usa cruises december 2022

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Enjoy 75% off your second guest’s cruise fare. Plus, additional guests in your stateroom sail free on select Caribbean sailings.

December Cruises

Your most unforgettable holiday season yet.

Escape the winter weather on a December cruise. Spend the holiday season at sea with family, friends, and loved ones on an unforgettable adventure in the sunshine. Head south to New Zealand to explore serene fjords, mountains, vineyards, and laid-back cities. Get close to extraordinary wildlife in the Galapagos, or explore Asia’s dynamic cities coupled with beach time on sun-kissed islands to unwind.

December is the perfect time to visit the Caribbean, too. Snorkel over coral reefs, swim with wild dolphins, admire the candy-colored Dutch architecture of the Southern Caribbean, and even discover the incredible Panama Canal. Embark on a warm-weather adventure this December with Celebrity Cruises.

Itineraries

Top december cruise destinations.

Enjoy a sunny escape to the Southern Hemisphere, where summer is in full swing. Admire the sweeping natural landscapes of New Zealand on a cruise from Sydney. You could spend both Christmas and New Year’s enjoying the holiday spirit as you explore the coast, visiting the serene beauty of the fiords, Scottish-influenced Dunedin, cosmopolitan Christchurch, and the award-winning wineries at Hawke’s Bay. Spend a day in Auckland, too, before visiting the serene Bay of Islands.

The Galapagos

December cruises to the Galapagos Islands promise an experience unlike any other. Board one of our cruise ships for an all-included vacation to this awe-inspiring island chain. Award-winning excursions are led by expert naturalists who will show you surreal landscapes and unique wildlife up close. Waddle next to blue-footed boobies, wander past scaly iguanas, and marvel at animal species you won’t find anywhere else.

The Bahamas

Bask in the tropical sunshine as you celebrate the holiday season with a getaway to The Bahamas and Key West. Doze in a hammock on Blue Lagoon Island with an iced rum punch on a day trip from Nassau, or whizz down thrilling water slides at Atlantis on Paradise Island. Snorkel over dazzling corals and the intriguing wreck of the S.S. Sapona off the coast of Bimini, and explore quirky, arty Key West, where you can visit Hemingway’s home and feast on tangy Key lime pie.

Southern Caribbean

Relax in the glorious sunshine of the Southern Caribbean on a December cruise with Celebrity. Swim over sunken wrecks in the crystal-clear waters around Aruba. Stroll the cobbled streets of historic Cartagena, and drift along Martha Brae River in Jamaica under a canopy of green before digging into spicy jerk chicken and a fruity rum punch. Join a holiday cruise to Panama and marvel at the engineering masterpiece of the Panama Canal.

Thailand & Vietnam

Sail between Hong Kong and Singapore on a voyage to some of Asia’s most exciting cities. In Vietnam, visit Ho Chi Minh City, where ancient, incense-scented temples sit against a backdrop of gleaming skyscrapers. In pretty Hoi An, crisscrossed with canals, you could join a cooking class or cycle through the lush countryside. In Bangkok, your time will be filled with gilded palaces, gleaming Buddhas, and bustling markets before heading to Ko Samui’s white-sand beaches.

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New York Cruise Guide > Cruises > December 2022

Cruises from NYC December 2022

The complete calendar of cruises from New York ports (Manhattan, Brooklyn and Cape Liberty cruise terminals) in December of 2022. Enjoy an early winter cruise out of NYC.

12 cruises are scheduled in December. 3 go to the Caribbean, 6 to the Bahamas, 2 to Bermuda and 1 to Europe.

December 3: 19-night cruise to Europe on Queen Mary 2 . December 4, 2022: 7-night cruise to the Bahamas on Royal Caribbean December 11, 2022: 7-night cruise to the Bahamas on Royal Caribbean December 13: 5-night cruise to Bermuda on Norwegian Cruise Line December 16: 7-night cruise to Puerto Rico on Norwegian Cruise Line December 18: 8-night cruise to the Bahamas & Florida on Royal Caribbean . December 18: 5-night cruise to Bermuda on Norwegian Cruise Line December 22: 11-night cruise to the Caribbean on Norwegian Cruise Line December 22: 12-night cruise to the Caribbean on Queen Mary 2 . December 23: 8-night cruise to the Bahamas & Florida on Norwegian Cruise Line December 26, 2022: 7-night cruise to the Bahamas on Royal Caribbean December 31: 8-night cruise to the Bahamas & Florida on Norwegian Cruise Line

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7-Night Very Merrytime Eastern Caribbean Cruise from Port Canaveral

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Pools, Waterslides & Recreation

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Cruise Itinerary

• Be a part of the magic at Walt Disney World Resort
• Take an out-of-this-world tour of Kennedy Space Center
• Window-shop and take in the scenic surf-side sights at Cocoa Beach
• Watch a Broadway-quality musical and splash it up in a freshwater pool
• Savor upscale restaurants, buffets, poolside snacks and room-service
• Find one-of-a-kind fun in unique clubs designed for kids, teens, tweens and adults
• Wander the picturesque grounds of Mount Healthy National Park
• Swim and interact with dolphins at Dolphin Discovery
• Soak up the sun and surf of Tortola's most popular beach, Cane Garden Bay
• Bask on a white-sand beach or explore the tropical terrain by bike
• Scuba dive at a marine sanctuary and observe tropical fish, turtles and rays
• Soar high over a lush rainforest canopy on a zipline adventure
• Bring the family together for swimming, snorkeling, biking, kayaking and more
• Kids can ride 2 winding waterslides and socialize inside exclusive clubs
• At a private beach, adults sip on cocktails, sunbathe and enjoy massages

Spend the holidays sailing on these festive cruises

If you are looking for a holiday vacation alternative to skiing or snowboarding, why not set sail?

Cruise lines are offering a range of celebrations and specialty voyages for travelers who want to book a last-minute getaway, whether you want to soak up some sun during the cold winter months or do some shopping at Christmas markets. From two-week sailings in the Caribbean to European river voyages and journeys through the American South, there is probably a cruise for you.

We round up this year's holiday offerings from five cruise lines that still have availability.

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What holiday cruises can I still book for 2022?

►  American Queen Voyages: On American Queen Voyages' Holidays on the River cruises, guests can spend the holidays cruising along the Mississippi River, sipping hot chocolate and warming up at bonfires on the levee.

The line will sail from New Orleans to Memphis on Dec. 11 with stops in St. Francisville, Louisiana, and Natchez, Mississippi, among others, and make a similar reverse journey on Dec. 18, according to its website . Guests can also spend Christmas with the cruise line on a round-trip sailing from New Orleans on Dec. 25. The cruise includes stops in Natchez and Baton Rouge, Louisiana.

Each voyage will be nine days long and sail on the American Queen steamboat decked out in its holiday finest. The sailings also will feature a holiday gala, treats like gingerbread, and a traditional Réveillon dinner from culinary ambassador Regina Charboneau.

Available staterooms start at $3,898 for the Dec. 18 cruise and $4,098 for the Dec. 11 and 25 cruises, per person based on double occupancy. The fares include one night in a hotel before the cruise, all food and drinks ,  Wi-Fi and more.

►  Royal Caribbean International: Royal Caribbean hosts a variety of activities at Christmastime, including a tree-lighting ceremony, an ugly-sweater party and holiday scavenger hunts starting as early as Dec. 1, a spokesperson for the line told USA TODAY in an email. Exact offerings may vary by the itinerary.

There will be a priest on board for Christmas Eve and Christmas Day services, as well as a rabbi during Hanukkah. The line will celebrate Hanukkah with a daily candle lighting and holiday-inspired food as well, according to the spokesperson.

On New Year's Eve, Royal Caribbean holds parties throughout its fleet with countdowns to midnight.

This year, the line is offering a range of holiday cruises, including a five-night sailing to the Caribbean and the Bahamas from Florida's Port Canaveral on Dec. 5 on the line's Mariner of the Seas ship, and a three-night cruise from Los Angeles on Dec. 16 that will visit Ensenada, Mexico, on Navigator of the Seas, according to its website.

Available rooms on the Dec. 5 sailing start at $219 and at $242 for the Dec. 16 cruise, per person based on double occupancy. The  fares include most meals , some drinks, and the majority of onboard entertainment.

►  Azamara: Azamara will decorate its ships for the holidays beginning in December, readying them for all manner of festivities.   Crew members will perform carols, and the line will serve snacks like Christmas cookies, as well as special holiday menus in the main dining room and specialty restaurants on Christmas Eve and Christmas Day, according to press materials provided by the line. There will also be a priest on board for religious services.

The line is sailing two holiday voyages. The Azamara Journey will take travelers through South Africa on a 14-night trip leaving from Cape Town on Dec. 20 with stops in Richards Bay and Durban, among others, according to the line's website .

Azamara Onward will also sail a 14-night Caribbean cruise from Miami on Dec. 22 that will visit destinations including George Town in Grand Cayman, Cartagena, Colombia and Samaná in the Dominican Republic.

On New Year's Eve, the line also hosts its White Night party on the pool deck – where guests are asked to wear all white – featuring food, music and dancing.

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Available rooms start at $1,999 for the Dec. 20 cruise and $3,599 for the Dec. 22 sailing, per person, based on double occupancy. The fares include most food, drinks such as sodas and select alcoholic beverages, plus gratuities, among other amenities.

►  Disney Cruise Line:  Disney Cruise Line is sailing Very Merrytime cruises on all five of its ships, allowing guests to spend the holidays at sea with their favorite characters.

Decor includes poinsettias, garlands and a 24-foot-tall Christmas tree, according to the line's website . Characters dress in holiday attire, too, and guests can meet Santa Claus, among other activities, though exact offerings vary by ship and itinerary.

A five-night Western Caribbean cruise from Galveston, Texas, on Dec. 13 for two adults and two 5-year-old children starts at $2,889, according to the line's website , though cruise prices vary depending on the children's ages, dates of sailing and other factors. The fares include breakfast, lunch and dinner , soft drinks, character meet-and-greets and more.

►  Viking:  Viking's Christmas Market River Cruises take travelers to quaint towns and bustling cities throughout Europe. Among the line's holiday offerings are the Christmas on the Rhine sailing from Amsterdam in the Netherlands to Basel, Switzerland – or the reverse – with stops in Cologne, Germany, Strasbourg, France, and more, according to its website .

Christmas on the Danube sails from Budapest, Hungary, to Regensburg, Germany – and makes the journey in reverse – visiting Vienna, the Wachau Valley and more. Both sailings are eight days long with departure dates from late November to late December. The cruises offer plenty of chances for seasonal shopping, with celebrations on board as well, including tree-trimming and live music, according to press materials provided by the line.

Available rooms on the Christmas on the Rhine cruise start at $2,299 and at $2,499 for Christmas on the Danube, per person based on double occupancy, though prices may vary depending on the dates. The fares include port taxes and fees, all meals, plus beer, wine and soft drinks with lunch and dinner.

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Cruise from Miami, Florida

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THE WORLD'S BEST FAMILY VACATION

Introducing the new Icon of the Seas℠ , a whole new class of Royal Caribbean® adventure. Let your adrenaline surge at the largest waterpark at sea. Here, every day is a sun day with an all-you-can-swim buffet of seven unique pools — the most ever on a cruise. And families discover adventure for all ages at Surfside ℠ , a stay-all-day destination right onboard that opens the floodgates on family fun.

EXPLORE Icon of the Seas℠

A BOLDER WAY TO GETAWAY WEEKEND CRUISES

Break up with your weekly routine with a weekend cruise from Miami and set sail on a memory filled getaway that’ll take you so much further than a standard staycation. Royal Caribbean® offers plenty of bolder-than-ever weekend sailings to some of the Caribbean’s most stunning shores onboard the world’s most incredible cruise ships — no days off required. Which means you can fill your year with even more bucket list adventures.

EXPLORE WEEKEND CRUISES

WOW-WORTHY SIGHTS IN THE MAGIC CITY 

From a bustling downtown with shimmering skyscrapers to endless beaches, Miami is an urban paradise all year long. Enjoy a plethora of things to do before your cruise out of Miami. If you crave an exhilarating day of adventure on the water, head to Oleta State Park for a myriad of water sports in the Biscayne Bay. If you’re needing an art fix, explore the Perez Art Museum or historic Vizcaya Museum and Gardens. If a break in nature is needed, there’s no shortage of places to experience wildlife up close, head to Zoo Miami or Miami Seaquarium for interactive shows and encounters. With so many options and things to do, Miami is the perfect place to set the tone for your next cruise adventure.

Blazing With Adventure

Feel the heat of adventure in The Magic City and cool off with with a cruise to the Bahamas or Caribbean from the Miami cruise port on some of our most amped up ships yet.

INDEPENDENCE OF THE Seas

You’ll always find bold adventures onboard Independence of the Seas ®. From non-stop thrills to mouthwatering dining and the hit Broadway musical Grease, this fan-favorite is your ticket to a memory-maxing getaway.

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Freedom of the SeaS

Trade “sea days” for “see more” days on an all-around all-star - Freedom of the Seas®. Experience more to do onboard the ship, with fewer days between some of the world's most exotic travel destinations.

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ICON OF THE SEAS

It’s time for the time of your life — multiple times a day. Onboard the new Icon of the Seas ℠. Brace yourself for the largest waterpark at sea. Or take your pick of seven different pools. And in between, bond over bites with over 20 ways to dine.

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KICK START THE ULTIMATE ADVENTURE FROM MIAMI

Whether you’re on a short getaway or weeklong wander, conquer record-breaking thrills and discover epic ways to chill at the award-winning Perfect Day at CocoCay. Luxe the day away in an Overwater Cabana at Coco Beach Club ® .Or crank up the party at Hideaway Beach ℠ , the ultimate adults-only beachfront paradise. Plus, get your fix of non-stop thrills like the tallest waterslide in the Caribbean. And refuel over foodie finds from signature wings to all-you-can-eat island favorites.

Whether you’re on a short getaway or weeklong wander, conquer record-breaking thrills and discover epic ways to chill at the award-winning Perfect Day at CocoCay. Luxe the day away in an Overwater Cabana at  Coco Beach Club® .Or crank up the party at  Hideaway Beach ℠, the ultimate adults-only beachfront paradise. Plus, get your fix of non-stop thrills like the tallest waterslide in North America. And refuel over foodie finds from signature wings to all-you-can-eat island favorites.s.

Whether you’re on a short getaway or weeklong wander, conquer record-breaking thrills and discover epic ways to chill at the award-winning Perfect Day at CocoCay. Luxe the day away in an Overwater Cabana at Coco Beach Club ® .Or crank up the party at Hideaway Beach ℠ , the ultimate adults-only beachfront paradise. Plus, get your fix of non-stop thrills like the tallest waterslide in North America. And refuel over foodie finds from signature wings to all-you-can-eat island favorites.

Miami Shore Excursions

Amazing experiences coming soon., sorry, there are no excursions for this port at this moment., things to do in miami.

Art Deco Hotels Collins Avenue, Miami, Florida

South Beach is a bright hot spot no matter what time of day. Soak up the sun along the shore and admire the Art Deco gems along lively Ocean Drive. Stroll busy Collins Avenue, sip mojitos in beach bars, dance in ultra-hip nightclubs, and enjoy the best people watching in the city.

Called Culture

Older Men Close Up Smoking Cuban Cigars, Miami, Florida

Experience Miami’s Cuban traditions along Calle Ocho in Little Havana. Here you can wander streets filled with fiery salsa sounds and meet locals smoking cigars over a game of dominoes. From its colorfully painted rooster statues to its hand-rolled cigar shops and open-air fruit markets, this is as authentic as it gets.

Blank Canvas

Unleash your creative side with a jaunt through the Wynwood Art District during your Miami cruise. Every façade in this art-centric neighborhood comes decked out in vibrant life-size murals by globally recognized talents. And don’t miss Wynwood Walls, a collection of old warehouses adorned with abstract paintings, graffiti quotes and unique sculptures.

Local Cuisine

Miami is an international culinary powerhouse. Michelin-starred chefs fill many kitchens and Latin American flavors highlight many menus. You can’t miss the city’s signature Cuban food: Enjoy pastelitos (pastries) for breakfast, lunch on a famous frita (spicy burger), then savor ropa vieja (beef stew) for dinner. If seafood is your thing, crack into succulent stone crab claws, a true South Florida delicacy.

Bayside Marketplace, across from the port, is a popular waterfront shopping spot for visitors. Locals love the quirky boutiques in Coconut Grove. Lincoln Road Mall spans 10 blocks of shops— and Miracle Mile is a long string of specialty stores. Cruise to Miami and head to Calle Ocho for hand-stitched guayabera shirts and hand-rolled Cuban cigars.

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Mexican Riviera

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How can i find a cheap cruise.

Cheap cruise deals are fairly easy to find in most cases, and you can begin by considering what kind of features and itinerary you want. The more simplistic the experience is, the cheaper it is in general. On Expedia.com, you can filter for specific features and sort your results by price. By mixing and matching certain features, unforgettable experiences may be available with discount cruises. For example, booking a cruise with stunning restaurants and live performances while opting for an inside cabin without an ocean view window or balcony could be ideal for a traveler who doesn't plan on spending much time in their cabin anyways

What is the cheapest month to take a cruise?

The cheapest month to take a cruise varies based on your destination and the cruise line company that runs the ship. A Caribbean cruise , for example, is generally cheapest in the late summer and early fall since it's the local hurricane season.

Can I cancel my cruise booking?

Yes, you can cancel, but there may be fees for canceling depending on how far in advance you cancel and what kind of booking you have. You can check the specific cruise lines’ cancellation policies in your itinerary on Expedia.com.

Are river cruises worth the money?

River cruises are quite relaxing, with much more varied scenery than you'd experience on an ocean cruise. These ships often also feature several stops along the river, so passengers can enjoy a greater variety of destinations to explore. Viking river cruises are especially adept at providing this unforgettable experience.

What cruises are best for families?

The best family cruises in 2024 / 2025 tend to be Disney cruises with plenty of offerings for kids and adults alike, though MSC cruises are known for their iconic Children Cruise Free promotion. Disney cruises, specifically, are essentially a Disney theme park on a boat with live shows, rides, and attractions with your kids' favorite characters.

How much does a cruise ship cost?

Cruise prices can vary quite a bit, with cheap cruises and especially luxurious all-inclusive cruises available. Budget lines can offer cruise tickets as low as $50 per night in some cases, while the more high-end experiences can reach up to $1,000 per night and more.

What are some of the best cruise lines?

Several different cruise lines have a lot to offer, such as Viking cruises , which are known for traversing oceans and rivers with a style that blends outdoor and indoor splendor. Celebrity cruise line is more upscale with luxurious features like WiFi, included beverages, champagne, and suites with panoramic views. Other top cruise lines include Royal Caribbean International , Carnival Cruise , Disney Cruise , and Norwegian Cruise .

How far in advance do you need to book a cruise?

It's generally best to book a cruise about 6 to 12 months before your cruise departure. That's the safest way to balance availability and affordability. Technically, you can book earlier or later than that, with some last-minute cruise deals occasionally available up to a weekbefore cruise departure.

Are cruise trips affordable?

They can be, and it's especially simple to search for more affordable cruises with Expedia.com. Not only can you filter by cruise length, cruise line, and cabin experience, but you may also sort your results by price to put the more affordable options first on your search results page.

What is it like to go on a cruise?

A cruise is generally designed to offer the most relaxing experience possible. Despite the size of the ship, it's possible to feel the wave. Many passengers report that the movements help them sleep. Additionally, many fun cruises offer live stage performances, several restaurants, and shopping opportunities. When the ship is in international waters, you may even be able to enjoy a bit of tax-free shopping.

Are cruises a good way to travel?

Cruise travel is great if you're looking for some varied fun. Compared to a plane or a train, cruises have their own attractions and can be considered an integral part of cruise vacations. Plus, a cruise can hit several different destinations as well, with plenty of time to enjoy the cruise and scenic locales. It's certainly worth it for a unique experience no other method of travel can match.

Which cruise line is the cheapest?

The actual cheapest cruise available depends on a variety of different factors. Still, Carnival Cruise tends to be very affordable overall, most of the time with great options like the Carnival Sunrise and Carnival Horizon . Royal Caribbean is also another fantastic cruise line offering great deals if you are watching your budget.

How can I get the best cruise deals in 2024 / 2025?

If you're looking for some of the best cruise deals, booking through Expedia.com makes it easy since you can sort your cruise search results by price and have access to special deals. One Key members can earn  OneKeyCash  on all eligible bookings and get instant discounts with Member Prices. Sign up today!

What do I need to know when I book a cruise?

To book a cruise, you'll need to know where you'll be setting off from and where you'll be going, in addition to how many people will be with you and the features of the specific cruise you book. Keep in mind that you'll want to factor in spending money in your budget for the cruise's restaurants and shops in most cases.

Where should I go on a cruise in 2024 / 2025?

Plenty of incredible cruise destinations are accessible such as cruises to the Bahamas and cruises to Mexico . You may also be interested in cruises to Alaska or cruises to Europe for something outside of the Caribbean.

What countries are best to visit by cruise ship?

A lot of countries are accessible via a cruise, but the best include a cruise to Australia . However, a cruise to Australia is quite a long trip at sea and really allows you to take in everything the cruise ship has to offer.

Can I get last-minute cruise deals?

Yes, last-minute cruise deals are often available, and you can find them on Expedia.com by inputting your travel dates in your search and sorting your results by price. The deals will automatically be applied to the price estimates so that the cheapest estimates will show up first on your search results page.

Are cruises all-inclusive?

Cruises aren't always all-inclusive, but they can be. If you're interested in all-inclusive cruises, you can activate a search filter for it to ensure your search results only show cruises that meet your all-inclusive standard.

Is food free on a cruise?

Food is sometimes free on a cruise, but there are often specialty restaurants that aren't included with the general booking that you'll have to pay for separately. Check the details of each cruise before you book in the "What's included" section after clicking the cruise on your search results page.

What cruise lines are adults only?

Several lines offer adults-only cruise experiences, including Viking cruises , Carnival cruises , and Princess cruises . With an adults-only cruise, you can relax in a tranquil and laid-back setting without kids running around and enjoy all the cocktails you want.

What cruise lines are considered to be the most luxurious?

Viking cruises are considered exceptionally luxurious, with smaller ships and larger cabins that make them feel more exclusive, but Celebrity cruises offer luxury cruise lines too. Booking a luxury cruise means you can expect high-end amenities including gourmet restaurants, sizable suites, top-tier performances, massive pools, and much more.

What are the best cruises for couples?

Viking Cruises have much to offer for a more romantic experience. Holland America Line cruises can be quite refined and romantic as well, with an adult-oriented experience that's sophisticated rather than rowdy. Romantic cruises offer exceptional service as well as cozy suites for you and your partner to enjoy that's complemented by delicious food often themed around the cruise destination.

Why should I go on a cruise for my honeymoon?

Going on a cruise is a great way for you and your new spouse to be pampered with luxury while also being able to explore a new destination. Whether you're taking a cruise to Hawaii or a cruise to Bermuda , a particularly romantic experience is almost guaranteed thanks to the sheer number of things to do.

Are there any Christmas cruises?

Yes, quite a few cruise lines operate around Christmas, and you can find them easily by entering travel dates around Christmas into your 2024 cruise search. Some of the most popular Christmas cruises are available with Carnival and Disney.

Do I need a passport to go on a cruise?

Whether or not you need a passport depends on where you're going and the kind of cruise it is. Any US territory like Bermuda and Puerto Rico won't require a passport, of course, but you also don't need one if you're on a closed-loop cruise. This is a cruise that begins and ends at a US cruise terminal, even if there are stops in other countries on the way.

Why should I book a cruise with Expedia.com?

Booking a cruise with Expedia.com makes it easy to find a cruise type that works best for you. You can use the cruise finder and sort by cruise line, type, destination, length, and itinerary. One Key members also earn OneKeyCash on all eligible bookings that can be used to save on future eligible trips.

What happens if a cruise is canceled?

Every cruise has a different cancellation policy, but generally, passengers are entitled to either a full refund or a credit for a future cruise at a later date. Remember that they may automatically change your booking to their rescheduled date, so you may have to contact them if that date doesn't work for your schedule.

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• Introduction
• Conclusions
• Article Information

The reports to the Vaccine Adverse Event Reporting System met the case definition of myocarditis (reported cases). Among individuals older than 40 years of age, there were no more than 8 reports of myocarditis for any individual age after receiving either vaccine. For the BNT162b2 vaccine, there were 114 246 837 first vaccination doses and 95 532 396 second vaccination doses; and for the mRNA-1273 vaccine, there were 78 158 611 and 66 163 001, respectively. The y-axis range differs between panels A and B.

The reports to the Vaccine Adverse Event Reporting System met the case definition of myocarditis (reported cases). Among recipients of either vaccine, there were only 13 reports or less of myocarditis beyond 10 days for any individual time from vaccination to symptom onset. The y-axis range differs between panels A and B.

A, For the BNT162b2 vaccine, there were 138 reported cases of myocarditis with known date for symptom onset and dose after 114 246 837 first vaccination doses and 888 reported cases after 95 532 396 second vaccination doses.

B, For the mRNA-1273 vaccine, there were 116 reported cases of myocarditis with known date for symptom onset and dose after 78 158 611 first vaccination doses and 311 reported cases after 66 163 001 second vaccination doses.

eMethods. Medical Dictionary for Regulatory Activities Preferred Terms, Definitions of Myocarditis and Pericarditis, Myocarditis medical review form

eFigure. Flow diagram of cases of myocarditis and pericarditis reported to Vaccine Adverse Event Reporting System (VAERS) after receiving mRNA-based COVID-19 vaccine, United States, December 14, 2020-August 31, 2021.

eTable 1. Characteristics of all myocarditis cases reported to Vaccine Adverse Event Reporting System (VAERS) after mRNA-based COVID-19 vaccination, United States, December 14, 2020–August 31, 2021.

eTable 2. Characteristics of all pericarditis cases reported to Vaccine Adverse Event Reporting System (VAERS) after mRNA-based COVID-19 vaccination, United States, December 14, 2020–August 31, 2021.

eTable 3. Characteristics of myocarditis cases reported to Vaccine Adverse Event Reporting System after mRNA-based COVID-19 vaccination by case definition status.

• Myocarditis and Pericarditis After Vaccination for COVID-19 JAMA Research Letter September 28, 2021 This study investigates the incidence of myocarditis and pericarditis emergency department or inpatient hospital encounters before COVID-19 vaccine availability (January 2019–January 2021) and during a COVID-19 vaccination period (February-May 2021) in a large US health care system. George A. Diaz, MD; Guilford T. Parsons, MD, MS; Sara K. Gering, BS, BSN; Audrey R. Meier, MPH; Ian V. Hutchinson, PhD, DSc; Ari Robicsek, MD
• Myocarditis Following a Third BNT162b2 Vaccination Dose in Military Recruits in Israel JAMA Research Letter April 26, 2022 This study assessed whether a third vaccine dose was associated with the risk of myocarditis among military personnel in Israel. Limor Friedensohn, MD; Dan Levin, MD; Maggie Fadlon-Derai, MHA; Liron Gershovitz, MD; Noam Fink, MD; Elon Glassberg, MD; Barak Gordon, MD
• Myocarditis Cases After mRNA-Based COVID-19 Vaccination in the US—Reply JAMA Comment & Response May 24, 2022 Matthew E. Oster, MD, MPH; David K. Shay, MD, MPH; Tom T. Shimabukuro, MD, MPH, MBA
• Myocarditis Cases After mRNA-Based COVID-19 Vaccination in the US JAMA Comment & Response May 24, 2022 Sheila R. Weiss, PhD
• JAMA Network Articles of the Year 2022 JAMA Medical News & Perspectives December 27, 2022 This Medical News article is our annual roundup of the top-viewed articles from all JAMA Network journals. Melissa Suran, PhD, MSJ
• Diagnosis and Treatment of Acute Myocarditis—A Review JAMA Review April 4, 2023 This Review summarizes current evidence regarding the diagnosis and treatment of acute myocarditis. Enrico Ammirati, MD, PhD; Javid J. Moslehi, MD
• Patient Information: Acute Myocarditis JAMA JAMA Patient Page August 8, 2023 This JAMA Patient Page describes acute myocarditis and its symptoms, causes, diagnosis, and treatment. Kristin Walter, MD, MS
• Myocarditis Following Immunization With mRNA COVID-19 Vaccines in Members of the US Military JAMA Cardiology Brief Report October 1, 2021 This case series describes myocarditis presenting after COVID-19 vaccination within the Military Health System. Jay Montgomery, MD; Margaret Ryan, MD, MPH; Renata Engler, MD; Donna Hoffman, MSN; Bruce McClenathan, MD; Limone Collins, MD; David Loran, DNP; David Hrncir, MD; Kelsie Herring, MD; Michael Platzer, MD; Nehkonti Adams, MD; Aliye Sanou, MD; Leslie T. Cooper Jr, MD
• Patients With Acute Myocarditis Following mRNA COVID-19 Vaccination JAMA Cardiology Brief Report October 1, 2021 This study describes 4 patients who presented with acute myocarditis after mRNA COVID-19 vaccination. Han W. Kim, MD; Elizabeth R. Jenista, PhD; David C. Wendell, PhD; Clerio F. Azevedo, MD; Michael J. Campbell, MD; Stephen N. Darty, BS; Michele A. Parker, MS; Raymond J. Kim, MD
• Association of Myocarditis With BNT162b2 Vaccination in Children JAMA Cardiology Brief Report December 1, 2021 This case series reviews comprehensive cardiac imaging in children with myocarditis after COVID-19 vaccine. Audrey Dionne, MD; Francesca Sperotto, MD; Stephanie Chamberlain; Annette L. Baker, MSN, CPNP; Andrew J. Powell, MD; Ashwin Prakash, MD; Daniel A. Castellanos, MD; Susan F. Saleeb, MD; Sarah D. de Ferranti, MD, MPH; Jane W. Newburger, MD, MPH; Kevin G. Friedman, MD

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Oster ME , Shay DK , Su JR, et al. Myocarditis Cases Reported After mRNA-Based COVID-19 Vaccination in the US From December 2020 to August 2021. JAMA. 2022;327(4):331–340. doi:10.1001/jama.2021.24110

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Myocarditis Cases Reported After mRNA-Based COVID-19 Vaccination in the US From December 2020 to August 2021

• 1 US Centers for Disease Control and Prevention, Atlanta, Georgia
• 2 School of Medicine, Emory University, Atlanta, Georgia
• 3 Children’s Healthcare of Atlanta, Atlanta, Georgia
• 4 Vanderbilt University Medical Center, Nashville, Tennessee
• 5 Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
• 6 Boston Medical Center, Boston, Massachusetts
• 7 Duke University, Durham, North Carolina
• 8 US Food and Drug Administration, Silver Spring, Maryland
• Research Letter Myocarditis and Pericarditis After Vaccination for COVID-19 George A. Diaz, MD; Guilford T. Parsons, MD, MS; Sara K. Gering, BS, BSN; Audrey R. Meier, MPH; Ian V. Hutchinson, PhD, DSc; Ari Robicsek, MD JAMA
• Research Letter Myocarditis Following a Third BNT162b2 Vaccination Dose in Military Recruits in Israel Limor Friedensohn, MD; Dan Levin, MD; Maggie Fadlon-Derai, MHA; Liron Gershovitz, MD; Noam Fink, MD; Elon Glassberg, MD; Barak Gordon, MD JAMA
• Comment & Response Myocarditis Cases After mRNA-Based COVID-19 Vaccination in the US—Reply Matthew E. Oster, MD, MPH; David K. Shay, MD, MPH; Tom T. Shimabukuro, MD, MPH, MBA JAMA
• Comment & Response Myocarditis Cases After mRNA-Based COVID-19 Vaccination in the US Sheila R. Weiss, PhD JAMA
• Medical News & Perspectives JAMA Network Articles of the Year 2022 Melissa Suran, PhD, MSJ JAMA
• Review Diagnosis and Treatment of Acute Myocarditis—A Review Enrico Ammirati, MD, PhD; Javid J. Moslehi, MD JAMA
• JAMA Patient Page Patient Information: Acute Myocarditis Kristin Walter, MD, MS JAMA
• Brief Report Myocarditis Following Immunization With mRNA COVID-19 Vaccines in Members of the US Military Jay Montgomery, MD; Margaret Ryan, MD, MPH; Renata Engler, MD; Donna Hoffman, MSN; Bruce McClenathan, MD; Limone Collins, MD; David Loran, DNP; David Hrncir, MD; Kelsie Herring, MD; Michael Platzer, MD; Nehkonti Adams, MD; Aliye Sanou, MD; Leslie T. Cooper Jr, MD JAMA Cardiology
• Brief Report Patients With Acute Myocarditis Following mRNA COVID-19 Vaccination Han W. Kim, MD; Elizabeth R. Jenista, PhD; David C. Wendell, PhD; Clerio F. Azevedo, MD; Michael J. Campbell, MD; Stephen N. Darty, BS; Michele A. Parker, MS; Raymond J. Kim, MD JAMA Cardiology
• Brief Report Association of Myocarditis With BNT162b2 Vaccination in Children Audrey Dionne, MD; Francesca Sperotto, MD; Stephanie Chamberlain; Annette L. Baker, MSN, CPNP; Andrew J. Powell, MD; Ashwin Prakash, MD; Daniel A. Castellanos, MD; Susan F. Saleeb, MD; Sarah D. de Ferranti, MD, MPH; Jane W. Newburger, MD, MPH; Kevin G. Friedman, MD JAMA Cardiology

Question   What is the risk of myocarditis after mRNA-based COVID-19 vaccination in the US?

Findings   In this descriptive study of 1626 cases of myocarditis in a national passive reporting system, the crude reporting rates within 7 days after vaccination exceeded the expected rates across multiple age and sex strata. The rates of myocarditis cases were highest after the second vaccination dose in adolescent males aged 12 to 15 years (70.7 per million doses of the BNT162b2 vaccine), in adolescent males aged 16 to 17 years (105.9 per million doses of the BNT162b2 vaccine), and in young men aged 18 to 24 years (52.4 and 56.3 per million doses of the BNT162b2 vaccine and the mRNA-1273 vaccine, respectively).

Meaning   Based on passive surveillance reporting in the US, the risk of myocarditis after receiving mRNA-based COVID-19 vaccines was increased across multiple age and sex strata and was highest after the second vaccination dose in adolescent males and young men.

Importance   Vaccination against COVID-19 provides clear public health benefits, but vaccination also carries potential risks. The risks and outcomes of myocarditis after COVID-19 vaccination are unclear.

Objective   To describe reports of myocarditis and the reporting rates after mRNA-based COVID-19 vaccination in the US.

Design, Setting, and Participants   Descriptive study of reports of myocarditis to the Vaccine Adverse Event Reporting System (VAERS) that occurred after mRNA-based COVID-19 vaccine administration between December 2020 and August 2021 in 192 405 448 individuals older than 12 years of age in the US; data were processed by VAERS as of September 30, 2021.

Exposures   Vaccination with BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna).

Main Outcomes and Measures   Reports of myocarditis to VAERS were adjudicated and summarized for all age groups. Crude reporting rates were calculated across age and sex strata. Expected rates of myocarditis by age and sex were calculated using 2017-2019 claims data. For persons younger than 30 years of age, medical record reviews and clinician interviews were conducted to describe clinical presentation, diagnostic test results, treatment, and early outcomes.

Results   Among 192 405 448 persons receiving a total of 354 100 845 mRNA-based COVID-19 vaccines during the study period, there were 1991 reports of myocarditis to VAERS and 1626 of these reports met the case definition of myocarditis. Of those with myocarditis, the median age was 21 years (IQR, 16-31 years) and the median time to symptom onset was 2 days (IQR, 1-3 days). Males comprised 82% of the myocarditis cases for whom sex was reported. The crude reporting rates for cases of myocarditis within 7 days after COVID-19 vaccination exceeded the expected rates of myocarditis across multiple age and sex strata. The rates of myocarditis were highest after the second vaccination dose in adolescent males aged 12 to 15 years (70.7 per million doses of the BNT162b2 vaccine), in adolescent males aged 16 to 17 years (105.9 per million doses of the BNT162b2 vaccine), and in young men aged 18 to 24 years (52.4 and 56.3 per million doses of the BNT162b2 vaccine and the mRNA-1273 vaccine, respectively). There were 826 cases of myocarditis among those younger than 30 years of age who had detailed clinical information available; of these cases, 792 of 809 (98%) had elevated troponin levels, 569 of 794 (72%) had abnormal electrocardiogram results, and 223 of 312 (72%) had abnormal cardiac magnetic resonance imaging results. Approximately 96% of persons (784/813) were hospitalized and 87% (577/661) of these had resolution of presenting symptoms by hospital discharge. The most common treatment was nonsteroidal anti-inflammatory drugs (589/676; 87%).

Conclusions and Relevance   Based on passive surveillance reporting in the US, the risk of myocarditis after receiving mRNA-based COVID-19 vaccines was increased across multiple age and sex strata and was highest after the second vaccination dose in adolescent males and young men. This risk should be considered in the context of the benefits of COVID-19 vaccination.

Myocarditis is an inflammatory condition of the heart muscle that has a bimodal peak incidence during infancy and adolescence or young adulthood. 1 - 4 The clinical presentation and course of myocarditis is variable, with some patients not requiring treatment and others experiencing severe heart failure that requires subsequent heart transplantation or leads to death. 5 Onset of myocarditis typically follows an inciting process, often a viral illness; however, no antecedent cause is identified in many cases. 6 It has been hypothesized that vaccination can serve as a trigger for myocarditis; however, only the smallpox vaccine has previously been causally associated with myocarditis based on reports among US military personnel, with cases typically occurring 7 to 12 days after vaccination. 7

With the implementation of a large-scale, national COVID-19 vaccination program starting in December 2020, the US Centers for Disease Control and Prevention (CDC) and the US Food and Drug Administration began monitoring for a number of adverse events of special interest, including myocarditis and pericarditis, in the Vaccine Adverse Event Reporting System (VAERS), a long-standing national spontaneous reporting (passive surveillance) system. 8 As the reports of myocarditis after COVID-19 vaccination were reported to VAERS, the Clinical Immunization Safety Assessment Project, 9 a collaboration between the CDC and medical research centers, which includes physicians treating infectious diseases and other specialists (eg, cardiologists), consulted on several of the cases. In addition, reports from several countries raised concerns that mRNA-based COVID-19 vaccines may be associated with acute myocarditis. 10 - 15

Given this concern, the aims were to describe reports and confirmed cases of myocarditis initially reported to VAERS after mRNA-based COVID-19 vaccination and to provide estimates of the risk of myocarditis after mRNA-based COVID-19 vaccination based on age, sex, and vaccine type.

VAERS is a US spontaneous reporting (passive surveillance) system that functions as an early warning system for potential vaccine adverse events. 8 Co-administered by the CDC and the US Food and Drug Administration, VAERS accepts reports of all adverse events after vaccination from patients, parents, clinicians, vaccine manufacturers, and others regardless of whether the events could plausibly be associated with receipt of the vaccine. Reports to VAERS include information about the vaccinated person, the vaccine or vaccines administered, and the adverse events experienced by the vaccinated person. The reports to VAERS are then reviewed by third-party professional coders who have been trained in the assignment of Medical Dictionary for Regulatory Activities preferred terms. 16 The coders then assign appropriate terms based on the information available in the reports.

This activity was reviewed by the CDC and was conducted to be consistent with applicable federal law and CDC policy. The activities herein were confirmed to be nonresearch under the Common Rule in accordance with institutional procedures and therefore were not subject to institutional review board requirements. Informed consent was not obtained for this secondary use of existing information; see 45 CFR part 46.102(l)(2), 21 CFR part 56, 42 USC §241(d), 5 USC §552a, and 44 USC §3501 et seq.

The exposure of concern was vaccination with one of the mRNA-based COVID-19 vaccines: the BNT162b2 vaccine (Pfizer-BioNTech) or the mRNA-1273 vaccine (Moderna). During the analytic period, persons aged 12 years or older were eligible for the BNT162b2 vaccine and persons aged 18 years or older were eligible for the mRNA-1273 vaccine. The number of COVID-19 vaccine doses administered during the analytic period was obtained through the CDC’s COVID-19 Data Tracker. 17

The primary outcome was the occurrence of myocarditis and the secondary outcome was pericarditis. Reports to VAERS with these outcomes were initially characterized using the Medical Dictionary for Regulatory Activities preferred terms of myocarditis or pericarditis (specific terms are listed in the eMethods in the Supplement ). After initial review of reports of myocarditis to VAERS and review of the patient’s medical records (when available), the reports were further reviewed by CDC physicians and public health professionals to verify that they met the CDC’s case definition for probable or confirmed myocarditis (descriptions previously published and included in the eMethods in the Supplement ). 18 The CDC’s case definition of probable myocarditis requires the presence of new concerning symptoms, abnormal cardiac test results, and no other identifiable cause of the symptoms and findings. Confirmed cases of myocarditis further require histopathological confirmation of myocarditis or cardiac magnetic resonance imaging (MRI) findings consistent with myocarditis.

Deaths were included only if the individual had met the case definition for confirmed myocarditis and there was no other identifiable cause of death. Individual cases not involving death were included only if the person had met the case definition for probable myocarditis or confirmed myocarditis.

We characterized reports of myocarditis or pericarditis after COVID-19 vaccination that met the CDC’s case definition and were received by VAERS between December 14, 2020 (when COVID-19 vaccines were first publicly available in the US), and August 31, 2021, by age, sex, race, ethnicity, and vaccine type; data were processed by VAERS as of September 30, 2021. Race and ethnicity were optional fixed categories available by self-identification at the time of vaccination or by the individual filing a VAERS report. Race and ethnicity were included to provide the most complete baseline description possible for individual reports; however, further analyses were not stratified by race and ethnicity due to the high percentage of missing data. Reports of pericarditis with evidence of potential myocardial involvement were included in the review of reports of myocarditis. The eFigure in the Supplement outlines the categorization of the reports of myocarditis and pericarditis reviewed.

Further analyses were conducted only for myocarditis because of the preponderance of those reports to VAERS, in Clinical Immunization Safety Assessment Project consultations, and in published articles. 10 - 12 , 19 - 21 Crude reporting rates for myocarditis during a 7-day risk interval were calculated using the number of reports of myocarditis to VAERS per million doses of COVID-19 vaccine administered during the analytic period and stratified by age, sex, vaccination dose (first, second, or unknown), and vaccine type. Expected rates of myocarditis by age and sex were calculated using 2017-2019 data from the IBM MarketScan Commercial Research Database. This database contains individual-level, deidentified, inpatient and outpatient medical and prescription drug claims, and enrollment information submitted to IBM Watson Health by large employers and health plans. The data were accessed using version 4.0 of the IBM MarketScan Treatment Pathways analytic platform. Age- and sex-specific rates were calculated by determining the number of individuals with myocarditis ( International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10] codes B33.20, B33.22, B33.24, I40.0, I40.1, I40.8, I40.9, or I51.4) 22 identified during an inpatient encounter in 2017-2019 relative to the number of individuals of similar age and sex who were continually enrolled during the year in which the myocarditis-related hospitalization occurred; individuals with any diagnosis of myocarditis prior to that year were excluded. Given the limitations of the IBM MarketScan Commercial Research Database to capture enrollees aged 65 years or older, an expected rate for myocarditis was not calculated for this population. A 95% CI was calculated using Poisson distribution in SAS version 9.4 (SAS Institute Inc) for each expected rate of myocarditis and for each observed rate in a strata with at least 1 case.

In cases of probable or confirmed myocarditis among those younger than 30 years of age, their clinical course was then summarized to the extent possible based on medical review and clinician interviews. This clinical course included presenting symptoms, diagnostic test results, treatment, and early outcomes (abstraction form appears in the eMethods in the Supplement ). 23

When applicable, missing data were delineated in the results or the numbers with complete data were listed. No assumptions or imputations were made regarding missing data. Any percentages that were calculated included only those cases of myocarditis with adequate data to calculate the percentages.

Between December 14, 2020, and August 31, 2021, 192 405 448 individuals older than 12 years of age received a total of 354 100 845 mRNA-based COVID-19 vaccines. VAERS received 1991 reports of myocarditis (391 of which also included pericarditis) after receipt of at least 1 dose of mRNA-based COVID-19 vaccine (eTable 1 in the Supplement ) and 684 reports of pericarditis without the presence of myocarditis (eTable 2 in the Supplement ).

Of the 1991 reports of myocarditis, 1626 met the CDC’s case definition for probable or confirmed myocarditis ( Table 1 ). There were 208 reports that did not meet the CDC’s case definition for myocarditis and 157 reports that required more information to perform adjudication (eTable 3 in the Supplement ). Of the 1626 reports that met the CDC’s case definition for myocarditis, 1195 (73%) were younger than 30 years of age, 543 (33%) were younger than 18 years of age, and the median age was 21 years (IQR, 16-31 years) ( Figure 1 ). Of the reports of myocarditis with dose information, 82% (1265/1538) occurred after the second vaccination dose. Of those with a reported dose and time to symptom onset, the median time from vaccination to symptom onset was 3 days (IQR, 1-8 days) after the first vaccination dose and 74% (187/254) of myocarditis events occurred within 7 days. After the second vaccination dose, the median time to symptom onset was 2 days (IQR, 1-3 days) and 90% (1081/1199) of myocarditis events occurred within 7 days ( Figure 2 ).

Males comprised 82% (1334/1625) of the cases of myocarditis for whom sex was reported. The largest proportions of cases of myocarditis were among White persons (non-Hispanic or ethnicity not reported; 69% [914/1330]) and Hispanic persons (of all races; 17% [228/1330]). Among persons younger than 30 years of age, there were no confirmed cases of myocarditis in those who died after mRNA-based COVID-19 vaccination without another identifiable cause and there was 1 probable case of myocarditis but there was insufficient information available for a thorough investigation. At the time of data review, there were 2 reports of death in persons younger than 30 years of age with potential myocarditis that remain under investigation and are not included in the case counts.

Symptom onset of myocarditis was within 7 days after vaccination for 947 reports of individuals who received the BNT162b2 vaccine and for 382 reports of individuals who received the mRNA-1273 vaccine. The rates of myocarditis varied by vaccine type, sex, age, and first or second vaccination dose ( Table 2 ). The reporting rates of myocarditis were highest after the second vaccination dose in adolescent males aged 12 to 15 years (70.73 [95% CI, 61.68-81.11] per million doses of the BNT162b2 vaccine), in adolescent males aged 16 to 17 years (105.86 [95% CI, 91.65-122.27] per million doses of the BNT162b2 vaccine), and in young men aged 18 to 24 years (52.43 [95% CI, 45.56-60.33] per million doses of the BNT162b2 vaccine and 56.31 [95% CI, 47.08-67.34] per million doses of the mRNA-1273 vaccine). The lower estimate of the 95% CI for reporting rates of myocarditis in adolescent males and young men exceeded the upper bound of the expected rates after the first vaccination dose with the BNT162b2 vaccine in those aged 12 to 24 years, after the second vaccination dose with the BNT162b2 vaccine in those aged 12 to 49 years, after the first vaccination dose with the mRNA-1273 vaccine in those aged 18 to 39 years, and after the second vaccination dose with the mRNA-1273 vaccine in those aged 18 to 49 years.

The reporting rates of myocarditis in females were lower than those in males across all age strata younger than 50 years of age. The reporting rates of myocarditis were highest after the second vaccination dose in adolescent females aged 12 to 15 years (6.35 [95% CI, 4.05-9.96] per million doses of the BNT162b2 vaccine), in adolescent females aged 16 to 17 years (10.98 [95% CI, 7.16-16.84] per million doses of the BNT162b2 vaccine), in young women aged 18 to 24 years (6.87 [95% CI, 4.27-11.05] per million doses of the mRNA-1273 vaccine), and in women aged 25 to 29 years (8.22 [95% CI, 5.03-13.41] per million doses of the mRNA-1273 vaccine). The lower estimate of the 95% CI for reporting rates of myocarditis in females exceeded the upper bound of the expected rates after the second vaccination dose with the BNT162b2 vaccine in those aged 12 to 29 years and after the second vaccination dose with the mRNA-1273 vaccine in those aged 18 to 29 years.

Among the 1372 reports of myocarditis in persons younger than 30 years of age, 1305 were able to be adjudicated, with 92% (1195/1305) meeting the CDC’s case definition. Of these, chart abstractions or medical interviews were completed for 69% (826/1195) ( Table 3 ). The symptoms commonly reported in the verified cases of myocarditis in persons younger than 30 years of age included chest pain, pressure, or discomfort (727/817; 89%) and dyspnea or shortness of breath (242/817; 30%). Troponin levels were elevated in 98% (792/809) of the cases of myocarditis. The electrocardiogram result was abnormal in 72% (569/794) of cases of myocarditis. Of the patients who had received a cardiac MRI, 72% (223/312) had abnormal findings consistent with myocarditis. The echocardiogram results were available for 721 cases of myocarditis; of these, 84 (12%) demonstrated a notable decreased left ventricular ejection fraction (<50%). Among the 676 cases for whom treatment data were available, 589 (87%) received nonsteroidal anti-inflammatory drugs. Intravenous immunoglobulin and glucocorticoids were each used in 12% of the cases of myocarditis (78/676 and 81/676, respectively). Intensive therapies such as vasoactive medications (12 cases of myocarditis) and intubation or mechanical ventilation (2 cases) were rare. There were no verified cases of myocarditis requiring a heart transplant, extracorporeal membrane oxygenation, or a ventricular assist device. Of the 96% (784/813) of cases of myocarditis who were hospitalized, 98% (747/762) were discharged from the hospital at time of review. In 87% (577/661) of discharged cases of myocarditis, there was resolution of the presenting symptoms by hospital discharge.

In this review of reports to VAERS between December 2020 and August 2021, myocarditis was identified as a rare but serious adverse event that can occur after mRNA-based COVID-19 vaccination, particularly in adolescent males and young men. However, this increased risk must be weighed against the benefits of COVID-19 vaccination. 18

Compared with cases of non–vaccine-associated myocarditis, the reports of myocarditis to VAERS after mRNA-based COVID-19 vaccination were similar in demographic characteristics but different in their acute clinical course. First, the greater frequency noted among vaccine recipients aged 12 to 29 years vs those aged 30 years or older was similar to the age distribution seen in typical cases of myocarditis. 2 , 4 This pattern may explain why cases of myocarditis were not discovered until months after initial Emergency Use Authorization of the vaccines in the US (ie, until the vaccines were widely available to younger persons). Second, the sex distribution in cases of myocarditis after COVID-19 vaccination was similar to that seen in typical cases of myocarditis; there is a strong male predominance for both conditions. 2 , 4

However, the onset of myocarditis symptoms after exposure to a potential immunological trigger was shorter for COVID-19 vaccine–associated cases of myocarditis than is typical for myocarditis cases diagnosed after a viral illness. 24 - 26 Cases of myocarditis reported after COVID-19 vaccination were typically diagnosed within days of vaccination, whereas cases of typical viral myocarditis can often have indolent courses with symptoms sometimes present for weeks to months after a trigger if the cause is ever identified. 1 The major presenting symptoms appeared to resolve faster in cases of myocarditis after COVID-19 vaccination than in typical viral cases of myocarditis. Even though almost all individuals with cases of myocarditis were hospitalized and clinically monitored, they typically experienced symptomatic recovery after receiving only pain management. In contrast, typical viral cases of myocarditis can have a more variable clinical course. For example, up to 6% of typical viral myocarditis cases in adolescents require a heart transplant or result in mortality. 27

In the current study, the initial evaluation and treatment of COVID-19 vaccine–associated myocarditis cases was similar to that of typical myocarditis cases. 28 - 31 Initial evaluation usually included measurement of troponin level, electrocardiography, and echocardiography. 1 Cardiac MRI was often used for diagnostic purposes and also for possible prognostic purposes. 32 , 33 Supportive care was a mainstay of treatment, with specific cardiac or intensive care therapies as indicated by the patient’s clinical status.

Long-term outcome data are not yet available for COVID-19 vaccine–associated myocarditis cases. The CDC has started active follow-up surveillance in adolescents and young adults to assess the health and functional status and cardiac outcomes at 3 to 6 months in probable and confirmed cases of myocarditis reported to VAERS after COVID-19 vaccination. 34 For patients with myocarditis, the American Heart Association and the American College of Cardiology guidelines advise that patients should be instructed to refrain from competitive sports for 3 to 6 months, and that documentation of a normal electrocardiogram result, ambulatory rhythm monitoring, and an exercise test should be obtained prior to resumption of sports. 35 The use of cardiac MRI is unclear, but it may be useful in evaluating the progression or resolution of myocarditis in those with abnormalities on the baseline cardiac MRI. 36 Further doses of mRNA-based COVID-19 vaccines should be deferred, but may be considered in select circumstances. 37

This study has several limitations. First, although clinicians are required to report serious adverse events after COVID-19 vaccination, including all events leading to hospitalization, VAERS is a passive reporting system. As such, the reports of myocarditis to VAERS may be incomplete, and the quality of the information reported is variable. Missing data for sex, vaccination dose number, and race and ethnicity were not uncommon in the reports received; history of prior SARS-CoV-2 infection also was not known. Furthermore, as a passive system, VAERS data are subject to reporting biases in that both underreporting and overreporting are possible. 38 Given the high verification rate of reports of myocarditis to VAERS after mRNA-based COVID-19 vaccination, underreporting is more likely. Therefore, the actual rates of myocarditis per million doses of vaccine are likely higher than estimated.

Second, efforts by CDC investigators to obtain medical records or interview physicians were not always successful despite the special allowance for sharing information with the CDC under the Health Insurance Portability and Accountability Act of 1996. 39 This challenge limited the ability to perform case adjudication and complete investigations for some reports of myocarditis, although efforts are still ongoing when feasible.

Third, the data from vaccination administration were limited to what is reported to the CDC and thus may be incomplete, particularly with regard to demographics.

Fourth, calculation of expected rates from the IBM MarketScan Commercial Research Database relied on administrative data via the use of ICD-10 codes and there was no opportunity for clinical review. Furthermore, these data had limited information regarding the Medicare population; thus expected rates for those older than 65 years of age were not calculated. However, it is expected that the rates in those older than 65 years of age would not be higher than the rates in those aged 50 to 64 years. 4

Based on passive surveillance reporting in the US, the risk of myocarditis after receiving mRNA-based COVID-19 vaccines was increased across multiple age and sex strata and was highest after the second vaccination dose in adolescent males and young men. This risk should be considered in the context of the benefits of COVID-19 vaccination.

Corresponding Author: Matthew E. Oster, MD, MPH, US Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333 ( [email protected] ).

Correction: This article was corrected March 21, 2022, to change “pericarditis” to “myocarditis” in the first row, first column of eTable 1 in the Supplement.

Accepted for Publication: December 16, 2021.

Author Contributions: Drs Oster and Su had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Oster, Shay, Su, Creech, Edwards, Dendy, Schlaudecker, Woo, Shimabukuro.

Acquisition, analysis, or interpretation of data: Oster, Shay, Su, Gee, Creech, Broder, Edwards, Soslow, Schlaudecker, Lang, Barnett, Ruberg, Smith, Campbell, Lopes, Sperling, Baumblatt, Thompson, Marquez, Strid, Woo, Pugsley, Reagan-Steiner, DeStefano, Shimabukuro.

Drafting of the manuscript: Oster, Shay, Su, Gee, Creech, Marquez, Strid, Woo, Shimabukuro.

Critical revision of the manuscript for important intellectual content: Oster, Shay, Su, Creech, Broder, Edwards, Soslow, Dendy, Schlaudecker, Lang, Barnett, Ruberg, Smith, Campbell, Lopes, Sperling, Baumblatt, Thompson, Pugsley, Reagan-Steiner, DeStefano, Shimabukuro.

Statistical analysis: Oster, Su, Marquez, Strid, Woo, Shimabukuro.

Obtained funding: Edwards, DeStefano.

Administrative, technical, or material support: Oster, Gee, Creech, Broder, Edwards, Soslow, Schlaudecker, Smith, Baumblatt, Thompson, Reagan-Steiner, DeStefano.

Supervision: Su, Edwards, Soslow, Dendy, Schlaudecker, Campbell, Sperling, DeStefano, Shimabukuro.

Conflict of Interest Disclosures: Dr Creech reported receiving grants from the National Institutes of Health for the Moderna and Janssen clinical trials and receiving personal fees from Astellas and Horizon. Dr Edwards reported receiving grants from the National Institutes of Health; receiving personal fees from BioNet, IBM, X-4 Pharma, Seqirus, Roche, Pfizer, Merck, Moderna, and Sanofi; and receiving compensation for being the associate editor of Clinical Infectious Diseases . Dr Soslow reported receiving personal fees from Esperare. Dr Schlaudecker reported receiving grants from Pfizer and receiving personal fees from Sanofi Pasteur. Drs Barnett, Ruberg, and Smith reported receiving grants from Pfizer. Dr Lopes reported receiving personal fees from Bayer, Boehringer Ingleheim, Bristol Myers Squibb, Daiichi Sankyo, GlaxoSmithKline, Medtronic, Merck, Pfizer, Portola, and Sanofi and receiving grants from Bristol Myers Squibb, GlaxoSmithKline, Medtronic, Pfizer, and Sanofi. No other disclosures were reported.

Funding/Support: This work was supported by contracts 200-2012-53709 (Boston Medical Center), 200-2012-53661 (Cincinnati Children’s Hospital Medical Center), 200-2012-53663 (Duke University), and 200-2012-50430 (Vanderbilt University Medical Center) with the US Centers for Disease Control and Prevention (CDC) Clinical Immunization Safety Assessment Project.

Role of the Funder/Sponsor: The CDC provided funding via the Clinical Immunization Safety Assessment Project to Drs Creech, Edwards, Soslow, Dendy, Schlaudecker, Lang, Barnett, Ruberg, Smith, Campbell, and Lopes. The authors affiliated with the CDC along with the other coauthors conducted the investigations; performed collection, management, analysis, and interpretation of the data; were involved in the preparation, review, and approval of the manuscript; and made the decision to submit the manuscript for publication.

Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the CDC or the US Food and Drug Administration. Mention of a product or company name is for identification purposes only and does not constitute endorsement by the CDC or the US Food and Drug Administration.

Additional Contributions: We thank the following CDC staff who contributed to this article without compensation outside their normal salaries (in alphabetical order and contribution specified in parenthesis at end of each list of names): Nickolas Agathis, MD, MPH, Stephen R. Benoit, MD, MPH, Beau B. Bruce, MD, PhD, Abigail L. Carlson, MD, MPH, Meredith G. Dixon, MD, Jonathan Duffy, MD, MPH, Charles Duke, MD, MPH, Charles Edge, MSN, MS, Robyn Neblett Fanfair, MD, MPH, Nathan W. Furukawa, MD, MPH, Gavin Grant, MD, MPH, Grace Marx, MD, MPH, Maureen J. Miller, MD, MPH, Pedro Moro, MD, MPH, Meredith Oakley, DVM, MPH, Kia Padgett, MPH, BSN, RN, Janice Perez-Padilla, MPH, BSN, RN, Robert Perry, MD, MPH, Nimia Reyes, MD, MPH, Ernest E. Smith, MD, MPH&TM, David Sniadack, MD, MPH, Pamela Tucker, MD, Edward C. Weiss, MD, MPH, Erin Whitehouse, PhD, MPH, RN, Pascale M. Wortley, MD, MPH, and Rachael Zacks, MD (for clinical investigations and interviews); Amelia Jazwa, MSPH, Tara Johnson, MPH, MS, and Jamila Shields, MPH (for project coordination); Charles Licata, PhD, and Bicheng Zhang, MS (for data acquisition and organization); Charles E. Rose, PhD (for statistical consultation); and Scott D. Grosse, PhD (for calculation of expected rates of myocarditis). We also thank the clinical staff who cared for these patients and reported the adverse events to the Vaccine Adverse Event Reporting System.

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12 Themed Cruises You Should Have On Your Radar In 2024

T aking a cruise is an experience unlike anything else. Days at sea on a ship full of entertainment and relaxation make for a fantastic vacation. But what if you want even more from your cruise? A theme might be what's missing. In addition to all the usual cruise experiences, themed cruises allow fans of a particular artist, lifestyle, hobby (or even animal), to celebrate their passion on the high seas with activities, events, surprises, and sometimes special guests.

There are dozens of themed cruises on offer each year, usually hosted by major cruise lines like Norwegian , Carnival, and Royal Caribbean. But don't let their numbers fool you. According to  Business Insider , themed cruises are rapidly climbing in popularity, and some trips are selling out in record time. That means it's important to find your dream-themed cruise and reserve your tickets as early as possible.

Fortunately, even if they're sold out, most themed cruises will let you join a waiting list, so there's still hope! Here are 12 themed cruises that will set sail in 2024 and are well worth boarding, either now or the next time they hit the high seas.

Read more: Under-The-Radar Beaches You Need To Visit In The Caribbean

The Emo's Not Dead Cruise

If you truly know it's not a phase, the Emo's Not Dead Cruise is perfect for you. Gather with fellow emo fans for four days (and nights) of concerts, activities, and even a private party at Great Stirrup Kay in the Bahamas. Over a dozen bands will perform, including Yellowcard, Senses Fail, and Armor for Sleep. Alongside themed activities like a masquerade ball, cruisegoers can also enjoy surprisingly cheerful activities like a bellyflop competition in the ship's pool.

The first Emo's Not Dead cruise was in 2022. Cruisegoer and emo fan TheReelChris shared highlights on  YouTube , calling it "EPIC." Fans in the comments section agree, with Schecterplayer92 adding, "This was one of the best experiences of my life." With a killer lineup and entertaining activities scheduled, it seems like Emo's Not Dead 2024 will also be a rad experience. The cruise will be hosted on the Norwegian Pearl, leaving from Miami on February 26 and returning on March 1, 2024. But what would an emo-related cruise be without a little sadness? Unfortunately, the cruise is already sold out. If you're interested, you can  sign up for the waiting list  and hope.

Meow Meow Cruise

Some of us know that no matter how great a vacation might be, cats would make it even better. Meow Meow Cruise has solved that problem. While guests unfortunately aren't allowed to bring their own furry friends aboard Virgin Voyages' Scarlet Lady, the four-day cruise will give them their feline fix in plenty of other ways. 

Activities include cat-themed trivia and a scavenger hunt. But the best part may be communing with fellow cat people (many of whom stroll around the ship wearing cat ears). You'll also be able to mingle with real cats -- one of 2024's ports of call is Key West, where you'll find the Ernest Hemingway Home & Museum and its community of about 60 friendly polydactyl kitties, many of them descended from one of the author's own pets.

It's hard to find reviews for Meow Meow Cruise, but the fact that this themed cruise has been going on annually since 2015 speaks for itself. The 2024 Meow Meow Cruise sets sail from Miami on February 21, with a return date of February 25. Tickets are still available, but to be sure you don't miss out, consider booking right now.

In My Cruise Era

Sure, cruises are great — and cruising is a multi-billion dollar industry — but is anything more popular than Taylor Swift? For those who can't imagine anyone saying "no" to that question, there's no better cruise than In My Cruise Era. While not officially affiliated with Taylor Swift, this themed cruise is a passionate fan homage. Swifties will be able to dress up in their favorite Taylor-inspired looks, exchange friendship bracelets, perform their idol's songs during karaoke sessions, and more. We're also guessing there will be of lots impromptu song breaks throughout the ship from Taylor's extensive catalog.

Royal Caribbean's Allure of the Seas will host this cruise, which sets sail from Miami on October 21, 2024 -- which, as People Magazine points out, is one day after the Eras Tour will be in the city. Fans lucky enough to attend the concert can continue their Taylor euphoria for four more days on the high seas. Since this is a new themed cruise, there aren't any reviews, but based on the positive fan vibes from Eras Tour concerts and movie viewings, among other events, we're guessing it's going to be a great time for Swifties. Swifties must agree, since the cruise is already sold out. Cancellations do happen, though, so hopeful fans can join the waiting list.  Contact the cruise's organizers to sign up.

Disney's Halloween On The High Seas

Go on just about any cruise-related blog or website and you'll see that Disney Cruise Line's Halloween-themed cruise, officially called Halloween on the High Seas, is a popular favorite. As you probably expect from Disney, this themed cruise is perfect for a family vacation , so it's not too scary. The cruise is hosted on multiple Disney Cruise Line ships, and each one is decorated with the care and attention to detail you'll find in most Disney-related enterprises. The Pumpkin Tree is the highlight of the decor, with pumpkins that eventually appear on its branches and transform into lit and unlit jack o'lanterns.

Halloween on the High Seas also features Halloween activities (including a trick-or-treating night) and exclusive Halloween-themed desserts. Disney cruises in general are known for their opportunities to meet the studio's beloved characters, and during the Halloween on the High Seas cruises, some of those characters are in costume. Notably, Disney Cruise Line's official site tells us, Minnie Mouse, Daisy Duck, and Clarabelle Cow will be dressed as the Sanderson Sisters -- who wouldn't want to see that? 

This magical mixture of whimsy, fun, and exclusive opportunities is the perfect way to cast a spell on Disney fans of all ages. Luckily, Halloween on the High Seas is held during a number of different times in September and October, so you and your family should be able to find a place on board!

The Hallmark Channel Christmas Cruise

Sure, Hallmark Channel Christmas movies might be a little on the cheesy side, but let's be honest: lots of us dream of being in one in real life. You can get a little of the real-life Hallmark movie experience by visiting some of the movies' filming locations , but now there's a way to have an even more immersive experience: The Hallmark Channel Christmas Cruise.

Passengers will get to meet Hallmark Channel movie stars, attend panels and photo ops, and get to see a new Hallmark Christmas movie before its world premiere. Maybe best of all, passengers can take part in lots of Hallmark Christmas movie-inspired activities, including tree lighting and cookie decorating -- all while wearing their favorite ugly Christmas sweaters.

2024 is the first year of the Hallmark Channel Christmas Cruise. It was originally intended to be just one cruise, but a second one was added after the first one sold out. As of now, two Hallmark Channel Christmas Cruises are scheduled for 2024. Both go from Miami to the Bahamas and back and last four days in November. ... And both are sold out. But Christmas is a time of miracles, so if a Hallmark Channel Christmas experience on the high seas sounds like your dream come true, sign up for the waiting list as soon as you can!

Hurtigruten Northern Lights Cruises

Themed cruises are often about fandoms and hobbies. But Norway-based cruise line Hurtigruten offers a themed cruise that's about something even bigger: the Northern Lights . There are several Northern Lights-themed cruises out there, including some luxurious options by Cunard. Unfortunately, the Northern Lights aren't always visible, but Hurtigruten stands out by offering a Northern Lights Promise for cruises scheduled between September 26 and March 31 and lasting longer than 11 days. If the Northern Lights aren't visible during your cruise, they'll give you another one. So if you're serious about seeing the Aurora Borealis, this is the company to choose.

The Northern Lights are the focus of Hurtigruten's eponymous cruises, but there are also other things to do on board, including scientific lectures and photography lessons. There are excursions, too -- notably a dog sledding option. Passengers who've taken one of Hurtigruten's cruises unanimously praise the stunning fjords and landscapes you can admire from the ship and during excursions, not to mention their experiences of seeing the Northern Lights. Some warn that the ships aren't as luxurious or modern as many other cruise ships, primarily because Hurtigruten's ships are also functional vessels intended to transport and deliver mail to various points on the Norwegian coast. Still,  Cruise Critic reviewers like cmolaison praise the friendly crew, the surprising level of comfort, and the "stunning vistas" you'll see, saying he and his family "highly recommend" taking a Hurtigruten cruise.

Cruise & Crop Crafting Cruises

If the perfect vacation for you is a combination of R&R and crafting, you're in luck! There are several crafting-themed cruises. One of the most popular is organized by Cruise & Crop, with ships around the world hosting different crafting- and arts-themed trips. This makes them the most accessible themed cruises on our list, with different price ranges, departure points, itineraries, and ports of call. One thing all crafting cruises have in common, though, is groups of like-minded people exploring their creativity amid the other joys of cruising.

For instance, one of Crop & Cruise's 2024 offerings is a Mexican Riviera cruise aboard Royal Caribbean's Navigator of the Seas, featuring scrapbooking and other papercraft classes taught by artist Barb Warne. The ship departs from Los Angeles on April 19, returning April 26. Many Cruise & Crop cruises sell out quickly, so if this idea has sparked both your wanderlust and your creativity, be sure to check their list of 2024 cruises and reserve as soon as you can.

Star Trek: The Cruise

For seven days and nights every year, thousands of Star Trek fans gather to be a part of a fandom extravaganza at sea. Star Trek: The Cruise is an experience that features celebrities aboard (2024's guests include LeVar Burton and Wil Wheaton, among many others), costume and cosplay events, and lots of fun activities. 

But what makes Star Trek: The Cruise truly unique is that audience participation is very much encouraged. Passengers and celebrity guests are all considered the crew of one great, big, intergalactic vessel. Passengers get to interact with the guest stars in events like karaoke battles, and stars share parts of their earthly lives with Q&A sessions and even glimpses at other projects they may be involved in.

The first Star Trek: The Cruise was held in 2017 and since then it's been a fan favorite. Star Wars and cruising aficionado Aaron Bossig writes on  Trek Movie.com that many fans go on the cruise every year, and proudly wear t-shirts from the previous ones. He calls Star Trek: The Cruise "an extra special convention experience." 2024's edition will be held on the Mariner of the Seas, departing from Cape Canaveral, Florida, on February 22 and returning on February 29.

Literature Festival At Sea

Once a year, aboard the legendary Queen Mary 2, passengers can mingle with writers, poets, journalists, and critics in a full-blown literary festival in the middle of the Atlantic Ocean. Literature Festival at Sea invites writers in all genres to host round table discussions, participate in Q&As revolving around their work and areas of expertise, host workshops, and converse with passengers.

Whether passengers want to participate as much as possible or just attend a few events, the Festival seems to be an excellent addition to a typical Queen Mary 2 voyage. On TripAdvisor , passenger Artemis C writes of her experience at a previous Literature Festival at Sea that "the whole week was a joy". 

2024's lineup features crime novelists, journalists, historians, and more, for what's sure to be a fascinating week of discussion and discovery. If you'd like to combine an elegant transatlantic cruise and a literary experience, 2024's Literature Festival at Sea will take place from November 13-20, departing from Southampton, U.K., and arriving in New York. Cunard has also launched an Australian Literature Festival at Sea, scheduled from December 11-16, 2024, on the Queen Elizabeth, which departs from and returns to Sydney. 

Chefs Making Waves

Many cruise lines are proud of their food offerings. Some cruises feature dishes created by world-famous chefs, and others even host food and wine festivals. But no culinary cruise event seems quite as, well, fun, as Chefs Making Waves. This culinary-themed cruise will set sail for the first time in 2024. Onboard will be a number of beloved celebrity chefs, including Anne Burrell and the Cake Boss himself, Buddy Valastro. Cooking demos and, of course, food tastings of all kinds (including sit-down meals, desserts, and street food) are on the menu. Best of all, Chefs Making Waves is an all-inclusive cruise, so everyone can eat and drink without having to pay extra!

There will be all of the usual cruise-related fun, from swimming to excursions, to help you work up an appetite. There will also be unique games, with some of the chefs participating in events like bingo and a celebrity chef sing-off. If this sounds like an awesome cruise, you're not the only one who feels that way. Chefs Making Waves will take place from March 25-29, departing from Miami with excursions in Great Stirrup Cay and Nassau, Bahamas ... and it's already sold out. But you can still  sign up for the waiting list . With a little luck, you'll be able to enjoy this delicious, themed cruise experience.

Soul Train Cruise

Imagine a festival with a lineup featuring some of the best soul and R&B acts of all time. Now imagine it's on a relaxing cruise ship. This dream is actually reality -- it's called the Soul Train Cruise. The popular themed cruise will be celebrating its 11th year in 2024 and the lineup is on fire. Dozens of groups and artists will perform, including The Temptations, Boyz II Men, and En Vogue. Passengers can also learn how to dance like people did back in the old school days of Soul Train's TV show, with lessons from some of the show's actual dancers. There will also be wine tastings, Q&A's, comedy shows, and a lot more.

With all of this on offer, it's no surprise that the Soul Train Cruise is sold out. But sign up on the waiting list and keep your calendar free from January 27-February 3, and you may get lucky. If you do, the cruise leaves from Fort Lauderdale, with ports of call in Tortola (British Virgin Islands) and St. Maarten.

The Gothic Cruise

The Gothic Cruise is an annual event held on an ordinary cruise ship. Goths mingle with "norms" but have their own private events on board, mostly DJ sets and concerts. There's also a masquerade ball, with Goths decked out in their finest Victorian-style garb ... as long as it meets ship safety requirements, that is. The cruise's website specifies that simulated weapons aren't allowed and notes that hoop skirts are fine for the ball but not in the ship's dining areas, "due to the close proximity of the tables". And yet, the Goth community thrives on these cruises -- and even gains norm fans along the way. 

In a Porthole Magazine article about the Gothic Cruise, longtime attendee Spike Pittman says that many mainstream passengers are wary of the Goths at first, "But by the end they're begging to get into our private events." Some even book their future cruises to coincide with the Gothic Cruise, even if they don't plan on attending every event. 

The Gothic Cruise has been held since 1989. Cruising doesn't seem very Goth, but in the end, the article points out, it comes down to what all themed cruises offer: a sense of community (in this case, one that often stays up all night and sleeps during the day). If this moves your little black heart, the 2024 Gothic Cruise will be held on the Norwegian Escape (but book through the Gothic Cruise's website for private event access), departing from Orlando on March 2, and returning March 9.

Read the original article on Explore .

Late-Season Influenza Vaccine Effectiveness Against Medically Attended Outpatient Illness, United States, December 2022-April 2023

Affiliations.

• 1 Influenza Division, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
• 2 Baylor Scott & White Health, Temple, Texas, USA.
• 3 Department of Pediatrics, Baylor College of Medicine, Temple, Texas, USA.
• 4 Department of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
• 5 Department of Emergency Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.
• 6 Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA.
• 7 Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA.
• 8 Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
• 9 Henry Ford Health, Detroit, Michigan, USA.
• 10 Biodesign Center for Personalized Diagnostics, Arizona State University, Tempe, Arizona, USA.
• 11 Biodesign Center for Fundamental & Applied Microbiomics, Arizona State University, Tempe, Arizona, USA.
• 12 Division of Infectious Diseases and HIV Medicine, University Hospitals of Cleveland, Cleveland, Ohio, USA.
• 13 Department of Emergency Medicine, University Hospitals of Cleveland, Cleveland, Ohio, USA.
• 14 Duke Human Vaccine Institute, Duke University School of Medicine, Durham, North Carolina, USA.
• PMID: 38923314
• PMCID: PMC11194453
• DOI: 10.1111/irv.13342

Background: The 2022-23 US influenza season peaked early in fall 2022.

Methods: Late-season influenza vaccine effectiveness (VE) against outpatient, laboratory-confirmed influenza was calculated among participants of the US Influenza VE Network using a test-negative design.

Results: Of 2561 participants enrolled from December 12, 2022 to April 30, 2023, 91 laboratory-confirmed influenza cases primarily had A(H1N1)pdm09 (6B.1A.5a.2a.1) or A(H3N2) (3C.2a1b.2a.2b). Overall, VE was 30% (95% confidence interval -9%, 54%); low late-season activity precluded estimation for most subgroups.

Conclusions: 2022-23 late-season outpatient influenza VE was not statistically significant. Genomic characterization may improve the identification of influenza viruses that circulate postinfluenza peak.

Keywords: influenza; vaccination; vaccine effectiveness.

© 2024 The Author(s). Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.

• Aged, 80 and over
• Child, Preschool
• Influenza A Virus, H1N1 Subtype* / genetics
• Influenza A Virus, H1N1 Subtype* / immunology
• Influenza A Virus, H3N2 Subtype* / genetics
• Influenza A Virus, H3N2 Subtype* / immunology
• Influenza Vaccines* / administration & dosage
• Influenza Vaccines* / immunology
• Influenza, Human* / epidemiology
• Influenza, Human* / immunology
• Influenza, Human* / prevention & control
• Influenza, Human* / virology
• Middle Aged
• Outpatients* / statistics & numerical data
• United States / epidemiology
• Vaccination / statistics & numerical data
• Vaccine Efficacy*
• Young Adult
• Influenza Vaccines

Grants and funding

• CC/CDC HHS/United States
• 1 U01 IP001180-01/US Centers for Disease Control and Prevention Cooperative Agreement
• 1 U01 IP001181-01/US Centers for Disease Control and Prevention Cooperative Agreement
• 1 U01 IP001182-01/US Centers for Disease Control and Prevention Cooperative Agreement
• 1 U01 IP001184-01/US Centers for Disease Control and Prevention Cooperative Agreement
• 1 U01 IP001189-01/US Centers for Disease Control and Prevention Cooperative Agreement
• 1 U01 IP001191-01/US Centers for Disease Control and Prevention Cooperative Agreement
• 1 U01 IP001193-01/US Centers for Disease Control and Prevention Cooperative Agreement
• 1 U01 IP001194-01/US Centers for Disease Control and Prevention Cooperative Agreement
• UL1TR001857/NH/NIH HHS/United States

Featured Article

A comprehensive list of 2024 tech layoffs

From major layoffs at tesla, amazon and microsoft to small fintech startups and apps.

The tech layoff wave is still going strong in 2024. Following significant workforce reductions in 2022 and 2023 , this year has already seen 60,000 job cuts across 254 companies, according to independent layoffs tracker Layoffs.fyi . Companies like Tesla , Amazon , Google , TikTok , Snap and Microsoft have conducted sizable layoffs in the first months of 2024. Smaller-sized startups have also seen a fair amount of cuts, and in some cases, have shut down operations altogether .

By tracking these layoffs, we’re able to understand the impact on innovation across companies large and small. We’re also able to see the potential impact of businesses embracing AI and automation for jobs that had previously been considered safe. It also serves as a reminder of the human impact of layoffs and what could be at stake in regards to increased innovation.

Below you’ll find a comprehensive list of all the known layoffs in tech that have occurred in 2024, to be updated regularly. If you have a tip on a layoff, contact us here . If you prefer to remain anonymous, you can contact us here .

• January 2024: 19,350 employees laid off — see all January 2024 Tech Layoffs
• February 2024: 15,589 employees laid off — see all February 2024 Tech Layoffs
• March 2024: 7,403 employees laid off — see all March 2024 Tech Layoffs
• April 2024: 22,153 employees laid off — see all April 2024 Tech Layoffs
• May 2024: 9,882 employees laid off — see all May 2024 Tech Layoffs

Ginkgo Bioworks

Terminated 158 employees, with another batch of layoffs expected to come as the company aims to reduce its workforce by 25%.

Is making cuts to 10% of its workforce, impacting around 20 to 25 employees.

Is laying off 375 employees, accounting for 5% of its total workforce.

Will eliminate up to 85 employees based in Ireland, the company announced.

Is reportedly laying off around 30 employees in Israel and will move positions to other regions to cut costs.

Cut 16 employees in its supplier resource management department as it focuses on automation.

Is reducing its global headcount by 23% in a major restructuring effort as the online learning platform aims to become a “leaner” operation.

Is closing up shop and liquidating its assets. The number of employees affected is currently unknown.

Is reducing its headcount by 15% as the company attempts to “think in longer time frames,” the company announced in a blog post.

Is making more cuts, co-CEO Carey Anne Nadeau announced on LinkedIn . The number of employees impacted is currently unknown.

Will lay off its 143 employees by July 3 due to a “funding loss,” and will no longer be accepting new orders. The company has not shut down fully though, telling TechCrunch: “We are actively exploring options for the brand but do not have anything definitive to communicate at this time.”

Running Tide

Shut down its operations and laid off its remaining employees after raising more than $50 million since its 2017 start.

Is laying off 70 employees, about 30% of its workforce, three weeks after an earlier round of cuts impacted 34 employees.

Is slashing around 450 jobs at its Indonesian e-commerce division, accounting for 9% of the unit. 

Has eliminated around 30% of its total workforce , CEO Graham Gaylor confirmed in a statement.

Is reportedly conducting large cuts across the company. The total number of employees impacted is currently unknown.

Has cut around 45 jobs as part of a restructuring effort.

Copia Global

Has laid off at least 1,060 employees two weeks after the startup filed for administration.

Is laying off its 1,000+ staff drivers as it embraces a gig worker model similar to that of Lyft and Uber.

Has cut 30 employees a month after the Bengaluru-based startup laid off 160 people.

Has confirmed layoffs of 150 jobs as it drastically scales back its expansion ambitions to focus on its markets in Norway and Sweden.

Is laying off 100 workers, or 20% of its staff, in another round of cuts.

Is reportedly laying off 10% of its workforce, amounting to around 30 people.

Is reportedly cutting hundreds of employees working in its Azure cloud business, though the exact number of employees impacted is currently unknown.

Is laying off 100 employees months after reducing its headcount by 50 workers.

Is reportedly making large cuts globally across several of its Cloud teams, including teams focused on sustainability, consulting and partner engineering.

Is eliminating 40 employees as part of a restructuring effort, CEO David Campbell wrote in a post on LinkedIn . 

Gro Intelligence

Is shutting down its operations after laying off 60% of its staff in March in an attempt to stay afloat.

Jasper Health

Has laid off a substantial part of its workforce , TechCrunch learned. Engineering and product design departments were most impacted by the cuts at the cancer care platform startup.

Is laying off 37 tech workers at FlightStats , the flight tracking startup it acquired in 2016, as it plans to consolidate its operations in India and the U.K.

Is cutting 15 employees in a round of layoffs, impacting 20% of the Israeli startup’s total workforce.

Has laid off hundreds of employees in a bid to keep the EV startup alive . One current and one laid off employee told TechCrunch exclusively that an estimated 150 people remain at the company.

Is shutting down its operations and laying off the rest of its staff. The COVID-19 test company laid off half of its workforce earlier this month to cut costs.

Has let go of 105 employees as the company seeks to “streamline” its operations, according to an email to staffers from current CEO Gary Little.

Lucid Motors

Is laying off about 400 employees , roughly 6% of its workforce, as part of a restructuring ahead of the launch of its first electric SUV later this year.

Will reportedly make large cuts to its global operations and marketing teams. The amount of employees impacted is currently unknown.

Will reportedly cut 14% of its staff , impacting 175 employees, as the company shifts its focus from original Disney+ programming back to films.

Let go of 20% of its staff as the coding startup shifts its focus to enterprise sales.

Cut about 30% of its total workforce . The recruiting startup that uses AI to find candidates was last valued at over $1.2 billion in January 2022 .

Eliminated 6% of its staff in another round of layoffs as the fast-delivery startup attempts to become cash-flow positive by the end of 2024.

Plans to lay off 106 employees , according to a WARN notice filed in Texas. 

Has shut down its operations . The number of employees affected is currently unknown.

Is cutting roughly 1,000 jobs, impacting 8% of the company’s headcount, CEO Chris Hyams wrote in a letter to staff .

Cut around 40% of its workforce, impacting about 550 employees, sources told TechCrunch . The company’s chief operating officer, Abe Ghabra, has also left the company.

Will eliminate 57 positions in San Francisco , according to a WARN notice filed in California.

Is eliminating 800 employees , accounting for 13% of its workforce, as part of a restructuring effort.

Told The Verge it has laid off most of its staff and is no longer selling its smart home controllers and light switches as it looks for a buyer.

Laid off roughly 170 workers , impacting a third of its total headcount, in an effort to cut back on annual operating costs. 

Closed Arkane Austin, Tango Gameworks, and more game studios as part of cuts at Bethesda . It’s currently unclear how many employees will be impacted.

Is eliminating 230 employees, about 49% of its workforce, in a cost cutting measure laid out in documents filed with the U.S. SEC .

Is slashing its workforce by 20% . The cuts will affect around 140 employees, and the company is also cutting ties with “the majority” of its contract workers.

Has laid off about 3% of its workforce , impacting 116 people, the company confirmed to TechCrunch in a statement. The cuts come over a year after the company eliminated about 4% of its headcount .

Is laying off 15% of its workforce , affecting about 400 people, as part of a cost-cutting effort. The company’s CEO Barry McCarthy is also stepping down.

Has gutted its charging team in a new round of layoffs , CEO Elon Musk announced in an overnight email to executives.

Has laid off staff across key teams like Flutter, Dart and Python . It is currently unclear how many employees were let go.

Is laying off more employees to “preserve cash,” according to an internal email viewed by TechCrunch . The number of cuts is currently unknown.

Is shutting down operations in the U.S., the U.K. and Europe, impacting at least 6,000 jobs across the closing markets .

Is cutting about 180 jobs in a profitability push and has let go its chief executive Hemant Bakshi, a source familiar with the matter told TechCrunch.

True Anomaly

The space and defense startup laid off nearly 30 people, accounting for about 25% of its workforce, due to “duplication of roles and functions across the company,” TechCrunch exclusively reported.

Is expected to cut employees in its Austin office for the second time this year.

Plans to eliminate 740 employees at its Oregon headquarters this summer, according to a WARN Act notice.

Stability AI

Is eliminating 10% of its workforce following the exit of former CEO Emad Mostaque.

Is laying off workers as part of continued cost cutting measures . The number of employees affected was at the time unknown.

Is reducing its total workforce by 1% . It’s the second round of layoffs for the EV maker this year.

Is laying off 5% of its workforce , affecting around 579 employees. The GTA 6 publisher also announced the elimination of “several projects” in development.

Is eliminating about 20% of its 59 employees in a restructuring effort.

Is cutting “more than 10%” of its global workforce , per an internal email sent by CEO Elon Musk. That could impact more than 14,000 workers worldwide, as Tesla prepares itself “for our next phase of growth” amid a challenging EV market.

Is reducing its global workforce by nearly 4%, impacting up to 140 employees .

Is laying off 250 employees based in Ireland as it restructures its Training and Quality team.

Hinge Health

Cut approximately 10% of its workforce, TechCrunch exclusively learned , as the company prepares for an IPO and aims to reach profitability.

Has laid off 382 employees, amounting to 32% of its total workforce, TechCrunch exclusively learned . The background-screening platform was last valued at $5 billion in April of 2022.

Reportedly laid off a sizable part of its staff in a restructuring effort. The number of employees impacted is currently unknown, but sources told Inc42 that it could be “in the range of 70-100” workers.

Is laying off 614 employees in California after abandoning its electric car project , according to a WARN notice .

Agility Robotics

Has laid off a “small number” of employees as part of a company-wide focus on commercialization efforts.

Ghost Autonomy

Shut down operations. The company, which was backed by OpenAI, employed about 100 people .

Is shutting down Yummly , the recipe and cooking app it acquired in 2017.

Will cut hundreds of jobs across Sales, Marketing, Global Services and its Physical Stores Technology team.

Byju’s

Is laying off about 500 employees , accounting for 3% of its total workforce, as part of a restructuring effort.

Has laid off 20% of its staff after acquiring point-of-sale platform Cuboh. The company previously laid off 100 people in 2022.

Nintendo of America

Is restructuring its testing department, which is largely made up of contractors. A Nintendo spokesperson told Kotaku the changes will end some assignments but will lead to the creation of new full-time positions.

Cut its global workforce by about 6,000 jobs , according to a 10-K SEC filing . The filing reveals the company cut 13,000 jobs in the last year .

Has made cuts to its staff, the company confirmed to TechCrunch . A report in Fintech Business Weekly estimates that 17 people, or about 15% of the company, were impacted. 

Is cutting 195 roles in an effort to become more sustainable, CEO Henry Chan wrote in a blog post . The layoffs impact nearly a quarter of its staff.

Reportedly eliminated 20% of its total workforce in its second restructuring effort in the past year.

Chipper Cash

Conducted another round of layoffs impacting 20 employees, CEO Ham Serunjogi announced in a blog post . 

Has reportedly cut 16% of its staff in a strategic move to support its Textio Lift product. 

Is reportedly laying off around 25% of its workforce . According to Axios, the cuts affect roughly 80 people.

Phantom Auto

Is shutting down after failing to secure new funding, TechCrunch has learned . The remote driving startup, which had cut staff last year, employed a little more than 100 people.

Is reportedly slashing its marketing and communications staff. The company previously announced a strategy to replace upwards of 8,000 jobs with AI.

Inscribe.ai

Cut just under 40% of its staff, equating to dozens of employees, the company confirmed to TechCrunch .

Laid off around 15 people earlier this year , following comments from CEO Chris Caren that the company would be able to reduce 20% of its headcount thanks to AI.

Laid off 13% of its staff based in its New York office as the web3 fantasy sports platform focuses on its Paris headquarters, a source familiar with the matter told TechCrunch .

Is eliminating roughly 7% of its workforce as part of organizational restructuring. The fintech unicorn last conducted layoffs in August 2022.

Is cutting about 13% of its workforce , affecting 40 employees. It’s the second round of layoffs for the battery startup in recent months.

Project Ronin

Is shutting down, resulting in a “permanent mass layoff” impacting around 150 employees.

February 2024

Plans to lay off 15% of its workforce and says it likely does not have enough cash on hand to survive the next 12 months.

Cut 5% of its workforce , impacting 670 employees, as it moves away from the “development of future licensed IP.”

Is letting go of about 350 employees, accounting for 30% of its workforce.

Is likely cutting hundreds of employees who worked on the company’s autonomous electric car project now that the effort has stopped, TechCrunch has learned.

Is laying off 900 employees from its PlayStation unit, affecting 8% of the division’s workforce. Insomniac Games, Naughty Dog, Guerrilla and Firesprite studios will also be impacted .

Will reportedly cut 1,500 roles in 2024 , primarily in its Product & Technology division, accounting for more than 8% of the company’s workforce.

Eliminated roughly 60 employees , or 17% of its workforce. It’s the financial startup’s third major layoff round in the past 12 months.

Is laying off 10% of its salaried workforce in a bid to cut costs in an increasingly tough market for EVs.

Meati Foods

Will lay off 13% of its workforce as it works to “build a financially sustainable business,” CEO Phil Graves told TechCrunch exclusively .

Announced it will eliminate 5% of its employees, impacting more than 4,000 people .

Will lay off about 550 workers in a move designed to promote “operating expense efficiency.”

Announced in an SEC filing that it will lay off roughly 250 employees as part of a restructuring effort.

Is scaling back its investment in a number of products, TechCrunch has learned, resulting in layoffs that will affect roughly 60 employees .

Is laying off 230 employees worldwide as part of the company’s efforts to advance its focus on “the AI-enabled workplace of the future.”

Is cutting 30% of its North American workforce as part of a restructuring.

Is reportedly cutting jobs in its healthcare businesses One Medical and Amazon Pharmacy. The number of impacted roles is currently unknown.

Announced plans to eliminate 6% of its workforce , largely impacting the company’s sales and marketing divisions.

Announced plans to cut 10% of its workforce , impacting roughly 500-plus employees, in an effort to “reduce hierarchy.”

Polygon Labs

Has laid off 60 employees , or about 19% of its staff, CEO Marc Boiron announced in a blog post .

Is laying off approximately 400 employees . The layoffs come almost exactly a year to the day after Okta announced plans to cut about 300 employees.

January 2024

Will lay off 95 workers in New York City, according to a filing with the New York Department of Labor.

Is laying off about 6% of its global workforce , or 280 employees, the company confirmed to TechCrunch.

Conducted another round of layoffs earlier this month, amounting to roughly 15% of its workforce, a source familiar with the situation told TechCrunch. 

Is reportedly laying off around 1,000 people in the Cash App, foundational and Square arms of Block.

Has reportedly begun company-wide layoffs . While it is unclear how many people will be affected, one source told TechCrunch it was expected to be in the “thousands.”

Aurora Solar

Has laid off 20% of its staff of about 1,000 people, TechCrunch exclusively learned. The cuts to the software startup come despite record growth in the solar industry last year.

Is laying off 350 people , or one-third of its headcount, after Amazon’s bid to acquire the Roomba-maker shuttered. Longtime CEO Colin Angle has also stepped down.

Is reportedly laying off 700 workers , or around 1% of its staff. This comes after the company had a significant reduction of 10% of its workforce in 2023.

Is reportedly planning to cut around 20% of its staff in the next few weeks. The company announced similar cuts in October, when founder Ryan Petersen returned as CEO and slashed its workforce by 20%.

Is laying off 1,900 employees across its gaming divisions following its acquisition of Activision Blizzard. Blizzard president Mike Ybarra announced he will also be stepping down.

Is cutting about 400 jobs , 7% of its workforce, as the food delivery startup seeks to bring further improvements to its finances ahead of a planned IPO later this year.

Laid off dozens of workers , according to sources familiar with the decision. The autonomous vehicle technology company has since confirmed that about 3% of its workforce has been laid off.

Will lay off 9% of the company’s workforce , affecting about 1,000 full-time employees. In a blog post , the company also plans to cut contract roles in the coming months.

Announced it intends to offer voluntary buyouts or job changes to 8,000 employees amid restructuring.

Laid off 20% of its staff , affecting 282 workers. In a blog post , Co-CEO Pedro Franceschi said that the company is prioritizing “long-term thinking and ownership over short-term gains in our comp structure.”

Eliminated around 60 jobs across the U.S. in Los Angeles, New York, and Austin in addition to layoffs in international markets. The affected roles, according to NPR’s initial reporting, are largely in sales and advertising.

Is cutting 90% of its employees as it shuts down its online used car marketplace and shifts resources into two business units: one focused on auto financing and the other on AI-powered analytics.

Is laying off 11% of its workforce , affecting about 530 employees, as the company focuses on “fewer, high-impact projects.” The League of Legends maker is also sunsetting its five-year-old publishing group , Riot Forge.

Is eliminating 13% of its global workforce , affecting 1,650 employees, in a restructuring effort aimed at cutting layers of management.

Will eliminate 100 employees , a spokesperson confirmed to TechCrunch, as part of a restructuring effort in its creator management and operations teams.

Is laying off “hundreds” of employees in its advertising sales team, according to a leaked memo. The cuts come a week after the company did sweeping layoffs across its hardware teams. And more layoffs will come throughout the year, as CEO Sundar Pichai told the company in a memo obtained by the Verge .

Lost Boys Interactive

Reportedly laid off a “sizable” number of employees January 12. The game developer studio was acquired by Borderlands maker Gearbox in 2022.

Is going to lay off employees in 2024, TechCrunch exclusively learned , with the total impacted employees potentially reaching as high as 20% of the animation studio’s 1,300 person workforce. The cutbacks come as Disney looks to reduce the studio’s output as it struggles to achieve profitability in streaming.

Is laying off 5% of its workforce , citing an “increasingly challenging landscape,” according to a leaked memo obtained by Business Insider.

Is laying off 17% of its staff , impacting 170 people. In an internal memo obtained by the Verge , Discord CEO Jason Citron blamed the cuts on the company growing too quickly.

Laid off hundreds of employees across its Google Assistant division and the team that manages Pixel, Nest and Fitbit hardware. The company confirmed to TechCrunch that Fitbit co-founders James Park and Eric Friedman are also exiting.

Is laying off “several hundreds” of employees at Prime Video and MGM Studios, according to a memo obtained by TechCrunch. The cuts come days after the 500 layoffs at Amazon’s Twitch .

Is reportedly laying off 500 employees , 35% of its current staff, amid a continued struggle to achieve profitability in the face of rising costs and community backlash. The pending layoffs come after hundreds more employees were laid off in 2023.

Treasure Financial

Confirmed to TechCunch that layoffs, conducted in December, had impacted 14 employees, accounting for 60% to 70% of the company, according to multiple sources.

Confirmed it cut 10% of its contractor workforce at the end of 2023 as it turns to AI to streamline content production and translations previously handled by humans.

Rent the Runway

Will cut about 10% of corporate roles as it goes through a restructuring plan following Anushka Salinas’ planned resignation as operating chief and president at the end of January.

Is reducing its workforce by about 25% , or 1,800 people. The video game engine maker went through three rounds of layoffs in 2023.

Laid off two-thirds of its employees as the German startup, which built collaborative presentation software, looks to pursue a “completely different path.” CEO and co-founder Christian Reber also stepped down.

The AI and biomedical startup reportedly cut 17% of its workforce January 8, citing “shifts in the economic environment,” in a LinkedIn post announcing the layoffs. 

Eliminated 38% of its staff January 8 as the online retail logistics company follows up after conducting layoffs in September 2023.

Announced January 8 it is laying off 28% of its staff , or 154 workers, as the small modular nuclear reactor company shifts its focus to “key strategic areas.”

Is reportedly laying off 15% of its workforce focused on computer vision for retailers.

Is shutting down at the end of 2024 after a 12 year run. The design collaboration startup was once valued at nearly $2B.

Is laying off nearly 20% of its workforce as it tries to maintain its battle with Nielsen over media measurement. CEO Ross McCray stepped down from the company.

Orca Security

Is laying off roughly 15% of its staff , totaling 60 employees. The Israel-based unicorn reportedly plans to move some impacted employees into other positions at the company.

Laid off its entire 200-person workforce January 2 after attempts to raise more capital failed, TechCrunch exclusively learned . The mass layoff comes just seven months after the startup acquired rival Zencity . 

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An official website of the United States government.

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