treatment

COVID-19 Roundup: Pediatric Vaccine Effectiveness, WHO Recommendations, Overdose Rates, Mask Mandates

Vaccine Effectiveness in Pediatric Populations1

The Pfizer-BioNTech COVID-19 vaccine effectively protected children and adolescents aged 5 to 17 years against emergency department (ED) and urgent care encounters.

Researchers utilized the VISION Network to conduct a 10-state analysis from April 9, 2021, to January 29, 2022. Included were 39,217 encounters of children and adolescents with laboratory confirmed COVID-19 at 306 EDs and urgent care facilities.

“[Two] doses protect against COVID-19-associated emergency department and urgent care encounters among children and adolescents,” researchers said. “However, vaccine effectiveness (VE) was lower during Omicron predominance and decreased with time since vaccination; a booster dose restored VE to 81% among adolescents aged 16-17 years. Overall, 2-dose VE against COVID-19-associated hospitalizations was 73%-94%.”

WHO Treatment Recommendations2

The World Health Organization (WHO) has updated its guidelines on recommended medications for the treatment of COVID-19.  

Molnupiravir is now recommended for use in those with non-severe illness, in those at high risk of hospitalization, and in combination with other mitigation strategies against potential harms. This recommendation follows the results of 6 randomized controlled trials that indicated that molnupiravir reduced the risk of hospitalization and time to symptom resolution. Molnupiravir may have had a small impact on mortality. No recommendation was made on the use of molnupiravir in patients with severe or critical illness.

As an update to prior recommendations, casirivimab-imdevimab should now only be used in cases where rapid viral genotyping is available and where infection with a susceptible variant is confirmed. Preliminary evidence suggests a lack of efficacy of casirivamb-imdevimab against the omicron BA1 variant.

The WHO’s Guideline Development Group is currently reviewing evidence on the use of remdesivir in patients with COVID-19.

Overdose Morality Rates3

The rate of drug overdose mortality increased significantly during the COVID-19 pandemic, with Black individuals having the highest percentage increase.

Researchers utilized data from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research (WONDER) platform and the National Center for Health Statistics to examine drug overdose death rates by ethnicity and race from 1999 to 2020.

Results indicate that overdose death rates per 100,000 people for Black individuals increased from 24.7 in 2019 to 36.8 in 2020, compared with 31.6 in 2020 for White individuals. This relationship was reversed in 2010, as the rate for White individuals was 100.1% higher than that of Black individuals (15.8 and 7.9, respectively).

“In this cross-sectional study, we observed that Black individuals had the largest percentage increase in overdose mortality rates in 2020, overtaking the rate among White individuals for the first time since 1999, and American Indian or Alaska Native individuals experienced the highest rate of overdose mortality in 2020 of any group observed,” the researchers concluded.

Mask Guidelines4

The Centers for Disease Control and Prevention (CDC) has updated their recommendations on indoor mask use.

Local hospitalizations, hospital capacity, and infection rates can now be used instead of COVID-19 transmission levels to determine areas with levels of low, medium, and high COVID-19 risk. With this new framework from the CDC, approximately 70% of individuals are no longer recommended to mask indoors.

The CDC still recommends that individuals wear a mask indoors in areas of high COVID-19 levels.

 

—Leigh Precopio

 

 

References:

  1. Klein NP, Stockwell MS, Demarco M, et al. Effectiveness of COVID-19 Pfizer-BNT162b2 mRNA vaccination in preventing COVID-19-assocciated emergency department and urgent care encounters and hospitalizations among nonimmunocompromised children and adolescents aged 5-17 years – VISION Network, 10 states, April 2021-January 2022. MMWR Morb Moral Wkly Rep. 2022;71(9):352-358. https://www.cdc.gov/mmwr/volumes/71/wr/mm7109e3.htm?s_cid=mm7109e3_whttps://www.cdc.gov/mmwr/volumes/71/wr/mm7109e3.htm?s_cid=mm7109e3_w
  2. Agarwal A, Rochwerg B, Lamontagne F; Guideline Development Group. A living WHO guideline on drugs for COVID-19. BMJ. Published online September 4, 2020. Updated March 3, 2022. Accessed March 8, 2022. https://www.bmj.com/content/370/bmj.m3379
  3. Friedman JR, Hansen H. Evaluation of increases in drug overdose mortality rates in the US by race and ethnicity before and during the COVID-19 pandemic. JAMA Psychiatry. Published online March 2, 2022. doi:10.1001/jamapsychiatry.2022.0004
  4. Transcript for CDC media telebriefing: update on COVID-19. News release. Centers for Disease Control and Prevention; February 25, 2022. Accessed March 8, 2022. https://www.cdc.gov/media/releases/2022/t0225-covid-19-update.html