Adults living with HIV in New York had lower COVID-19 vaccine uptake
COVID-19 vaccine uptake among adults living with HIV in New York was lower than that of the rest of the state's population as of October 2021, according to a study today in Morbidity and Mortality Weekly Report (MMWR).
New York public health agencies and the Centers for Disease Control and Prevention (CDC) studied COVID-19 vaccination rates among 101,205 state residents living with HIV as of October 24, 2021, using HIV surveillance and immunization registry data.
Of the 101,205 people studied, 63.5% had received either a single dose of the Johnson & Johnson vaccine or two doses of the Pfizer/BioNTech or Moderna mRNA vaccines, while 4.3% had received one dose of an mRNA vaccine, and 32.2% were unvaccinated. In comparison, the general adult New York population had a 75.0% vaccination rate.
Adults with HIV who were older than 65 years were more likely to have completed a COVID-19 regimen than those 18 to 49 years old (71.4% vs 54.3%). Uptake was higher among men than women (64.8% vs 60.5%) and among those identifying as nonbinary or nonconforming (58.1%). Among racial groups, vaccine uptake was greatest among White people with HIV (70.8%) and lowest among their Black (58.6%) and American Indian or Alaska Native counterparts (58.4%).
COVID-19 vaccine coverage was much lower among those living with HIV who were not taking HIV-suppression drugs in 2020 (38.1%) than among those who were virally suppressed (72.0%) and those without surveillance-based evidence of HIV care in 2020 (29.1%), compared with those who received care (69.2%).
New York has the highest US per capita rate of people living with HIV, who have been shown to be at elevated risk for COVID-19–related hospitalization and in-hospital death, the researchers noted. This group was prioritized for vaccination early in the US vaccine rollout.
"Differences in demographic composition between PLWDH [people living with HIV] and the general population might partly explain lower coverage; however, coverage was <75% across all examined PLWDH subgroups," the study authors wrote. "Unmeasured factors, including socioeconomic status, might further explain the lower COVID-19 vaccination coverage among PLWDH."
The researchers called for ensuring COVID-19 vaccine coverage, including booster doses, among people with HIV. "Including COVID-19 vaccination in HIV-related service delivery might be effective at reducing disparities in vaccination coverage among PLWDH," they wrote.
Feb 4 MMWR study
Study finds antibiotic misuse occurs among all education levels
A review and meta-analysis of studies from more than 40 countries found that individuals misuse antibiotics regardless of their education level, researchers reported yesterday in Antimicrobial Resistance & Infection Control.
The researchers conducted a meta-analysis of 85 studies that measured the association between education and any aspect of antibiotic misuse, including use of antibiotics that were not prescribed, non-adherence to treatment guidelines, and storage of leftover antibiotics for future use. The studies encompassed a total of 85,789 subjects from 42 countries of different socioeconomic status, of whom 24,579 had misused antibiotics. Summary odds ratios (ORs) were estimated using a random effects model.
In high-income countries, medium education (9 to 12 years) was associated with 20% lower odds of antibiotic misuse (OR, 0.80; 95% confidence interval [CI], 0.66 to 0.97) compared with low education (9 or fewer years), while high education (more than 12 years) was associated with 14% lower odds of any aspect of antibiotic misuse (OR, 0.86; 95% CI, 0.72 to 1.03). The association between higher education and reduced odds of antibiotic misuse was more pronounced in the Middle East (OR, 0.64; 95% CI, 0.42 to 1.00) and countries of lower-middle economies (OR, 0.67, 95% CI 0.41 to 1.11). Each additional year of education was associated with 4% lower odds of any aspect of antibiotic misuse in lower-middle economies (OR, 0.96; 95% CI 0.92 to 1.00) and in the Middle East (OR, 0.96; 95% CI, 0.93 to 1.00).
In Europe, however, high education was associated with 25% higher odds of antibiotic misuse (OR, 1.25; 95% CI, 1.00 to 1.58). In addition, compared with lower education, high education levels in all countries were associated with 41% higher odds of storage of leftover antibiotics (OR, 1.41; 95% CI, 1.22 to 1.64). Each additional year of education was associated with 3% higher odds of antibiotic storage (OR, 1.03; 95% CI, 1.01 to 1.06).
"This meta-analysis shed the light on the importance of orienting intervention programs to improve the rationale use of antibiotics to all communities independent of their educational level," the study authors wrote. "It also pointed out on the considerable need for cohort studies that examined the association between education and antibiotic misuse and control the measures of association for potentially confounding variables."
Feb 3 Antimicrob Resist Infect Control study
US flu markers decline further, H3N2 still dominant
US flu levels dropped further and dipped below the national baseline last week, though sporadic activity continues across the country, the Centers for Disease Control and Prevention (CDC) said today in its latest weekly update.
The percentage of outpatient visits for flulike illness declined from 2.8% to 2.0% last week, putting it below the national baseline of 2.5%. Only four states reported high flulike illness activity, another marker of outpatient visits. The number was down from 12 the week before. The states include New Mexico, Wyoming, Oklahoma, and Mississippi.
At clinical labs, 1.7% of respiratory specimens tested positive for flu, down from 1.9% the previous week. And testing at public health labs showed that influenza A made up 99.2% of positive flu samples, and of subtyped viruses, all were H3N2.
Hospitalizations declined slightly again, and no new pediatric flu deaths were reported, keeping the season's total at five.
Feb 4 CDC FluView update
Vaccine-derived polio sickens more in two African countries
Two African nations—the Democratic Republic of the Congo (DRC) and Nigeria—reported new polio cases this week, all involving circulating vaccine-derived poliovirus type 2, according to the latest weekly update from the Global Polio Eradication Initiative (GPEI).
The DRC has three new cases, all from Maniema province, and all were counted as part of its 2021 total, which is now at 24 cases.
Elsewhere, Nigeria reported two more cases, both from Bauchi state. Both had 2021 illness onsets, lifting its total for the year to 395.
In other developments, the GPEI said a polio vaccination campaign in Ukraine began on Feb 1, with a goal of reaching children ages 6 months to 6 years who missed their routine doses. The campaign is part of the response to an outbreak of vaccine-derived polio in the country that was detected in October 2021.
Feb 3 GPEI update