Safety Monitoring of COVID-19 mRNA Vaccine Second Booster Doses Among Adults Aged ≥50 Years - United States, March 29, 2022-July 10, 2022.

The Advisory Committee on Immunization Practices (ACIP) recommends that all persons aged ≥5 years receive 1 booster dose of a COVID-19 vaccine after completion of their primary series.* On March 29, 2022, the Food and Drug Administration (FDA) authorized a second mRNA booster dose ≥4 months after receipt of a first booster dose for adults aged ≥50 years and persons aged ≥12 years with moderate to severe immunocompromise (1,2). To characterize the safety of a second mRNA booster dose among persons aged ≥50 years, CDC reviewed adverse events and health impact assessments reported to v-safe and the Vaccine Adverse Event Reporting System (VAERS) after receipt of a second mRNA booster dose during March 29-July 10, 2022. V-safe is a voluntary smartphone-based U.S. active surveillance system that monitors adverse events occurring after COVID-19 vaccination. VAERS is a U.S. passive surveillance system for monitoring adverse events after vaccination, managed by CDC and FDA (3). During March 29-July 10, 2022, approximately 16.8 million persons in the United States aged ≥50 years received a fourth dose.† Among 286,380 v-safe registrants aged ≥50 years who reported receiving a second booster of an mRNA vaccine, 86.9% received vaccines from the same manufacturer for all 4 doses (i.e., homologous vaccination). Among registrants who reported homologous vaccination, injection site and systemic reactions were less frequent after the second booster dose than after the first booster dose. VAERS received 8,515 reports of adverse events after second mRNA booster doses among adults aged ≥50 years, including 8,073 (94.8%) nonserious and 442 (5.1%) serious events. CDC recommends that health care providers and patients be advised that local and systemic reactions are expected after a second booster dose, and that serious adverse events are uncommon.

Reactogenicity of Simultaneous COVID-19 mRNA Booster and Influenza Vaccination in the US.

Importance: COVID-19 and seasonal influenza vaccines are essential in preventing respiratory infections and their potentially severe complications. Simultaneous administration of vaccines is efficient and may improve coverage with each vaccine. However, the safety of simultaneous administration of COVID-19 and influenza vaccines has not been well described. Objective: To evaluate adverse events and health impacts associated with simultaneously administered COVID-19 mRNA booster and seasonal influenza vaccines in the US population. Design, Setting, and Participants: In this retrospective cohort study, self-reported vaccine data were collected on days 0 to 7 after vaccination from September 22, 2021, through May 1, 2022, through v-safe, a voluntary smartphone-based monitoring system established by the Centers for Disease Control and Prevention. Participants were persons who voluntarily registered in v-safe following COVID-19 vaccination. Exposure: Receipt of simultaneously administered COVID-19 mRNA booster and seasonal influenza vaccines or COVID-19 mRNA booster alone. Main Outcomes and Measures: Local injection site and systemic reactions (eg, fatigue, headache, and myalgia) and health impacts reported by v-safe respondents in the week following COVID-19 mRNA booster vaccination. Adjusted odds ratios (aORs) were estimated for simultaneous administration compared with booster dose alone, controlling for sex, age, and week of vaccination. Results: Of a total of 981 099 persons aged 12 years or older registered with v-safe, simultaneous administration of COVID-19 mRNA booster and seasonal influenza vaccines was reported by 92 023 (9.4%) v-safe respondents; of these respondents, 54 926 (59.7%) were female, 36 234 (39.4%) were male, and sex was unknown for 863 (0.9%). In the week following vaccination, any systemic reactions were reported by 36 144 (58.9%) of 61 390 respondents who simultaneously received Pfizer-BioNTech booster and influenza vaccines and 21 027 (68.6%) of 30633 respondents who simultaneously received Moderna booster and influenza vaccines. Respondents who simultaneously received influenza and Pfizer-BioNTech booster vaccines (aOR, 1.08; 95% CI, 1.06-1.10) or influenza and Moderna booster vaccines (aOR, 1.11; 95% CI, 1.08-1.14) were slightly more likely to report any systemic reaction in the week following simultaneous vaccination than respondents who received only a COVID-19 mRNA vaccine booster. Conclusions and Relevance: In this study, compared with administration of COVID-19 mRNA booster vaccines alone, simultaneous administration of COVID-19 mRNA booster and seasonal influenza vaccines was associated with significant increases in reports of systemic reactions during days 0 to 7 following vaccination. These results may help better characterize the outcomes associated with simultaneously administered COVID-19 booster and influenza vaccines in the US population.

Collection and Rearing of Container Mosquitoes and a 24-h Addition to the CDC Bottle Bioassay.

Container mosquitoes (Diptera: Culicidae) oviposit their eggs in both natural and artificial containers. Many container mosquito species also serve as important vectors of disease-causing pathogens including Aedes aegypti, Ae. albopictus, and Ae. triseriatus. Control of these species can be done through the use of adulticide sprays. The efficacy of these treatments is highly dependent on the insecticide susceptibility status of the local mosquito populations. This paper provides protocols on collecting and rearing container mosquitoes for use in the Centers for Disease Control and Prevention (CDC) bottle bioassay. A brief description of the CDC bottle bioassay is provided as well as a standardized protocol for the incorporation of a 24-h mortality to the CDC bottle bioassay. Results from this 24-h holding addition to the CDC bottle bioassay reveal that some forms of resistance may be missed without the incorporation of the additional mortality reading. These protocols provide a foundation for new laboratories to establish rearing protocols and begin conducting resistance monitoring.

Baseline Susceptibility Status of Florida Populations of Aedes aegypti (Diptera: Culicidae) and Aedes albopictus.

Resistance to insecticides used to control mosquito vectors threatens the ability of mosquito-control organizations to protect public health. Aedes aegypti (Linnaeus) and Aedes albopictus (Skuse) are invasive species widely distributed throughout Florida and have been implicated in recent epidemics of Zika, dengue, and chikungunya viruses. Knowledge of the susceptibility status of these mosquito species to pyrethroid and organophosphate active ingredients (AIs) is needed to inform product selection and treatment decisions. The susceptibility of 37 Ae. aegypti and 42 Ae. albopictus populations from Florida was assessed in response to six pyrethroid and three organophosphate AIs using the CDC bottle bioassay method. Of all bioassays completed with a pyrethroid AI, 95% for Ae. aegypti and 30% for Ae. albopictus resulted in a resistant outcome. For organophosphate AIs, ~31% of assays conducted for both species were classified as resistant. The highest frequency of susceptibility for both species was observed in response to the organophosphate AI, naled. Lambda-cyhalothrin was the only pyrethroid to result in a susceptible status for Ae. aegypti and also had the highest frequency of susceptibility for Ae. albopictus. Resistance was detected to every AI tested for both Ae. aegypti and Ae. albopictus, but there was a pronounced trend of pyrethroid resistance in Florida populations of Ae. aegypti. The results of this work provide evidence for the need to decrease reliance on pyrethroids and to implement different methods of control of Ae. aegypti in Florida.

Intersectional stigma and psychosocial well-being among MSM living with HIV in Guangxi, China.

The existing literature suggests a negative impact of intersectional stigma on multiple aspects of psychosocial well-being among individuals with multiple stigmatized identities. However, such impact remains poorly understood. This study aims to investigate the association between intersectional stigma and psychosocial well-being among 193 men who have sex with men (MSM) living with HIV. Based on their responses to measures of HIV-related stigma and sexual and gender minority (SGM) stigma, the participants were grouped into "high" vs "low" on each type of stigma. The General Linear Model (GLM) was used to analyze the main and interaction effect of two types of stigma on multiple psychosocial measures. Our results indicated a significant interaction effect of two types of stigma on depression, anxiety, quality of life, and psychological resilience after controlling for key socio-demographic covariates. The findings suggest that experiencing both HIV-related stigma and SGM stigma may synergistically lead to poor psychosocial well-being among MSM in a more profound manner than experiencing only one type of stigma. It is critical for researchers and clinicians to consider the patients' multiple stigmatized identities, develop effective intervention strategies, and improve the psychosocial well-being of MSM living with HIV in China and other cultural settings.

State-wide survey of Aedes aegypti and Aedes albopictus (Diptera: Culicidae) in Florida.

Aedes aegypti and Aedes albopictus are invasive mosquito species with geographic ranges that have oscillated within Florida since their presence was first documented. Local transmission of dengue, chikungunya, and Zika viruses serves as evidence of the public health importance of these two species. It is important to have detailed knowledge of their distribution to aid in mosquito control efforts and understand the risk of arbovirus transmission to humans. Through a partnership involving the University of Florida Institute of Food and Agricultural Sciences Cooperative Extension Service and the Florida Medical Entomology Laboratory; the Florida Department of Health; and mosquito control agencies throughout Florida, a container mosquito surveillance program involving all life stages was launched in the summer of 2016 to detect the presence of Ae. aegypti and Ae. albopictus. Results from this survey were mapped to provide a picture of the current known distribution of Ae. aegypti and Ae. albopictus in Florida. Aedes aegypti and/or Ae. albopictus were detected in the 56 counties that were part of the survey. Only Aedes albopictus was detected in 26 counties, primarily in the panhandle region of Florida. The results of this work underscore the importance of maintaining container mosquito surveillance in a state where chikungunya, dengue, and Zika viruses are present and where there is continued risk for exotic arbovirus introductions.

Entomology in the 21st Century: Tackling Insect Invasions, Promoting Advancements in Technology, and Using Effective Science Communication-2018 Student Debates.

The 2018 student debates of the Entomological Society of America were held at the Joint Annual Meeting for the Entomological Societies of America, Canada, and British Columbia in Vancouver, BC. Three unbiased introductory speakers and six debate teams discussed and debated topics under the theme 'Entomology in the 21st Century: Tackling Insect Invasions, Promoting Advancements in Technology, and Using Effective Science Communication'. This year's debate topics included: 1) What is the most harmful invasive insect species in the world? 2) How can scientists diffuse the stigma or scare factor surrounding issues that become controversial such as genetically modified organisms, agricultural biotechnological developments, or pesticide chemicals? 3) What new/emerging technologies have the potential to revolutionize entomology (other than Clustered Regularly Interspaced Short Palindromic Repeats)? Introductory speakers and debate teams spent approximately 9 mo preparing their statements and arguments and had the opportunity to share this at the Joint Annual Meeting with an engaged audience.

A Mosquito Workshop and Community Intervention: A Pilot Education Campaign to Identify Risk Factors Associated with Container Mosquitoes in San Pedro Sula, Honduras.

Dengue poses a significant public health threat and results in ~96 million clinical cases every year. Central America is a region burdened by neglected tropical diseases, including dengue. The primary vectors of dengue, Aedes aegypti and Aedes albopictus, are widely distributed in Honduras. Additionally, sustained and consistent mosquito control is lacking in the country. Successful control of container mosquitoes relies heavily on participation from community leaders, stakeholders, and the community itself. We conducted a pilot study in San Pedro Sula, Honduras where community leaders and stakeholders were trained on mosquito biology and control and were able to apply that knowledge to an underserved community in San Pedro Sula. Surveys to assess the number and type of containers in the community and the number of containers on the residence identified associations with select socioeconomic factors and other variables based on survey questions. The average number of containers on the premises was 15 (± 2.3) and the most prevalent containers (>50%) were flowerpots, garbage, and toys, which could be targeted in mosquito control programs. This pilot study offers a framework for training community leaders and stakeholders to create a sustainable community-based vector control program for container mosquitoes.

Laboratory Evaluation of a Novel Lethal Ovitrap for Control of Aedes aegypti.

Aedes aegypti (L.) (Diptera: Culicidae) are known to flourish in a variety of natural and residential habitats and are competent vectors of at least 22 different arboviruses, including dengue, chikungunya, and Zika. Their global distribution, anthropophilic nature, and vector competency make them species of interest for control. A novel durable dual-action lethal ovitrap (DDALO) with combined larviciding and adulticiding effects, as well as a slow-release polymer (isobutyl methacrylate), was designed to target Ae. aegypti. The use of the DDALO resulted in high adult mosquito mortality (~95-100%) in no-choice laboratory cage studies targeting gravid females and successfully prevented all deposited eggs from hatching. Aging of the traps caused some loss in activity over time, but they still caused adult mortality (~50%) and continued to prevent successful hatching of eggs for 6 mo. Oviposition preference studies resulted in ~4.5 times as many larvae developing in untreated DDALOs compared with the other containers combined. Small-cage multigenerational studies resulted in significantly lower populations of adult mosquitoes in cages containing treated DDALOs after 4 wk. Successful laboratory studies show that the DDALO appears to be a promising tool that could be used for controlling wild vector populations of Ae. aegypti in combination with other mosquito control practices.

Evaluation of Cyantraniliprole and Other Commercial Fly Baits under Laboratory and Field Conditions.

Laboratory and field trials were performed to evaluate the attractiveness and efficacy of commercial baits (cyantraniliprole; methomyl + (Z)-9-tricosene; dinotefuran + (Z)-9-tricosene; imidacloprid granular + (Z)-9-tricosene; and imidacloprid liquid + (Z)-9-tricosene). In choice tests; flies were most attracted to cyantraniliprole bait > dinotefuran + (Z)-9 > methomyl + (Z)-9 bait > imidacloprid granular + (Z)-9 bait > imidacloprid liquid + (Z)-9 bait. Significant degradation in bait efficacy was observed after two weeks of aging excluding imidacloprid granular; which began to degrade in field conditions after one week. Cyantraniliprole; the new fly bait active ingredient in Zyrox(®); had the longest time to knockdown in the laboratory tests; but on susceptible flies; achieved 95%-100% knockdown within an hour of exposure. Zyrox(®) was resistant to weathering for a week; and was more attractive to flies in the field when compared to methomyl + (Z)-9 bait.

Free open access medical education can help rural clinicians deliver 'quality care, out there'.

Rural clinicians require expertise across a broad range of specialties, presenting difficulty in maintaining currency of knowledge and application of best practice. Free open access medical education is a new paradigm in continuing professional education. Use of the internet and social media allows a globally accessible crowd-sourced adjunct, providing inline (contextual) and offline (asynchronous) content to augment traditional educational principles and the availability of relevant resources for life-long learning. This markedly reduces knowledge translation (the delay from inception of a new idea to bedside implementation) and allows rural clinicians to further expertise by engaging in discussion of cutting edge concepts with peers worldwide.