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Surveillance Summaries: Assisted Reproductive Technology Surveillance — United States, 2018

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This report provides 2018 data on assisted reproductive technology procedures from the 50 states, the District of Columbia, and Puerto Rico. In 2018, 203,119 assisted reproductive technology (ART) procedures were performed in 456 U.S. fertility clinics and reported to CDC. ART includes fertility treatments in which eggs or embryos are handled in the laboratory (i.e., in vitro fertilization and related procedures). These procedures resulted in 73,831 live birth deliveries and 81,478 infants born. Nationally, 3,135 ART procedures were performed per 1 million women ages 15–44 years. In 2018, ART contributed to 2% of all infants born in the United States from procedures performed in 2017 and 2018. Although singleton infants accounted for the majority of ART infants, multiple births from ART contributed to approximately 13% of all US multiple births. Increasing the use of single-embryo transfer, when clinically appropriate, can help reduce multiple births. To monitor adverse health consequences of multiple births, long-term follow-up of ART infants through integration of existing maternal and infant health surveillance systems with data from CDC’s National ART Surveillance System might be useful.

Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older — United States, 2022

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The adult immunization schedule is updated every year, providing a guide for health care providers to make sure adults get the vaccines they need based on age, medical conditions, and special situations. The 2022 recommendations for individuals aged 19 or older remain largely the same as the previous year, with new or revised recommendations impacting select vaccines. Despite challenges caused by the COVID-19 pandemic, adults and their health care providers should follow the recommended vaccine schedule to protect against serious and sometimes deadly diseases. The adult immunization schedule consolidates and summarizes current recommendations of the Advisory Committee on Immunization Practices (ACIP) for the vaccination of people aged 19 years or older. It is published annually as a guide for health care professionals, and most recommendations in the 2022 schedule are unchanged from 2021. Notable updates include new recommendations for pneumococcal vaccines, hepatitis B vaccination through age 59, and zoster (shingles) vaccination for immunocompromised adults. An appendix listing vaccine contraindications and precautions has also been added. Health care professionals are a trusted source of health information and a key influence in a patient’s decision to get vaccinated.

Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger — United States, 2022

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The immunization schedule for children and adolescents is updated every year, providing a guide for health care providers to make sure children and adolescents – from birth through age 18 years – get the vaccines they need for a healthy future. The 2022 immunization schedule remains largely the same as the previous year, with revised recommendations impacting select vaccines. Despite ongoing challenges caused by the COVID-19 pandemic, it’s critical to remain vigilant to ensure children and adolescents get all the vaccines they need on schedule to protect against serious and sometimes deadly disease. The immunization schedule for children and adolescents is published annually to consolidate and summarize updates to Advisory Committee on Immunization Practices (ACIP) recommendations on vaccination of children and adolescents from birth through age 18 years, and to assist healthcare providers in implementing those recommendations. Most recommendations remain the same in 2022. An appendix listing vaccine contraindications and precautions has been added. Routine immunization services are essential to protect our communities against outbreaks of vaccine-preventable diseases and ensure a bright and heathy future for our children. All vaccines can be safely administered during the COVID-19 pandemic. To safely maintain or reinitiate vaccination during the COVID19 pandemic, health care providers should diligently implement strategies such as screening for COVID-19 exposure and symptoms prior to and upon arrival, separating sick from well patients, and following infection prevention and control procedures. Children and adolescents should receive all recommended vaccines and catch-up doses of any missed vaccines.

Multistate Outbreak of SARS-CoV-2 B.1.1.529 (Omicron) Variant Infections Among Persons in a Social Network Attending Convention — New York City, November 18–December 20, 2021

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An investigation of infections among a group of mostly COVID-19-vaccinated attendees of an indoor New York City convention that socialized together outside of the conference found there were fewer infections among vaccinated attendees who had received a booster dose. Data from this investigation reinforce the importance of COVID-19 vaccination – including booster doses and in combination with early notification and other prevention measures such as mask wearing –  in limiting COVID-19 transmission and preventing severe illness. On December 2, 2021, the Minnesota Department of Health notified CDC of a COVID-19 case caused by the Omicron variant in a Minnesota resident (patient A).  It was the first such case identified in the state and one of the earliest identified in the United States. Patient A had attended a large indoor convention in New York City and had close contact with 29 other attendees over five days. Patient A reported COVID-19 symptoms starting November 22, the day after the convention, upon returning to Minnesota. CDC and 13 state health departments organized an investigation to characterize the trends in infections with the Omicron variant among this group of close contacts and to determine the extent of spread to attendees’ household members. Investigators interviewed 23 of the 30 exposed attendees. The attack rate (percentage of people exposed who tested positive) was high, both among the group of close contacts (70%) and among household contacts of infected attendees (33%). There were fewer infections among attendees who had received a booster dose before the convention (6 of 11) compared with attendees who had received a primary COVID-19 vaccine series but not a booster dose (10 of 12). The findings show the Omicron variant’s ability to evade protection against infection offered by vaccination; however, illness was relatively mild among this group, consistent with evidence that vaccinated people with COVID-19 are less likely to experience serious illness than people who are not vaccinated and get COVID-19.

Investigation of SARS-CoV-2 Transmission Associated With a Large Indoor Convention — New York City, November–December 2021

Despite multiple introductions as evidenced by detection of at least three strains of the virus that causes COVID-19, an investigation did not find evidence of widespread transmission among a highly vaccinated population at a large event in an indoor setting where mask use was required and monitored. On December 2, 2021, the Minnesota Department of Health reported one of the first U.S. cases of community-acquired SARS-Co-V-2 (the virus that causes COVID-19) variant B.1.1.529 (Omicron) in a person (patient A) attending a large indoor convention in New York City. Investigators assessed COVID-19 cases associated with the event and potential exposures among U.S.-based attendees using data from COVID-19 surveillance systems and an online survey shared with attendees. The investigation did not find evidence of widespread transmission during the event. The event took place among a highly vaccinated population in a large indoor convention in New York City, where masks were required and monitored. Compared with survey respondents who tested negative, respondents who tested positive for COVID-19 were more likely to report attending bars, karaoke, and nightclubs and eating or drinking indoors near other people for more than 15 minutes. A combination of prevention measures, including vaccination, consistent mask wearing, and indoor ventilation, likely limited the spread of COVID-19 during this large indoor event.

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Notes from the Field: Outbreak of COVID-19 Among a Highly Vaccinated Population Aboard a U.S. Navy Ship After a Port Visit — Reykjavik, Iceland, July 2021

During a COVID-19 outbreak on a United States Navy ship in late July 2021, spread was limited because of high vaccination rates among crew members and other prevention steps including masking, physical distancing, and cleaning. Using a combination of prevention strategies can limit the spread of COVID-19, even in the close quarters of a ship. On July 27, 2021, a vaccinated crew member on a United States Navy ship who had cough and congestion for four days tested positive for the virus that causes COVID-19. The ship had about 350 personnel, and at least 98% of those onboard were vaccinated against COVID-19. Masking and physical distancing requirements on the ship were relaxed while at sea. Vaccinated crew members had permission to go ashore during an Iceland port visit (July 18-21) before COVID-19 cases rapidly increased in the country by July 27 with the emergence of the Delta variant. Upon identifying the initial person on the ship to test positive on July 27, all ship personnel were required to report if they had COVID-19 symptoms. This resulted in identification of 11 additional people with infection. As a result, the ship immediately implemented prevention measures including masking, physical distancing, increased cleaning, isolation of 12 patients, and testing of 69 close contacts. The overall infection rate from this outbreak was 6.3%. At the onset of the COVID-19 pandemic, outbreaks on some U.S. Navy ships led to attack rates greater than 25% of the crew in the confined environment. Infection rates from previous U.S. Navy shipboard outbreaks before the availability of COVID-19 vaccines were four to six times higher than this outbreak among a vaccinated group. This outbreak in an enclosed environment suggests that high vaccination rates among crew members along with prevention measures such as mask-wearing can reduce the spread of COVID-19.

Previously Released: Safety Monitoring of COVID-19 Vaccine Booster Doses Among Adults — United States, September 22, 2021–February 6, 2022

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Previously Released: Waning 2-Dose and 3-Dose Effectiveness of mRNA Vaccines Against COVID-19–Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults During Periods of Delta and Omicron Variant Predominance — VISION Network, 10 States, August 2021–January 2022

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Previously Released: Effectiveness of Maternal Vaccination with mRNA COVID-19 Vaccine During Pregnancy Against COVID-19–Associated Hospitalization in Infants Aged <6 Months — 17 States, July 2021–January 2022

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Previously Released: Hospitalizations of Children and Adolescents with Laboratory-Confirmed COVID-19 — COVID-NET, 14 States, July 2021–January 2022

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• Death Rates Attributed to Excessive Cold or Hypothermia, by Urbanization Level and Sex — National Vital Statistics System, 2018–2020

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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.