The Perfect Enemy | News Scan for Sep 09, 2022
September 29, 2022

News Scan for Sep 09, 2022

COVID boosters for pregnant, lactating women
Enterovirus D68 warning
More polio in 5 countries
Read Time:4 Minute

COVID boosters safe and well tolerated in pregnant and lactating women

COVID vaccine boosters or third doses after an initial two-dose series are well tolerated in pregnant and lactating women, according to a large cohort study published yesterday in JAMA Network Open.

A team at the University of Washington conducted a US-based online survey in January 2021 to examine patterns in adults who were pregnant, lactating, or planning pregnancy at the time of COVID vaccination. They noted that, although earlier studies showed that the primary vaccine series was well tolerated and safe for pregnant and breastfeeding women, not much was known about their experiences with boosters.

As of Apr 4, 2022, 17,014 participants reported they had received a COVID booster or third dose. Of those 11.8% were pregnant, 60.4% were lactating, and 27.8% were neither. Most (82.8%) reported a local reaction, and 67.9% reported at least one systemic symptom after the additional vaccine dose.

Very few reported obstetric or breastfeeding concerns after vaccination. Compared to participants who weren’t pregnant or lactating, pregnant women were more likely to report a local reaction (adjusted odds ratio [aOR], 1.2; 95% CI, 1.0 to 1.4; P = .01), but less likely to report systemic reactions (aOR, 0.7; 95% CI, 0.6 to 0.8; P < .001).

The authors wrote that the frequencies of local and systemic reactions after the booster or third doses in all three groups was similar to those reported in vaccine trials for the general population, as well as for levels found in national safety surveillance systems for booster doses. They also noted that for pregnant participants, obstetric symptoms were lower after the extra vaccine dose than for the second dose in the primary series.

“In our study, pregnant participants frequently reported receiving recommendations for the booster or third dose from their health care professionals, which suggests that clinicians may play a significant role in vaccine acceptance and as a source for vaccine information, a finding supported by previous studies among pregnant individuals,” they wrote.
Sep 8 JAMA Netw Open study

CDC warns of increasing enterovirus D68 infections

The US Centers for Disease Control and Prevention (CDC) today issued a health alert for medical providers about a rise in children’s illnesses involving enterovirus D68 (EV-D68), which can cause severe respiratory illness and has been linked to acute flaccid myelitis (AFM).

In a Health Alert Network (HAN) advisory, it said health providers in several US regions reported increases in hospitalizations for children with severe respiratory illness who tested positive for rhinovirus and/or enterovirus. The two related viruses circulate year-round but typically peak in the spring and fall. EV-D68 is thought to peak in late summer or early fall. The two illnesses have similar clinical and testing profiles.

In 2014, EV-D68 caused a large outbreak, with 1,153 cases, with neurologic complications in 120. Similar cases of the poliolike condition were reported in Canada, Europe, and Asia. Expanded surveillance found increases in 2016, 2018, and, to a lesser extent, 2020. National peaks in AFM also occurred in the falls of 2014, 2016, and 2018.

The CDC said that number of EV-D68 cases in July and August was greater than the same period of the previous 3 years. However, the CDC hasn’t received increased reports of AFM cases that have 2022 onsets.

Officials urged healthcare providers to consider EV-D68 as a possible cause of acute severe respiratory illness, with or without fever, in children. In adults, the virus is more commonly detected in those with underlying health conditions. The CDC also advised doctors to consider AFM in patients with acute flaccid limb weakness, especially after respiratory illness or fever, from August to November.
Sep 9 CDC HAN notice

Countries in 3 regions report more polio cases

Five countries reported more polio cases this week, and the United Kingdom reported two more environmental samples from London, according to the latest update from the Global Polio Eradication Initiative (GPEI).

Pakistan reported 2 more wild poliovirus type 1 (WPV1) cases, raising its total for the year to 17. Both were reported from Khyber Pakhtunkhwa province, which has been the country’s hot spot.

The other four countries reported more illnesses involving vaccine-derived strains. Mozambique reported 2 circulating vaccine-derived poliovirus type 1 (cVDPV1) cases, 1 each in Tete and Zambrezia provinces, bringing its total for the year to 4.

The other three countries reported more circulating vaccine-derived poliovirus type 2 (cVDPV2) cases. The Democratic Republic of the Congo reported 7 more cases in three provinces, boosting its total for the year to 82. Ghana reported 1 case in North East province, marking its second case of 2022. And Yemen reported 10 more cases in six governorates, putting its total for the year at 120.

In the United Kingdom, officials reported two more positive cVDPV2 environmental samples, both from London. The virus was first isolated in London wastewater in May. No human cases have been identified, but health officials assume the strain is circulating and have implemented steps to interrupt circulation, such as intensified surveillance and identification of immunization gaps.
Sep 8 GPEI update