Ms. Hester is Content Specialist with Contemporary OB/GYN and Contemporary Pediatrics.

Miranda Hester

The Centers for Disease Control and Prevention (CDC) have produced the first set of 

 for people who have received either 2 doses of the Pfizer/BioNTech or Moderna vaccine or the 1 dose of the Johnson & Johnson/Janssen vaccine.

For the purposes of the guidance, a person is considered fully vaccinated for COVID-19, ≥2 weeks after receiving the second dose of the 2-dose vaccines and the ≥2 weeks after receiving the vaccine of the single-dose vaccine. The recommendations are also only for non-health care settings.

Visit with other fully vaccinated people in an indoor space without mask wearing or social distancing.

Visit with unvaccinated people from a single household without mask wearing or social distancing, if the unvaccinated people are at low risk for severe COVID-19 disease

Abstain from quarantine and testing after a known exposure, if the exposure was to asymptomatic people.

The guidance also recommends that fully vaccinated people continue to:

Wear a well-fitted face covering in public

Continue mask wearing, social distancing, and other infection control measures when visiting with unvaccinated people at increased risk of severe disease or if visiting with unvaccinated people from multiple households

Undergo testing if COVID-19 symptoms occur

Follow CDC and health department travel requirements

Continue avoiding medium- and large-sized in-person gatherings.

1. Centers for Disease Control and Prevention. Interim public health recommendations for fully vaccinated people. Published March 8, 2021. Accessed March 8, 2021. 

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-guidance.html

Articles

The CDC has issued interim guidance for masking, social distancing, hand hygiene, and other infection control measures for people who are fully vaccinated for COVID-19.

CDC Issues First Recommendations For People Fully Vaccinated for COVID-19

As the United States approaches the 1-year anniversary of the start of shut downs related to the coronavirus 2019 (COVID-19) disease in the United States, there’s a sense of both hope, due to the recent authorization of 3 vaccines, and fatigue because many people feel worn out from dealing with business, educational and recreational closings and limitations.

Accelerated vaccination efforts, rumored easing of 

 recommendations among those who have been fully vaccinated, and the complete lifting of masking restrictions in certain states like Texas, could all lead to even those people who have been most vigilantly staying at home during this pandemic, tempted to relax their protocols. However, officials with Infectious Diseases Society of America hosted a briefing that serves as a reminder that infection prevention measures that have existed from the beginning, testing and wearing masks, will be just as important to ending the pandemic as the vaccines.

In her opening remakes in the briefing, Romney M. Humphries, PhD, D(ABMM), M(ASCP), professor of pathology, microbiology and immunology at Vanderbilt University Medical Center in Nashville, Tennessee, stated that although vaccination may be seen as a priority to many, robust testing for COVID-19 remains essential to infection control. It’s an important tool in not only finding cases, but helping with enrollment for therapeutic clinical trials, determining a community’s quarantine requirements, tracking spikes in cases, and monitoring for variants and further evolution in the virus. Then Mary K. Hayden, MD, FIDSA, professor of internal medicine and pathology at Rush Medical College in Chicago, Illinois, spoke about how one of the difficulties of testing is the vast number of scenarios. She stressed that testing was important not only because of public health implications, but it can also help prevent spread in the home due to family members taking measures, such as wearing masks and having the COVID-19 positive person be physically separated from others.

Humphries discussed whether COVID-19 testing in schools could be a helpful way to control the spread of the disease as well as an avenue for keeping schools open. Testing for COVID-19 in schools would likely follow the patterns of many other things in schools: wealthy districts would have the needed resources and poorer districts might not. She also noted that a lack of infrastructure made it unlikely that schools would be a major area of testing.

She said that other measures, such as having children with symptoms remain at home and monitoring their disease course would be just as helpful in controlling the spread.

In a briefing this morning, the Infectious Diseases Society of America (IDSA) stressed the continued importance of COVID-19 control measures that have been there from the start.

IDSA: COVID-19 Testing, Masking Still Needed to Control Pandemic

The impact of cardiometabolic levels on a person’s mental health has become more elucidated in recent years. A new 

 examines the role that insulin levels as well as body mass index have on depression and psychosis later in in life.1

The researchers did a cohort study from the Avon Longitudinal Study of Parents and Children, using data from participants aged 1 to 24 years. Fasting insulin was measured at 9, 15, 18, and 24 years and body mass index measurements were performed at 1, 2, 3, 4, 7, 9, 10, 11, 12, 15, 18, and 24 years. The researchers also looked at data for a number of potential confounders including emotional and behavioral problems from childhood, smoking, physical activity, the father’s social class, and average caloric intake.

Fasting insulin level data were available for 5790 participants and body mass index data were available for 10,463 people, with a slight female majority in both categories. The researchers found that there were 5 distinct trajectories for body mass index and 3 distinct trajectories for 

 insulin. Every distinct trajectory was differentiated by mid-childhood. A persistently high fasting insulin level was linked to both a psychosis a psychosis at-risk mental state (adjusted odds ratio [aOR], 5.01; 95% CI, 1.76-13.19) and psychotic disorder (aOR, 3.22; 95% CI, 1.11-9.90). However, it was not liked to depression (aOR, 1.38; 95% CI, 0.75-2.54).

A recent study examined how insulin levels and body mass index may have ties to mental health concerns.

Cardiometabolic Issues Associated With Later Mental Health Concerns

The Infectious Disease Society of America held a webcast on the current available treatment options for COVID-19 on the morning of November 23, 2020. During the week of Thanksgiving, as many continue to plan to travel or to host dinners on Thursday with many guests, the priority guidance from the participants was to continue with the safety measures that have helped people remain safe since the pandemic’s start in the United States: social distance, wash hands, use a mask, and reduce exposure to others.

The discussion on treatment began with discussing monoclonal antibodies, which have become a hot topic in COVID-19 treatment following the emergency use authorization from the US Food and Drug Administration for casirivimab and imdevimab over the weekend. Adarsh Bhimraj, MD, FIDSA, associate staff physician in the Department of Infectious Diseases at the Cleveland Clinic, in Ohio, and Rajesh T. Gandhi, MD, FIDSA, professor of medicine at Harvard Medical School in Boston, Massachusetts, both highlighted that the data for the efficacy of monoclonal antibodies are still in the early days of study, but the information coming in from the early studies appears to be positive. Gandhi also stressed that as of right now, only dexamethasone has been shown to improve survival.

Infectious Disease Society of America offered a look at the current treatment options for COVID-19 and stressed the need to maintain precautions to keep people safe.