This past week was relatively quiet in infectious disease land, but next week could be a blockbuster.
COVID-19 Vaccines for Young Children
Unless you've been playing that head-in-the-sand game, you know that FDA and ACIP have meetings planned in the next few days to review data and make decisions and recommendations.
First up is the FDA VRBPAC meetings June 14 and 15. The first day will be devoted to discussion of the Moderna vaccine data for children 6 - 17 years of age. Both FDA and pharmaceutical company Moderna briefing documents were posted recently. I don't expect much controversy for authorization for this older age group based on FDA's briefing. Wednesday's session will cover both Pfizer and Moderna requests for EUA for vaccines for children under 5 and under 6, respectively. The briefing documents for Moderna cover this age group, but the Pfizer briefing documents aren't yet posted at the time I write this. Vaccine authorization for the younger children could be a little more controversial given the risk/benefit calculations and uncertainties about protection levels for omicron subvariants.
Then, the CDC/ACIP is scheduled to meet on June 17 and 18. The agenda isn't yet posted, but my educated guess is that they will discuss Moderna's vaccine on Friday and Pfizer's on Saturday, if either or both have been authorized by FDA. If the ACIP vote is favorable and Dr. Walensky approves, vaccines could be going into arms of children under 5 soon thereafter.
I'm certainly going to be tuned in to the live presentations as much as my schedule will permit. I'll try to summarize things in next week's post.
Local Monkeypox Follow-up
You recall I mentioned some questionable cases in Maryland in last week's post. I have some limited follow-up, all second- or third-hand so the true story might be slightly different. The first case was tested by Maryland DOH with negative results. I was surprised. I don't know what clinical follow-up has been done. For the second case that my colleague helped with over the phone, Maryland DOH decided not to test, said they would follow up with family in a few days, but so far have not contacted the family.
In the meantime, a third questionable case presented to our hospital and another of my colleagues saw the child and helped with collecting specimens. Although the clinical picture is not as strong for monkeypox, skin biopsies and several other samples were collected that will be very helpful for piecing this together. As the 3 of us shared ideas, the main alternative diagnoses for the first 2 cases would be a very unusual presentation of hand, foot, and mouth disease. The third child had enterovirus specimens collected so hoping that can help all of us in the DMV area manage these cases. Atypical hand/foot/mouth disease in the middle of a monkeypox watch? Stay tuned.