As students return to school, COVID-19 infections among children are up by about 240 percent since July. This week, the COVID-19 death toll in the United States surpassed that of the 1918 flu pandemic, with more than 1 in 500 Americans having lost their lives to COVID-19. Death rates continue to be disproportionately higher among Black, Latino, and American Indian and Alaskan Native people. At the same time, the summer surge of COVID-19 cases seems to be slowing, with averages of new daily cases and hospitalizations declining. [IMPAQ 9.24.2021] 

Vaccine and Booster Updates. The FDA granted emergency use authorization to the Pfizer booster shot. Use is limited to adults 65 or older adults, 18 or older at high risk for severe illness, and those at high risk of exposure due to their jobs, such as health care workers. Additionally, recent CDC research concluded that unvaccinated people are 11 times more likely to die from COVID-19 than those who have been vaccinated. In other vaccine news:

·    President Biden’s recently announced vaccine mandate for employers with at least 100 workers will be written by the Occupational Safety and Health Administration.

·    A pediatric study of the Pfizer vaccine showed that children ages 5-11 who received a lower dose of the vaccine had comparable antibody responses to participants ages 16-25 who received the typical adult dosage. Children also had comparable side effects to the 16-25 group. Pfizer plans to file for emergency authorization of its COVID-19 vaccine for children under 11 in October.

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Healthcare workers are now among those eligible to receive a COVID-19 booster shot, as the FDA on Sept. 22 granted emergency use authorization for a booster dose of Pfizer's COVID-19 vaccine for Americans who are ages 65 and older, have a job that increases their risk of infection and are at high risk of severe COVID-19.

Five things to know:

1. Those who are eligible may receive a Pfizer booster shot at least six months after their second dose.
   
   
2. Acting FDA Commissioner Janet Woodcock, MD, said the country's booster strategy is subject to change as more data becomes available on COVID-19 vaccines' protection over time. The booster rollout will likely be staggered, starting with the populations deemed most vulnerable.
   
   Dr. Woodcock said the FDA is prioritizing healthcare workers, teachers, day care staff, grocery workers and those in homeless shelters or prisons due to their institutional or occupational exposure to COVID-19.
   
   
3. The CDC's Advisory Committee on Immunization Practices will hold a meeting Sept. 23 at which they will decide who falls under the category of people who are at high risk of severe COVID-19.
   
   
4. The FDA has not explicitly addressed when or if the millions of Americans who received COVID-19 vaccines made by Moderna and Johnson & Johnson will be eligible for booster doses. The agency still needs to review data produced by those drugmakers.
   
   
5. About 22 million Americans received their second Pfizer dose at least six months ago, according to the CDC. About half of them are 65 and older. 

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Young and middle-aged adults (25-64 years old) in the U.S. have been dying at higher rates since 2010, according to a new report from the National Academies of Sciences, Engineering, and Medicine. High and Rising Mortality Rates Among Working-Age Adults says that rising death rates are striking working-age Americans, whose risk of dying from certain conditions — such as drug overdoses or hypertensive heart disease — has been climbing since the 1990s.

The comprehensive report, based on data from 1990-2017, documents a public health crisis sweeping the American workforce, which has profound implications for families, employers, and the U.S. economy. This trend was prevalent before the pandemic arrived, but working-age Americans have been deeply affected by the pandemic, the report notes. Americans are more likely to die before age 65 than peers in other rich nations.

The rising death rate is due primarily to drug overdoses, alcohol, suicides, and cardiometabolic conditions — a category that includes diabetes and heart diseases caused by high blood pressure and other conditions. The report recommends urgent policy actions in light of this crisis, including addressing the overdose epidemic, the underlying causes of substance use disorders more broadly, access to mental health services, and stronger efforts to tackle obesity.

New Report release: The past century has witnessed remarkable advances in life expectancy in the United States and throughout the world. In 2010, however, progress in life expectancy in the United States began to stall, despite continuing to increase in other high-income countries. Alarmingly, U.S. life expectancy fell between 2014 and 2015 and continued to decline through 2017, the longest sustained decline in life expectancy in a century (since the influenza pandemic of 1918-1919). The recent decline in U.S. life expectancy appears to have been the product of two trends: (1) an increase in mortality among middle-aged and younger adults, defined as those aged 25-64 years (i.e., "working age"), which began in the 1990s for several specific causes of death (e.g., drug- and alcohol-related causes and suicide); and (2) a slowing of declines in working-age mortality due to other causes of death (mainly cardiovascular diseases) after 2010.

Download: High and Rising Mortality Rates Among Working-Age Adults | The National Academies Press (nap.edu)

More online info here

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The recently announced U.S. Department of Agriculture’s Emergency Rural Health Care Grant will support projects that broaden access to rural health care services by increasing telehealth capabilities in rural America. Is your organization prepared to apply?

During this 60-minute interactive webinar, grant experts Angela Connor, Director of Grants and Public Funding at Amwell, and Maureen Meyer, MBA, GPC, an independent grants consultant for Amwell, offer an in-depth overview of the Emergency Rural Health Care Grant and tips for developing a competitive application.

Watch this webinar to learn about:

• Applicant eligibility and scoring
• Eligible uses of funding and cost-sharing
• The application process

Webinar and details here

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Racial Disparities in Maternal Health -U.S. Commission on Civil Rights-2021 Statutory Enforcement Report (9.15.2021)

Excerpt from the report: 

Dr. Joia Crear-Perry, Founder and President of the National Birth Equity Collaborative, testified to the Commission about some of the causes of racial disparities in maternal health outcomes, writing that:

We know the root causes of poor maternal health—racism and gender oppression inside of healthcare systems and every other facet of society. Women of color are more likely to experience a comorbid illness and report being unfairly treated within healthcare settings based on their race or ethnicity. The inequities that Black women face have become even more urgent as the pandemic and civil unrests show the many ways racism can kill,  whether from COVID, police brutality or hemorrhaging during childbirth. 26  Each year, nearly 700 women in the U.S. die due to complications of pregnancy or delivery  either during their pregnancy or within one year of the end of their pregnancy.27 A woman today  is “50 [percent] more likely to die in childbirth than her own mother was.”28

During the Commission’s briefing in November 2020, Associate Director for Science in the Division of Reproductive Health at the Centers for Disease Control and Prevention Shanna Cox testified that:

[T]he pregnancy-related mortality ratio in the U.S. is not decreasing, and given these  deaths are largely preventable, these numbers are absolutely unacceptable. Considerable racial disparities exist, with Black and Native women two to three times more likely to die from pregnancy-related complications than White women.29 25

Download full report 

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More States Seeing Uptick of Pregnant COVID Patients in ICUs

— Nearly all are unvaccinated, sources say

A report from the University of Alabama at Birmingham (UAB) in August revealed that there had been a sharp increase in the number of pregnant patients who were being hospitalized with COVID-19. Nearly a month later, physicians from other states have started to voice similar concerns about the growing number of unvaccinated pregnant patients who have been admitted to ICUs with severe infection. [ MedPage Today]

Mississippi state health officials announced on September 9 that eight pregnant women had died from COVID-19 in recent weeks; their babies were all delivered prematurely and survived, said state medical officer Thomas Dobbs, MD, MPH, during a press conference. 

... In Illinois, cities like Springfield and Peoria are also seeing more ICU admissions for pregnant COVID patients.  Michael Leonardi, MD, an ob-gyn who specializes in high-risk pregnancies at OSF HealthCare in Peoria, told MedPage Today that, starting roughly 6 weeks ago, pregnant COVID patients have been admitted to OSF with growing frequency.

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The National Institute of Mental Health (NIMH) recently released the 2021 Annual Update to the NIMH Strategic Plan for Research to keep pace with ever-evolving scientific approaches and research priorities. The Plan, originally published in 2020, guides NIMH grantees, potential grant applicants, and staff in the design and implementation of future research.

The updated Strategic Plan continues to emphasize investments in the research workforce and research on mental health disparities, while also highlighting new efforts, such as the Accelerating Medicines Partnership® - Schizophrenia (AMP® SCZ) initiative. In addition, it includes an updated Message from the Director and a new section on COVID-19.

NIMH also developed a companion Progress Report, highlighting significant accomplishments made during fiscal year 2020 toward achieving the goals described in the Strategic Plan. The shareable one-page Progress Report can be found in the Our Progress section in the digital version of the Plan. We also encourage you to visit the Progress pages, where we highlight key contributions of NIMH-funded investigators in advancing research toward achieving the four Goals of the NIMH Strategic Plan for Research and the Institute's mission.

More details and Strategic Plan 

Download NIMH Strategic Plan 

Progress Report 

Check back with us and register for the upcoming Mental Health program session in early 2022. 

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The U.S. Census Bureau announced today that median household income in 2020 decreased 2.9% between 2019 and 2020, and the official poverty rate increased 1.0 percentage point. Meanwhile, the percentage of people with health insurance coverage for all or part of 2020 was 91.4%. An estimated 8.6% of people, or 28.0 million, did not have health insurance at any point during 2020, according to the 2021 Current Population Survey Annual Social and Economic Supplement (CPS ASEC).

The Supplemental Poverty Measure (SPM) rate in 2020, also released today, was 9.1%. This was 2.6 percentage points lower than the 2019 SPM rate. The SPM estimates reflect post-tax income that include stimulus payments. The SPM provides an alternative way of measuring poverty in the United States and serves as an additional indicator of economic well-being.

More> 

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People with moderately to severely compromised immune systems are especially vulnerable to COVID-19 and may not build the same level of immunity to 2-dose vaccine series compared to people who are not immunocompromised. CDC recommends that people with moderately to severely compromised immune systems receive an additional dose of mRNA COVID-19 vaccine at least 28 days after a second dose of Pfizer-BioNTech COVID-19 or Moderna COVID-19 vaccine. This additional dose is intended to improve the response of people who are immunocompromised to their initial vaccine series.

Although CDC does not recommend additional doses or booster shots for any other population at this time, HHS has announced a plan to begin offering COVID-19 vaccine booster shots this fall. 

More> 

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