The Alameda County Public Health Department sends out Health Alerts, Advisories, and Updates regarding communicable disease outbreaks, immunization updates, and other public health concerns to Alameda County clinicians and other partners. See recent releases below.

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ADVISORY: provides important information for a specific incident or situation; may not require immediate action.

February 14, 2022


UPDATE! COVID-19 Vaccine Booster Eligibility

On Friday, February 11th, the CDC updated its guidance for COVID-19 vaccination for people who are moderately or severely immunocompromised:

  • Immunocompromised persons who have completed a primary series of an mRNA vaccine (Pfizer or Moderna) are recommended to receive an mRNA booster dose 3 months (instead of 5 months) after the last primary dose.
  • Immunocompromised persons who have received a single J&J COVID-19 vaccine should receive one additional dose of an mRNA COVID-19 vaccine and one booster dose (preferably mRNA) for a total of 3 vaccine doses.

The CDC also clarified that immunocompromised persons who have completed their primary series of 3 mRNA doses should receive an mRNA vaccine booster dose—to make a total of 4 doses.

Also, for those who previously received passive COVID-19 antibody products, the CDC no longer recommends a waiting period prior to COVID-19 vaccination.

February 03, 2022


Ivermectin + Therapeutics Changes for Outpatient Treatment of Mild to Moderate COVID-19

On February 1, 2022, the CDC shared the following COCA Now: Ivermectin Products are Not Approved by FDA to Prevent or Treat COVID-19. Clinicians should be aware of the symptoms associated with ivermectin overdose, including:

  • Gastrointestinal symptoms such as nausea, vomiting, and diarrhea
  • Low blood pressure
  • Neurologic effects such as decreased consciousness, confusion, hallucinations, central nervous system depression, seizures, coma, and death

Ivermectin may also increase sedative effects of other medications such as benzodiazepines and barbiturates.

On February 2, 2022, CDPH released the following health alert: CaHAN (Omicron Variant Update: Therapeutics Changes for Outpatient Treatment of Mild to Moderate COVID-19)

For questions regarding the distribution of COVID-19 outpatient therapeutic products within ALCO, please contact Cynthia Frankel, RN, Alameda County Therapeutics Distribution Lead at

For clinical questions about COVID-19 therapeutics, please contact Arnie Spanjers, MD, Alameda County Public Health Department at

For the full health advisory, please see ACPHD's Health Advisory.

January 28, 2022


Outpatient Therapies for the Treatment and Prevention of COVID-19 in High-Risk Patients

The purpose of this Health Advisory is to inform clinicians in Alameda County about the availability of outpatient therapies for high-risk patients with 1) mild to moderate COVID-19 illness who are not yet hospitalized; or 2) ongoing risk of exposure to COVID-19. When resources are limited, therapy should be prioritized for patients who are at the highest risk of progressing to severe COVID-19, as described in the NIH Panel’s interim statement.

Please see the full health advisory full details and visit our COVID-19 website.

For questions regarding the distribution of COVID-19 outpatient therapeutic products within ALCO, please contact Cynthia Frankel, RN, Alameda County Therapeutics Distribution Lead at

For clinical questions about COVID-19 therapeutics, please contact Arnie Spanjers, MD, Alameda County Public Health Department at

January 19, 2022


Prioritization of COVID-19 CMR Reporting

The increase of COVID-19 cases in Alameda County caused by the Omicron variant of SARS-CoV-2 is creating a substantial burden on communities, health care systems, and providers. Alameda County is closely monitoring the situation. Submission of Confidential Morbidity Reports (CMRs) for COVID-19 cases is required by state regulation but may be challenging during periods of high case volume.

Until further notice, clinical providers in Alameda County should prioritize submission of CMRs for patients with COVID-19 that have been hospitalized or have died. CMRs for other COVID cases should continue to be submitted as capacity allows. Multi-System Inflammatory Syndromes in Children (MIS-C) is required to be reported separately, and should continue to be prioritized for CMR submission. Laboratories must continue to report positive and negative results via Electronic Laboratory Reporting (ELR) or by fax.

Please see the full health advisory for details, including actions requested of clinicians and additional resources.

December 28, 2021


Changes to J&J Guidance and CDPH Booster Requirements

Due to the risk of Thrombosis with Thrombocytopenia Syndrome (TTS), a rare but serious adverse event, the CDC now recommends the use of mRNA vaccines over the Janssen/J&J vaccine for all vaccine-eligible persons. Vaccine providers should start the two-dose mRNA vaccine series even if there is uncertainty about how the patient will receive their second dose; setting alone should not be a reason to offer the J&J vaccine. However, J&J may be offered in some situations as described below:

  • When there is a contraindication to mRNA vaccines (e.g., severe allergic reaction after a previous dose or to a component of an mRNA vaccine)
  • When a person would otherwise remain unvaccinated for COVID-19 due to limited access to vaccines.
  • When a person wants to receive J&J despite the safety concerns identified

 For more information, please review the CDC’s Interim Clinical Considerations.

As Omicron spreads, it is important that providers encourage all eligible patients to get a booster, especially those over 50 or those with significant underlying health conditions.

For more information, please see PDF.

November 30, 2021


Increasing Influenza A (H3N2) Activity

On November 24, 2021, The Centers for Disease Control and Prevention (CDC) issued a Health Alert Network (HAN) Health Advisory about increased influenza A(H3N2) activity that could mark the beginning of the 2021-2022 influenza season. The purpose of this HAN Health Advisory is to:

  1. Remind public health practitioners and clinicians to recommend and offer the current seasonal influenza vaccine to all eligible persons aged six months and older (Flu vaccine and COVID-19 vaccine can be given at the same visit).
  2. Remind clinicians to consider testing for both influenza virus and SARS-CoV-2 in patients with influenza-like illness (ILI).
  3. Advise clinicians that antiviral treatment is recommended as early as possible for any patient with confirmed or suspected influenza who is: a) hospitalized; b) at higher risk for influenza complications; or c) developing progressive illness. In patients with suspected influenza, decisions about starting antiviral treatment should not wait for laboratory confirmation of influenza, however COVID-19 should be excluded if a rapid assay is available.
  4. Remind public health practitioners and clinicians to consider mitigation measures including antiviral post-exposure prophylaxis during influenza outbreaks in institutions (e.g., long-term care facilities, university dormitories) in the setting of co-circulation of SARS-CoV-2.
  5. Remind the public to use non-pharmaceutical interventions (NPI) or everyday preventive actions, in addition to getting a flu vaccine. Everyday preventive actions include staying home when sick, covering coughs and sneezes, and washing hands often.

Please review the full health advisory for detailed recommendations on testing, treatment, post-exposure prophylaxis, public education and additional resources for clinicians.

November 29, 2021


Legionella Amidst Reopening of Businesses & School Facilities

Legionella bacteria are aerobic, gram negative, intracellular pathogens found in water and soil, generally in small numbers insufficient to cause disease.

Legionellosis refers to any clinical syndrome associated with Legionella infection, and can present as Pontiac fever, which is an acute, self-limited febrile illness as well as the more severe Legionnaire’s disease which refers to pneumonia. Even during outbreaks, only a minority of people develop disease, and associated risk factors include age>50, smoking history, and underlying medical conditions such as chronic lung disease, cardiovascular disease, kidney or liver failure, diabetes, malignancy, and immune system disorders. More recently, there have also been increasing cases of Legionella co-infections in patients diagnosed with COVID-19.

Please see the full health advisory for a situation update and action requested of clinicians.

November 22, 2021


COVID-19 Vaccine Booster Eligibility

On Friday, November 19th, the CDC expanded COVID-19 vaccine booster eligibility to all adults. This aligns with CDPH’s letter released on November 9th, which emphasizes that no one seeking a booster dose should be turned away if:

  • The patient is 18 or over AND has met the 6-month original vaccination series time period for the Moderna or Pfizer vaccine OR it has been at least 2 months since their J&J vaccine

It is recommended that healthcare providers proactively outreach to all patients who are eligible for a booster with information about their eligibility, locations for receiving booster doses, and instructions for how to make an appointment/walk-in. In addition, providers should not miss any opportunity to vaccinate the unvaccinated or provide boosters, by offering vaccine during routine or nonroutine visits to medical offices, clinics, pharmacies, and hospitals.

For more information about helping patients choose the appropriate booster type, please see the CDC’s Interim Clinical Considerations. For information about providing booster doses to those patients who received their primary series with a vaccine not authorized in the U.S. OR as part of a clinical trial, please see the CDC’s Emergency Use Instructions.

October 04, 2021


COVID-19 Vaccination for Pregnant People to Prevent Serious Illness, Deaths, and Adverse Pregnancy Outcomes

The Centers for Disease Control and Prevention (CDC) recommends urgent action to increase COVID-19 vaccination among people who are pregnant, recently pregnant (including those who are lactating), who are trying to become pregnant now, or who might become pregnant in the future. CDC strongly recommends COVID-19 vaccination either before or during pregnancy because the benefits of vaccination outweigh known or potential risks.

In addition to the risks of severe illness and death for pregnant and recently pregnant people, there is an increased risk for adverse pregnancy and neonatal outcomes, including preterm birth and admission of their neonate(s) to an intensive care unit (ICU). Other adverse pregnancy outcomes, such as stillbirth, have been reported.

September 29, 2021


Respiratory Syncytial Virus and Influenza Activity and Guidance for Clinicians

Respiratory syncytial virus (RSV) and other respiratory viruses besides SARS-CoV-2 are circulating in California causing potentially serious illnesses in infants and older adults. Testing for influenza and RSV is recommended, and testing for other respiratory pathogens should be considered, especially in patients with respiratory illnesses who test negative for SARS-CoV-2. Continue to vaccinate patients 6 months and older against influenza. Influenza vaccine and COVID-19 can be co-administered. Encourage parents and caregivers to keep young children with acute respiratory illnesses out of childcare, even if they have tested negative for SARS-CoV-2. Discourage health care personnel, childcare providers, and staff of long-term care facilities from working while acutely ill, even if they have tested negative for SARS-CoV-2.

September 28, 2021


Increases in Availability of Cannabis Products Containing Delta-8 THC

On September 14, 2021, the CDC issued a health advisory notice in response to the increase in availability of enhanced delta-8 tetrahydrocannabinol (THC) cannabis products and the rise of serious adverse health events (e.g., vomiting, hallucinations, and loss of consciousness) that occurred after ingesting the enhanced delta-8 THC products. While delta-8 THC naturally contains less THC, the chemical property responsible for creating the “high” feeling that consumers experience when ingesting traditional delta-9 THC products, delta-8 THC products are now being synthetically enhanced or altered by some manufacturers to contain higher levels of THC.

Recently, these practices have led to serious adverse health events, including among pediatric patients younger than 18 years old. These products have not been approved by the FDA. Retailers/consumers are advised to research delta-8 products thoroughly before selling and/or consuming them.

Additional information about the delta-8 and the serious adverse health events can be found below:

September 21, 2021


Maintain Vigilance for Vaccine Preventable Diseases

Due to the need for evacuation, individuals from Afghanistan are being resettled in the United States including California. The Alameda County Public Health Department (ACPHD) asks clinicians caring for this vulnerable community to remain vigilant for signs and symptoms of measles, polio, and other vaccine-preventable diseases such as mumps, varicella and pertussis among persons recently resettled from Afghanistan. Clinicians are urged to contact the local health department to report suspected cases of these vaccine-preventable diseases.

See advisory for additional details, guidance, and recommendations.

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