Anne Schuchat

This report describes various factors that contributed to accelerated spread of coronavirus disease 2019 during February–April 2020.

The need for closer linkages between scientific and programmatic areas focused on addressing vaccine-preventable and acute respiratory infections led to establishment of the National Center for Immunization and Respiratory Diseases (NCIRD) at the Centers for Disease Control and Prevention. During its first 10 years (2006–2015), NCIRD worked with partners to improve preparedness and response to pandemic influenza and other emergent respiratory infections, provide an evidence base for addition of 7 newly recommended vaccines, and modernize vaccine distribution. Clinical tools were developed for improved conversations with parents, which helped sustain childhood immunization as a social norm. Coverage increased for vaccines to protect adolescents against pertussis, meningococcal meningitis, and human papillomavirus–associated cancers. NCIRD programs supported outbreak response for new respiratory pathogens and oversaw response of the Centers for Disease Control and Prevention to the 2009 influenza A(H1N1) pandemic. Other national public health institutes might also find closer linkages between epidemiology, laboratory, and immunization programs useful.

This Viewpoint from the acting director of the CDC and coauthors reports data on opioid prescribing and related misuse and overdose-related deaths for the perio

Pneumococcus, or Streptococcus pneumoniae, the “captain of the men of death” in the parlance of Sir William Osler, has killed millions of people while repeatedly frustrating clinicians, vaccine experts, and epidemiologists. The advent of effective antibiotics did not eliminate deaths from pneumococcal disease. Pneumococcal morbidity has remained substantial among the elderly population even though most have received the 23-valent pneumococcal polysaccharide vaccine (PPSV-23). Diagnostic tests for pneumonia are relatively insensitive and nonspecific.¹ Thus, it is difficult to evaluate the efficacy of pneumococcal vaccines against pneumonias that do not lead to detectable bloodstream infection.

This issue of the Journal presents a milestone in expanding the coverage of cancers associated with the human papillomavirus (HPV). Joura and colleagues¹ report the results of a randomized, controlled trial of a new 9-valent HPV vaccine versus a quadrivalent HPV vaccine in more than 14,000 young women. The authors found that the new vaccine had an efficacy of nearly 97% against high-grade cervical, vulvar, and vaginal disease related to HPV types 31, 33, 45, 52, and 58. In the intention-to-treat analysis, the 9-valent vaccine was not found to be more beneficial than the quadrivalent vaccine, presumably because so many . . .