Centers For Control Research Articles

Infections after musculoskeletal injuries in earthquake survivors.

This study aimed to investigate the infections following musculoskeletal injuries in earthquake survivors, offering a future clinical point of reference for the handling of musculoskeletal injuries resulting from earthquakes. In this single-center retrospective observational study, 225 earthquake survivors (120 females, 105 males; median: 39 years; range, 18 to 94 years) admitted between February 2023 and April 2023 were evaluated. Patients with musculoskeletal injuries and patients who had at least one month of follow-up data were included in the study. Diagnosis of healthcare-associated infections was verified by an infection control physician in accordance with the Centers for Disease Control and Prevention. Among all cultures, the most isolated pathogen was Acinetobacter baumannii (49.4%), followed by enterococci (28.6%). Colistin sensitivity of A. baumannii was 36 (94.7%). However, sensitivity rate was 5.3% for ciprofloxacin, 10.5% for piperacillin-tazobactam, and 26.4% for carbapenems, which are frequently used for skin and soft tissue infections. Among all, 76% of the microorganisms isolated from wound culture and 58% of the microorganisms isolated from deep tissue culture were found to be multidrug-resistant pathogens. During the follow-up, 12 (5.3%) patients had hospital-acquired urinary tract infections, 13 (5.7%) patients had hospitalacquired bloodstream infections, one (0.4%) patient had hospital-acquired pneumonia, and 74 (32.8%) patients had surgical site infections. Eighty (35.6%) of the patients were followed up in the intensive care unit, and the overall mortality rate was 2.7%. While gram-positive microorganisms are frequently the causative microorganisms in infections after traumatic injuries, this study revealed that gram-negative microorganisms could be observed more frequently in postearthquake traumatic injuries. Most causative microorganisms are resistant to commonly prescribed antibiotics in clinical settings, which makes them more challenging to treat.

Estimating disease prevalence from partially-sampled clusters using the conditional linear family for multivariate Bernoulli data

In periodontal disease surveillance in human populations, full-mouth clinical examinations to classify the disease status of individuals are the gold standard for estimating periodontitis prevalence. However, conducting full-mouth exams is resource intensive, time consuming, and costly, especially in studies involving thousands of participants. Partial-recording protocols have been utilized in oral health surveys worldwide to gather correlated binary outcomes of periodontal disease on selected teeth in lieu of full-mouth exams. Since the use of partial-recording protocols tends to underestimate disease prevalence, a statistical distributional approach considering the pattern of tooth-level disease in the mouth was proposed to substantially reduce bias for the estimation of periodontitis prevalence. This approach employed multivariate Bernoulli distributions for observation (tooth)-level disease indicators to define formulae for the prevalence of disease (periodontitis) at the cluster (person)-level for various full-mouth case definitions. In turn, prevalence estimators were based on plug- in estimates of parameters from a conditional linear family for binary data gathered under partial recording protocols. Work in this article extended existing prevalence estimators for simple case definitions based on single clinical measures of tooth-level periodontal disease to a definition of severe periodontitis using two measures as defined by the Centers for Disease Control and Prevention and the American Academy of Periodontology, and later adopted by the 2017 World Workshop in Periodontology. Simulations evaluated the finite-sample performance of the proposed estimators and their confidence intervals for three established partial-recording protocols. In general, the prevalence estimators performed well relative to bias and coverage when tooth-level probabilities of disease and within-mouth correlation structures were correctly specified and even when the pattern of tooth-pair correlations was misspecified. Journal of Statistical Research 2024, Vol. 58, No. 1, pp. 3-31.

Characterization of mosquito host-biting networks of potential Rift Valley fever virus vectors in north-eastern KwaZulu-Natal province, South Africa

BackgroundRift Valley fever virus (RVFV) is a zoonotic mosquito-borne virus with serious implications for livestock health, human health, and the economy in Africa, and is suspected to be endemic in north-eastern KwaZulu-Natal (KZN), South Africa. The vectors of RVFV in this area are poorly known, although several species, such as Aedes (Neomelaniconion) mcintoshi, Aedes (Neomelaniconion) circumluteolus, Aedes (Aedimorphus) durbanensis, and Culex (Lasioconops) poicilipes may be involved. The aim of the study was to determine the vertebrate blood meal sources of potential RVFV mosquito vectors in north-eastern KZN and to characterize the host-biting network.MethodsBlood-fed mosquitoes were collected monthly from November 2019 to February 2023 using a backpack aspirator, CO2-baited Centers for Disease Control and Prevention (CDC) miniature light traps and tent traps, in the vicinity of water bodies and livestock farming households. The mosquitoes were morphologically identified. DNA was extracted from individual mosquitoes and used as templates to amplify the vertebrate cytochrome c oxidase I (COI) and cytochrome b (cytb) genes using conventional polymerase chain reaction (PCR). Amplicons were sequenced and queried in GenBank and the Barcode of Life Data systems to identify the vertebrate blood meal sources and confirm mosquito identifications. All mosquitoes were screened for RVFV using real time reverse transcription (RT)-PCR.ResultsWe identified the mammalian (88.8%) and avian (11.3%) blood meal sources from 409 blood-fed mosquitoes. Aedes circumluteolus (n = 128) made up the largest proportion of collected mosquitoes. Cattle (n = 195) and nyala (n = 61) were the most frequent domestic and wild hosts, respectively. Bipartite network analysis showed that the rural network consisted of more host-biting interactions than the reserve network. All mosquitoes tested negative for RVFV.ConclusionsSeveral mosquito species, including Ae. circumluteolus, and vertebrate host species, including cattle and nyala, could play a central role in RVFV transmission. Future research in this region should focus on these species to better understand RVFV amplification.Graphical

Wound healing after intracutaneous vs. staple-assisted skin closure in lumbar, non-instrumented spine surgery: a multicenter prospective randomized trial.

Superficial surgical site infection (SSSI) is a prominent problem in spine surgery. Intracutaneous sutures and staple-assisted closure are two widely used surgical techniques for skin closure. Yet, their comparative impact on wound healing and infection rates is underexplored. Our goal was to address this gap and compare wound healing between these two techniques. This study was a multicenter international prospective randomized trial. Patient data were prospectively collected at three large academic centers, patients who underwent non-instrumented lumbar primary spine surgery were included. Patients were intraoperatively randomized to either intracutaneous suture or staple-assisted closure cohorts. The primary endpoint was SSSI within 30days after surgery according to the wound infection Centers for Disease Control and Prevention (CDC) classification system. Of 207 patients, 110 were randomized to intracutaneous sutures and 97 to staple-assisted closure. Both groups were homogenous with respect to epidemiological as well as surgical parameters. Two patients (one of each group) suffered from an A1 wound infection at the 30-day follow up. Median skin closure time was faster in the staple-assisted closure group (198s vs. 13s, p < 0,001). This study showed an overall low superficial surgical site infection rate in both patient cohorts in primary non instrumented spine surgery.

Cross-Site Evaluation of Alcohol Screening and Brief Intervention Implementation Programs in Healthcare Systems Serving Individuals of Reproductive Age.

With US Centers for Disease Control and Prevention funding, from 2018 to 2022, 4 large healthcare systems (n = 53 health centers across 7 states) serving people of reproductive age trained staff and provided implementation support for alcohol screening and brief intervention (SBI). This cross-site evaluation explores each healthcare system's implementation approach to implement SBI, reduce excessive alcohol use, and prevent prenatal alcohol exposure (PAE) and fetal alcohol spectrum disorders. The SBIRT (Screening, Brief Intervention, and Referral to Treatment) Program Matrix framed the multilevel strategies to implement alcohol SBI programs from 2018 to 2022. Qualitative and quantitative data sources examined outcomes, guided by one logic model, through systems-level process data and provider-level performance metrics. Data analyses utilized frequencies and means for quantitative data and themes for qualitative data according to an established framework. Successful approaches within systems included using electronic health records, flexible implementation and workflow protocols, customized training and technical assistance programs, quality assurance feedback loops, and stakeholder buy-in. Centralized management structures were efficient in standardizing implementation across health centers. Decentralized management structures used tailored approaches, enhancing provider/staff SBI acceptance. Across systems, 1259 staff (eg, clinicians, medical assistants) were trained to provide alcohol SBI services and reported pre-post training increases in self-efficacy in performing brief intervention; skills in PAE counseling; and confidence in screening. Fifty-three (48 providing data) health centers implemented alcohol SBI, screening 106 826 patients over the study period with most of the 10 087 patients who screened positive for excessive alcohol use receiving a BI. Maximizing the use of technology, employing flexibility in program delivery, and institutionalizing processes and protocols improved workflow, efficiency, and program reach. Ongoing partnership and stakeholder communication identify areas for ongoing improvement, engagement, and best practices for sustainability around substance use screening, which are essential with increases in substance use since the pandemic.

A dynamic model and cost-effectiveness on screening coverage and treatment of syphilis included MSM population in the United States

Syphilis is a major sexually transmitted disease, causing a significant public health burden for countries all over the world. Since 2000, there has been a new outbreak of the syphilis epidemic in the United States. Therefore, the prevention and control of syphilis have important research significance. We have established a sex structure and ordinary differential equation model that includes men who have sex with men (MSM). Its epidemiological and biological parameters were obtained by fitting with regional monitoring data from the Centers for Disease Control and Prevention from 1984 to 2014, and the basic reproduction number (R0\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}${\\mathcal{R}_{0}}$\\end{document}) of syphilis is 1.3876. Through cost-effectiveness analysis, we have found that the most cost-effective strategies in the cases of sufficient and insufficient funds are conducting syphilis screening for 50% of sexually active susceptible individuals and conducting syphilis screening for 30% of sexually active susceptible individuals while increasing the treatment rate, respectively. Therefore, in the prevention and control strategies of syphilis, measures such as increasing the coverage rate of syphilis screening for susceptible individuals and simultaneously increasing both the screening coverage rate and the treatment rate are valuable control strategy measures for reference.

Strengthening Maternal and Infant Health Resilience Before Weather and Climate Disasters: Preparedness Resources from CDC's Division of Reproductive Health.

This report describes opportunities to address emergency preparedness to incorporate the needs of pregnant and postpartum populations. This report briefly summarizes data on the impacts of weather and climate disasters on maternal and infant health and outlines opportunities for individuals, health care providers, and public health practitioners to increase capacity to prepare for these occurrences, which are becoming more frequent and costly. Specific resources from the U.S. Centers for Disease Control and Prevention's Division of Reproductive Health are shared to support individual preparedness, communication of disaster safety messages, and emergency preparedness planning capacity among health care providers and health departments.

Impact of socioeconomic status on open globe injuries during the COVID-19 pandemic.

We explored the associations between socioeconomic status, as evaluated by the Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry Social Vulnerability Index (SVI), and characteristics of open globe injury (OGI) in a Level I trauma center during the COVID-19 pandemic. Retrospective review of electronic medical records of patients who underwent OGI evaluation and repair at Harborview Medical Center between March/2017 and March/2021. Demographic data and patient characteristics were recorded. The SVI was obtained based on the patient's home address. Patients were grouped into the "historical" (pre-COVID) cohort, including dates from March 2017 - March 2020, and the "COVID" cohort, including dates from March 2020 - March 2021. 318 patients (77.4% male) were included. Average ± S.D. age (years) and SVI scores were 44.7 ± 22.7 and 0.413 ± 0.195, respectively. SVI scores were significantly higher (more vulnerable) during the COVID-19 pandemic compared to years prior (p = 0.017), however when compared to scores for the same patients prior to the pandemic, no difference was found (p = 0.609). There was no significant difference between intentional and non-intentional trauma, work-related injuries, OGI type, presence of endophthalmitis, or ocular trauma score (p ≥ 0.293). Still, significantly fewer motor vehicle-associated (MVA) OGIs occurred during the pandemic (p = 0.041). Patients with OGI during the COVID-19 pandemic had higher SVI scores, however when considering the overall effect of the pandemic, our findings are likely reflective of the societal changes at large. There was no identifiable impact on the mechanisms or characteristics of ocular injuries, except for fewer MVA injuries.

Engaging Community Health Workers in the Centers for Disease Control and Prevention's COVID-19 Public Health Response to Address Health Disparities and Build Community Resilience.

In 2021, the Centers for Disease Control and Prevention's (CDC) National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) funded community health workers (CHWs) for COVID Response and Resilient Communities (CCR). CCR is a 3-year, $350 million initiative to implement CHW strategies aimed at reducing COVID-19 impacts, building resilience, and improving health equity by addressing health-related social needs. This paper describes the CCR initiative and experiences to date, underscoring CHWs' critical role in CDC's pandemic response. CCR funds 67 recipients to reach communities who are disproportionately affected by long-standing health disparities (hereafter, priority populations). CCR aims to decrease the impact of COVID-19 and increase community resilience to respond to COVID-19 and future public health emergencies. Recipients implement three strategies: train CHWs to support the COVID-19 response, increase the workforce of CHWs to manage the spread of the disease, and improve utilization of community and clinical resources to engage CHWs to help strengthen communities' resilience to mitigate the impact of COVID-19. We funded three additional organizations to provide technical assistance to CCR recipients and collaborate with us on a national evaluation of the program. CCR recipients hired about 950 CHWs and integrated these CHWs into over 1,000 organizations and care teams. At the end of the second program year, CHWs made over 250,000 referrals to social services and over 150,000 referrals to address specific health conditions. CCR demonstrates that CHWs can be quickly mobilized to participate in a public health emergency and reach those most affected by COVID-19.

The spatial-temporal distribution of hepatitis B virus infection in China,2006–2018

ObjectivesHepatitis B is a liver disease caused by Hepatitis B virus (HBV) infection and is highly prevalent in China. To better understand the epidemiological characteristics of hepatitis B in China and develop effective disease control strategies, we employed temporal and spatial statistical methods.MethodsWe obtained HBV incidence data from the Public Health Science Data Center of the Chinese Center for Disease Control and Prevention for the years 2006 to 2018. Using Geographic Information System (GIS) and SaTScan scanning technology, we conducted spatial autocorrelation analysis and spatiotemporal scan analysis to create a map and visualize the distribution of hepatitis B incidence.ResultsWhile hepatitis B incidence rebounded in 2011 and 2017, the overall incidence in China decreased.In the trend analysis by item, the incidence varies from high to low. The global spatial autocorrelation analysis revealed a clustered distribution, and the Moran index analysis of spatial autocorrelation within local regions identified five provinces as H-H clusters (hot spots), while one province was an L-L cluster (cold spot). Spatial scan analysis identified 11 significant spatial clusters.ConclusionsWe found significant clustering in the spatial distribution of hepatitis B incidence and positive spatial correlation of hepatitis B incidence in China. We also identified high-risk times and regional clusters of hepatitis B incidence.

Pemetaan Moluska Komoditas Ekspor dan Impor Melalui Balai Besar KIPM Jakarta I

Indonesia has high biodiversity and it has the opportunity to expand as fisheries business in the international commodity market. The research aims to analyze the diversity of mollusk species, map the distribution, and analyze the sustainability of these commodities in the Indonesian export and import markets. The research conducted at the Jakarta I Fish Quarantine Center for Quality Control and Safety of Fishery Products (BBKIPM) on January to February 2023. The data used comes from data available at BBKIPM Jakarta 1 on 2021 to 2022 periods. The method used is descriptive quantitative analysis. The results showed that mollusk commodities traded in exports were more diverse than imported mollusks. The most commodity classes are pelecypod (35 species), gastropods (12 species) and cephalopods (12 species). The total number of exported mollusk commodities (4,823,969.879 kg) is higher than imports (7,281.04 kg) on 2021 to 2022 periods. Mollusk exports from Indonesia spread to 44 countries on 2021 to 2022 periods. Meanwhile, mollusk imports to Indonesia only came from 2 countries (2021) and either from 1 country (2022).

Adopting the 2023 CDC Early Testing for Perinatal Hepatitis C: Call to Action for Pediatric Primary Care Providers.

In the US, the burden of hepatitis C virus (HCV) infection is disproportionately high among young adults including pregnant persons, resulting in increased infections among children as perinatal transmission remains the main route of HCV infection in children. Hence, in 2020, the Centers for Disease Control and Prevention (CDC) recommended universal HCV screening during each pregnancy. HCV infection in infancy is usually asymptomatic, so the diagnosis entirely relies on testing of perinatally-exposed infants which, historically, included anti-HCV antibody testing at ≥ 18 months of age. However, nation-wide perinatal HCV testing rates have been suboptimal with significant loss to follow up. To address this problem, in 2023, the CDC introduced early single HCV RNA testing at 2-6 months of age with an alternative for HCV RNA testing up to 17 months of age if not previously tested. The high sensitivity and specificity of the HCV real-time PCR laid the grounds for this policy shift. In this review we highlight how these new CDC recommendations will enhance testing of infants and children and ultimately contribute to overall HCV elimination efforts. We also emphasize the role of all pediatric providers and obstetricians in implementing these new guidelines. Additionally, we offer our perspective and practical advice for testing of perinatally exposed infants and children. Currently, curative oral antivirals for HCV-infection treatment are approved for children ≥ 3 years of age. As pediatricians, advocating for children's wellness, it is our utmost duty to ensure that every child exposed to perinatal hepatitis C has been tested, diagnosed, linked to care, treated, and achieved cure.

Discovery of D8-03 as an Inhibitor of Intracellular Growth of Francisella tularensis.

Francisella tularensis is a Gram-negative facultative intracellular bacterial pathogen that is classified by the Centers for Disease Control and Prevention as a Tier 1 Select Agent. F. tularensis infection causes the disease tularemia, also known as rabbit fever. Treatment of tularemia is limited to few effective antibiotics which are associated with high relapse rates, toxicity, and potential emergence of antibiotic-resistant strains. Consequently, new therapeutic options for tularemia are needed. Through screening a focused chemical library and subsequent structure-activity relationship studies, we have discovered a new and potent inhibitor of intracellular growth of Francisella tularensis, D8-03. Importantly, D8-03 effectively reduces bacterial burden in mice infected with F. tularensis. Preliminary mechanistic investigations suggest that D8-03 works through a potentially novel host-dependent mechanism and serves as a promising lead compound for further development.

Economic Costs Attributed to Diagnosed Diabetes in Each U.S. State and the District of Columbia: 2021.

To update state-specific estimates of diabetes-attributable costs in the U.S. and assess changes in spending from 2013 to 2021. We used an attributable fraction approach to estimate direct medical costs of diagnosed diabetes using the 2021 State Health Expenditure Accounts, the 2021 Behavioral Risk Factor Surveillance System, and the Centers for Medicare and Medicaid Services 2018-2019 Minimum Data Set. We estimated diabetes-attributable productivity losses from morbidity and mortality using the 2016-2021 National Health Interview Survey and the 2021 mortality data from the Centers for Disease Control and Prevention. Costs were adjusted to 2021 U.S. dollars. Total diabetes-attributable cost in 2021 was $640 billion ($335 billion in direct medical costs and $305 billion in indirect costs). The median state-level total diabetes-attributable cost was $8.2 billion (range $842 million to $81 billion). The median state-level per-person cost was $21,082, ranging from $17,452 to $37,090. Total diabetes-attributable cost increased by a median of 33% between 2013 and 2021, ranging from 16 to 68% across states. Medical costs increased by 50% overall (range 33-79%) and by 27% (range 15-41%) for per person with diabetes. Costs paid by Medicaid experienced the highest increase between 2013 and 2021 (median 153%; range 41-483%). State economic costs of diagnosed diabetes are substantial and increased over the last decade. These costs and their growth vary considerably across states. These findings may help state policy makers in developing evidenced-based public health interventions in their respective states to prevent and control the prevalence of diabetes.

Determination of volatile impurities and ethanol content in ethanol-based hand sanitizers: Compliance and toxicity

This study aimed to assess volatile impurities and ethanol content in ethanol-based hand sanitizers. A total of 31 different brands of hand sanitizers were analyzed using headspace gas chromatography-mass spectrometry to detect impurities and determine alcohol content for compliance. Volatile impurities were identified through Mass Spectrometry database analysis, and regression analysis was employed to ascertain ethanol percentage. Furthermore, a simulated toxicological analysis was conducted to evaluate the potential toxic effects associated with hand sanitizer usage.The detected impurities primarily included ethyl acetate, benzene, acetone, and acetal, along with contaminations such as isobutanol and non-recommended alcohols. In addition, 71 % of samples contained less than the recommended 60 % v/v alcohol concentration, failing to comply with guidelines from the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). Additionally, the simulation study underscored acute and chronic toxicities primarily linked to benzene contamination.Given that some of the studied products are imported while others are locally produced, it is imperative for consumers worldwide to be informed that certain hand sanitizers may not only be ineffective but also contain harmful residues.

Real-time PCR assay to detect the novel Clade Ib monkeypox virus, September 2023 to May 2024.

Monkeypox virus (MPXV) is an emerging zoonotic pathogen with complex epidemiology necessitating rapid diagnosis and distinguishing between clades and subclades. The emerging Clade Ib lacks the genomic region used in the Clade I-specific assay from the Centers for Disease Control and Prevention. We report an MPXV real-time PCR to specifically detect Clade Ib. The assay demonstrated proficient sensitivity and specificity in 92 samples and can be included along other TaqMan-based assays to detect MPXV and distinguish between clades and subclades.

Influenza C virus in U.S. children with acute respiratory infection 2016–2019

Influenza C virus (ICV) is an orthomyxovirus related to influenza A and B, yet due to few commercial assays, epidemiologic studies may underestimate incidence of ICV infection and disease. We describe the epidemiology and characteristics of ICV within the New Vaccine Surveillance Network (NVSN), a Centers for Disease Control and Prevention (CDC)-led network that conducts population-based surveillance for pediatric acute respiratory illness (ARI). Nasal or/combined throat swabs were collected from emergency department (ED) or inpatient ARI cases, or healthy controls, between 12/05/2016–10/31/2019 and tested by molecular assays for ICV and other respiratory viruses. Parent surveys and chart review were used to analyze demographic and clinical characteristics of ICV+ children. Among 19,321 children tested for ICV, 115/17,668 (0.7 %) ARI cases and 8/1653 (0.5 %) healthy controls tested ICV+. Median age of ICV+ patients was 18 months and 88 (71.5 %) were ≤36 months. Among ICV+ ARI patients, 40 % (46/115) were enrolled in the ED, 60 % (69/115) were inpatients, with 15 admitted to intensive care. Most ICV+ ARI patients had fever (67.8 %), cough (94.8 %), or wheezing (60.9 %). Most (60.9 %) ARI cases had ≥1 co-detected viruses including rhinovirus, RSV, and adenovirus. In summary, ICV detection was rarely associated with ARI in children, and most ICV+ patients were ≤3 years old with co-detected respiratory viruses.

2234 Temporal trends in Parkinson’s disease-related mortality from 1999–2020: a Nationwide cohort study

Abstract Introduction Parkinson’s disease (PD) is the most common neurodegenerative movement disorder and is associated with significant disability. The prevalence of PD is increasing and the literature demonstrates potential sex and race disparities in patient outcomes. There is a paucity of data about the demographic trends in PD-related mortality in the United States (US). This descriptive study aimed to report the national demographic trends in PD-related mortality over a 20-year period. Methods From January 1999 to December 2020, the US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiological Research (CDC-WONDER) Underlying Cause of Death database was queried. Data were extracted to determine the PD-related age adjusted mortality rate (AAMR) stratified by age, sex, ethnicity and geographic area, with the 1999 deaths as the reference group. Annual percentage change (APC) for AAMR was then calculated using Joinpoint regression. Results From 1999 to 2020, there were 515,884 PD-related deaths in the study period. AAMR increased from 5.3 per 100,000 population in 1999 to 9.8 per 100,000 in 2020. Males had consistently higher AAMR than females and white race had consistently higher overall AAMR (7.6 per 100,000), followed by American Indians/Alaska Natives (4.4 per 100,000), Asians/Pacific Islanders (4.1 per 100,000) and Black/African Americans (3.4 per 100,000). The Midwest had the highest AAMR followed by West, South and Northeast. Utah, Idaho and Minnesota had the highest state-level AAMR. Conclusion This study using a national dataset identified significant age, sex, race and geographic disparities in PD-related mortality in the US. Older age, male sex, white race and Midwest locality were associated with the highest AAMR.

Estimated number of lives directly saved by COVID-19 vaccination programmes in the WHO European Region from December, 2020, to March, 2023: a retrospective surveillance study

By March, 2023, 54 countries, areas, and territories (hereafter CAT) in the WHO European Region had reported more than 2·2 million COVID-19-related deaths to the WHO Regional Office for Europe. Here, we estimated how many lives were directly saved by vaccinating adults in the WHO European Region from December, 2020, to March, 2023. In this retrospective surveillance study, we estimated the number of lives directly saved by age group, vaccine dose, and circulating variant-of-concern (VOC) period, regionally and nationally, using weekly data on COVID-19 mortality and infection, COVID-19 vaccination uptake, and SARS-CoV-2 virus characterisations by lineage downloaded from The European Surveillance System on June 11, 2023, as well as vaccine effectiveness data from the literature. We included data for six age groups (25-49 years, 50-59 years, ≥60 years, 60-69 years, 70-79 years, and ≥80 years). To be included in the analysis, CAT needed to have reported both COVID-19 vaccination and mortality data for at least one of the four older age groups. Only CAT that reported weekly data for both COVID-19 vaccination and mortality by age group for 90% of study weeks or more in the full study period were included. We calculated the percentage reduction in the number of expected and reported deaths. Between December, 2020, and March, 2023, in 34 of 54 CAT included in the analysis, COVID-19 vaccines reduced deaths by 59% overall (CAT range 17-82%), representing approximately 1·6 million lives saved (range 1·5-1·7 million) in those aged 25 years or older: 96% of lives saved were aged 60 years or older and 52% were aged 80 years or older; first boosters saved 51% of lives, and 60% were saved during the Omicron period. Over nearly 2·5 years, most lives saved by COVID-19 vaccination were in older adults by first booster dose and during the Omicron period, reinforcing the importance of up-to-date vaccination among the most at-risk individuals. Further modelling work should evaluate indirect effects of vaccination and public health and social measures. US Centers for Disease Control and Prevention.

The Intersection of LGBTQ+ Identity and Disability: A Need for School Based Support

According to the Centers for Disease Control and Prevention (2023), it is estimated that there are over 61 million individuals who report having a disability, whether academic, behavioral, or medical. In addition, the US Census Bureau’s Household Pulse Survey (2023) revealed that there are approximately 20 million people who openly identify as LGBTQ+. When examining each demographic together, it is reported that there are approximately three to five million LGBTQ+ individuals who report having a disability (Movement Advancement Project, 2019). These statistics reveal the need to analyze these intersecting experiences.