A Scottish study finds no link between COVID-19 vaccination or infection of pregnant women and major congenital anomalies in their babies.

The nationwide study, led by University of Edinburgh and Public Health Scotland researchers, was published late last week in Nature Communications.

The team analyzed the electronic health records of babies whose mothers had received the Pfizer/BioNTech (73.7%) or Moderna (7.9%) mRNA COVID-19 vaccine after Dec 8, 2020.

The May 2020 to April 2022 study aimed to identify any association between congenital anomalies (structural or functional abnormalities at birth) and maternal vaccination or SARS-CoV-2 infection from 6 weeks before conception to 20 weeks' gestation. All fetuses or babies had reached at least 12 weeks' gestation by the time of live birth, miscarriage, stillbirth, or abortion.

Findings provide reassurance

Among the 6,731 babies of vaccinated mothers, 153 (2.3%) had any anomaly, and 120 (1.8%) had a nongenetic anomaly. Of the 20,193 babies of unvaccinated women, 467 had any anomaly (2.3%), and 375 (1.9%) had a nongenetic anomaly.

Of the 1,574 babies of infected mothers, 32 (2.0%) had any anomaly, and 26 (1.7%) had a nongenetic anomaly. Of the 4,722 babies of uninfected mothers, 85 (1.8%) had any anomaly, and 72 (1.5%) had a nongenetic anomaly.

Vaccination remains the best way for women to protect themselves and their babies from the known risks of SARS-CoV-2.

Primary analyses identified no link between vaccination and any anomaly (adjusted odds ratio [aOR], 1.01) or nongenetic anomaly (aOR, 1.00) or between infection and any anomaly (aOR, 1.02) or nongenetic anomaly (aOR, 0.94).

When the exposure window was narrowed from conception to 10 weeks' gestation, there was still no link between vaccination or infection and anomalies.

"This supports current policy and clinical advice that vaccination can be given at any stage of pregnancy and to women planning to become pregnant, and that vaccination remains the best way for women to protect themselves and their babies from the known risks of SARS-CoV-2 infection in late pregnancy," the researchers wrote.

The US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) recently reported 12 more highly pathogenic H5N1 avian flu detections in mammals, including skunks, bears, a raccoon, and a red fox.

Most of the animals that tested positive were from West Coast states, including Oregon, Washington, and Alaska. Oregon reported the virus in six skunks and a raccoon. Washington reported the virus in a racoon, and Alaska confirmed H5N1 in a Kodiak bear on Kodiak Island.

Elsewhere, Nebraska reported the H5N1 strain in a grizzly bear from Scotts Bluff County. A Jan 5 report from the Scottsbluff Star Herald said a bear was among four animals at the Riverside Discovery Center that died from avian flu. The others were a cougar and two tigers. The report said the animals ate local geese that had been donated to the zoo.

Also, Montana reported the virus in a grizzly bear from Teton County and a red fox from Madison County. The reports lift the number of H5N1 detections in US mammals since April 2022 to 110.

Also, APHIS has reported a few more outbreaks in poultry in the first days of 2023, in Kansas, Missouri, and Oregon. The outbreaks in Missouri and Oregon involve backyard birds, while the Kansas outbreak affected a commercial game bird farm in Anderson County that houses 8,900 birds.

Since the H5N1 Eurasian virus was first detected in US poultry in February 2022, the virus has led to the loss of a record 57.8 million poultry across 47 states.

A report today from the World Organization for Animal Health (WOAH) indicates that farmers in many countries are still using medically important antibiotics for growth promotion.

The first of a planned annual report from the Observatory of WOAH looks at whether, and how, member states are implementing international standards for disease prevention and control, animal welfare, and veterinary public health.

With regard to antimicrobial use in animals, it shows that, of the 155 member states that submitted data for 2020 and 2021, 40 indicated using antimicrobials as growth promoters, which is deemed not to be responsible use. In addition, 21 reported using antimicrobials that have been defined by the World Health Organization as highest priority critically important antimicrobials for human medicine.

The report also shows that, of 159 member states that submitted information on efforts to address antimicrobial resistance (AMR) in animals, only 7 (4%) reported having an integrated multisectoral surveillance system from antimicrobial use and resistance, 14% did not have an AMR National Action Plan (AMR-NAP), and 27% had an AMR-NAP but had not yet implemented it. Nine percent of WOAH member states indicated they had no training available on AMR in the animal sector, but trends indicate that percentage is decreasing.

"Findings presented in this Report outline for the first time a global perspective of Members’ adherence to standards," the agency said in a news release. "At the same time, they raise awareness of some of the current gaps in their implementation."

WOAH says countries that are using critically important antimicrobials for growth promotion should urgently prohibit them, and that nations that have not finalized AMR-NAPs or are struggling with implementation should be supported.

An analysis of primary care antibiotic use in Burkina Faso and the Democratic Republic of the Congo (DRC) suggests that a high proportion of broad-spectrum antibiotic use could be replaced by narrower-spectrum or no antibiotic use, researchers reported late last week in The Lancet Infectious Diseases.

In a letter to the journal, researchers from Burkina Faso, the DRC, and Belgium said they conducted the study to evaluate whether the antibiotic use targets identified in the World Health Organization's (WHO's) AWaRE (Access, Watch, and Reserve) Antibiotic Book are realistic and achievable for low- and middle-income countries. The book recommends that 90% of infections requiring an antibiotic in primary healthcare can be treated with oral Access antibiotics rather than broad-spectrum Watch antibiotics, and that more than 50% of minor infections can be treated without antibiotics.

The WHO AWaRe Antibiotic Book has great potential to optimise antibiotic use in primary care.

Analyzing data from patient surveys after visits to primary healthcare centers and over-the-counter medicine stores, the researchers found that 638 (60%) of 1,062 patients in Burkina Faso and 297 (80%) of 371 patients in the DRC used antibiotics, of which 8% and 30% were Watch antibiotics. Of the Watch antibiotic prescriptions, 8% were for gastrointestinal complaints without diarrhea, 8% were for skin infections, and 6% were for bronchitis—conditions for which Watch antibiotics are not indicated.

If the AWaRE Antibiotic Book were adhered to, the researchers estimate that 69% of Watch antibiotic use in Burkina Faso and 75% of Watch antibiotic use in the DRC could be replaced by Access antibiotics or no antibiotics, which suggests that the 90% Access target is "theoretically attainable in both countries," they wrote.

"The WHO AWaRe Antibiotic Book has great potential to optimise antibiotic use in primary care, foremost when at once regulating or guiding over-the-counter dispensing of Watch antibiotics, and facilitating follow-up of patients' clinical evolution," the researchers concluded.