Association between live childhood vaccines and COVID-19 outcomes: a national-level analysis

Abstract We investigated whether countries with higher coverage of childhood live vaccines [BCG or measles-containing-vaccine (MCV)] have reduced risk of coronavirus disease 2019 (COVID-19)-related mortality, while accounting for known systems differences between countries. In this ecological study of 140 countries using publicly available national-level data, higher vaccine coverage, representing estimated proportion of people vaccinated during the last 14 years, was associated with lower COVID-19 deaths. The associations attenuated for both vaccine variables, and MCV coverage became no longer significant once adjusted for published estimates of the Healthcare access and quality index (HAQI), a validated summary score of healthcare quality indicators. The magnitude of association between BCG coverage and COVID-19 death rate varied according to HAQI, and MCV coverage had little effect on the association between BCG and COVID-19 deaths. While there are associations between live vaccine coverage and COVID-19 outcomes, the vaccine coverage variables themselves were strongly correlated with COVID-19 testing rate, HAQI and life expectancy. This suggests that the population-level associations may be further confounded by differences in structural health systems and policies. Cluster randomised studies of booster vaccines would be ideal to evaluate the efficacy of trained immunity in preventing COVID-19 infections and mortality in vaccinated populations and on community transmission.

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Association between live childhood vaccines and COVID-19 outcomes: a national-level analysis

10.1101/2020.10.17.20214510 ◽

2020 ◽

Cited By ~ 2

Author(s):

Chikara Ogimi ◽

Pingping Qu ◽

Michael Boeckh ◽

Rachel A. Bender Ignacio ◽

Sahar Z. Zangeneh

Keyword(s):

Life Expectancy ◽

Vaccine Coverage ◽

Healthcare Access ◽

National Level ◽

Population Level ◽

Summary Score ◽

Level Data ◽

Childhood Vaccines ◽

Access And Quality ◽

Cluster Randomized

AbstractWe investigated whether countries with higher coverage of childhood live vaccines [BCG or measles-containing-vaccine (MCV)] have reduced risk of COVID-19 related mortality, accounting for known systems differences between countries. In this ecological study of 140 countries using publicly available national-level data, higher vaccine coverage, representing estimated proportion of people vaccinated during the last 15 years, was associated with lower COVID-19 deaths. The associations attenuated for both vaccine variables, and MCV coverage became no longer significant once adjusted for a validated summary score accounting for life expectancy and healthcare quality indicators, the Healthcare access and quality index (HAQI). The magnitude of association between BCG coverage and COVID-19 death rate varied according to HAQI, and MCV coverage had little effect on the association between BCG and COVID-19 deaths. While there are associations between live vaccine coverage and COVID-19 outcomes, the vaccine coverage variables themselves were strongly correlated with COVID-19 testing rate, HAQI, and life expectancy. This suggests that the population-level associations may be further confounded by differences in structural health systems and policies. Cluster randomized studies of booster vaccines would be ideal to evaluate the efficacy of trained immunity in preventing COVID-19 infections and mortality in vaccinated individuals and on community transmission.

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MEASURING QUALITY OF LIFE IN OLDER ADULTS LIVING WITH T2DM: A COMPARISON WITH YOUNGER ADULTS USING 2015 BRFSS DATA

Innovation in Aging ◽

10.1093/geroni/igz038.966 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S258-S259

Author(s):

Brittany Smalls ◽

Myles Moody ◽

Matthew Rutledge ◽

Amy Cowley

Keyword(s):

Older Adults ◽

Burden Of Disease ◽

National Level ◽

Population Level ◽

Younger Adults ◽

Physical Burden ◽

Level Data ◽

Gender Education ◽

The Us ◽

Optimal Health

Abstract Challenges due to burden of disease can affect adherence to self-care behaviors and optimal health outcomes in those living with T2DM. This study utilized state- and national-level data from the 2015 BRFSS to compare QoL measured by the prevalence of physical and mental burden days among older adults (OAs) compared to younger adults living with T2DM. The results of our analysis showed that OAs living in the US were significantly less likely to experience at least one mental burden day when compared to their younger counterparts (OR =0.61, 95% CI: 0.58, 0.64), while gender, education, race, BMI, and depression, CVD, or another chronic condition were significantly associated with the odds of experiencing at least one mental burden day. Whereas, in Kentucky OAs were less likely to experience at least one mental burden day when compared to their younger counterparts (OR= 0.48, 95% CI: 0.35, 0.66). Gender, education, BMI, and depression were significantly associated with the odds of experiencing at least one mental burden day or one physical burden day. The findings of this study suggests that the questions used by BRFSS to measure QoL may not be the most suitable for OAs who likely have different criteria for self-reported mental or physical burden days. When assessing QoL or burden of disease among the aging at a population level, considerable thought should be given into the questions asked and if they appropriately examine patient-level QoL in this population.

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Comparing the Health of Transgender Women, Transgender Men, and Gender Non-Conforming Individuals Using Population-Level Data

Annals of LGBTQ Public and Population Health ◽

10.1891/lgbtq.2019-0002 ◽

2020 ◽

Vol 1 (1) ◽

pp. 43-62 ◽

Cited By ~ 1

Author(s):

Arryn A. Guy ◽

Wren Yoder ◽

Kelly Manser ◽

Stephen D. Ramos ◽

Steve N. Du Bois

Keyword(s):

Mental Health ◽

Physical Health ◽

Healthcare Access ◽

Population Level ◽

Transgender Women ◽

Level Data ◽

Race Ethnicity ◽

And Gender ◽

Mental And Physical Health ◽

Transgender Men

Converging evidence indicates transgender and gender non-conforming (TGNC) individuals generally experience poorer health than their cisgender counterparts. Less is known about TGNC health across gender identity subgroups. Extant work has yielded mixed findings, precluding conclusions regarding the comparative health of transgender women, transgender men, and gender non-conforming individuals. Additionally, this work is limited methodologically, e.g., utilizing convenience samples and operationalizing “transgender” differently across studies. This study aims to improve upon these limitations, and more broadly add to the literature on within-group health differences among TGNC individuals. We used 2016 U.S. population-level data (N = 1,117), conducting MANCOVA (multivariate analysis of covariance) and logistic regression to compare the health of transgender women, transgender men, and GNC individuals. Health outcomes of mental and physical health, substance use, and healthcare access/utilization were selected based on empirical and theoretical support for their relevance to TGNC health. We also completed interaction analyses to test the intersectional effects on health of gender identity and emergent sociodemographic variables, e.g. race/ethnicity. Across TGNC subgroups, individuals reported similar alcohol use, mental health, and healthcare access/utilization. Transgender men reported worse physical health than their counterparts, and GNC individuals reported lower smoking prevalence than their counterparts. Interaction analyses by race/ethnicity indicated Hispanic transgender women reported worse physical health than other Hispanic TGNC individuals, while Black transgender men, Multiracial GNC individuals, and Hispanic transgender women reported worse mental health than some of their intra-racial/ethnic TGNC counterparts. Findings add to the growing literature on TGNC health and highlight TGNC subgroups that may be vulnerable regarding mental and physical health.

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SARS-CoV-2 infection and COVID-19 vaccination rates in pregnant women in Scotland

Nature Medicine ◽

10.1038/s41591-021-01666-2 ◽

2022 ◽

Author(s):

Sarah J. Stock ◽

Jade Carruthers ◽

Clara Calvert ◽

Cheryl Denny ◽

Jack Donaghy ◽

...

Keyword(s):

Pregnant Women ◽

Vaccine Coverage ◽

Population Data ◽

Population Level ◽

Vaccine Uptake ◽

Female Population ◽

Background Rate ◽

Vaccination Rates ◽

Level Data ◽

Critical Care Admission

AbstractPopulation-level data on COVID-19 vaccine uptake in pregnancy and SARS-CoV-2 infection outcomes are lacking. We describe COVID-19 vaccine uptake and SARS-CoV-2 infection in pregnant women in Scotland, using whole-population data from a national, prospective cohort. Between the start of a COVID-19 vaccine program in Scotland, on 8 December 2020 and 31 October 2021, 25,917 COVID-19 vaccinations were given to 18,457 pregnant women. Vaccine coverage was substantially lower in pregnant women than in the general female population of 18−44 years; 32.3% of women giving birth in October 2021 had two doses of vaccine compared to 77.4% in all women. The extended perinatal mortality rate for women who gave birth within 28 d of a COVID-19 diagnosis was 22.6 per 1,000 births (95% CI 12.9−38.5; pandemic background rate 5.6 per 1,000 births; 452 out of 80,456; 95% CI 5.1−6.2). Overall, 77.4% (3,833 out of 4,950; 95% CI 76.2−78.6) of SARS-CoV-2 infections, 90.9% (748 out of 823; 95% CI 88.7−92.7) of SARS-CoV-2 associated with hospital admission and 98% (102 out of 104; 95% CI 92.5−99.7) of SARS-CoV-2 associated with critical care admission, as well as all baby deaths, occurred in pregnant women who were unvaccinated at the time of COVID-19 diagnosis. Addressing low vaccine uptake rates in pregnant women is imperative to protect the health of women and babies in the ongoing pandemic.

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Abstract 034: Tracking Lifestyle Behaviors, Healthcare Access, and Healthcare Quality for Cardiometabolic Diseases at the State-Level From 1990-2016

Circulation ◽

10.1161/circ.137.suppl_1.034 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Marissa B Reitsma ◽

Ryan M Barber ◽

Gregory A Roth ◽

Ashkan Afshin

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Heart Disease ◽

Healthcare Access ◽

State Level ◽

Population Level ◽

The State ◽

Factor Index ◽

Access And Quality ◽

Lifestyle Risk

Introduction: While a range of population-level and clinical interventions have been implemented to improve cardiometabolic (CM) health in the US, little is known about their different effects at the state-level. Objective: To develop a novel index to evaluate the performance of the healthcare system and population-level interventions to improve CM health at the state-level from 1990 to 2016. Methods: To evaluate healthcare access and quality, we estimated risk-standardized age-standardized mortality rates for six CM diseases that are amenable to healthcare. Risk-standardization removed geographic variation in all risk factors not directly amenable to medical intervention. To evaluate the effect of population-level interventions, we estimated the risk-weighted exposure to lifestyle risk factors including smoking, alcohol, diet, body mass index, and physical activity. We averaged the healthcare index with the risk factor index to create a single composite index. Data sources included mortality and risk factor estimates from the Global Burden of Disease 2016 Study. Results: Between 1990 and 2016, healthcare access and quality for CM diseases significantly improved in 38 states. These increases were mainly driven by significant improvements nationwide in healthcare for ischemic heart disease, ischemic stroke, and rheumatic heart disease. Notably, healthcare for diabetes significantly worsened in 16 states. There were no significant changes in the lifestyle risk factor index since 1990. Stability was driven by diverging trends, with smoking and diet quality significantly improving and BMI significantly worsening in all states. Importantly, the gap between the best and worst performing states across all indices increased between 1990 and 2016, indicating greater health disparities. Conclusions: This study has quantified the separate and combined effects of healthcare access, quality, and risk factors on CM health, with implications on priority setting for both population-level and clinical interventions.

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Population-Level Prevalence, Bother, and Treatment Behavior for Urinary Incontinence in an Eastern European Country: Findings from the LUTS POLAND Study

Journal of Clinical Medicine ◽

10.3390/jcm10112314 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2314

Author(s):

Mikolaj Przydacz ◽

Marcin Chlosta ◽

Piotr Chlosta

Keyword(s):

Quality Of Life ◽

Urinary Incontinence ◽

Rural Areas ◽

Eastern European Country ◽

Population Level ◽

Eastern European ◽

Level Data ◽

Urban And Rural Areas ◽

Eastern European Countries

Objectives: Population-level data are lacking for urinary incontinence (UI) in Central and Eastern European countries. Therefore, the objective of this study was to estimate the prevalence, bother, and behavior regarding treatment for UI in a population-representative group of Polish adults aged ≥ 40 years. Methods: Data for this epidemiological study were derived from the larger LUTS POLAND project, in which a group of adults that typified the Polish population were surveyed, by telephone, about lower urinary tract symptoms. Respondents were classified by age, sex, and place of residence. UI was assessed with a standard protocol and established International Continence Society definitions. Results: The LUTS POLAND survey included 6005 completed interviews. The prevalence of UI was 14.6–25.4%; women reported a greater occurrence compared with men (p < 0.001). For both sexes, UI prevalence increased with age. Stress UI was the most common type of UI in women, and urgency UI was the most prevalent in men. We did not find a difference in prevalence between urban and rural areas. Individuals were greatly bothered by UI. For women, mixed UI was the most bothersome, whereas for men, leak for no reason was most annoying. More than half of respondents (51.4–62.3%) who reported UI expressed anxiety about the effect of UI on their quality of life. Nevertheless, only around one third (29.2–38.1%) of respondents with UI sought treatment, most of whom received treatment. Persons from urban and rural areas did not differ in the degrees of treatment seeking and treatment receiving. Conclusion: Urinary incontinence was prevalent and greatly bothersome among Polish adults aged ≥ 40 years. Consequently, UI had detrimental effects on quality of life. Nonetheless, most affected persons did not seek treatment. Therefore, we need to increase population awareness in Poland about UI and available treatment methods, and we need to ensure adequate allocation of government and healthcare system resources.

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The domestication of Cucurbita argyrosperma as revealed by the genome of its wild relative

Horticulture Research ◽

10.1038/s41438-021-00544-9 ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Josué Barrera-Redondo ◽

Guillermo Sánchez-de la Vega ◽

Jonás A. Aguirre-Liguori ◽

Gabriela Castellanos-Morales ◽

Yocelyn T. Gutiérrez-Guerrero ◽

...

Keyword(s):

Defense Mechanisms ◽

Population Level ◽

Growth Hormones ◽

Comparative Genomic ◽

Structural Variants ◽

Closely Related Species ◽

Level Data ◽

Genomic Analyses ◽

Genotype By Sequencing ◽

Regulation Of Growth

AbstractDespite their economic importance and well-characterized domestication syndrome, the genomic impact of domestication and the identification of variants underlying the domestication traits in Cucurbita species (pumpkins and squashes) is currently lacking. Cucurbita argyrosperma, also known as cushaw pumpkin or silver-seed gourd, is a Mexican crop consumed primarily for its seeds rather than fruit flesh. This makes it a good model to study Cucurbita domestication, as seeds were an essential component of early Mesoamerican diet and likely the first targets of human-guided selection in pumpkins and squashes. We obtained population-level data using tunable Genotype by Sequencing libraries for 192 individuals of the wild and domesticated subspecies of C. argyrosperma across Mexico. We also assembled the first high-quality wild Cucurbita genome. Comparative genomic analyses revealed several structural variants and presence/absence of genes related to domestication. Our results indicate a monophyletic origin of this domesticated crop in the lowlands of Jalisco. We found evidence of gene flow between the domesticated and wild subspecies, which likely alleviated the effects of the domestication bottleneck. We uncovered candidate domestication genes that are involved in the regulation of growth hormones, plant defense mechanisms, seed development, and germination. The presence of shared selected alleles with the closely related species Cucurbita moschata suggests domestication-related introgression between both taxa.

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COVID-19 Infection and Previous BCG Vaccination Coverage in the Ecuadorian Population

Vaccines ◽

10.3390/vaccines9020091 ◽

2021 ◽

Vol 9 (2) ◽

pp. 91

Author(s):

Daniel Garzon-Chavez ◽

Jackson Rivas-Condo ◽

Adriana Echeverria ◽

Jhoanna Mozo ◽

Emmanuelle Quentin ◽

...

Keyword(s):

Vaccination Coverage ◽

Vaccine Coverage ◽

National Level ◽

Kendall Test ◽

Amino Acid Sequences ◽

Bcg Vaccination ◽

High Prevalence ◽

Health Organization ◽

Low Coverage ◽

Homologous Amino Acid

The Bacillus Calmette–Guérin (BCG) is a well-known vaccine with almost a century of use, with the apparent capability to improve cytokine production and epigenetics changes that could develop a better response to pathogens. It has been postulated that BCG protection against SARS-CoV-2 has a potential role in the pandemic, through the presence of homologous amino acid sequences. To identify a possible link between BCG vaccination coverage and COVID-19 cases, we used official epidemic data and Ecuadorian Ministry of Health and Pan American Health Organization vaccination information. BCG information before 1979 was available only at a national level. Therefore, projections based on the last 20 years were performed, to compare by specific geographic units. We used a Mann–Kendall test to identify BCG coverage variations, and mapping was conducted with a free geographic information system (QGIS). Nine provinces where BCG vaccine coverage was lower than 74.25% show a significant statistical association (χ2 Pearson’s = 4.800, df = 1, p = 0.028), with a higher prevalence of cases for people aged 50 to 64 years than in younger people aged 20 to 49 years. Despite the availability of BCG vaccination data and the mathematical models needed to compare these data with COVID-19 cases, our results show that, in geographic areas where BCG coverage was low, 50% presented a high prevalence of COVID-19 cases that were young; thus, low-coverage years were more affected.

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Uganda’s increasing dependence on development partner’s support for immunization – a five year resource tracking study (2012 – 2016)

BMC Public Health ◽

10.1186/s12889-021-10178-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Carol Kamya ◽

Christabel Abewe ◽

Peter Waiswa ◽

Gilbert Asiimwe ◽

Faith Namugaya ◽

...

Keyword(s):

Vaccine Coverage ◽

National Level ◽

Health Financing ◽

Health Facilities ◽

Development Partner ◽

National Medical ◽

External Sources ◽

Lower Health ◽

Health Accounts ◽

The Government

Abstract Background In Uganda, there are persistent weaknesses in obtaining accurate, reliable and complete data on local and external investments in immunization to guide planning, financing, and resource mobilization. This study aimed to measure and describe the financial envelope for immunization from 2012 to 2016 and analyze expenditures at sub-national level. Methods The Systems of Health Accounts (SHA) 2011 methodology was used to quantify and map the resource envelope for immunization. Data was collected at national and sub-national levels from public and external sources of immunization. Data were coded, categorized and disaggregated by expenditure on immunization activities using the SHA 2011. Results Over the five-year period, funding for immunization increased fourfold from US$20.4 million in 2012 to US$ 85.6 million in 2016. The Ugandan government was the main contributor (55%) to immunization resources from 2012 to 2014 however, Gavi, the Vaccine Alliance contributed the majority (59%) of the resources to immunization in 2015 and 2016. Majority (66%) of the funds were managed by the National Medical Stores. Over the five-year period, 80% of the funds allocated to immunization activities were spent on facility based routine immunization (expenditure on human resources and outreaches). At sub-national level, districts allocated 15% of their total annual resources to immunization to support supervision of lower health facilities and distribution of vaccines. Health facilities spent 5.5% of their total annual resources on immunization to support outreaches. Conclusion Development partner support has aided the improvement of vaccine coverage and increased access to vaccines however, there is an increasing dependence on this support for a critical national program raising sustainability concerns alongside other challenges like being off-budget and unpredictable. To ensure financial sustainability, there is need to operationalize the immunization fund, advocate and mobilize additional resources for immunization from the Government of Uganda and the private sector, increase the reliability of resources for immunization as well as leverage on health financing reforms like the National Health Insurance.

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