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Recommendations and Reports: Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2021–22 Influenza Season

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This report updates the 2020–21 recommendations of the Advisory Committee on Immunization Practices (ACIP) for the use of seasonal influenza vaccines in the United States. Influenza vaccination is recommended each year for all people 6 months and older, with rare exceptions. Influenza vaccination is recommended ideally before the end of October. Because the viruses that cause influenza and COVID-19 might spread at the same time this fall and winter, preventing and reducing influenza-associated doctor’s visits, hospitalizations, and intensive care unit admissions through influenza vaccination could reduce stress on the U.S. health care system. This report provides recommendations for the use of influenza vaccines for the 2021–2022 influenza season. Inactivated influenza vaccines, recombinant influenza vaccines, and live attenuated influenza vaccines (nasal spray vaccines) are all expected to be available this season. There is no preferential recommendation for one influenza vaccine over another for people for whom more than one licensed, recommended, and appropriate vaccine is available. There are some new changes this season. All available influenza vaccines this season will be quadrivalent (four-component) vaccines. The guidance for coadministration of vaccines has been updated, and COVID-19 vaccines may be given with other vaccines, including influenza vaccines. Guidance on timing of vaccination has been updated. Vaccination soon after influenza vaccine becomes available can be considered for pregnant people who are in the third trimester of pregnancy and for children who only need one dose of influenza vaccine this season. As in previous seasons, children who need two doses are recommended to get the first dose soon after vaccine becomes available. The approved age indication for Flucelvax Quadrivalent (ccIIV4) has been expanded from ages 4 years and older to 2 years and older. Lastly, contraindications and precautions concerning people with a previous severe allergic reaction to influenza vaccines have been updated.

Progress Toward Polio Eradication — Worldwide, January 2019–June 2021

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In 2020, wild polio cases increased in Afghanistan and decreased in Pakistan compared with 2019, and rising rates of under-immunized children, as well as COVID-19 disruptions, led to increases in outbreaks of circulating vaccine-derived polio in 13 additional countries. Wild poliovirus continues to circulate in two countries: Afghanistan and Pakistan. In 2020, polio cases increased in Afghanistan and decreased in Pakistan compared with 2019. However, circulating vaccine-derived poliovirus cases continue to spread globally, with outbreaks reported in 32 countries, including 13 new countries in 2020. As the COVID-19 pandemic disrupts polio eradication efforts, the Global Polio Eradication Initiative and partners launched an updated five-year eradication strategy in June 2021. The strategy focuses on stopping wild polio circulation and vaccine-derived polio outbreaks by responding quickly to outbreaks, widening use of a new oral polio vaccine, integrating polio eradication efforts with other country-level outbreak responses and health efforts, and ensuring accountability at all levels to create a polio-free world.

Trends in Nonfatal and Fatal Overdoses Involving Benzodiazepines — 38 States and the District of Columbia, 2019–2020

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Fatal and nonfatal benzodiazepine overdoses increased from 2019 to 2020, and illicit benzodiazepines are increasingly contributing to overdose deaths. This class of drugs is commonly prescribed to treat insomnia and anxiety and is increasingly being misused. Additionally, more than 90% of benzodiazepine overdose deaths involved either prescription or illicitly manufactured opioids, highlighting the dangers of co-using opioids and benzodiazepines. Benzodiazepines (sometimes called “benzos”) work to calm or sedate a person and are a commonly prescribed class of drugs that treat insomnia and anxiety. Benzodiazepines are also produced and distributed illicitly. Prescription benzodiazepines include diazepam (Valium), alprazolam (Xanax), and clonazepam (Klonopin). Illicit benzodiazepines include etizolam, flualprazolam, and flubromazolam. Fatal and nonfatal benzodiazepine overdoses increased from 2019 to 2020, especially among those co-involved with opioid overdoses. Benzodiazepine overdose emergency department visits increased almost 24%. Deaths involving prescription benzodiazepines increased nearly 22%; deaths involving illicit benzodiazepines increased over 500%. Over 90% of benzodiazepine overdose deaths involved either prescription or illicitly manufactured opioids, highlighting the dangers of co-using opioids and benzodiazepines. Improving awareness among health care professionals and the public about the increasing problem of benzodiazepine overdose from both prescription and illicit sources — and how co-use of opioids is driving these increases — is critical to help prevent additional overdoses.

Mental Health and Substance Use Among Adults with Disabilities During the COVID-19 Pandemic — United States, February–March 2021

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Nearly two-thirds of adults with disabilities surveyed in February–March 2021 reported symptoms of at least one mental health condition or substance use in the past month. Even more alarming, serious thoughts of suicide were about 2.5 times as high among adults with disabilities as those without disabilities. Improving access to medical care for adults with disabilities, including screening and support services for mental health and substance use, can improve their health during emergencies such as the COVID-19 pandemic. U.S. adults were surveyed online during February–March 2021 to assess their mental health and substance use during the COVID-19 pandemic. Overall, 64% of adults aged 18 and older with disabilities reported mental health symptoms, such as anxiety or depression or substance use, compared with 36% of adults without disabilities.

New COVID-19 Cases and Hospitalizations Among Adults, by Vaccination Status — New York, May 3–July 25, 2021 (Early Release August 18, 2021)

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Sustained Effectiveness of Pfizer-BioNTech and Moderna Vaccines Against COVID-19 Associated Hospitalizations Among Adults — United States, March–July 2021 (Early Release August 18, 2021)

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Effectiveness of Pfizer-BioNTech and Moderna Vaccines in Preventing SARS-CoV-2 Infection Among Nursing Home Residents Before and During Widespread Circulation of the SARS-CoV-2 B.1.617.2 (Delta) Variant — National Healthcare Safety Network, March 1–August 1, 2021 (Early Release August 18, 2021)

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Effectiveness of COVID-19 Vaccines in Preventing SARS-CoV-2 Infection Among Frontline Workers Before and During B.1.617.2 (Delta) Variant Predominance — Eight U.S. Locations, December 2020–August 2021 (Early Release August 24, 2021)

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SARS-CoV-2 Infections and Hospitalizations Among Persons Aged ≥16 Years, by Vaccination Status — Los Angeles County, California, May 1–July 25, 2021 (Early Release August 24, 2021)

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Notes from the Field: Illicit Benzodiazepines Detected in Patients Evaluated in Emergency Departments for Suspected Opioid Overdose — Four States, October 6, 2020–March 9, 2021

Illicit benzodiazepine use is growing. These emerging substances may also be co-used with opioids, making them even more dangerous. Administering naloxone for opioid overdose may not be enough, as a person whose overdose involves both benzodiazepines and opioids may need additional care. This report describes the detection of illicit benzodiazepines among patients seen in the emergency department with a suspected opioid overdose in four states. Of 141 biologic specimens examined, illicit benzodiazepines were detected in 21 patients. At least one opioid was detected in 20 of those cases. This report documents concerning co-exposure of opioids and illicit benzodiazepines among patients presenting with a suspected opioid overdose from multiple geographically diverse emergency departments.

QuickStats: Percentage of Children and Adolescents Aged 0–17 Years Who Have Experienced a Specified Stressful Life Event, by Type of Event and Poverty Status — National Health Interview Survey, United States, 2019

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CDC works 24/7 protecting America’s health, safety and security. Whether diseases start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America’s most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world.