Becker's Clinical Quality & Infection Control

18 INFECTION CONTROL HPV vaccination rates could eradicate cervical cancer in North Dakota By Erica Carbajal I n 2019, nearly 90 percent of adolescents in North Dakota received at least one dose of the HPV vaccine. As a result of the high vaccination rate, health officials say cervical cancer could soon be eradicated in the state, the Grand Forks Herald reported June 1. "We do have the potential, through vaccination and also preventive screen- ings, to completely eliminate a cancer, and that's really exciting," Molly How- ell, state immunization manager, told the news outlet. Eighty-eight percent of adolescents aged 13 to 17 in North Dakota started the vaccination series for HPV in 2019, the most common sexually transmit- ted infection in the U.S., while 77 percent completed the vaccination series. With those numbers, the state had the second-highest HPV vaccination rate in the country, the Grand Forks Herald reported. Across the entire U.S., 72 percent of teens got their first HPV vaccination shot in 2019, while 54 percent completed the series. Ms. Howell said encouragement from primary care providers is behind the state's high HPV vaccination rate, as well as why rates remained steady amid the COVID-19 pandemic. As of June 1, most states, including North Dakota, do not mandate the HPV vaccine, though several do as part of school vaccination requirements, ac- cording to data from the National Conference of State Legislatures. n Drop in pediatric vaccinations amid pandemic may pose 'serious public health threat': CDC By Gabrielle Masson M any children are still behind on routine vaccinations after vaccination levels dropped dramatically during the early months of the pandemic, according to CDC data published June 10. The vaccina- tion drop may raise the risk of other outbreaks that could derail school reopenings, the CDC said. CDC researchers analyzed data from 10 jurisdictions between March and May 2020 and found that shots for children and teens were substantially lower for routine vaccinations — including DTaP (diphtheria, tetanus and acellular per- tussis), measles and HPV — across all age groups, compared to the same three-month period in 2018 and 2019. The drop in HPV vaccinations is espe- cially worrisome, experts say. Instead of showing up immediately, HPV infec- tions can take years to develop into can- cer, according to the CDC. After some stay-at-home orders were lifted in summer of 2020, weekly rou- tine pediatric vaccine doses increased in most areas, even surpassing pre-pan- demic levels in some places. Howev- er, the rebound "was not sufficient to achieve the catch-up vaccination need- ed to address the many months when children missed routine vaccination," the CDC said. Furthermore, the lag may pose "a serious public health threat that would result in vaccine-preventable dis- ease outbreaks, especially in schools that have reopened for in-person learn- ing," according to the CDC. The CDC recommends providers give COVID-19 vaccines on the same day as other vaccines. The agency revised its guidance in May to allow for the shot to be given at the same time as others. n COVID-19 severity not directly linked to infectiousness, study suggests By Mackenzie Bean P eople with mild or asymptomatic COVID-19 cases may be just as infectious as those with severe cases who require hospitalization, a study published May 25 in Science found. A team led by researchers in Berlin analyzed data on 25,381 COVID-19 samples collected in Germany between Feb. 24, 2020, and April 2. Of these cases, 9,519 involved hospitalizations, and 1,533 involved infections from the alpha variant first found in the U.K. ey analyzed viral load for each sample and used the results to estimate infectiousness levels. Five study findings: 1. Only 8 percent of patients had high viral loads, which suggests greater infectiousness. 2. Of these individuals with high viral loads, about one-third either had no symptoms or had mild symptoms. 3. Overall, viral loads were lowest among children and increased with age. 4. Laboratory-based estimates of infectivity were 2.6 times higher for people infected with the alpha variant compared to those infected with other virus strains. 5. Patients with mild or no symptoms had higher viral loads at the time of their first posi- tive COVID-19 sample, compared to hospitalized patients for ages up to 70 years. n

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