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Articles

Surveillance Summaries: Disease Surveillance Among U.S.-Bound Immigrants and Refugees — Electronic Disease Notification System, United States, 2014–2019

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Public health agencies should use CDC’s Electronic Disease Notification (EDN) system data to monitor, evaluate, and improve health-related programs and policies for U.S.-bound or recently arrived immigrants, refugees, and others. During 2014–2019, the mandatory overseas medical exam for immigrants, refugees, and others who apply from abroad for admission to live permanently in the United States prevented importation of 6,586 cases of infectious tuberculosis (TB), 815 cases of syphilis, and 131 cases of gonorrhea. The recommended post-arrival TB exam further identified 475 cases of culture-positive TB, thereby limiting community transmission in the United States. CDC’s EDN system collects data from overseas medical exams then sends the collected medical data and arrival notifications to U.S. public health agencies where the newly arrived person intends to live. EDN also collects data from post-arrival TB exams. Public health agencies should continue to use EDN data and enter results of post-arrival TB exams to monitor, evaluate, and improve health-related programs and policies for U.S.-bound or recently arrived immigrants, refugees, and others.

Zika-Associated Birth Defects Reported in Pregnancies with Laboratory Evidence of Confirmed or Possible Zika Virus Infection — U.S. Zika Pregnancy and Infant Registry, December 1, 2015–March 31, 2018

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About 5% of infants born to women with confirmed or possible Zika virus infection during pregnancy had a Zika-associated brain or eye defect. One-third of these infants had more than one birth defect. In the event of a future Zika outbreak, health care providers should consider prenatal Zika virus infection in infants with certain brain and eye defects. This report is based on data on Zika-associated birth defects among 6,799 infants born in the U.S. states, District of Columbia, territories, and freely associated states from December 2015 to March 2018. It found that 4.6% of infants born to women with confirmed or possible Zika virus infection during pregnancy had a Zika-associated brain or eye defect. Among the subgroup of pregnancies with confirmed Zika virus infection, 6.1% of infants had a Zika-associated brain or eye defect. Several specific brain and eye defects were more commonly reported. These findings could help to target public health surveillance efforts to the most common brain and eye defects associated with Zika infection during pregnancy should a Zika outbreak reemerge. These findings might also provide a signal to the reemergence of Zika, particularly in geographic regions without ongoing comprehensive Zika virus surveillance.

Use of Recombinant Zoster Vaccine in Immunocompromised Adults Aged ≥19 Years: Recommendations of the Advisory Committee on Immunization Practices — United States, 2022

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To help address an unmet need for shingles prevention among people who are immunocompromised (weakened immune system), CDC recommends people aged 19 years and older who are or will be immunocompromised because of known disease or therapy receive two doses of recombinant zoster vaccine (RZV, Shingrix). Immunocompromised adults generally have a higher risk of developing shingles and having severe complications, and this updated recommendation enables providers to vaccinate their patients against shingles at the most appropriate time. Shingles is a painful disease and the risk of getting it increases with age. Since 2017, CDC has recommended that adults aged 50 years and older get two doses of Shingrix, separated by two to six months, to prevent shingles and the complications from the disease. The risk for shingles among younger adults with weakened immune systems due to an underlying health condition or therapy can be comparable to – or higher than – the general adult population aged 50 years and older. In July 2021, the Food and Drug Administration (FDA) approved the vaccine for immunocompromised adults aged 18 and older. In October 2021, following a careful examination of data CDC’s Advisory Committee on Immunization Practices expanded the existing recommendation to include immunocompromised adults aged 19 and older. This report outlines this updated recommendation and provides clinical considerations to help health care professionals determine when and to whom they should recommend this vaccine.

Progress Toward Poliomyelitis Eradication ― Afghanistan, January 2020–November 2021

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With a historically low number of reported wild poliovirus type 1 (WPV1) cases in 2021, Afghanistan has an opportunity to interrupt WPV transmission through sustained polio surveillance and quality vaccination campaigns, reaching children who were previously inaccessible and coordinating with Pakistan to improve cross-border polio eradication efforts. Afghanistan and Pakistan remain the only countries with endemic wild poliovirus type 1 (WPV1) transmission. With a historically low number of reported polio cases in 2021, Afghanistan has an opportunity to interrupt WPV1 transmission by the end of 2023. During January–November 2021, Afghanistan detected only four WPV1 and 43 type 2 circulating vaccine-derived poliovirus (cVDPV2) cases, compared to 56 and 281, respectively, during the same period in 2020. National efforts to sustain polio surveillance and implement vaccination campaigns, particularly reaching the increased number in 2021 of under- or unvaccinated and inaccessible Afghan children, should remain a public health priority in 2022. If efforts are robust, sustained, implemented countrywide, and coordinated with Pakistan to improve cross-border eradication activities, substantial progress toward interrupting WPV1 transmission in Afghanistan is possible during 2022–2023.

Use of the Janssen (Johnson & Johnson) COVID-19 Vaccine: Updated Interim Recommendations from the Advisory Committee on Immunization Practices — United States, December 2021

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This report details recommendations from the Advisory Committee on Immunization Practices (ACIP) for preferential use of mRNA COVID-19 vaccines (Pfizer-BioNTech/Comirnaty and Moderna) over Johnson & Johnson’s Janssen COVID-19 vaccine. After a thorough review of available vaccine safety and effectiveness data during an emergency meeting in December 2021, ACIP recommended preferential use of mRNA COVID-19 vaccines (Pfizer-BioNTech/Comirnaty and Moderna) over Johnson & Johnson’s Janssen COVID-19 vaccine for everyone ages 18 years and older in the U.S. CDC endorsed the committee’s decision and updated its recommendations for the prevention of COVID-19, stating a preference for mRNA COVID-19 vaccines (Pfizer-BioNTech or Moderna) over viral vector COVID-19 vaccines (J&J), if they are available. The mRNA COVID-19 vaccines are preferred over the J&J COVID-19 vaccine for primary and booster vaccination. The Janssen COVID-19 vaccine may be considered in some situations, including for people with a contraindication for mRNA COVID-19 vaccines. Given the current state of the pandemic both in the United States and around the world, the ACIP reaffirmed that receiving any vaccine is better than being unvaccinated.

Previously Released: Racial and Ethnic Disparities in Receipt of Medications for Treatment of COVID-19 — United States, March 2020–August 2021

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• Early Evidence of the SARS-CoV-2 B.1.1.529 (Omicron) Variant in Community Wastewater — United States, November–December 2021Wastewater (sewage) surveillance is an important tool for tracking the spread of COVID-19 in communities, but using this method to track specific variants has been limited. In late 2021, wastewater surveillance programs in California, Colorado, New York, and Texas detected evidence of the Omicron variant in these communities before it was identified in cases in these communities. Infected people can shed viral genetic material (ribonucleic acid or RNA) in their stool and this viral material can be measured in community wastewater. Variant-specific wastewater testing looks for mutations associated with known variants. CDC established the National Wastewater Surveillance System in September 2020 to provide data on the presence of, and trends in, SARS-CoV-2 infections that might not be detected through clinical testing. Health departments in four states (California, Colorado, New York, and Texas) were the first wastewater surveillance programs to detect evidence of the Omicron variant in community wastewater. Variant-specific wastewater data are one indicator of the possible presence of a variant in a community and can help inform public health decision-making.

• Percentage of Children Aged 2–17 Years With >2 Hours of Screen Time Per Weekday, by Sex and Age Group — National Health Interview Survey, United States, 2020

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