Army Public Health Weekly Update, 05 November 2021

Date Published: 11/5/2021
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​​​The Army Public Health Update is a collection of articles taken from public sources to offer awareness of current health issues and the media coverage given to them. The articles do not necessarily represent U.S. Army Medical Command opinions, views, policy, or guidance, and should not be construed or interpreted as being endorsed by the U.S. Army Medical Command.

The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the U.S. Army and is not a medical intelligence product. Medical intelligence is available from the National Center for Medical Intelligence External Link .

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Table of Contents


    COVID-19 Vaccines for Children and Teens

    2 November- CDC now recommends that children between the ages of 5 and 11 years receive the Pfizer-BioNTech pediatric COVID-19 Vaccine. Get more information and read CDC's media statement. CDC External Link

    ​COVID-19 Vaccine​​ Quick Reference Guide for Healthcare Professionals​

    ​26 October - This Quick Reference Guide provides basic information on the proper storage, preparation, and administration of the currently authorized COVID-19 vaccine products in the United States. For additional infor​mation and detailed clinical guidance go to the manufacturers' website and CDC’s webpages listed.​​ CDC​ External Link


    Are you prepared for flu season? Let TRICARE help

    1 November- Flu season is here once again. Are you prepared? With the COVID-19 Delta variant continuing to spread and our health care system overburdened, it's important for all of us to help combat the spread of flu. And the best way to do so is to get a flu shot. "Getting the flu vaccine is about far more than just protecting yourself," said Army Lt. Col. (Dr.) Christopher Ellison, deputy director of operations for the Defense Health Agency Immunization Healthcare Division. "Even healthy people have a responsibility to reduce the overall impact of respiratory diseases on the population, particularly the most vulnerable members."

    Who needs a flu shot?

    The Centers for Disease Control and Prevention recommends a yearly flu vaccine for everyone 6 months of age and older. If you're at higher risk of developing serious flu complications, it's particularly important to get the vaccine. People at high risk for flu-related complications if they get sick include adults age 65 and over, people with underlying health conditions, pregnant women, infants, and young children. If you aren't sure if you should get the flu vaccine, talk to your doctor.

    Where can I get a flu shot?

    TRICARE covers the flu vaccine. You can get a vaccine at no cost in three ways:

    1. At a military hospital or clinic

    You can get your flu shot at your local military hospital or clinic. The vaccine will continue to be available at military facilities through the entire flu season. Flu season usually runs from October through May. Most of the time flu activity peaks between December and February. Getting vaccinated now can lower your chances of getting the flu.

    Did you schedule your COVID-19 vaccine through the Defense Health Agency Appointing Portal(DAP)? You can now use DAP to schedule your flu vaccine at a military hospital or clinic close to you.

    2. At a participating TRICARE retail network pharmacy

    If you get your flu vaccine at a TRICARE retail network pharmacy, the pharmacist must administer the vaccine for it to be covered by TRICARE. Search online or call 1-877-363-1303 to find a retail network pharmacy in the U.S. and most U.S. territories.

    If you get your vaccine at a non-network pharmacy, you may have out-of-pocket expenses and need to file a claim for reimbursement. If you're overseas, a non-network pharmacy may be your only option. Visit Pharmacy Claims for information on how you can file a claim.

    3. Using a TRICARE-authorized provider

    You can go to a TRICARE-authorized provider at a participating network onsite clinic. If you go to your doctor for the vaccine, you'll need to pay your copayment or cost-share for the office visit. If you get the flu vaccine administered by a TRICARE-authorized non-network provider, you may have to pay out-of-pocket expenses and need to file a claim for reimbursement. Be sure to follow the rules of your TRICARE plan. To find a TRICARE provider near you, use Find a Doctor to search the provider directory. External Link

    Army distributes over 1.5 million doses of flu vaccine

    28 October- As the annual flu season ramps up, the U.S. Army Medical Materiel Agency is hard at work distributing more than 1.5 million doses of vaccine to protect the fighting force, their Families and retirees. The Army's allotment of the yearly influenza vaccine makes up nearly half of the 3.3 million doses currently being distributed throughout the Department of Defense, according to Liz Andrews, deputy director of USAMMA's Distribution Operations Center, or DOC. USAMMA's DOC oversees the annual distribution process for active-duty and reserve Soldiers, as well as Department of Army Civilians and Family members. The organization works closely with other DOD agencies to ensure prompt delivery and availability each year. “This season is going really well," Andrews said. “We are ahead of schedule compared to the last four years. Early requirement gathering and early solicitation from the Defense Logistics Agency has enabled this season to be a success." USAMMA is a direct reporting unit to Army Medical Logistics Command. Both units are headquartered at Fort Detrick, Maryland. While seasonal influenza viruses can circulate year-round, they typically begin increasing in October before peaking between December and February in the U.S., according to the Centers for Disease Control and Prevention. However, significant flu activity can last as late as May. Clinicians recommend getting a flu shot every year, and especially now during the ongoing COVID-19 pandemic. The most effective way to protect yourself from both influenza and COVID-19 is to get vaccinated against both viruses, according to the World Health Organization. Flu season was less significant in 2020 due to several reasons, including that many people more often wore masks when out in public, practiced physical distancing, frequently washed hands or simply stayed home in an effort to protect against possible COVID-19 infection. “This year's season is expected to be much higher due to more people traveling again," said Lt. Col. Todd Reeder, pharmacy consultant and director of the DOC. “People should still continue to wear their mask as they are effective in preventing the spread of droplets from a sneeze or cough." In addition to handwashing and continued physical distancing when possible, Reeder said an annual flu shot continues to be the best preventative measure against the flu virus. DVIDS External Link 

    Military's base-by-base suicide numbers reveal startling statistics at some of the highest-profile installations

    1 November- Some of the military's highest-profile bases in 2020 had the greatest number of suicides, a troubling trend for the Pentagon as it contends with a growing number of troops dying not in combat but in their own homes and barracks. The Marine Corps' Camp Lejeune and the Army's Fort Bragg, both in North Carolina, saw 21 troops die by suicide in 2020, according to Pentagon data obtained by USA TODAY. Fort Carson in Colorado had 18 such deaths in 2020. The Pentagon, in a document attached to the suicide figures, cautioned against ranking them by risk, noting that the populations of the installations vary by size: Lejeune has more than 38,000 troops. Bragg has 50,000 and Fort Carson has more than 25,000 soldiers, according to the Army. USA Today External Link


    CDC expected to sign off on vaccine for children ages 5 to 11

    3 November- Advisers to the Centers for Disease Control and Prevention are meeting Tuesday to discuss giving the Pfizer-BioNTech coronavirus vaccine to children ages 5 to 11 and are expected to recommend moving forward. The Food and Drug Administration has already authorized the two-shot regimen, in which each vaccine dose is one-third of that used for adolescents and adults. CDC Director Rochelle Walensky is expected to sign off later Tuesday on the recommendation from the Advisory Committee on Immunization Practices, allowing clinicians, pharmacies and other health-care providers to start giving the shots as early as Wednesday. The vaccination effort is expected to be fully running by next week, said Jeff Zients, the White House coronavirus coordinator, at a news conference Monday. Biden administration officials have said the government has enough of the Pfizer-BioNTech vaccine for all 28 million children in this age group. States, territories and other jurisdictions began placing initial orders about two weeks ago, and workers at Pfizer and at distribution centers have begun the process of preparing and packing 15 million doses, Zients said. The Washington Post External Link

    FDA authorizes Pfizer's Covid-19 vaccine for children 5 to 11

    29 October- The US Food and Drug Administration issued emergency use authorization on Friday for Pfizer's Covid-19 vaccine for children 5 to 11. This is the first Covid-19 vaccine authorized in the United States for younger children. The FDA's vaccine advisers voted 17-0 with one abstention on Tuesday to recommend EUA for the vaccine, which is formulated at one-third the dose of the vaccine used for people 12 and older. Pfizer says a clinical trial showed its vaccine provides more than 90% protection against symptomatic disease among children, even at one-third the dose, and the company hopes the lower dose will reduce the risk of any side effects. Shots can't be administered yet -- the question now goes to the US Centers for Disease Control and Prevention. The CDC's vaccine advisers, the Advisory Committee on Immunization Practices, meet November 2 to discuss whether to recommend use of the vaccine among US children. Then the CDC director, Dr. Rochelle Walensky, makes the final decision on use of the vaccine. The White House says it has a plan already in place for distributing vaccines to children. Vaccines could be administered as soon as the CDC signs off. Pfizer's Covid-19 vaccine was previously authorized for children ages 12 to 15. The vaccine is approved for people age 16 and older. The American Academy of Pediatrics welcomed the decision. CNN External Link

    Hormones changing? This may be caused by fast food consumption found in most U.S. restaurants says study

    3 November- Hormonal change is sometimes normal for a growing teenager or young adult, but too much is not, so some go to the doctor for questions and what to do on this. However, a new study has found out that a component recently found on fast food items from US restaurant chains may contribute to a hormonal imbalance and changes, hence the warning. According to a research by Lariah Edwards and other members of the team in the paper entitled "Phthalate and novel plasticizer concentrations in food items from U.S. fast-food chains: a preliminary analysis," fast food items have phthalates plasticizer in them. Moreover, this causes massive changes in hormones such as estrogen and testosterone, or some of the basic hormones that a human body has. These hormones are also important to the everyday lifestyle of people and having chemicals affecting them can also cause a toll on a person's health and daily functions. Research regarding Phthalates also indicates it leads to harmful diseases and conditions such as impeding neurodevelopment and developing obesity in the long run. Tech Times External Link

    How does a pandemic start winding down? You are looking at it

    31 October- The pandemic isn't over. But new cases nationally have dropped below 75,000 a day, less than half the number in August. The United States will soon reopen land borders to vaccinated visitors and lift several international travel restrictions. More than 2 million people boarded flights last Sunday, not too far from pre-pandemic travel levels. Kids, many of them newly vaccine-eligible, are back in school, with no massive surge of new coronavirus infections. Some older students, forced to mask, wear their face coverings as if they were chin guards. The holidays are coming, and it won't be like 2020 this time. It's already obvious in the Halloween decorations, so over-the-top it looks like people are overcompensating for last year's depressed trick-or-treating. The pandemic appears to be winding down in the United States in a thousand subtle ways, but without any singular milestone, or a cymbal-crashing announcement of freedom from the virus. “It doesn't end. We just stop caring. Or we care a lot less," Jennifer Nuzzo, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, said when asked when the pandemic would be over. “I think for most people, it just fades into the background of their lives." There could still be a winter surge since respiratory viruses thrive when people huddle in heated rooms. Some experts said they expect at least a modest uptick in infections over the next few weeks. Last year's brutal winter wave of infections, which peaked in January, was just getting rolling at this point on the calendar. And although aggregate national numbers are lower, many cold-weather states, particularly in the Mountain West, have recently seen a rise in cases and hospitalizations. Alaska, slipping into its dark winter, has the highest infection rate in the nation. The Washington Post External Link

    Minimal Guillain-Barre syndrome risk confirmed following Zoster vaccination

    2 November- An Original Investigation published by the JAMA Network on November 1, 2021, confirmed a case series cohort study found a slightly increased risk of Guillain-Barré syndrome during the 42 days following RZV vaccination in the Medicare population. Approximately three excess Guillain-Barré syndrome (GBS) cases per million vaccinations were identified. Amongst those who received a Zoster vaccine in this study, the mean age was 74.8 years at first dose, and 58% were women. In summary, these researchers suggest 'Clinicians and patients should be aware of this risk while considering the benefit of decreasing the risk of herpes zoster and its complications through an efficacious vaccine, as a risk-benefit balance remains in favor of vaccination.' Shingles, also known as herpes zoster, is a painful skin rash caused by reactivation of the varicella-zoster virus, which causes chickenpox. This finding supports the U.S. FDA's action during March 2021. The FDA evaluated data from a post marketing observational study that assessed the risk of GBS following vaccination with Shingrix. Based on this evaluation, FDA has determined that the results of an observational study showed an association of GBS with Shingrix. But that available evidence is insufficient to establish a causal relationship. In response, the FDA issued a Safety Communication to inform the public and healthcare providers that the FDA has required and approved safety labeling changes to the Prescribing Information for Shingrix (Zoster Vaccine Recombinant, Adjuvanted) to include a new warning about the risk for GBS following administration of Shingrix. Precision Vaccinations External Link

    Novavax COVID-19 vaccine gets first authorization; expects more within weeks, CEO says

    1 November- Novavax Inc. (NVAX.O) expects regulators in India, the Philippines and elsewhere to make a decision on its COVID-19 vaccine within "weeks," its chief executive told Reuters, after the shot on Monday received its first emergency use authorization (EUA) from Indonesia. Novavax shares were up about 13% after the company also said it had filed an application for emergency use of the vaccine to Canada and the European Medicines Agency. For Indonesia, the shot will be manufactured by the world's largest vaccine manufacturer, Serum Institute in India (SII), and sold under the Indian company's brand name, Covovax. Novavax said initial shipments into Indonesia are expected to begin imminently. The World Health Organization (WHO) is also reviewing Novavax's regulatory filing and the U.S. drugmaker expects that review to be resolved in the coming weeks, Chief Executive Stanley Erck told Reuters in a phone interview on Monday. A green light from the WHO would set the stage for Novavax to begin shipping doses to the COVAX program that supplies shots to low-income countries. Novavax and SII have together committed to provide more than 1.1 billion doses to COVAX, which is co-led by the WHO. “I think we'll get some doses to COVAX this year," Erck said. "But I think (Novavax is) going to really start being able to ship large quantity to COVAX in the first quarter" of 2022. Reuters External Link

    The COVID-19 pandemic has now killed 5 million people around the world

    1 November- Global deaths from COVID-19 have now surpassed 5 million, according to the data released Monday from Johns Hopkins University's coronavirus tracker. The U.S. leads the world in the number of confirmed deaths from the virus with more than 745,800 people dead from COVID-19. Brazil (with more than 607,000 deaths) and India (with more than 450,000 deaths) follow the U.S. in the number of lives lost since the start of the pandemic. Yet another tragic milestone of the pandemic comes just as the U.S. prepares to start vaccinating children between the ages of 5 and 11. But in other parts of the world, health officials are seeing worrying signs of a coronavirus surge — just as some nations are relaxing measures to international travelers. This official global tally only accounts for confirmed cases around the world, according to Amber D'Souza, professor of epidemiology at the university's Bloomberg School of Public Health, who spoke to National Geographic. Prior to Johns Hopkins releasing the latest global data on Monday D'Souza told the outlet: "It's quite possible that the number of deaths is double what we see. But 5 million is such a staggering number on its own. No country has been able to escape it." NPR External Link

    U.S. has administered over 422 million doses of COVID-19 vaccines -CDC

    31 October- The United States had administered 422,070,099 doses of COVID-19 vaccines in the country as of Sunday morning, the U.S. Centers for Disease Control and Prevention said. Those figures were up from the 420,657,683 vaccine doses the CDC said had gone into arms by Saturday. The agency said 221,520,153 people had received at least one dose, while 192,453,500 people were fully vaccinated as of 6 a.m. EDT on Sunday. The CDC tally includes two-dose vaccines from Moderna Inc. (MRNA.O) and Pfizer Inc./BioNTech (PFE.N)(22UAy.DE), as well as Johnson & Johnson's (JNJ.N) one-shot vaccine. About 18.6 million people have received a booster dose of either Pfizer, Moderna or Johnson & Johnson's COVID-19 vaccine. Booster doses from Moderna and Johnson & Johnson were authorized by the U.S. health regulator on Oct. 20. Reuters External Link


    CDC: Weekly U.S. Influenza Surveillance Report

    Key Updates for Week 42, ending October 23, 2021:

    HHS-Protect Hospitalization Surveillance- Hospitals report to HHS-Protect the number of patients admitted with laboratory-confirmed influenza. During week 42, 288 patients with laboratory-confirmed influenza were admitted to the hospital.

    Influenza-Associated Pediatric Mortality- No influenza-associated pediatric deaths occurring during the 2021-2022 season have been reported to CDC. CDC External Link


    Officials find plastic in organic smoothie product; company launches recall

    31 October- PataFoods Inc. dba Amara is recalling Amara brand “Organic Smoothie Melts" from the marketplace because of the potential presence of pieces of plastic. Canadian officials are concerned that consumers may still have the frozen products on hand because their expiration dates run into 2023. Consumers should not consume the recalled product described below, according to the recall notice posted by the Canadian Food Inspection Agency. The company reports that the carrot-raspberry smoothie product was distributed in the provinces of Alberta and Ontario, with national distribution possible. “This recall was triggered by Canadian Food Inspection Agency (CFIA) test results. The CFIA is conducting a food safety investigation, which may lead to the recall of other products," according to the recall notice. As of the posting of the notice no injuries or other adverse effects had been reported in connection with the product. Food Safety News External Link

    Warning after counterfeit Nestlé coffee found in Germany

    1 November- A counterfeit version of Nestlé branded coffee has been found on sale in Germany and may contain foreign objects. Nestlé Deutschland reported the product was packaged in a glass jar that looked like an old version of Nescafé Gold. There are also concerns it may contain broken glass and plastic. The food firm said it had not manufactured or distributed the implicated product and had not used this shape of glass for Nescafé Gold for years and it is not commercially available. The counterfeit product is known to have been sold at weekly markets and smaller shops but other details about the incident remain unclear. It has an EAN code of 405500210900, batch number 60820814B1 9:15 and best before date of 10-21. People who have purchased a counterfeit pack are advised to inform the police and stop consuming the coffee. Nestlé has contacted the relevant authorities and urged them to investigate and stop the fraud. Food Safety News External Link


    Peanut allergies: What to know before kids return to school

    28 October- Peanut allergies are one of the most common causes of severe allergy attacks and the most common food allergy in children under age 18. With children once again returning to classroom settings amidst the COVID-19 pandemic and vaccinations being opened up to younger age groups, food allergies remain a growing food safety and public health concern. According to the U.S. Centers for Disease Control and Prevention (CDC), food allergies impact about 2 students per classroom. Peanuts are one of eight foods or food groups that account for the most serious allergic reactions in the U.S. Strict avoidance of the food allergen is the only way to prevent a reaction and, with peanut allergies, constant vigilance and attention are required. According to the Mayo Clinic, peanut allergy occurs when the immune system mistakenly identifies peanut proteins as harmful substances and direct and indirect contact can cause the immune system to release symptom-causing chemicals into the bloodstream. Symptoms include skin reactions like hives or swelling, itching or tingling around the mouth and throat, digestive issues like diarrhea or vomiting, a tightening of the throat, runny nose and shortness of breath or wheezing. Additionally, peanut allergy is the most common cause of food-induced anaphylaxis, with requires treatment with an epinephrine auto injector and a trip to the emergency room. Fox News External Link 


    DRC Ebola outbreak rises to 8 cases, 6 deaths

    2 November- In a follow-up on the Ebola Virus Disease (EVD) outbreak in the Democratic Republic of the Congo (DRC), health authorities reported two new cases in new Health Areas (HA) of Ngilinga and Bundji (one each) in Beni Health Zone (HZ) in North Kivu Province. To date, three HAs have reported confirmed cases, namely, Butsili HA (6 cases), Bundji (one case) and Ngilinga HA (one case). As of 30 October 2021, total of eight confirmed cases of EVD have been reported in Beni HZ in the Democratic Republic of the Congo, with six deaths (including four community deaths) (case fatality ratio (CFR) 75.0%). Children below the age of five years accounts for 50.0% (4/8) of the cases. A total of 551 contacts are under follow up, of which 448 (81.3%) are being actively followed up, 70 (12.7%) contacts had never been seen, 11 contacts have not been seen in the past 48 hours and 9 (1.6%) contact are lost to follow-up. Vaccination efforts continue around all confirmed cases. Vaccinators are using the “ring vaccination" approach, where contacts and contacts of contacts are vaccinated. Outbreak News Today External Link


    Israel: AY4.2 Delta variant detected

    20 October- The Israel Ministry of Health reported Tuesday the AY4.2, previously detected in several European destinations, variant was detected in Israel. The patient in question is an 11-year-old boy who was detected already upon arrival in Ben Gurion International Airport, ordered to go into isolation and currently there are no additional confirmed contacts. Investigation is underway. The Ministry of Health regularly monitors variants of concern of all types and their development. Scientists said AY4.2 carries two characteristic mutations in the spike, Y145H and A222V, both of which have been found in various other coronavirus lineages since the beginning of the pandemic. The first strains carrying both mutations were sequenced in April 2020. AY4.2 is rare outside the UK. Outbreak News Today External Link


    H5N1 avian influenza confirmed at a wildbird rescue centre in Worcestershire, UK

    26 October- The UK Chief Veterinary Officer has confirmed a case of H5N1 avian influenza (bird flu) at a wildbird rescue centre in Worcestershire today. Wild birds migrating to the UK from mainland Europe during the winter months can carry the disease and this can lead to cases in poultry and other captive birds. All birds on site will be humanely culled. A 3km and 10km temporary control zone has also been put in place around the infected premises to limit the risk of the disease spreading. UK Health Security Agency advises that the risk to public health from the virus is very low and the Food Standards Agency has made clear that bird flu poses a very low food safety risk for UK consumers. The premises does not supply poultry, meat or eggs to the commercial food chain. Outbreak News Today External Link


    China: Another H5N6 avian influenza case reported in Hunan Province

    1 November- The government of Macao (computer translated) reported an additional H5N6 avian influenza case on Mainland China in Hunan Province. According to data, the patient is a 58-year-old female farmer living in Yongzhou City, Hunan Province. She developed symptoms on August 29 and was admitted to the hospital on August 31. She is now in a serious condition and had a history of exposure to the live poultry market before the onset of illness. Since April 2014, there have been confirmed cases of H5N6 avian influenza in Sichuan, Guangdong, Yunnan, Hubei, Hunan, Anhui, Guangxi Zhuang Autonomous Region and Jiangsu. This case would be the 51st case reported in China in the past 7 years. The Health Bureau urged residents to avoid contact with poultry and birds and pay attention to personal and food hygiene. Outbreak News Today External Link


    U.S.: Delaware- Reports 1st flu cases of the season

    1 November- Delaware state health officials report the first two laboratory-confirmed cases of influenza for the 2021-2022 flu season, including the first pediatric case of the season. The cases involve a Kent County child under the age of 5, infected with influenza strain B, who was hospitalized, as well as a 26-year-old Sussex County woman, with influenza strain A, who was not hospitalized. Neither individual had received the flu vaccine. “This first case of the flu is an excellent reminder for us to get our flu vaccine as soon as possible," said DPH Director Dr. Karyl Rattay. “We must not get lulled into a false sense of security with last year's unusually low case numbers. With Delawareans resuming pre-pandemic activities, the flu is a definite threat to our health. Because hospitals and physicians' offices are already taxed with COVID-19 cases, we must do everything we can to prevent adding more to their burden and the flu vaccine is a very good start." The flu vaccine is recommended for Delawareans 6 months of age and older and can be administered at the same time as the COVID-19 vaccine. Since it takes approximately two weeks after vaccination for antibodies that protect against influenza virus infection to develop in the body, it is important to get vaccinated as early as possible to give your body time to build immunity. Getting the flu vaccine now will also provide protection during the entire flu season. Outbreak News Today External Link


    Chikungunya in the Americas: More than 120K cases reported, 97% in Brazil

    30 October- The Pan American Health Organization (PAHO) reports 122,203 chikungunya cases year to date in the Americas. This compares with 103,000 total cases reported in all of 2020. Brazil accounted for more than 97 percent of the total with 119,019 cases, including 57,221 confirmed cases. This is followed by Guatemala with 1,091 cases and Belize with 737. Eight fatalities were reported in the region, all in Brazil. Chikungunya is a viral disease transmitted to humans by infected mosquitoes. It causes fever and severe joint pain, which is often debilitating. Other symptoms include muscle pain, headache, nausea, fatigue, and rash. The disease shares some clinical signs with dengue and Zika, and can be misdiagnosed in areas where they are common. As there is no cure, treatment is focused on relieving the symptoms. Outbreak News Today External Link