42: New Neonatal Abstinence Syndrome Report

Dr. Nirav Shah, ASTHO President and Director of the Maine Center for Disease Control and Prevention, discusses concerns of workshop participants about the way Emergency Use Authorization (EUA) decisions are communicated; Ericka McGowan, ASTHO’s...

Dr. Nirav Shah, ASTHO President and Director of the Maine Center for Disease Control and Prevention, discusses concerns of workshop participants about the way Emergency Use Authorization (EUA) decisions are communicated; Ericka McGowan, ASTHO’s Senior Director of Emerging Infectious Disease, writes a blog article sharing seven things to know about vaccines for pregnant people; Priyanka Surio, ASTHO’s Senior Director for Public Health Data Modernization and Informatics, reviews a new report assessing data collection related to Neonatal Abstinence Syndrome; and ASTHO promotes key job openings.

The National Academies Webpage: FDA EUA Workshop

ASTHO Blog Article: Pregnancy, breastfeeding, and COVID-19 vaccines – Seven things to know

ASTHO Report: Strengthening health agencies’ Neonatal Abstinence Syndrome surveillance through consensus-driven data standards and practices

ASTHO Webpage: Job opportunities in public health and at ASTHO

ASTHO logo



This is Public Health Review Morning Edition for Thursday, October 7th, 2021. I'm Robert Johnson.

Here's today's news from the Association of State and Territorial Health Officials.


For a second day, public health leaders discuss the FDA's emergency use authorization framework, the process used to quickly dispatch COVID-19 vaccines and diagnostics to states and territories during the pandemic.

ASTHO president, Dr. Nirav Shah, speaking at the end of the workshop Wednesday, said some attendees had two main concerns about the way EUAs are communicated.


The first is whether the decision underlying the EUA is correct, whether we think it actually speaks for the right science—that, to the extent it is or is not, directly ties in to the public's trust in that EUA.

The second is just the manner of which they are communicated, initially by FDA and then translated by health officials, laboratory directors.


The event was hosted by the National Academies of Sciences, Engineering, and Medicine.


Public health officials continue to worry about low COVID-19 vaccine uptake among pregnant people, the CDC recently posting an urgent health advisory recommending vaccinations for those thinking of having a baby or already pregnant.

Ericka McGowan is senior director of emerging infectious disease at ASTHO. She writes seven things to know about vaccines for pregnant people in a new blog article now online.


Pregnant people are one of many vulnerable populations in this country, and the data has shown that they do suffer severe outcomes—more severe outcomes than others—if they actually contract the virus. So, because vaccines are still our best defense against the virus, you know, having information that actually shows and demonstrates that pregnant people and their children will be safe if they take this vaccine and also protected is very important.

This article can help state health officials convey that message.



The opioid epidemic has led to higher rates of neonatal abstinence syndrome in infants, but how consistent or complete is the data gathered to help direct the response?

A new ASTHO report considers these and other questions. It's the result of a collaboration with ASTHO members and numerous other individuals and organizations.

Priyanka Surio is ASTHO's senior director for public health data modernization and informatics. She led the project for ASTHO and talks about the report in today's morning conversation.

You've been working on this project for a year, and now the report is out. What would I find if I went through it right now?


If you go through the report, which is available on our ASTHO webpage, you'd be able to find out the current landscape of what states are doing to collect information around neonatal abstinence syndrome and what they also would like to be able to capture information on that's not yet feasible.

You'd also see a section about how states can improve their ability to track or collect this data in their surveillance systems and also by building a registry; so, we actually outlined the registry development process in this report.

And then finally, we go through the process that we took to achieve consensus. This is, again, every state and territorial health agency that was involved essentially provided their consensus or agreement for data elements to be captured for this condition and for certain definitions to be used, and that was  then validated by that subject matter expert review board. So, it actually walks us through that process as well so people know how we achieved consensus.


Is this an area of public health where data is lacking?


This is definitely an area where data has been lacking, and only a handful of states have been able to capture information around neonatal abstinence syndrome.

And by creating this report and embarking on this project, we're strengthening the ability for states to essentially capture that information better, and we're also strengthening the field and strengthening the ability to capture more information on opioid crisis as well.

And I think this sets us up for being able to do that for any public health condition.


Before we get to that, how would you imagine a state or a territory using the information that you've put in this report that's available now?


So, a state or territorial health agency could use this by looking at what information they have access to already, or maybe comparing what information they're capturing or data they're collecting around neonatal abstinence syndrome at the moment. And if they're not, this would give them ideas on what they can collect.

Then, it would further give them steps on how they can build a more systematic way of doing that, either through a registry or using existing data systems to capture that information; so it gives them some examples and some steps that they can take to do that.

All of it strengthens their ability to collect data.


You've shown how this model is working, can work, in dealing with the opioid crisis, but you're also thinking it could work in other areas of public health. Expand on that a little bit.


Again, the whole premise of this project was to involve states directly in agreeing to a common set of data that could be collected that's feasible for them, and also how that's being defined.

That can be used for any new or emerging public health issue or condition. It could be used for existing conditions. It can also be used to better enable data sharing and data flow between states and locals, between states and states, and between states and federal government.

So, there is a lot of application for the work that we did here to be replicated across even what we saw with the gaps of data with COVID-19.


And finally, the best argument for taking a look at this report?


I would say the best argument here would be that it directly shows you how public health can be engaged in setting the tone for how data is collected and used to protect the wellbeing and health of our nation.

And it does so in a way that, even though it's specific to the opioid crisis, we're dealing with crisis data and it shows you how to do that in a very quick way.



Finally this morning, ASTHO is looking to hire for several key positions.

The organization is on the lookout for a senior analyst to work on chronic disease prevention policy, a manager in its distance learning group, and a director of cross sector leadership and facilitation.


Find a link to these jobs and other openings, along with a link to download the NAS surveillance report, in the show notes.


Also, remember to follow us on Apple Podcasts or Spotify, or listen on Alexa or Google assistant. And, if you have a minute, please take time to leave us a rating and a review.


Join us tomorrow morning for more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition.


Priyanka Surio MPH PMP CHES

Senior Director of Public Health Data Modernization and Informatics, ASTHO

Nirav Shah MD JD

Director of the Maine Center for Disease Control and Prevention; President of ASTHO

Ericka McGowan MS

Senior Director, Emerging Infectious Disease, ASTHO