News Scan for Mar 11, 2022

COVID-19 vaccination of kids
US flu rebounds
Flu vaccine ineffectiveness
More polio positives in Israel

COVID vaccine uptake low in young US kids in first months of availability

The Centers for Disease Control and Prevention (CDC) said COVID-19 vaccine uptake among children 5 to 11 years old in the United States remained low during the first 11 weeks of vaccine eligibility, especially in high social vulnerability index (SVI) areas. The research was published today in Morbidity and Mortality Weekly Report (MMWR).

The Pfizer-BioNTech was approved for emergency use in 28 million eligible children ages 5 to 11 on Oct 29, 2021. Ninety-two percent of eligible children lived within 5 miles of an active vaccine providers within 1 month of vaccine availability. As of Jan 18, 2022, 39,786 providers had administered 13.3 million doses.

First-dose coverage at 4 weeks after launch was 15.0% (10.5% and 17.5% in high and low SVI areas, respectively; rate ratio [RR], 0.68; 95% confidence interval [CI] 0.60 to 0.78), and at 11 weeks was 27.7% (21.2% and 29.0%; RR, 0.76; 95% CI, 0.68 to 0.84), the authors said.

Vaccination series completion rate was 19.1% (13.7% and 21.7%; RR, 0.67; 95% CI, 0.58 to 0.77). Pharmacies administered 46.4% of doses to this age-group, including 48.7% of doses in high SVI areas, and 44.4% in low SVI areas.

"At 11 weeks, despite 54.0% of vaccine providers being in high SVI areas, the series completion rate was approximately 33.0% lower in high than in low SVI areas, underscoring the importance of strengthening strategies (e.g., education, culturally and linguistically relevant outreach, and engagement of trusted providers) to improve vaccination coverage in these communities," the authors concluded.

The authors said the vaccination trends in this age-group mirrored similar uptake trends in the 12- to 17-year-old group after it was approved in August 2021. If vaccines are approved for use in children younger than 5, the authors said to expect similar uptake numbers, and to offer more outreach to communities with high SVI.
Mar 11 MMWR


Flu activity up again in most of US

Activity is increasing again in most of the United States, with the highest respiratory test positivity rates in the central and south-central regions, the CDC said today.

Flu activity as measured by flu test positivity had been declining in January and into February, but started rising slightly again in about the middle of February. The percentage of outpatient visits for flulike illness increased slightly last week but is still below the national baseline. The CDC also said flu hospitalizations have been rising for the past 5 weeks.

One state—Oklahoma—reported high activity, and Idaho and Kansas reported moderate activity.

The CDC said the overwhelming majority of viruses are still H3N2, with antigenic data suggesting that most are different from the vaccine strain (see scan below on flu vaccine effectiveness thus far).

Two more pediatric flu deaths were reported, raising the season's total to 10. One involved  H3N2 and occurred the week ending Jan 29 and other was due to an unsubtyped influenza A virus and occurred the week ending Feb 19.
Mar 11 CDC FluView report


Preliminary CDC data show no flu vaccine protection thus far

Interim CDC data published today show that flu vaccines thus far in the 2021-22 season have not protected against H3N2, which has accounted for almost all US circulating strains this season.

In a study in Morbidity and Mortality Weekly Report (MMWR), CDC scientists analyzed data from 3,636 children and adults who had acute respiratory infection, of whom 194 (5%) tested positive for influenza. Among those who tested positive, 41% had received the 2021-22 seasonal flu vaccine, compared with 50% of those who tested negative.

The researchers determined that overall vaccine effectiveness (VE) against medically attended flu caused by the H3N2 strain was 16%, but the 95% confidence interval ranged from −16% to 39%, which is considered not statistically significant.

Among the 194 patients who tested positive for flu, none had influenza B. Of 178 influenza A viruses subtyped, 1 was H1N1 and 177 were H3N2.

"These findings are consistent with previous evidence of low to no protection against outpatient infection with A(H3N2) subclade 2a.2 viruses from an investigation of an influenza outbreak on a university campus during October–November 2021," the authors wrote. "These VE estimates underscore the need for ongoing diagnostic testing for influenza, influenza antiviral treatment and prophylaxis when indicated, and everyday preventive measures."

The CDC continues to recommend flu vaccination, however, because evidence suggests it can avert serious outcomes and is likely to prevent illness if other flu viruses such as H1N1 and influenza B circulate in the coming weeks.

The authors also noted that flu vaccine coverage is lower so far this season in certain groups, including some who are at high risk for severe flu. The agency was not able to assess flu VE last season because the nation saw such few cases.
Mar 11 MMWR study


Israel reports more polio positives, outbreak scope expands

Israel's investigation into a recent polio case—its first in more than 30 years—has turned up two positive stool samples, and a genetic analysis of the virus found that it is linked to circulating vaccine-derived poliovirus type 3 (cVDPV3) environmental samples collected in Israel and the Palestinian Territories between September 2021 and January 2022.

Yesterday, Israel's health ministry said that, as part of the probe into the recently announced infection in a Jerusalem child, positive stool samples were found in one of the child's contacts, who is asymptomatic. Another positive sample was found via anonymous stool sampling conducted in the area in and around Jerusalem.

In a related development, the World Health Organization (WHO) European regional office said yesterday that the patient is a 3-year-old girl who developed acute flaccid paralysis, after which stool testing confirmed a polio infection.

Further testing of the virus found that it was linked to environmental cVDPV3 strains found recently that had previously been designated as ambiguous VDPV3. They have now been reclassified as cVDPV3, confirming an outbreak in Israel and Palestine.

A weekly update from the Global Polio Eradication Initiative (GPEI) said there were six environmental positives, five in Jerusalem and one in North Province. It also noted eight environmental positives in Palestine, seven from the West Bank and one from Ramallah.
Mar 10 Israel health ministry statement
Mar 10 WHO European regional office statement
Mar 10 GPEI update
Mar 7 CIDRAP News scan

Elsewhere, two African countries reported more cVDPV2 cases this week, according to GPEI. The Democratic Republic of the Congo reported 1 more case, in Maniema. The illnesses is included in the country's total for 2021, which now stands at 27. And Nigeria reported one more case, its second of 2022.
Mar 10 GPEI update

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