Today, CDC released three studies in the Morbidity and Mortality Weekly Report (MMWR) that highlight the importance of using layered prevention strategies including universal masking to stop the spread and minimize disruptions to school operations for safe in-person education. These studies found that school districts without a universal masking policy in place were more likely to have COVID-19 outbreaks. Nationwide, counties without masking requirements saw the number of pediatric COVID-19 cases increase nearly twice as quickly during this same period.
One report from Arizona revealed that schools in two of the state’s most populous counties were 3.5 times more likely to have COVID-19 outbreaks if they did not have a mask requirement at the start of school compared with schools that required universal masking on day one. Universal masking is an important component in the recommended layered prevention strategy for schools, and this study continues to demonstrate that facemasks when used as part of the larger strategy can reduce spread of COVID-19 and prevent outbreaks in schools.
Another report found that during the two weeks following the start of school, the average change in pediatric COVID-19 case rates was lower among counties with school mask requirements (16.32 per 100,000/day) compared with counties without school mask requirements (34.85 cases per 100,000/day). This highlights the impact that universal masking policies can have on the communities that surround these school districts, as the impact of the policies can reduce the burden on the health care systems that support these school districts.
A third report studied COVID-19-related school closures and found that despite an estimated 1,801 school closures so far this school year, 96% of public schools have been able to remain open for full in-person learning. The continued focus on providing students with a safe environment for in-person learning is one of the main priorities for CDC’s guidance, and can be best achieved by following a layered prevention strategy.
These studies continue to demonstrate the importance and effectiveness of CDC’s Guidance for COVID-19 Prevention in K-12 Schools to help districts ensure safer in-person learning and stop the spread of COVID-19. Promoting vaccination of eligible persons, mask wearing, and screening testing are all proven methods to continue to work towards the end of the COVID-19 pandemic.
Both mRNA COVID-19 vaccines (Pfizer-BioNTech and Moderna) authorized and recommended in the United States protect against COVID-19-related hospitalization among adults 65 years and older, according to a new CDC assessment that finds fully vaccinated adults 65 years and older were 94% less likely to be hospitalized with COVID-19 than people of the same age who were not vaccinated. People 65 and older who were partially vaccinated were 64% less likely to be hospitalized with COVID-19 than people who were not vaccinated. People were considered “partially vaccinated” two weeks after their first dose of mRNA vaccine and “fully vaccinated” two weeks after their second dose.
These are the first real-world findings in the United States confirming clinical trial data showing mRNA vaccines prevent severe COVID-19 illness. The findings provide additional support for CDC’s recommendation for COVID-19 vaccination among people 65 and older in the U.S. population under the Emergency Use Authorization (EUA) for the applicable COVID-19 vaccine as the risk for severe illness with COVID-19 increases with age, with older adults at highest risk.
“These findings are encouraging and welcome news for the two-thirds of people aged 65 and up who are already fully vaccinated,” said CDC Director Rochelle P. Walensky, MD, MPH. “COVID-19 vaccines are highly effective and these real-world findings confirm the benefits seen in clinical trials, preventing hospitalizations among those most vulnerable. The results are promising for our communities and hospitals. As our vaccination efforts continue to expand, COVID-19 patients will not overwhelm health care systems – leaving hospital staff, beds, and services available for people who need them for other medical conditions.”
The assessment looked at hospitalizations in two U.S. hospital networks covering 24 hospitals in 14 states. Vaccine effectiveness was assessed by comparing the odds of COVID-19 vaccination among hospitalized people who tested positive for the virus that causes COVID-19 (these were case-patients) versus those who tested negative (these were controls). Among 417 participants in the assessment, there were 187 case-patients and 230 controls. Close to half of the patients were more than 75 years old.
Also noteworthy, while early reports from Israel also documented the real-world effectiveness of COVID-19 vaccination, including among older adults, those reports only looked at vaccination with Pfizer-BioNTech vaccine. In this CDC assessment, both Pfizer-BioNTech and Moderna vaccine products were equally represented.
As expected, the assessment confirmed that vaccination provided no protection to people who had received their first dose fewer than two weeks earlier. It takes two weeks for the body to form an immune response after vaccination.
This assessment is one of many planned COVID-19 vaccine effectiveness assessments to evaluate the real-world benefits of COVID-19 vaccines. Results from these assessments will help inform vaccine policy decisions aimed at saving lives and decreasing serious COVID-19 disease as much as possible.
CDC recommends everyone 16 years of age and older in the U.S. population under the EUA get the applicable COVID-19 vaccine as soon as possible.
New data published by the Centers for Disease Control and Prevention (CDC) show that reported annual cases of sexually transmitted diseases (STDs) in the United States continued to climb in 2019, reaching an all-time high for the sixth consecutive year.
The newly released 2019 STD Surveillance Report found:
2.5 million reported cases of chlamydia, gonorrhea, and syphilis, the three most commonly reported STDs in 2019.
A nearly 30% increase in these reportable STDs between 2015 and 2019.
The sharpest increase was in cases of syphilis among newborns (i.e., congenital syphilis), which nearly quadrupled between 2015 and 2019.
“Less than 20 years ago, gonorrhea rates in the U.S. were at historic lows, syphilis was close to elimination, and advances in chlamydia diagnostics made it easier to detect infections,” said Raul Romaguera, DMD, MPH, acting director for CDC’s Division of STD Prevention. “That progress has since unraveled, and our STD defenses are down. We must prioritize and focus our efforts to regain this lost ground and control the spread of STDs.”
STDs can have serious health consequences. People with these infections do not always experience disease symptoms, but, if left untreated, some can increase the risk of HIV infection, or can cause chronic pelvic pain, pelvic inflammatory disease, infertility, severe pregnancy and newborn complications, and infant death.
CDC’s 2019 data provide the most recent full picture of STD trends in the United States before the COVID-19 pandemic. Preliminary 2020 data suggest that many of these concerning trends continued in 2020, when much of the country experienced major disruptions to STD testing and treatment services due to the COVID-19 pandemic.
The STD burden is not equal
The burden of STDs increased overall and across many groups in 2019. But it continued to hit racial and ethnic minority groups, gay and bisexual men, and youth the hardest.
Racial/Ethnic Minority Groups
In 2019 STD rates:
For African American or Black people were5-8 times that of non-Hispanic White people.
For American Indian or Alaska Native and Native Hawaiian or Other Pacific Islander people were 3-5 times that of non-Hispanic White people.
For Hispanic or Latino people were 1-2 times that of non-Hispanic White people.
Gay and Bisexual Men
Make up nearly half of all 2019 primary and secondary syphilis cases.
Gonorrhea rates were 42 times that of heterosexual men in some areas.
Young People Aged 15–24 years
Make up 61% of chlamydia cases.
Make up 42% of gonorrhea cases.
“Focusing on hard-hit populations is critical to reducing disparities,” said Jo Valentine, MSW, associate director of the Office of Health Equity in CDC’s Division of STD Prevention. “To effectively reduce these disparities, the social, cultural, and economic conditions that make it more difficult for some populations to stay healthy must be addressed. These include poverty, unstable housing, drug use, lack of medical insurance or regular medical provider, and high burden of STDs in some communities.”
COVID-19 highlights needs and opportunities for STD control
Before the COVID-19 pandemic, reductions in STD screening, treatment, prevention, and partner services contributed to STD increases for many years. Since the pandemic began, large numbers of STD program staff at the state and local level have been deployed to the COVID-19 response, which can lead to more delays in services.
According to one surveyexternal icon, as of January 2021 about one-third of state and local STD program staff were still deployed to assist with COVID-19 response efforts. Staff also report burnout as they pivot from COVID-19 back to STD intervention and partner services. As noted in the recent reportexternal icon on sexually transmitted infections by the National Academy of Sciences, Engineering, and Medicine, “COVID-19 pandemic has exposed weaknesses in public health preparedness due to weak infrastructure, an under-capacitated and under-resourced workforce, and limited surge capacity.”
The COVID-19 pandemic exacerbated an already stretched system for STD control in the United States and accelerated the need to deliver accessible, high-quality STD services in new ways. CDC has identified several new and innovative ways STD services can meet more people where they are—during the COVID-19 pandemic and in the future—including:
STD express clinics, which provide walk-in testing & treatment without a full clinical exam.
Partnerships with pharmacies & retail health clinics, which can provide new access points for STD services (e.g., on-site testing and treatment).
Telehealth/telemedicine, which can close gaps in testing and treatment, ensure access to healthcare providers, support self-testing or patient-collected specimens, and is especially critical in rural areas.
Many of these services are among the strategies highlighted in the recently released HHS Sexually Transmitted Infections National Strategic Planexternal icon, which provides a roadmap to develop, enhance, and expand prevention and care programs at the national, state, tribal and local levels over the next five years to reverse the course of the STI epidemic.
“STDs will not wait for the pandemic to end, so we must rise to the challenge now,” Romaguera said. “These new data should create a sense of urgency and mobilize the resources needed, so that future reports can tell a different story.”
