scholarly journals Perspectives on COVID-19 vaccination among kidney and pancreas transplant recipients living in New York City

2021 ◽  
Author(s):  
Demetra Tsapepas ◽  
S Ali Husain ◽  
Kristen L King ◽  
Yvonne Burgos ◽  
David J Cohen ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Vulnerable Population ◽  
Pancreas Transplant ◽  
Vaccine Hesitancy ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Number Of Patients ◽  
Outreach Initiative

Abstract Purpose Solid organ transplant recipients are at increased risk of morbidity and mortality from coronavirus disease 2019 (COVID-19), but limited vaccine access and vaccine hesitancy can complicate efforts for expanded vaccination. We report patient perspectives and outcomes from a vaccine outreach initiative for a vulnerable population of transplant recipients living in New York City. Methods This was a retrospective review of qualitative perspectives from a COVID-19 vaccine outreach initiative. In the outreach effort, kidney and pancreas transplant recipients under care at the transplant center at NewYork-Presbyterian Hospital were initially contacted electronically with educational material about vaccination followed by telephone outreach to eligible unvaccinated patients. Calls were used to schedule vaccine appointments for patients who agreed, answer questions, and assess attitudes and concerns for patients not yet ready to be vaccinated, with conversational themes recorded. Results Of the 1,078 patients living in the 5 New York City boroughs who had not reported receiving COVID-19 vaccination, 320 eligible patients were contacted by telephone. Of these, 210 patients were scheduled for vaccination at our vaccine site (including 13 who agreed to vaccination after initially declining), while 110 patients were either not ready or not interested in being vaccinated. The total number of patients willing to be vaccinated was 554 when also including those already vaccinated. Unwillingness to be vaccinated was associated with younger age (median age of 47 vs 60 years, P < 0.001), Black race (P = 0.004), and residence in Bronx or Brooklyn counties (P = 0.018) or a zip code with a medium level of poverty (P = 0.044). The most common issues raised by patients who were ambivalent or not interested in vaccination were regarding unknown safety of the vaccines in general, a belief that there was a lack of data about the vaccines in transplant recipients, and a lack of trust in the scientific process underlying vaccine development, with 34% of the patients contacted expressing vaccine hesitancy overall. Conclusion Our qualitative summary identifies determinants of COVID-19 vaccine hesitancy in a diverse transplant patient population, supporting the need for transplant centers to implement tailored interventions to increase vaccine acceptance in this vulnerable population.

scholarly journals 24 COVID-19 Vaccine Hesitancy Among Emergency Department Patients and Caregivers in New York City

2021 ◽  
Vol 78 (2) ◽  
pp. S12
Author(s):  
C. Guzman ◽  
T. Firew ◽  
A. Wagh ◽  
B. Stefan ◽  
A. Ruscica ◽  
...  
Keyword(s):  
Emergency Department ◽  
New York ◽  
New York City ◽  
York City ◽  
Vaccine Hesitancy ◽  
Emergency Department Patients

scholarly journals Impact of a Novel Emergency Department Forward Treatment Area During the New York City COVID-19 Surge

2021 ◽  
Vol 22 (4) ◽  
pp. 871-877
Author(s):  
Joshua Moskovitz ◽  
Kaushal Khambhati ◽  
Comilla Sasson ◽  
Jason D’Amore ◽  
Michael Jones ◽  
...  
Keyword(s):  
Emergency Department ◽  
New York ◽  
New York City ◽  
York City ◽  
Treatment Area ◽  
Hospital System ◽  
Number Of Patients ◽  
Lower Oxygen ◽  
Disproportionate Number ◽  
Public Hospital System

Introduction: Coronavirus disease 2019 (COVID-19) caused a disproportionate number of patients to seek emergency care at hospitals in New York City (NYC) during the initial crisis. Our urban emergency department (ED), a member of the NYC public hospital system had to process the increased volume while also differentiating our patients’ critical needs. We established a forward treatment area (FTA) directly in front of the ED to accomplish these goals from March 23–April 16, 2020. Methods: A clinical greeter evaluated patients 18 years and older who presented to the walk-in entrance of the ED where they were screened for COVID-19-like complaints. If they did not appear critically ill and could ambulate they were directed into the FTA. Clinical and non-clinical staff worked in concert to register, evaluate, and process patients with either a disposition of directly home or into the ED for further care. Results: A total of 634 patients were seen in the FTA from March 23–April 16, 2020. Of the 634 patients evaluated, 135 (21%) were referred into the ED for further evaluation, of whom 81 (12.7% of the total) were admitted. These patients were disproportionately male (91 into the ED and 63 admitted) and tended to have a higher heart rate (105.4 vs 93.7), a higher respiratory rate (21.5 vs 18.1), and lower oxygen saturation (93.9% vs 97.8%). Conclusion: A forward treatment area is an effective method to rapidly screen and process an increased volume of COVID-19 patients when resources are limited. This treatment area helped decompress the ED by being rapidly deployable and effectively screening patients for safe discharge home.

scholarly journals Reduced Odds of SARS-CoV-2 Reinfection after Vaccination among New York City Adults, June–August 2021

2021 ◽  
Author(s):  
Alison Levin-Rector ◽  
Lauren Firestein ◽  
Emily McGibbon ◽  
Jessica Sell ◽  
Sungwoo Lim ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Conditional Logistic Regression ◽  
Positive Test ◽  
Vaccine Hesitancy ◽  
Poverty Level ◽  
Predominant Variant ◽  
Matching Criteria ◽  
And Control

AbstractBackgroundBelief in immunity from prior infection and concern that vaccines might not protect against new variants are contributors to vaccine hesitancy. We assessed effectiveness of full and partial COVID-19 vaccination against reinfection when Delta was the predominant variant in New York City.MethodsWe conducted a case-control study in which case-patients with reinfection during June 15– August 31, 2021 and control subjects with no reinfection were matched (1:3) on age, sex, timing of initial positive test in 2020, and neighborhood poverty level. Conditional logistic regression was used to calculate matched odds ratios (mOR) and 95% confidence intervals (CI).ResultsOf 349,598 adult residents who tested positive for SARS-CoV-2 infection in 2020, did not test positive again >90 days after initial positive test through June 15, 2021, and did not die before June 15, 2021, 1,067 were reinfected during June 15–August 31, 2021. Of 1,048 with complete matching criteria data, 499 (47.6%) were known to be symptomatic for COVID-19-like-illness, and 75 (7.2%) were hospitalized. Unvaccinated individuals, compared with fully vaccinated individuals, had elevated odds of reinfection (mOR, 2.23; 95% CI, 1.90, 2.61), of symptomatic reinfection (mOR, 2.17; 95% CI, 1.72, 2.74), and of reinfection with hospitalization (mOR, 2.59; 95% CI, 1.43, 4.69). Partially versus fully vaccinated individuals had 1.58 (95% CI: 1.22, 2.06) times the odds of reinfection. All three vaccines authorized or approved for use in the U.S. were similarly effective.ConclusionAmong adults with previous SARS-CoV-2 infection, vaccination reduced odds of reinfections when the Delta variant predominated.

scholarly journals Parental plans to vaccinate children for COVID-19 in New York City

2021 ◽  
Author(s):  
Chloe A Teasdale ◽  
Luisa N Borrell ◽  
Yanhan Shen ◽  
Spencer Kimball ◽  
Michael L Rinke ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Online Survey ◽  
Vaccine Safety ◽  
Vaccine Hesitancy ◽  
Black Parents ◽  
The Public ◽  
Public Health Threat ◽  
Pediatric Vaccination

Once COVID-19 vaccines are approved for children <12 years of age, high pediatric vaccination coverage will be needed to help minimize the public health threat from the SARS-CoV-2 epidemic. We conducted an online survey of 1,119 parents and caregivers of children <12 years in New York City from March 9 to April 11, 2021. Among parents surveyed, 61.9% reported plans to vaccinate their youngest child for COVID-19, 14.8% said they do not plan to vaccinate their child and 23.3% were unsure. Female and non-Hispanic Black parents were least likely to report plans to vaccinate their children. Safety, effectiveness and perceptions that children do not need vaccination were the primary reasons for vaccine hesitancy/resistance. Parents who have or will vaccinate themselves were significantly more likely to report they would vaccinate their children. Efforts to increase awareness about vaccine safety and education about the importance of vaccinating children are needed.

scholarly journals COVID‐19 in lung transplant recipients: A single center case series from New York City

2020 ◽  
Vol 20 (11) ◽  
pp. 3072-3080 ◽  
Author(s):  
Meghan Aversa ◽  
Luke Benvenuto ◽  
Michaela Anderson ◽  
Lori Shah ◽  
Hilary Robbins ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Lung Transplant ◽  
Case Series ◽  
Transplant Recipients ◽  
Single Center ◽  
Lung Transplant Recipients

scholarly journals 383. Increased Need for Antimicrobial Stewardship during a COVID-19 Outbreak in New York City

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S261-S261
Author(s):  
Maurice Policar ◽  
Peter Barber ◽  
Yesha Malik
Keyword(s):  
Health Care ◽  
New York ◽  
New York City ◽  
Antimicrobial Stewardship ◽  
York City ◽  
Antibiotic Usage ◽  
Antimicrobial Use ◽  
Time Period ◽  
Number Of Patients ◽  
The Impact

Abstract Background The impact of COVID-19 on the health care system in New York City (NYC) cannot be overstated. The first documented cases of COVID-19 in Queens NYC occurred in early March of 2020. The total number of patients with proven or suspected COVID-19 at Elmhurst Hospital peaked in early April. A dramatic increase in the use of antimicrobials occurred in April, and correlated with the increased number of intubated COVID-19 patients at Elmhurst Hospital. Methods Antimicrobial Stewardship Committee activities and meetings had been suspended for the months of March and April due to the increased clinical demands associated with the COVID-19 outbreak. In preparation for the May meeting, a retrospective analysis of antimicrobial use for March and April of 2020 was performed. Results The analysis revealed a 30% increase in the use of antimicrobials. The average total days of antimicrobials per 1000 patient days (TDA/TPD) was 445 for January through March of 2020. In April, this number climbed to 580. TDA/TPD increased from 57 to 90 (58%) for vancomycin, 25 to 35 (40%) for meropenem, and 31 to 89 (187%) for cefepime. The number of intervention by the Antibiotic Stewardship team remained low during this time period. Total Days of Antimicrobials per 1000 Patient Days (TDA/TPD) Conclusion A dramatic increase in the use of antimicrobials correlated with an increase in the number of intubated patients at Elmhurst Hospital during a COVID-19 outbreak. It is likely that the frequent appearance of fever and leukocytosis in intubated patients with COVID-19 prompted an increase in empiric antimicrobial use. The 48 hour time outs and prospective review of antimicrobial use may be necessary to maintain stewardship efforts during the COVID-19 epidemic. Further review of antibiotic usage in critically ill COVID-19 patients is needed to help define stewardship practices as we go forward in this pandemic. Disclosures All Authors: No reported disclosures

Abstract TMP72: Modeling the Impact of Interhospital Transfer Protocol Design on Mechanical Thrombectomy Eligibility and Outcomes in a Large Metropolitan Area

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Neal S Parikh ◽  
Abhinaba Chatterjee ◽  
Alexander E Merkler ◽  
Gino Gialdini ◽  
Benjamin R Kummer ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Mechanical Thrombectomy ◽  
Functional Independence ◽  
Travel Times ◽  
Start Time ◽  
Interhospital Transfer ◽  
Number Of Patients ◽  
The Impact

Introduction: The effect of mechanical thrombectomy (MT) on functional outcomes after acute ischemic stroke is time-dependent. Interhospital transfer (IHT) introduces delays between stroke onset and MT. Methods: We created models of two IHT network designs in New York City involving 26 Department of Health designated stroke centers without MT capabilities (spokes) and 14 hospitals able to perform MT (hubs). In Model A, all patients were transferred from the initial hospital without MT capabilities to the closest hub irrespective of hospital affiliation. In Model B, all patients were transferred to the closest affiliated hub. We calculated the number of patients eligible for MT presenting to each spoke annually using publicly available data. With Google Traffic API software, we estimated travel times between spoke and hub hospitals under constant conditions that approximated ambulance travel. We determined the effect of transfer time on MT eligibility based on a reported 2.5% reduction in odds of MT per minute of travel delay beyond a minimum threshold. Rates of a good functional outcome (modified Rankin Scale score 0-2) were predicted based on MT trial data. Last, we calculated the efficiency advantage needed among affiliated hospitals (Model B) to offset increased travel times. Results: In our models, 371 patients (interquartile range [IQR], 229-628) with a stroke amenable to MT present to New York City spoke hospitals without MT capability each year. The mean travel time to the closest hub was 15.9 (±5.7) minutes in Model A versus 23.0 (±9.5) minutes to the closest affiliated hub in Model B. Transferring patients to the closest hub irrespective of affiliation (Model A) resulted in 71 (IQR, 44-120) additional patients being eligible for MT upon arrival and thereby an additional 14 (IQR, 8-23) patients achieving functional independence per year. To attenuate the differences in outcomes between Model A and Model B, a 10.9-minute decrease was required in the combined door-in to door-out time at the spoke plus the door-in to MT-start time at the affiliated hub. Conclusions: Optimizing IHT networks requires balancing the efficiency gains of transferring to affiliated hospitals with the travel delays resulting from bypassing nearby MT-capable centers.

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