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CIDRAP- NEWS BRIEFS October19, 2023

Lance

MPH, CSP & CIT Retired, CHMM Emeritus
https://www.cidrap.umn.edu/all-news

COVID-19 vaccine uptake in pregnancy linked to previous vaccine acceptance



News brief

Today at 12:44 p.m.
Stephanie Soucheray, MA
Topics

COVID-19
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Pregnant patients who accepted recommended tetanus, diphtheria, and pertussis (Tdap) and flu vaccines in pregnancy were more likely to also get vaccinated against COVID-19, according to a new study in the Journal of Infection.

Though COVID-19 vaccines are safe and recommended in pregnancy, uptake has been low as vaccine hesitancy and misinformation has overshadowed the use of the vaccines. Several studies have shown the vaccines do not negatively affect pregnancy outcomes or hinder fertility, two claims rampant on social media.

The present study used data from the California Immunization Registry to look at the vaccine history of all pregnant patients who delivered at a single site from December 2020 through March 2022.

According to the authors, of the 7,857 patients who delivered during the study period, 4,410 (56.1%) accepted the COVID-19 vaccine in pregnancy. And of those who accepted the vaccine, 97.6% also received an influenza vaccine in pregnancy, and 88.5% received a Tdap vaccine.

No difference in outcomes


Advanced maternal age, obesity, Asian race, and private insurance were all correlated to COVID-19 vaccine uptake, the authors said. Younger pregnant patients, Black patients, and those on public insurance were less likely to get the vaccine.

Importantly, the study found no difference in pregnancy outcomes among those who did and did not get vaccinated against COVID-19.

There were no differences in preterm birth, low birthweight and NICU admission between patients who received and did not receive the COVID-19 vaccine.

"There were no differences in preterm birth, low birthweight and NICU admission between patients who received and did not receive the COVID-19 vaccine," the authors said. "Efforts to improve vaccination rates for the influenza and Tdap vaccine have the potential to translate to improved vaccination rates for COVID-19."


Study highlights deadly impact of antibiotic resistance in Latin America and the Caribbean


News brief

Today at 12:15 p.m.
Chris Dall, MA
Topics

Antimicrobial Stewardship

MRSA

Healthcare-Associated Infections
A systematic review and meta-analysis highlights the deadly impact of infections caused by multidrug-resistant organisms (MDROs) in Latin America and the Caribbean, researchers reported yesterday in Emerging Infectious Diseases.

To assess the lethality of MDRO infections in Latin American and the Caribbean, researchers reviewed studies published from 2000 through March 29, 2022 that estimated the case-fatality rate within 30 days of infection with a drug-resistant organism. Of the 54 studies that met the inclusion criteria, 49 were from Brazil (29), Argentina (8), Colombia (6), and Mexico (6). Of the 49 studies that reported the source of patients, all included hospital patients, 18 consisted of intensive care unit (ICU) patients, 20 included both ICU and non-ICU patients, and 43 included high-risk populations. The most commonly studied MDRO was methicillin-resistant Staphylococcus aureus (MRSA).

The overall unadjusted case-fatality rate related to MDRO infection was 45%, with higher lethality observed among patients infected with MDRO than among patients infected with non-resistant organisms (pooled adjusted odds ratio [OR], 1.93; 95% confidence interval [CI], 1.58 to 2.37). Attributable lethality was two times higher in patients infected with MRSA than with non-MRSA infections, and patients with vancomycin-resistant Enterococcus infections were four times more likely to die than those with vancomycin-susceptible Enterococcus infections.

Higher lethality was also observed in those who did not receive appropriate empirical treatment (OR, 2.27; 95% CI, 1.44 to 3.56) than those who did (OR, 1.59; 95% CI, 0.99 to 2.56).

The study authors say the findings highlight the need for stronger infection-prevention strategies in the region.

"Rather than relying solely on new drug development to address the problem of AMR [antimicrobial resistance], we should focus efforts on preventing the emergence and transmission of these organisms through the One Health initiative, principally in low-income settings," they wrote.



CDC study: People with HIV have elevated COVID reinfection rate


News brief

Today at 12:14 p.m.
Mary Van Beusekom, MS
Topics

COVID-19

HIV/AIDS

A new Centers for Disease Control and Prevention-led study finds that people with HIV (PWH) have higher COVID-19 reinfection rates than those without HIV (PWOH).

The study, published yesterday in Emerging Infectious Diseases, involved 453,587 adults in Chicago infected with SARS-CoV-2 from their first infection through May 2022. The investigators matched COVID-19 test results and vaccination data to Chicago's Enhanced HIV/AIDS Reporting System.

"HIV can compromise the immune system; persons with HIV (PWH), especially those not receiving antiretroviral therapy (ART), might be vulnerable to SARS-CoV-2 infection," the researchers wrote. "Understanding how COVID-19 affects PWH is important because approximately half of PWH are >50 years of age and have higher rates of medical comorbidities, compared with persons without HIV (PWOH)."

6.7% vs 5.2% reinfection rate


A total of 5.3% of the 453,587 COVID-positive residents were reinfected, including 192 of 2,886 (6.7%) PWH and 23,642 of 450,701 (5.2%) PWOH. Reinfection rates among PWH were 66 per 1,000 person-years, compared with 50 of 1,000 person-years among PWOH. PWH had a higher adjusted rate of COVID-19 reinfection (1.46 per 1,000 person-years) than PWOH.

Among reinfected residents, PWH were older (median age, 43 years) than PWOH (36 years). Relative to PWOH, PWH were more likely to be men (79.3% vs 40.9%) and Black (53.7% vs 27.0%) and to have received a primary COVID-19 vaccine series and booster (31.8% vs 22.1%). Of those reinfected, PWH were less likely than PWOH to be unvaccinated at their first infection (87.5% vs 91.0%).
PWH should follow the recommended COVID-19 vaccine schedule, including booster doses, to avoid SARS-CoV-2 reinfections.​


Of 131,682 residents vaccinated before their first SARS-CoV-2 infection, 54.2% had completed a primary Pfizer/BioNTech vaccine series. Of 23,834 reinfected residents, 39.6% (9,444 of 23,834) had completed a primary series but had not received a booster before reinfection.

Regardless of variant wave and calendar quarter, PWH consistently had a higher rate of reinfection than PWOH. The highest incidence for PWH occurred during Omicron strain predominance (50 cases per 1,000 person-years). Overall, an excess of 16 reinfections per 1,000 person-years were reported among PWH.

"PWH should follow the recommended COVID-19 vaccine schedule, including booster doses, to avoid SARS-CoV-2 reinfections," the authors wrote.

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