COVID-19: CDC Advisers Vote on Vaccine Allocation / Immunosuppression & Viral Shedding / Multidrug-Resistant Organisms

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

Check out today's COVID-19 developments:

CDC advisers vote on vaccine allocation: The CDC's Advisory Committee on Immunization Practices (ACIP) voted 13-1 on Tuesday in favor of prioritizing both healthcare workers and residents of long-term-care facilities for vaccination against SARS-CoV-2 during the initial phase of vaccination once a vaccine is authorized by the FDA and recommended by ACIP. One committee member emphasized the need to "preserve the healthcare capacity before it's too late," while others stressed the disproportionate number of deaths among long-term-care facility residents. The importance of ongoing safety monitoring was also discussed widely.

Immunosuppression & viral shedding: Immunocompromised patients with COVID-19 may shed viable SARS-CoV-2 for 2 months or longer, according to findings in the New England Journal of Medicine. Researchers performed cell culture on respiratory samples from 20 infected immunocompromised patients (most were recipients of hematopoietic stem-cell transplants or chimeric antigen receptor [CAR] T-cell therapy; 2 had lymphoma). Samples grew viable virus up to 61 days after symptom onset. In addition, genomic analysis indicated that patients had persistent infection. The researchers conclude that "current guidelines for COVID-19 isolation precautions may need to be revised for immunocompromised patients."

Multidrug-resistant organisms: Disruption of standard hospital infection-control procedures during the COVID-19 pandemic could lead to outbreaks of multidrug-resistant organisms, researchers conclude in MMWR. A New Jersey hospital identified 34 hospital-acquired carbapenem-resistant Acinetobacter baumannii (CRAB) colonizations or infections between February and July 2020, most of which occurred during the facility's COVID-19 surge. Half the cases were in patients with confirmed COVID-19. Overall, 29% of the patients died. Because of the pandemic, the hospital had adjusted its standard infection-control practices (e.g., it adopted extended use of ventilator circuits and some personal-protective equipment). In late May, the hospital resumed its standard precautions, and CRAB cases returned to baseline levels.