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Key Points Question What are the estimated numbers of COVID-19 cases and hospitalizations averted by case investigation and contact tracing (CICT) programs in the US? Findings This decision analytical model study used CICT program data from 23 jurisdictions and estimated that CICT programs averted 1.11 to 1.36 million cases and 27 231 to 33 527 hospitalizations over 60 days during the 2020 to 2021 winter peak of the pandemic. The upper estimate assumes that all interviewed cases and monitored contacts complied with isolation and quarantine guidelines, whereas the lower estimate assumes that fractions of interviewed cases and monitored or notified contacts did so. Meaning These findings suggest that CICT programs likely played a critical role in curtailing the pandemic.

Although the personnel time for influenza vaccination visits was short, there was substantial patient waiting and long occupancy of examination rooms. If universal influenza vaccination is to be efficiently managed in primary care practices, it may be necessary to implement "vaccination clinics" or sessions in which large numbers of children are scheduled for influenza vaccinations at times when adequate rooms and dedicated nursing staff are available.

These data indicate that extraimmunization can be costly. The challenge is to reduce extraimmunization without interfering with more important efforts to combat underimmunization. Improvements in immunization record keeping and sharing practices may help reduce extraimmunization.

ABSTRACT. Objective. To determine hepatitis A vaccination coverage and factors associated with not receiving hepatitis A vaccine among children.Methods. A random cluster sample survey was conducted of parents of children who attended kindergarten in Butte County, California, in 2000. Because of a history of recurrent epidemics, an aggressive hepatitis A vaccination program was ongoing during the time this study was conducted. Receipt of 1 or 2 doses of hepatitis A vaccine was studied.Results. Of 896 surveys sent, 648 (72%) were completed. The vaccination coverage for at least 1 dose of hepatitis A vaccine was 398 (62%) and for 2 doses was 272 (42%). Factors associated with not receiving the vaccine included lack of provider recommendation (vs having recommendation; odds ratio [OR]: 7.8; 95% confidence interval [CI]: 4.9 -12.2), not having heard of the vaccine (OR: 2.4; 95% CI: 1.2-4.9), and parent's not perceiving child is likely to get hepatitis A (vs perceiving child might get disease; OR: 2.1; CI: 1.6 -2.9).Conclusions. Vaccination coverage among kindergartners did not reach high levels (ie, >90%), despite aggressive vaccination efforts in this community. Lack of provider recommendation and lack of parental awareness of hepatitis A vaccine were the 2 most significant factors associated with failure to receive vaccine. These findings will facilitate the development of vaccination strategies for communities in which hepatitis A vaccination is recommended. unpublished data, 2002). Because of clinically unrecognized or asymptomatic infections, especially among children, the number of infections may be up to 10 times higher. 1 Because children account for at least one third of cases and also are a potential source of infection for others, routine vaccination of children is likely to be an effective way to reduce hepatitis A incidence. 2 In October 1999, the Advisory Committee on Immunization Practices (ACIP) updated recommendations for hepatitis A vaccination to include routine vaccination of children age Ն2 years in states, counties, and communities with hepatitis A incidence rates that were at least twice the 1987-1997 national average (Ն20 cases per 100 000 population). 2 Over time, this strategy has the potential to substantially lower disease incidence and possibly eliminate indigenous transmission of hepatitis A virus. 3 Butte County is located in the Sacramento Valley of northern California and had an estimated population in 2000 of 207 000. The county has had recurrent outbreaks since hepatitis A became reportable in 1966 and meets the ACIP's criteria for routine childhood hepatitis A vaccination. 4 During 1987-1997, the average annual hepatitis A incidence rate was 45.3 per 100 000 (CDC, unpublished data, 2001).From January 1995 through December 2000, a demonstration project was implemented in Butte County to assess the impact of routine vaccination of children on disease incidence over time. Hepatitis A vaccine was made widely available free of charge to children aged 2 to 12 years in 1995 and to succes...

To aid decision-making during CDC's response to the 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa, CDC activated a Modeling Task Force to generate estimates on various topics related to the response in West Africa and the risk for importation of cases into the United States. Analysis of eight Ebola response modeling projects conducted during August 2014-July 2015 provided insight into the types of questions addressed by modeling, the impact of the estimates generated, and the difficulties encountered during the modeling. This time frame was selected to cover the three phases of the West African epidemic curve. Questions posed to the Modeling Task Force changed as the epidemic progressed. Initially, the task force was asked to estimate the number of cases that might occur if no interventions were implemented compared with cases that might occur if interventions were implemented; however, at the peak of the epidemic, the focus shifted to estimating resource needs for Ebola treatment units. Then, as the epidemic decelerated, requests for modeling changed to generating estimates of the potential number of sexually transmitted Ebola cases. Modeling to provide information for decision-making during the CDC Ebola response involved limited data, a short turnaround time, and difficulty communicating the modeling process, including assumptions and interpretation of results. Despite these challenges, modeling yielded estimates and projections that public health officials used to make key decisions regarding response strategy and resources required. The impact of modeling during the Ebola response demonstrates the usefulness of modeling in future responses, particularly in the early stages and when data are scarce. Future modeling can be enhanced by planning ahead for data needs and data sharing, and by open communication among modelers, scientists, and others to ensure that modeling and its limitations are more clearly understood. The activities summarized in this report would not have been possible without collaboration with many U.S. and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html).

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The clinic could reach their target of 15,000 vaccinees with 2 fewer staff members by rearranging staff assignments from "Special" to "Medicare'' and "Cash'' stations. Computer simulation can help public health officials determine the most efficient use of staff, machinery, supplies, and time.