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Recommendations and Reports: Dengue Vaccine: Recommendations of the Advisory Committee on Immunization Practices, United States, 2021

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In early 2022, the dengue vaccine Dengvaxia will be available for children 9-16 years old with laboratory-confirmed evidence of a previous dengue infection and living in areas where dengue is endemic in the United States. Dengvaxia is the first dengue vaccine approved by the U. S. Food and Drug Administration (FDA) and recommended by the Advisory Committee on Immunization Practices (ACIP) for use in areas where dengue transmission is frequent and continuous (endemic). Dengue-endemic areas include the U.S. territories of American Samoa, Puerto Rico, and the U.S. Virgin Islands (USVI), and freely associated states, including the Federated States of Micronesia, the Republic of Marshall Islands, and the Republic of Palau. The vaccine will be available in early 2022. Children 9–16 years old with laboratory-confirmed evidence of a previous dengue virus infection and living in areas where dengue is endemic are eligible to receive the vaccine. Dengvaxia, produced by Sanofi Pasteur, has an efficacy of about 80% in protecting children who have previously been infected with dengue against dengue illness, hospitalization, and severe disease.

Report of Health Care Provider Recommendation for COVID-19 Vaccination Among Adults, by Recipient COVID-19 Vaccination Status and Attitudes — United States, April–September 2021

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Adults who received a recommendation for COVID-19 vaccination from their healthcare provider were more likely to have received a vaccine than those who did not receive a recommendation. This was noted among populations who historically have lower vaccination rates. In addition, a provider recommendation was associated with more confidence that the vaccines are safe and important to protect against COVID-19. To examine the impact of a provider recommendation on COVID-19 vaccination, CDC analyzed data from a nationally representative household survey of COVID-19 vaccination status, attitudes, and behaviors among adults. Adults who reported a provider recommendation were more likely to have received at least one dose of a COVID-19 vaccine (78%) than those who did not receive a recommendation (62%). A healthcare provider’s recommendation was associated with higher vaccination coverage, including among younger adults (18–29 years), some racial and ethnic minorities, and people living in rural areas. Furthermore, a provider recommendation was associated with increased confidence that the vaccines are safe and important for protection against COVID-19. Healthcare providers are a valued and trusted source of health information. They can serve as key influencers in decisions by patients to get vaccinated and can contribute to improving vaccine confidence. Understanding how these recommendations affect vaccination status and attitudes is important and can inform tailored interventions to increase confidence in COVID-19 vaccines as well as vaccination coverage overall.

Previously Released: SARS-CoV-2 B.1.1.529 (Omicron) Variant — United States, December 1–8, 2021

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Previously Released: Booster and Additional Primary Dose COVID-19 Vaccinations Among Adults Aged ≥65 Years — United States, August 13, 2021–November 19, 2021

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Previously Released: Trends in and Characteristics of Drug Overdose Deaths Involving Illicitly Manufactured Fentanyls — United States, 2019–2020

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• Mucormycosis Cases During the COVID-19 Pandemic — Honduras, May–September 2021
  Following an epidemic of COVID-19-associated mucormycosis in India, researchers investigated 17 mucormycosis cases that occurred in Honduras during the country’s mid-2021 COVID-19 surge. Most of the patients with mucormycosis experienced severe illness and died. Mucormycosis is a severe, often fatal disease caused by infection with molds. On July 15, 2021, the Secretary of Health of Honduras (SHH) was notified of an unexpected number of mucormycosis cases among COVID-19 patients. The SHH partnered with the Honduras Field Epidemiology Training Program, the Council of Ministers of Health of Central America and the Dominican Republic, the Pan American Health Organization, and the CDC to investigate the cases of mucormycosis at four hospitals in Honduras. Among 17 mucormycosis cases, 11 occurred in COVID-19 patients. Nine of 11 COVID-19 patients were unvaccinated. Common mucormycosis risk factors included diabetes and corticosteroid use. Few patients had other immunocompromising conditions. Most patients (10 of 17) died during hospitalization, including 8 of the 11 patients with COVID-19-associated mucormycosis. Two surviving patients had poor outcomes, including facial disfiguration and limb loss. To prevent mucormycosis cases and improve patient outcomes, clinicians should be alert for mucormycosis – even in people who are not severely immunocompromised – as early diagnosis and treatment can save lives. Prevention of COVID-19 through vaccination, maintenance of glycemic control in patients with diabetes, and careful use of steroids for COVID-19 treatment might help decrease the risk for mucormycosis associated with COVID-19.
• COVID-19–Associated Mucormycosis — Arkansas, July–September 202
  A new report looks at 10 cases of COVID-19-associated mucormycosis that occurred in Arkansas during a statewide surge in COVID-19 due to the highly transmissible Delta variant. None of the patients had been vaccinated against COVID-19; 6 of the 10 patients died. Mucormycosis is a rare, yet severe, invasive fungal infection caused by a specific group of molds. It typically affects people with conditions that weaken the immune system such as blood cancer, stem cell/solid organ transplantation, or uncontrolled diabetes. During September 17–24, 2021, local clinicians notified the Arkansas Department of Health (ADH) of multiple patients with mucormycosis following recent COVID-19 diagnoses. Ten COVID-19–associated mucormycosis cases that occurred during July 12–September 28, 2021 were reported to ADH by six hospitals. The patients had mucormycosis infections of the nose or eye sockets (including three patients whose infection spread to the brain), lungs, gastrointestinal tract, or multiple body sites. Of the 10 patients, eight had diabetes, none had been vaccinated against COVID-19, and six died. Given the severity of mucormycosis, it is important that clinicians be alert for COVID-19-associated mucormycosis, even in patients without conditions that severely weaken the immune system. Early diagnosis and treatment with appropriate antifungal drugs and surgery can save lives. Control of blood sugar in patients with diabetes, careful use of steroids for COVID-19 treatment, and vaccination against COVID-19 should be encouraged by healthcare providers.

• Distribution of Hours per Day That Office-Based Primary Care and Specialist Care Physicians Spent Outside Normal Office Hours Documenting Clinical Care in Their Medical Record System — United States, 2019

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

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.