Tina Q. Tan

This article identifies the major elements of the strategic road map for the Infectious Diseases Society of America's (IDSA) Inclusion, Diversity, Access, and Equity (IDA&E) initiative and discusses the long-term goals and the proposed steps needed to achieve these goals.

The coronavirus disease 2019 (COVID-19) pandemic in the United States has revealed major disparities in the access to testing and messaging about the pandemic based on the geographic location of individuals, particularly in communities of color, rural areas, and areas of low income. This geographic disparity, in addition to deeply rooted structural inequities, have posed additional challenges to adequately diagnose and provide care for individuals of all ages living in these settings. We describe the impact that COVID-19 has had on geographically disparate populations in the United States and share our recommendations on what might be done to ameliorate the current situation.

SUMMARY: Invasive infections caused by Streptococcus pneumoniae continue to be a major cause of morbidity and mortality worldwide, especially in children under 5 years of age. In the United States, 90% of invasive pneumococcal infections in children are caused by 13 serotypes of S. pneumoniae . The licensure (in 2000) and subsequent widespread use of a heptavalent pneumococcal conjugate vaccine (PCV7) have had a significant impact on decreasing the incidence of serious invasive pneumococcal disease (IPD) in all age groups, especially in children under 2 years of age. However, the emergence of replacement non-PCV7 serotypes, especially serotype 19A, has resulted in an increase in the incidence of serious and invasive infections. In 2010, a 13-valent PCV was licensed in the United States. However, the impact that this vaccine will have on IPD remains to be seen. The objectives of this review are to discuss the epidemiology of serious and invasive pneumococcal infections in the United States in the PCV era and to review some of the pneumococcal vaccines that are in development.

To examine the awareness, knowledge, barriers to usage and acceptance of recommended adult vaccines among obstetrician/gynecologists (OB/GYNs) compared to other adult primary care providers (APCPs). A self-administered survey was sent to 1,000 OB/GYN, 1,000 family practice and 1,000 internal medicine physicians nationwide. Of 3,000 mailed surveys, 733 (24.8%) were returned. Of those, 617 (84.18%) reported providing primary care to adults. Only 53.04% of APCPs reported having a vaccine record on > 50% of their primary care patients, with 33.15% of OB/GYNs having no record. This absence of a record was significantly greater for OB/GYNs vs. other APCPs. OB/GYNs were also significantly less likely to routinely discuss the importance of vaccines and offer any vaccines. With the exception of HPV vaccine, other providers were significantly more likely to provide Td, Tdap, influenza, hepatitis B and MMR compared to OB/GYNs. Overall 58.24% of APCPs administered vaccines to pregnant women: 4.86% administered MMR and 2.86% administered HPV vaccine, vaccines not recommended during pregnancy. Poor reimbursement and lack of knowledge and training in vaccine use were major factors that prevented APCPs from offering vaccines. The greatest perceived barriers to patient vaccine acceptance included concern about adverse effects, perceived lack of disease risk, distrust of vaccines, lack of disease awareness and cost. Intensive programs aimed at familiarizing APCPs with vaccine-preventable diseases and the importance of using vaccines are needed in order to improve vaccination rates.