Influenza Vaccinations During the COVID-19 Pandemic - 11 U.S. Jurisdictions, September-December 2020.

Influenza causes considerable morbidity and mortality in the United States. Between 2010 and 2020, an estimated 9-41 million cases resulted in 140,000-710,000 hospitalizations and 12,000-52,000 deaths annually (1). As the United States enters the 2021-22 influenza season, the potential impact of influenza illnesses is of concern given that influenza season will again coincide with the ongoing COVID-19 pandemic, which could further strain overburdened health care systems. The Advisory Committee on Immunization Practices (ACIP) recommends routine annual influenza vaccination for the 2021-22 influenza season for all persons aged ≥6 months who have no contraindications (2). To assess the potential impact of the COVID-19 pandemic on influenza vaccination coverage, the percentage change between administration of at least 1 dose of influenza vaccine during September-December 2020 was compared with the average administered in the corresponding periods in 2018 and 2019. The data analyzed were reported from 11 U.S. jurisdictions with high-performing state immunization information systems.* Overall, influenza vaccine administration was 9.0% higher in 2020 compared with the average in 2018 and 2019, combined. However, in 2020, the number of influenza vaccine doses administered to children aged 6-23 months and children aged 2-4 years, was 13.9% and 11.9% lower, respectively than the average for each age group in 2018 and 2019. Strategic efforts are needed to ensure high influenza vaccination coverage among all age groups, especially children aged 6 months-4 years who are not yet eligible to receive a COVID-19 vaccine. Administration of influenza vaccine and a COVID-19 vaccine among eligible populations is especially important to reduce the potential strain that influenza and COVID-19 cases could place on health care systems already overburdened by COVID-19.

Clinical Decision Support for Immunization Uptake and Use in Immunization Health Information Systems.

CONTEXT: In the United States, immunization recommendations and their associated schedules are developed by the Advisory Committee on Immunization Practices (ACIP). To assist with the translation process and better harmonize the outcomes of existing clinical decision support tools, the Centers for Disease Control and Prevention (CDC) created clinical decision support for immunization (CDSi) resources for each set of ACIP recommendations. These resources are continually updated and refined as new vaccine recommendations and clarifications become available and will be available to health information systems for a coronavirus disease 2019 (COVID-19) vaccine when one becomes available for use in the United States Objectives: To assess awareness of CDSi resources, whether CDSi resources were being used by immunization-related health information systems, and perceived impact of CDSi resources on stakeholders' work Design: Online surveys conducted from 2015-2019 including qualitative and quantitative questions Participants: The main and technical contact from each of the 64 CDC-funded immunization information system (IIS) awardees, IIS vendors, and electronic health record vendors Results: Awareness of at least one resource increased from 75% of respondents in 2015 to 100% in 2019. Use of at least one CDSi resource also increased from 47% in 2015 to 78% in 2019. About 80% or more of users of CDSi are somewhat or very highly satisfied with the resources and report a somewhat or very positive impact from using them Conclusion: As awareness and use of CDSi resources increases, the likelihood that patients receive recommended immunizations at the right time will also increase. Rapid and precise integration of vaccine recommendations into health information systems will be particularly important when a COVID-19 vaccine becomes available to help facilitate vaccine implementation.

Increasing human papillomavirus vaccination at the recommended age.

In the United States, human papillomavirus (HPV) vaccine has been recommended for females since 2006 and for males since 2011. However, national HPV vaccination coverage among adolescents is lower than national targets, and many adolescents initiate HPV vaccination later than the recommended age. We analyzed records for >2 million persons born during 1996-2000 who initiated HPV vaccination at age 9 through 16 years from six Immunization Information Systems Sentinel Sites, displayed the distribution of HPV vaccination initiation age, and calculated HPV vaccination coverage. More adolescents in recent cohorts initiated HPV vaccination at the recommended age of 11-12 years, the majority of whom received another recommended vaccine on the same day. However, >40% of all vaccinated adolescents did not initiate the HPV vaccination until age 13 years or later. Continued efforts are needed to increase HPV vaccination initiation at the recommended age.

Immediate and subsequent effects of matched and unmatched stimuli on targeted vocal stereotypy and untargeted motor stereotypy.

The authors evaluated the effects of matched and unmatched stimuli on immediate and subsequent engagement in targeted vocal stereotypy (Experiment 1) and untargeted motor stereotypy (Experiment 2). Results of Experiment 1 showed that (a) matched stimulation decreased immediate engagement in vocal stereotypy for 8 of 11 participants and increased subsequent engagement in vocal stereotypy for only 1 of the 8 participants and (b) unmatched stimulation decreased immediate engagement in vocal stereotypy for only 1 of 10 participants and did not increase subsequent engagement in vocal stereotypy for this participant. Results of Experiment 2 showed that for 8 of 14 participants, untargeted stereotypy increased when the matched or unmatched stimulus was present, after it was removed, or both. The authors briefly discuss the potential clinical implications of using matched stimulation to decrease vocal stereotypy and limitations of the findings.