Factors associated with mothers’ hesitancy to receive a COVID-19 vaccine

Abstract Background The US vaccination schedule includes DTaP, IPV, Hib and HepB doses in the first 6 months of life. A previous analysis found variability in the timing of HepB doses in infants receiving DTaP-IPV/Hib. We explored factors associated with co-administration of DTaP-IPV/Hib and HepB on the same day. Methods This was a retrospective study using the MarketScan® commercial claims and encounters database. Infants born from 1 July 2010 - 30 June 2016, continuously enrolled in an insurance plan for ≥ 13 months and receiving ≥ 3 DTaP-IPV/Hib doses were included. Infants were assessed for HepB claims relative to the first and third DTaP-IPV/Hib doses. Because a HepB birth dose was assumed, the first HepB claim from 29 - 169 days following birth was counted as Dose 2, and the second claim from 170 days - 12 months as Dose 3. Associations between demographic, provider, and insurance characteristics, receipt of other pediatric vaccines, and co-administration of DTaP-IPV/Hib and HepB were analyzed using multivariate logistic regression. Results Among 165,553 infants who received a first DTaP-IPV/Hib dose, 60.7% received HepB Dose 2 on the same day. Among 162,217 infants who received a third DTaP-IPV/Hib dose, 45.1% received HepB Dose 3 on the same day. Infants in the Northeast were less likely (OR=0.38, 95%CI=0.36-0.39), while those in the West were more likely (OR=1.41, 95%CI=1.36-1.46) than infants in the South to receive the first dose of DTaP-IPV/Hib and HepB Dose 2 on the same day. Infants vaccinated by pediatricians (OR=0.54, 95%CI=0.53-0.55) were less likely to receive the first dose of DTaP-IPV/Hib and HepB Dose 2 on the same day compared to infants vaccinated by family physicians. Infants who received PCV on the same day as the first dose of DTaP-IPV/Hib were more likely to receive HepB Dose 2 (OR=6.96, 95%CI=6.30-7.70) that day. These factors were also associated with co-administration of the third dose of DTaP-IPV/Hib and HepB Dose 3. Conclusion Differences in co-administration of DTaP-IPV/Hib and HepB were associated with region of residence, provider type and co-administration of PCV. The reasons underlying these differences merit exploration. A hexavalent vaccine containing DTaP, IPV, Hib, and HepB could improve timeliness of HepB vaccination, while reducing the number of injections during infancy. Disclosures Tanaz Petigara, PhD, Merck & Co., Inc. (Employee, Shareholder) Ya-Ting Chen, PhD, Merck & Co., Inc. (Employee, Shareholder) Zhiwen Liu, PhD, Merck & Co., Inc., (Employee) Michelle Goveia, MD, Merck & Co., Inc (Employee, Shareholder) David Johnson, MD, MPH, Sanofi Pasteur (Employee, Shareholder) Gary S. Marshall, MD, GlaxoSmithKline (Consultant, Scientific Research Study Investigator)Merck (Consultant, Scientific Research Study Investigator)Pfizer (Consultant, Scientific Research Study Investigator)Sanofi Pasteur (Consultant, Grant/Research Support, Scientific Research Study Investigator, Honorarium for conference lecture)Seqirus (Consultant, Scientific Research Study Investigator)

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Willingness to receive future COVID-19 vaccines following the COVID-19 epidemic in Shanghai, China

BMC Public Health ◽

10.1186/s12889-021-11174-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yehong Zhou ◽

Junjie Zhang ◽

Wenwen Wu ◽

Man Liang ◽

Qiang-Song Wu

Keyword(s):

Vaccine Safety ◽

Older Individuals ◽

Regression Analyses ◽

Pharmacological Interventions ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Factors Associated ◽

History Of ◽

Potential Factors ◽

To Receive

Abstract Background There are no pharmacological interventions currently available to prevent the transmission of SARS-CoV-2 or to treat COVID-19. The development of vaccines against COVID-19 is essential to contain the pandemic. we conducted a cross-sectional survey of Shanghai residents to understand residents’ willingness to be vaccinated with any future COVID-19 vaccines and take measures to further improve vaccination coverage. Methods We conducted a cross-sectional survey using self-administered anonymous questionnaires from 1 July to 8 September 2020. The main outcome was willingness of participants, and any children or older individuals living with them, to receive future COVID-19 vaccines. Logistic regression analyses were used to explore potential factors associated with vaccination willingness. Results A total of 1071 participants were asked about their willingness to receive future COVID-19 vaccines, for themselves and at least 747 children and 375 older individuals (≥60 years old) living with them. The highest proportion of expected willingness to vaccinate was among participants (88.6%), followed by children (85.3%) and older individuals (84.0%). The main reasons for reluctance to vaccinate among 119 participants were doubts regarding vaccine safety (60.0%) and efficacy (28.8%). Participants with a self-reported history of influenza vaccination were more likely to accept COVID-19 vaccines for themselves [adjusted odds ratio (OR) = 1.83; 95% confidence interval (CI): 1.19–2.82], their children (adjusted OR = 2.08; 95%CI: 1.30–3.33), and older individuals in their household (adjusted OR = 2.12; 95%CI: 1.14–3.99). Participants with older individuals in their families were less willing to vaccinate themselves (adjusted OR = 0.59; 95%CI: 0.40–0.87) and their children (adjusted OR = 0.58; 95%CI: 0.38–0.89). Conclusions Participants were more reluctant to accept COVID-19 vaccines for older individuals living with them. The presence of older individuals in the home also affected willingness of participants and their children to be vaccinated.

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Risk Factors Associated with Failure to Receive Vaccinations

PEDIATRICS ◽

10.1542/peds.64.3.304 ◽

1979 ◽

Vol 64 (3) ◽

pp. 304-309 ◽

Cited By ~ 2

Author(s):

James S. Marks ◽

Thomas J. Halpin ◽

John J. Irvin ◽

Deane A. Johnson ◽

John R. Keller

Keyword(s):

Socioeconomic Status ◽

Family Size ◽

Parental Education ◽

Maternal Education ◽

Oral Polio Vaccine ◽

Health Department ◽

Major Purpose ◽

Factors Associated ◽

Basic Series ◽

To Receive

A major purpose of a state-wide survey to document the vaccination status of 1,003 2-year-old children was to identify factors associated with failure to receive the recommended vaccinations. With a basic series of immunization defined as three doses of diphtheriatetanus-pertussis (DTP), three oral polio vaccine (OPV), one measles, and one rubella, 72.5% of the children had completed the series. When the completed series was redefined to include a fourth DTP and mumps vaccine the rate of completion dropped to 40.8%. However, 59.1% of the children who had not completed this optimal series could be brought up-to-date with a single visit to their provider of medical care. Demographic variables independently associated with completion of the basic series were increased paternal education (P < .001), increased maternal education (P < .02), smaller family size (P < .01) and higher socioeconomic status, as determined by census tract or rural town of residence (P < .02). Race was not found to be a factor associated with vaccination rates when socioeconomic status was controlled. Patients who received their vaccinations from private physicians had a better vaccination rate than those who attended health department clinics. This difference persisted even when socioeconomic status was controlled by residence (P < .02). The simultaneous comparison of parental education and family size demonstrated that a child having one parent with < 12 years education or having at least three siblings has a fourfold greater risk of failure to complete his immunization than children whose parents are both college graduates. By using paternal and maternal education level and family size as screening variables, children at high risk for failure to complete their immunizations could be identified prospectively and made the target of intervention programs to improve compliance.

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Antibiotic Prescribing for Adults Hospitalized in the Etiology of Pneumonia in the Community Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx088 ◽

2017 ◽

Vol 4 (2) ◽

Cited By ~ 6

Author(s):

Sara Tomczyk ◽

Seema Jain ◽

Anna M Bramley ◽

Wesley H Self ◽

Evan J Anderson ◽

...

Keyword(s):

Antibiotic Use ◽

Community Acquired Pneumonia ◽

Community Study ◽

Antibiotic Prescribing ◽

Beta Lactam ◽

First Line ◽

Factors Associated ◽

Admission Ward ◽

Healthcare Associated ◽

To Receive

Abstract Background Community-acquired pneumonia (CAP) 2007 guidelines from the Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) recommend a respiratory fluoroquinolone or beta-lactam plus macrolide as first-line antibiotics for adults hospitalized with CAP. Few studies have assessed guideline-concordant antibiotic use for patients hospitalized with CAP after the 2007 IDSA/ATS guidelines. We examine antibiotics prescribed and associated factors in adults hospitalized with CAP. Methods From January 2010 to June 2012, adults hospitalized with clinical and radiographic CAP were enrolled in a prospective Etiology of Pneumonia in the Community study across 5 US hospitals. Patients were interviewed using a standardized questionnaire, and medical charts were reviewed. Antibiotics prescribed were classified according to defined nonrecommended CAP antibiotics. We assessed factors associated with nonrecommended CAP antibiotics using logistic regression. Results Among enrollees, 1843 of 1874 (98%) ward and 440 of 446 (99%) ICU patients received ≥1 antibiotic ≤24 hours after admission. Ward patients were prescribed a respiratory fluoroquinolone alone (n = 613; 33%), or beta-lactam plus macrolide (n = 365; 19%), beta-lactam alone (n = 240; 13%), among other antibiotics, including vancomycin (n = 235; 13%) or piperacillin/tazobactam (n = 157; 8%) ≤24 hours after admission. Ward patients with known risk for healthcare-associated pneumonia (HCAP), recent outpatient antibiotic use, and in-hospital antibiotic use <6 hours after admission were significantly more likely to receive nonrecommended CAP antibiotics. Conclusions Although more than half of ward patients received antibiotics concordant with IDSA/ATS guidelines, a number received nonrecommended CAP antibiotics, including vancomycin and piperacillin/tazobactam; risk factors for HCAP, recent outpatient antibiotic, and rapid inpatient antibiotic use contributed to this. This hypothesis-generating descriptive epidemiology analysis could help inform antibiotic stewardship efforts, reinforces the need to harmonize guidelines for CAP and HCAP, and highlights the need for improved diagnostics to better equip clinicians.

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Understanding the sociodemographic factors associated with intention to receive SMS messages for health information in a rural area of Bangladesh

BMC Public Health ◽

10.1186/s12889-021-12418-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fakir M Amirul Islam ◽

Elisabeth A Lambert ◽

Sheikh Mohammed Shariful Islam ◽

M Arzan Hosen ◽

Bruce R Thompson ◽

...

Keyword(s):

Willingness To Pay ◽

Mobile Phone ◽

Health Information ◽

Rural Area ◽

Significant Proportion ◽

Sociodemographic Factors ◽

Factors Associated ◽

Rich People ◽

Education And Awareness ◽

To Receive

Abstract Background The use of digital interventions for managing chronic diseases is significantly increasing. The aim of this study was to estimate the proportion of ownership of a mobile phone, and factors associated with the ability to read and access SMS delivered health information, and willingness to pay for it among people with hypertension in a rural area in Bangladesh. Methods Data were collected from 307 participants aged 30 to 75 years with hypertension from a rural area in Bangladesh from December 2020 to January 2021. Outcome measures included ownership of a mobile phone, ability to read SMS, willingness to receive and pay for health information by SMS. Associated factors included age, gender, level of education, occupation, and socioeconomic status. We used regression analysis to identify variables associated with the outcome variables. Results Overall, 189 (61.6%) people owned a mobile phone which was higher in men (73.3% vs. 50%, p < 0.001), younger people (82.6% aged 30–39 years vs. 53.5% aged 60–75 years, p < 0.001). Of the total participants, 207 (67.4%) were willing to receive SMS, and 155 (50.5%) were willing to pay for receiving SMS for health information. The prevalence was significantly higher among professionals (odds ratio (OR), 95% confidence interval (CI): 4.58, 1.73–12.1) and businesspersons (OR 3.68, 95% CI 1.49–9.10) compared to farmers, respectively. The median (interquartile range [IQR]) of willingness to pay for health information SMS was 10 (28) Bangladesh Taka (BDT) (1 BDT ~ 0.013 US$), and there were no specific factors that were associated with the willingness of any higher amounts of payment. In terms of reading SMS of people who own a mobile, less than half could read SMS. The proportion of people who could read SMS was significantly higher among men, younger people, educated people, middle class or rich people, professionals or businesspersons. Of people who could read SMS, the majority read SMS occasionally. Conclusion A significant proportion of people are unable to read SMS. However, people are willing to receive and pay to receive SMS for health information. Education and awareness programs should be conducted among targeted groups, including people with low education and women.

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Biologic and Glucocorticoid Use after Methotrexate Initiation in Patients with Rheumatoid Arthritis

The Journal of Rheumatology ◽

10.3899/jrheum.180178 ◽

2018 ◽

Vol 46 (4) ◽

pp. 343-350 ◽

Cited By ~ 3

Author(s):

Michael D. George ◽

Brian C. Sauer ◽

Chia-Chen Teng ◽

Grant W. Cannon ◽

Bryant R. England ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Patient Outcomes ◽

Biologic Therapy ◽

Age Groups ◽

Biologic Therapies ◽

Factors Associated ◽

Therapy Initiation ◽

Patients With Heart Failure ◽

To Receive ◽

Improve Disease Control

Objective.Biologic therapies can improve disease control for patients with rheumatoid arthritis (RA) but may be both overused and underused. We aimed to identify predictors of greater use of biologic therapies and to identify factors associated with persistent glucocorticoid use.Methods.Using national US Veteran’s Affairs databases 2005–2016, we identified patients with RA receiving a first-ever prescription of methotrexate (MTX), requiring ≥ 6 months of baseline data. We evaluated predictors of biologic therapy initiation within 2 years of starting MTX and factors associated with baseline and persistent glucocorticoid use at 6–12 months using multivariable models.Results.Among 17,415 patients starting MTX, 3263 patients received biologic therapy within 2 years (20.6% 2-yr incidence). In adjusted analyses, biologic use was substantially lower in older patients [e.g., aHR 0.20 (95% CI 0.16, 0.26) for patients ≥ 80 vs < 50] and patients with more comorbidities [aHR 0.79 (95% CI 0.72, 0.87) for Charlson score ≥ 3 vs < 3]. Patients with heart failure [aHR 0.68 (95% CI 0.54, 0.84)], cancer [aHR 0.78 (95% CI 0.66, 0.92)], or who were nonwhite [aHR 0.79 (95% CI 0.72, 0.87)] were also less likely to receive a biologic. In contrast, baseline and persistent glucocorticoid use was similar across age groups and more common in patients with greater comorbidity.Conclusion.Biologic therapy is initiated less frequently in patients with RA who are older, have more comorbidities, and who are nonwhite. While biologics may be avoided in older and sicker patients because of safety concerns, glucocorticoid use is similar regardless of age and is more frequent in patients with comorbidities, with implications for patient outcomes.

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Factors associated with palliative care (PC) utilization in advanced and metastatic renal cell carcinoma (RCC).

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.6_suppl.297 ◽

2021 ◽

Vol 39 (6_suppl) ◽

pp. 297-297

Author(s):

Hiren V. Patel ◽

Joshua Sterling ◽

Arnav Srivastava ◽

Sinae Kim ◽

Biren Saraiya ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Palliative Care ◽

Cell Carcinoma ◽

Renal Cell ◽

Multivariable Analysis ◽

Stage Iv ◽

Stage Iii ◽

Clinical Factors ◽

Factors Associated ◽

To Receive

297 Background: Palliative care (PC) offers various benefits for patient with cancer that include, but are not limited to, decrease in disease-specific symptoms and improvement in functional status. Several oncological guidelines have adopted early integration of PC into oncologic care to improve quality of life among patients with advanced malignancies. However, PC utilization patterns and factors associated with its use in advanced renal cell carcinoma (RCC) remain poorly understood. Methods: Using the National Cancer Database (NCDB), we abstracted patients with stage III and IV RCC from 2004-2014 and evaluated PC utilization amongst this cohort. Socioeconomic and clinical factors were compared for patient receiving and not receiving PC for advanced RCC. Multivariable logistic regression identified factors that were associated with receipt of PC. Results: We identified 20,122 and 42,014 patients with stage III and IV RCC, respectively. Among this cohort, 329 and 9,317 patients received PC for stage III and IV RCC, respectively. From 2004 to 2014, PC utilization has been stable at ~1% for stage III RCC and has significantly increased from 17% to 20% for stage IV RCC. Multivariable analysis demonstrated that Blacks, income >$48,000, regions outside of Northeast, stage III RCC, and patients that received surgery were less likely to receive PC. Patients that were female, with more comorbidities, uninsured or with government insurance, lower educational status, treated at academic or integrated cancer program, with sarcomatoid histology, receiving systemic therapy were more likely to receive PC. Conclusions: While PC utilization has significantly increased for stage IV RCC, there are several demographic, socioeconomic, and clinical factors that predict PC usage among patients with advanced RCC. Taken together, this suggests the need for more equitable and systematic use of PC among patients with advanced RCC.

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Abstract P258: Factors Associated With Imaging Choice of Acute Ischemic Stroke Patients and the Related Health Outcomes

Circulation ◽

10.1161/circ.141.suppl_1.p258 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Jason J Wang ◽

Artem Boltyenkov ◽

Gabriela Martinez ◽

Jeffrey M Katz ◽

Angela Hoang ◽

...

Keyword(s):

Ischemic Stroke ◽

Health Outcomes ◽

Acute Ischemic Stroke ◽

Regression Models ◽

Critical Role ◽

Clear Understanding ◽

Negatively Associated ◽

Factors Associated ◽

To Receive ◽

Iv Tpa

Introduction: Acute ischemic stroke (AIS) presents an ongoing challenge for population health and availability of healthcare resources. Imaging plays a critical role in both diagnosis and treatment decisions in AIS, but optimal utilization regarding advanced imaging with angiography and perfusion using either CTAP or MRAP remain uncertain according to national guidelines. Consequently, wide variation in AIS imaging exists in clinical practice, mostly defaulted to physician preferences and institutional factors, without a clear understanding of the benefits and risks involved in stroke care. Although CTAP and MRAP each have unique benefits and risks in the AIS setting, the effect of this risk-benefit tradeoff on health outcomes and utilization of resources is unknown. This study analyses the factors associated with imaging preferences and the related health outcomes. Method: We performed a retrospective study on an AIS registry consisting of consecutive patients admitted to our institution from November 1, 2011, through October 1, 2018. Imaging and treatment selections and modified Rankin Score (mRS) at discharge were the main outcomes. Independent variables include age, gender, race-ethnicity, and NIH stroke score (NIHSS) at admission. Multivariable logistic regression models were performed. P<0.05 was considered statistically significant. Results: 1884 patients with curated imaging data during hospitalization were included. Among them, 32% were ≥80 years old, 47.4% female, 15.53% black, 60.3% white, and 24.4% with NIHSS≥10 at admission. CTAP and MRAP were performed in 21.1% and 72.2% patients, respectively. 46.1% received thrombolytics (IV-tPA), 1.3% had endovascular therapy (EVT), and 52.7% were not treated. The two clinical outcomes were independent functionality at discharge (mRS0-2) at 48.4%, and patients expired in hospital at 7.1%. Adjusted by all the factors, regression models showed that patients with NIHSS≥10 were more likely to receive CTAP (p<0.0001, OR=3.39) and less likely to receive MRAP (p<0.0001, OR=0.48); whereas age ≥80 was less likely to receive CTAP (p<0.0001, OR=0.37) or MRAP (p<0.0001, OR=0.37). NIHSS≥10 (p<0.0001, OR=0.15) and IV-tPA (p=0.0006, OR=0.69) were negatively related to independent functionality at discharge, and MRAP (p<0.0001, OR=1.97) was positively related to it. NIHSS≥10 (p=0.0212, OR=1.69) were positively related to mortality, while utilization of MRAP showed a negative relationship (p<0.0001, OR=0.26) with it. Conclusion: Higher NIHSS was positively associated with mortality and utilization of CTAP, while it is negatively associated with MRAP. MRAP was positively related to independent functionality at discharge. Older age was negatively associated with CTAP or MRAP utilization.

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Practices and Predictors of Analgesic Interventions for Adults Undergoing Painful Procedures

American Journal of Critical Care ◽

10.4037/ajcc2002.11.5.415 ◽

2002 ◽

Vol 11 (5) ◽

pp. 415-429 ◽

Cited By ~ 68

Author(s):

Kathleen A. Puntillo ◽

Lorie Rietman Wild ◽

Ann Bonham Morris ◽

Julie Stanik-Hutt ◽

Carol Lynn Thompson ◽

...

Keyword(s):

Combination Therapy ◽

Pain Intensity ◽

Regression Models ◽

Central Venous Catheters ◽

Central Venous ◽

Factors Associated ◽

Anesthetic Agents ◽

Multiple Regression Models ◽

Tracheal Suctioning ◽

To Receive

• Background Research is limited on analgesic practices associated with the commonly performed procedures of turning, inserting central venous catheters, removing wound drains, changing dressings on nonburn wounds, suctioning the trachea, and removing femoral sheaths. • Objective To determine types of analgesics administered for procedures, the prevalence and amounts of drugs given, and factors predictive of analgesic administration. • Methods Pain was assessed before and immediately after procedures. Analgesic, sedative, and anesthetic agents administered within 1 hour before and/or during each procedure were noted. • Results A total of 5957 adult patients at 164 national and 5 international sites participated. Pain intensity increased at the time of procedure for all procedures. More than 63% of patients received no analgesics. Less than 20% received opiates; mean total dose of opiate was 6.44 mg (SD, 8.96 mg). Only 10% of patients received combination therapy. Factors associated with the likelihood of receiving opiates were pain intensity before a procedure, femoral sheath removal, being white, and the duration of a procedure. Patients less likely to receive opiates had a medical diagnosis or were having tracheal suctioning. Only 14.5% of the variance in the amount of opiate administered was explained by factors entered into multiple regression models. Type of procedure was the only significant predictor of amount of opiate administered. • Conclusions Most patients were not intentionally medicated even though pain intensity increased during their procedure. When used, analgesic amounts were low, and combination therapy was infrequent. Clinical trials are needed to evaluate optimal pain management for patients undergoing procedures.

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