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Post-exposure rabies vaccine saves lives, and community pharmacies can help
News briefToday at 3:57 p.m.
Sarah Boden
Topics
Rabies
Community pharmacies may be key to preventing people exposed to the rabies virus from developing the fatal neurologic disease.
Spread through the bites and scratches of mammals, rabies is preventable if people get the post-exposure vaccine before clinical symptoms appear.
The first shot of the four-dose series is often given at an emergency department (ED), followed by doses administered on days three, seven, and 14. Needing so many shots can be burdensome, and some patients skip later doses, increasing the odds of the virus entering their central nervous system and killing them.
But a study published yesterday in the American Journal of Infection Control found that when a health system in the Appalachian Highlands gave people the option to get subsequent doses at a community pharmacy, the percentage of patients who completed their rabies vaccine series rose from 49.6% to 53.1%.
The statistically significant, though modest, bump is more consequential when considering that 80% of patients who used community pharmacies completed their rabies vaccine series, compared with just 47.9% of those who chose to get their subsequent shots at the ED.
"Unnecessary ED visits increase costs for patients and strain ED providers and systems," said the authors, led by Jeffrey A. Gray, PharmD, of Eastern Tennessee University.
The authors added that EDs often lack the infrastructure for follow-up care.
However, just 35 of the 367 patients in the study got their vaccines from community pharmacies. The authors said this low rate could be due to several factors, including issues with insurance coverage, inconsistent ED referrals to community pharmacies, and patients' awareness of community pharmacies as an option.
More Americans are getting exposed to rabies
While the United States reports fewer than 10 rabies deaths per year, the Centers for Disease Control and Prevention (CDC) reports that 2026 has seen increases in both animal rabies cases and human exposures.Some 100,000 US residents receive post-exposure rabies preventive shots (prophylaxis) every year, according to the CDC. Bats, raccoons, skunks, foxes, and mongooses are the main animal reservoirs of the virus.
Study suggests gut microbiome determines vaccine reaction
News briefToday at 3:54 p.m.
Stephanie Soucheray, MA
Topics
Misc Emerging Topics
A new study shows a person’s gut microbiome, specifically levels of inflammation in the intestine, may be behind post-vaccination fevers. The study was published earlier this month in Science.
Fever is a common reaction to a number of vaccines but can be a factor in vaccine hesitancy, the authors wrote, especially for vaccines against seasonal influenza and COVID-19.
The study was based on 171 healthy adults whose fecal microbiomes, body temperature, and blood-based immune markers were measured before and after receiving mRNA COVID-19 vaccination.
The authors found that Lachnospiraceae, a bacteria that lives in the gut and can produce flagellin (which forms flagella, providing cell motility), played an important role in vaccine-related reactions. Notably, participants who had fevers following vaccination had higher levels of flagellated bacteria in their intestinal samples.
Diet modification could help reduce fever risk
The authors said it is possible flagellin may activate inflammatory pathways and intensify vaccine-related reactions and that these reactions may be enhanced by a high-fat and highly processed diet, which leaves the body in an inflammatory state.“Although interventional human studies are needed to establish causality, this suggests that diet modification could be a viable strategy to influence microbiome-dependent vaccine responses,” the authors wrote.
Importantly, the authors noted that flagellin and inflammation do not affect antibody responses to vaccines, meaning increased vaccine side effects had no bearing on vaccine efficacy.
Policy brief suggests speedier, fairer COVID vaccine rollout could have averted millions of deaths by 2022
News briefToday at 3:20 p.m.
Mary Van Beusekom, MS
Topics
COVID-19
Had lower-income and lower middle–income countries rolled out the COVID-19 vaccine at the same rate as their wealthy counterparts, they might have prevented up to half of deaths related to the virus by fall 2021, according to a model-based policy brief from Canada’s United Nations University Institute for Water, Environment and Health (UNU-INWEH) and international partners.
And rolling out the vaccine 100 days after the virus was sequenced could have saved more than 8 million lives around the world by 2022, mostly in poorer countries, the authors said.
“COVID-19 vaccines were developed and deployed faster than any before them, yet countries differed widely in their ability to finance, procure, distribute and administer them,” they wrote. Sharing supplies more fairly could have averted 1.3 million deaths worldwide by 2022 by more evenly disrupting transmission, reducing the risk of new SARS-CoV-2 variants, and speeding economic recovery, they added.
Global consensus on vaccine-sharing rules needed
By the end of 2021, wealthy countries had administered, on average, at least one COVID-19 vaccine dose per person, compared with one dose for every three people in lower middle–income countries and one for every 25 in low-income countries.We must strengthen the foundations for equity through cooperative global mechanisms that can effectively improve financing, manufacturing and delivery, ensuring that life-saving solutions reach those who need them most.
Kaveh Madani, PhD
“When vaccine supplies are limited, distribution should respond to epidemiological evidence, including disease burden, risk of severe outcomes and the speed of transmission, so that vaccines reach the places where they can prevent the greatest harm,” lead author Mahan Ghafari, DPhil, of the University of Oxford, said in a UNU press release.
“But for millions of people in poorer countries, they still arrived too late,” he added. “The science moved at record speed while the systems for financing, sharing and delivering vaccines did not.”
Before the next pandemic, nations must agree on fair vaccine-sharing rules, said coauthor Kaveh Madani, PhD, director of UNU-INWEH. “We must strengthen the foundations for equity through cooperative global mechanisms that can effectively improve financing, manufacturing and delivery, ensuring that life-saving solutions reach those who need them most,” he said.
Japan’s COVID-19 efforts protected Olympians, Paralympians in 2021, analysis finds
News briefToday at 8:42 a.m.
Meghan Holohan
Topics
COVID-19
During the 2020 Olympic and Paralympic Games—which the COVID-19 pandemic delayed until 2021—stronger surveillance and mitigation efforts protected most athletes and team officials from contracting COVID-19, a study published last week in Eurosurveillance finds.
“The results indicate that SARS-CoV-2 transmission into and within athletes and team officials was minimized by multiple infection prevention measures,” said the authors, led by researchers at the Japan Institute for Health Security in Tokyo. “This conclusion is supported first by the low attack rates among both Olympic and Paralympic athletes and team officials.”
Less than 1% of participants infected
For the 2020 Games, Japan enhanced its COVID-19 surveillance and mitigation in several ways. Country teams entering the nation needed to quarantine for 14 days. Following that, athletes were discouraged from interacting with people from outside of the venues.Those involved in Olympics and Paralympics events underwent regular COVID-19 testing, which found those with COVID-19 infections early and allowed them to enter isolation early. Those attending Olympic and Paralympic venues wore masks and physically distanced from one another.
During the Olympic Games, only 0.6% of athletes and team officials (65 of 11,400) tested positive for COVID-19—the same rate as for the Paralympic Games (30/4,800).
Most people who tested positive (85/95) did so upon arrival or within two weeks of entering Japan. Sixty-eight of those infected with COVID-19 had the Delta variant, 66 people had a strain that originated outside of Japan, and two had a domestic strain.
“Low rates of infections, mainly affecting those from abroad shortly after their arrival in Japan indicate that the Games’ unique infection-control measures effectively minimized SARS-CoV-2 transmission,” the authors said.
Quick takes: Ebola cases top 10,000; New World screwworm in Texas, New Mexico; more avian flu in Washington cattle
News briefToday at 8:32 a.m.
Stephanie Soucheray, MA
Topics
Ebola
Viral Hemorrhagic Fever
New World Screwworm
Avian Influenza (Bird Flu)
- The Ebola outbreak in the Democratic Republic of the Congo (DRC) has now grown to 10,060 cases. Compared with the West African outbreak of 2014-2016, the current outbreak has at least three times the number of cases and number of deaths since it was declared on May 15, making it the fastest-growing Ebola outbreak in history. The European Centre for Disease Prevention and Control (ECDC) reported they are sending more experts to Nigeria this week to investigate how a woman in that country contracted the virus. The ECDC has also sent support to Kenya, where two people have died from the virus. Yesterday, 20 case contacts in Kenya were released from quarantine after finishing a 21-day monitoring period. Ninety-eight contacts remain in quarantine. In total, nine people in Kenya have tested positive for the virus.
- New World screwworm detections are increasing in both New Mexico and Texas this month, with six detections in the past week alone, and 15 in total for the month of October. Cattle in Luna County, New Mexico, were the most recently infected by the parasitic fly, along with cattle and sheep in Dona Ana County, New Mexico. In Texas, Hudspeth County is reporting two cattle detections. The jump in activity comes as officials in New Mexico re-opened a border crossing for Mexican cattle yesterday, after it had been closed for nearly two years to prevent the spread of New World screwworm. The crossing is in Columbus, New Mexico, and uses new safety measures, including tests and inspections, before allowing animals to enter into the United States.
- Over the last week, reports of H5N1 avian flu in Washington State cattle herds have tripled, from nine to 27. All but one cattle herd is located in Yakima County, Washington, with a single report in Benton County. “Seeing the virus move to another county is disappointing but our dairy farmers are working hard to implement their biosecurity plans, share lessons learned and help each other get through this,” said Washington State Veterinarian Amber Itle, VMD, MS. "This isn’t new for the country, but it is new for Washington.” On October 8, Washington reported its first detection of H5N1 in cattle, and on October 15 the state announced a dairy worker in Yakima County was infected with the virus, the first human H5N1 case reported in the United States so far this year.