknown food source has sickened 152 more people with 4 more states reporting cases, pushing the total to 279 cases from 29 states, the US Centers for Disease Control and Prevention (CDC) said yesterday in an update.

So far, 26 patients have been hospitalized, reflecting an increase of 8. No deaths have been reported. The latest illness onset was Sep 13. States reporting the most cases include Texas, Oklahoma, Illinois, Virginia, and Minnesota.

The CDC and its partners are collecting different types of data, but so far, no specific food source has been linked to the outbreak. It added that several restaurant subclusters have been identified in a number of states, which may help investigators narrow in on a potential source.

The true number of people infected in the outbreak and number of affected states may be much higher, because many people recover without medical care and are not tested. When the CDC first announced the outbreak on Sep 17, it noted that the event was rapidly growing.
Sep 23 CDC outbreak update
Sep 20 CIDRAP News scan


Potential human-to-human spread eyed in Ohio H1N2v flu case

In its latest weekly flu update today the CDC said a variant H1N2 (H1N2v) case has been reported from Ohio, the nation's third involving the influenza subtype this season.

The patient is younger than 18, wasn't hospitalized, and has recovered. Neither the patient nor his or her household contacts had contact with swine or had attended agricultural events where pigs were present, features that are often associated with swine-variant infections.

The CDC said it's possible that limited human-to-human transmission occurred, though so far, no ongoing transmission has been found.

Overall, 10 variant flu cases involving different subtypes have been reported in the United States this flu season. Another of the three H1N2v cases was reported from Ohio in May. The patient was a child who also had an infection that didn't require a hospital stay. He or she lives on a farm where pigs are present.
Sep 24 CDC FluView report
May 28 CIDRAP News scan

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