Relative calm in the pediatric infectious diseases world, though anything but that in the political scene surrounding vaccines and medical insurance. I was pleased to see that the Vaccine Integrity Project plans a review of hepatitis B immunization, hopefully available before the still-unscheduled next meeting of the ACIP.
While you ponder your Thanksgiving meal menus, here's a few items of interest from last week.
More Covid Vaccine Liability Information
In my posting of October 26 I reported on a webinar presented by the AAP and the Common Health Coalition. At the time I only had a few screen shots to share; neither organization had posted the recording or slides on their web sites. I promised to give you a follow-up when I had access to these materials, and the CHC came through this past week. Here's the pertinent links directly from their email:
"You can now access the webinar recording, the presentation slides, our updated Shared Clinical Decision-Making explainer, and liability resource. The American Academy of Pediatrics’ COVID-19 Vaccine FAQs and Pediatric COVID-19 Vaccine Dosing Guide are also available. If you have liability-related questions or vaccine administration concerns, you may submit them to AAP here."
All of these links contain very good information, worth browsing if you have concerns about covid vaccine administration. I do note, however, that the last link for the AAP is not really to ask questions - it appears to be more of a notification system so that AAP is aware of issues and can try to get ahead of any problematic issues and explore them, rather than directly answering individual questions.
WRIS and Measles
CDC is still putting out numbers for measles, one of the few areas where they are still working during the shutdown/cutbacks. New cases are fairly steady, thankfully not approaching the chaos of last spring's Texas outbreak. We're up to 1681 cases with 3 deaths as of November 5. Meanwhile, Canada's horrible numbers have reached 5138 cases; Alberta and Ontario provinces lead the way.
Tracking of winter respiratory infections, including covid, is nonexistent at the CDC. Other sources continue to suggest mild upswings in some areas of the country, but nothing substantial so far.
Immunizations in Gaza
Today, November 9, marks the start of a catch-up immunization campaign in Gaza. Three rounds are planned to ensure that children have received at least 3 doses of the pentavalent (diphtheria, tetanus, pertussis, hepatitis B, and Hib), polio, rotavirus, and pneumococcal vaccines and 2 doses of MMR. TB (BCG vaccine) also was mentioned. UNICEF is providing the vaccines and equipment including refrigeration. The announcement didn't provide a lot of details, but this statement caught my eye: "Before the conflict, Gaza maintained 54 immunization facilities and ranked among the top globally with an overall 98 per cent vaccination coverage rate for children. Today, 31 facilities are no longer operational after being damaged or destroyed in indiscriminate attacks, while the routine vaccination coverage rate has dropped below 70 per cent."
The second and third rounds of immunizations are planned for December 2025 and January 2026. Let's hope they are successful.
Rift Valley Fever
I've been watching this outbreak in 2 West African countries, Mauritania and Senegal, for several weeks now. RVF is primarily a disease of livestock but can spread to humans via exposure to contaminated meat or from infected mosquitoes. The human case tally so far is at 404 with 42 deaths. The risk to humans is not only from infection itself but also from its effects on food sources. Here's a little aid for those of us who are geographically challenged.
And a quick cartoon about transmission cycles:
Vascular and Inflammatory Conditions Following Covid Infection and Vaccination
This study from England focused on children < 18 years of age in the time period from January 1, 2020 to December 31, 2022 and was a retrospective cohort study utilizing electronic health record data. Given the study dates, this would have stretched from the first appearance of the original ancestral variant through the delta variant and into the earlier omicron stages. It included almost 14 million subjects to evaluate for covid infection and 3.4 million to evaluate for vaccination status. All vaccines administered during that time in England were the Pfizer vaccine. Here are the raw numbers for outcomes, focus on the 2 columns for incidence rates.
The trend in the blue bars below is towards fewer adverse events with vaccination compared to natural infection, in line with other studies. Also, multiple studies have shown that myocarditis following SARS-CoV-2 infection is more severe and longer lasting than that seen following vaccination.
So, more support for having vaccinated children in the first couple years of the pandemic. As I've said before, the current covid vaccination rate for children is very low and limits ability to perform analyses for rare adverse events.
Thanksgiving Menus
Every Thanksgiving I'm focused on gratitude and cooking. (Some of you may remember my account of the Wiedermann Thanksgiving massacree of 199? in my post of November 24, 2024.) This year will be a little different from our usual Thanksgiving because none of our family is able to come here for a banquet. Thankfully (pun intended?) friends have invited us to their house for Thanksgiving. I'll need to think carefully about which dish(es) to contribute, perhaps a more difficult task than just cooking everything I can think of.
Neither my LSW nor I is depicted in the painting below.
