scholarly journals 101. PCV13 Pediatric Vaccination Disparity and Impact Due to COVID-19 Pandemic in the US

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S63-S64
Author(s):  
Liping Huang ◽  
Jennifer L Nguyen ◽  
Johnna Perdrizet ◽  
Tamuno Alfred ◽  
Adriano Arguedas

Abstract Background Existing disparities in vaccination rates across different social and demographic groups in the US may have been exacerbated during the Coronavirus Disease 2019 (COVID) pandemic, leaving some children at risk for vaccine-preventable diseases. This study examined sociodemographic and risk factors of PCV13 infant primary series vaccination completion, before and during COVID. Methods Retrospective data from the Optum’s de-identified Clinformatics Data Mart Database were used to create 3 cohorts: C1, Pre-COVID; C2, During COVID; C3, Cross-COVID (Figure 1). C1 and C3 (C1&3) were combined and compared with C2 for primary dosing completion before and during COVID according to infant/caregiver characteristics. Full completion (FC) was defined as receipt of 3 doses of PCV13 within 8 months of birth. Multivariable logistic regression was used to compare FC vs. partial completion or no vaccine. Descriptive analyses were used to compare FC before and during COVID within subgroups. Figure 1: Study population and inclusion criteria Results A total of 132,183 and 16,522 infants with at least 8 months of follow up time were enrolled in C1&3 and C2, respectively. FC was significantly higher before COVID-19 (adjusted odds ratio = 1.12, 95% CI: 1.07-1.17). Adjusting for COVID, FC was significantly lower in infants who were Black, with co-morbidities or risk factors, living in households with >1 children or no children, household annual income < &99k, residing in a neighborhood with median education of high school or below, and whose primary caregiver was aged <25 years (Table 1). Comparing FC before and during COVID, the % decline relative to pre-COVID was > 2% among infants who were White, residing in the Mountain, New England or Pacific regions, in a household with 2 children, >&100k annual income, employer-based insurance or HMO, and median neighborhood education of bachelor degree plus (Table 2). Table 1. Multivariable binomial logistic regression results for PCV13 full primary dosing completion vs. not full completion (partial or no vaccine), N=144,799* Table 2. Primary dosing full completion rate pre-COVID vs. during COVID by social, demographic, and clinical risk factors Conclusion Health inequities in PCV13 primary series completion existed prior to COVID-19 and have remained during the pandemic. Our results, however, suggest that during the pandemic, groups traditionally considered to have better healthcare access (Whites, higher income, more education) had more impact on vaccine uptake. Further research is needed to confirm these trends as COVID mitigation measures subside. Disclosures Liping Huang, MD, MA, MS, Pfizer Inc (Employee) Jennifer L Nguyen, ScD, MPH, Pfizer Inc. (Employee) Johnna Perdrizet, MPH, Pfizer Inc (Employee) Tamuno Alfred, PhD, Pfizer Inc. (Employee) Adriano Arguedas, MD, Pfizer (Employee)

2021 ◽  
Vol 12 ◽  
Author(s):  
Victor Mazereel ◽  
Tom Vanbrabant ◽  
Franciska Desplenter ◽  
Johan Detraux ◽  
Livia De Picker ◽  
...  

Background: Patients with mental illness are at increased risk for COVID-19-related morbidity and mortality. Vaccination against COVID-19 is important to prevent or mitigate these negative consequences. However, concerns have been raised over vaccination rates in these patients.Methods: We retrospectively examined vaccine uptake in a large sample of Belgian patients admitted to or residing in a university psychiatric hospital or community mental health care setting between 29th of March 2021 and 30th of September 2021 in the Flanders Region. All patients were offered vaccination. Descriptive statistics were used to analyse the data. Logistic regression was used to examine factors associated with vaccine uptake.Results: 2,105 patients were included in the sample, of which 1,931 agreed to be vaccinated, corresponding with a total vaccination rate of 91.7%. Logistic regression showed an effect of the diagnosis “other disorders” (OR = 0.08, CI = 0.005–0.45), age (OR = 1.03, CI = 1.02–1.04) and residing in the psychosocial care center (OR = 0.50, CI = 0.32–0.80) on vaccination status.Conclusion: Vaccine uptake among people with mental illness is high and comparable to the general population, when implementing a targeted vaccination program.


2020 ◽  
Vol 187 (3) ◽  
pp. 112-112 ◽  
Author(s):  
Rachel H Kinsman ◽  
Rachel A Casey ◽  
Toby G Knowles ◽  
Séverine Tasker ◽  
Michelle S Lord ◽  
...  

BackgroundPuppy acquisition decisions may impact upon the health and behaviour of these dogs in later life. It is widely recommended by welfare organisations and veterinary bodies that puppies should not leave maternal care until at least eight weeks (56 days) of age, and that when acquiring a puppy it should be viewed with its mother.MethodsOwner-reported prospective data were used to explore risk factors for puppy acquisition age, and whether the mother was viewed during acquisition, within a cohort of dog owners participating in an ongoing longitudinal project.ResultsA quarter (461/1844) of puppies were acquired under eight weeks of age and 8.1 per cent were obtained without viewing the mother (n=149). Only 1.6 per cent of puppies were obtained under eight weeks of age and without the mother being seen (n=30). Multivariable logistic regression analysis revealed that owners who intended their puppy to be a working dog, visited their puppy prior to acquisition, and/or obtained a puppy of unknown breed composition had increased odds of acquiring a puppy under eight weeks of age. The odds also increased as the number of dogs in the household increased but decreased as annual income rose. Owners who visited their puppy prior to acquisition, obtained a Kennel Club registered puppy, viewed the puppy’s father, and/or collected their puppy from the breeder’s home had decreased odds of acquiring a puppy without viewing the mother.ConclusionTargeting interventions towards identified owners who are more likely to acquire a puppy against current recommendations could help reduce these types of acquisitions.


2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 126-126
Author(s):  
Philip Ratnasamy ◽  
Anees B. Chagpar

126 Background: Despite HPV vaccine availability, approximately one-third of annual global cervical cancer deaths occur in India. This may be related to cultural norms that lead to vaccine hesitancy. We sought to determine whether people of Indian ancestry (POIA) who move to the US continue to have disproportionately lower HPV vaccination rates than the rest of the US population and factors that influence HPV vaccine uptake in this group. Methods: The National Health Interview Survey (NHIS) is the largest source of health information for Americans and is designed to be representative of the entire civilian non-institutionalized US population. We utilized the 2018 NHIS to compare HPV vaccine initiation and completion rates between POIA and the general US population and factors correlating with HPV vaccine uptake in this group. Results: There were 17,004 people, representing 185,065,802 in the population, who were between the ages of 18-64 and who responded to questions regarding racial ancestry and HPV vaccination. Of this cohort, 1.69% identified themselves as being of Indian ancestry. Compared to other racial groups, POIA had a significantly lower rate of HPV vaccination (8.18% vs. 12.16%, 14.70%, 16.07%, and 12.41%, in White, Black, Other Asian, and those of other/mixed ancestry, respectively, p = 0.003). However, of those who received one HPV shot there was no difference in vaccine series completion between racial groups (3.17% vs. 4.27%, 3.51%, 4.31%, and 5.04% for POIA vs. White, Black, Other Asian, and those of other/mixed ancestry, respectively, p = 0.465). Among POIA, younger individuals and those who were single were more likely to obtain HPV vaccination (vaccination rates of 38.12%, 6.45% and 1.79% for ages 18-25, 26-45, and 46-64, respectively, p = 0.018, and 29.53% vs. 3.11% for single vs. married, respectively, p = 0.006). All individuals who were vaccinated had some form of health insurance (p = 0.020). Those born in the US had a higher rate of vaccination than those who were not (p = 0.019); however, duration of residence in the US did not influence vaccination rates among POIA (p = 0.502). While high levels of English proficiency were associated with a higher vaccination rate (p = 0.029), education status was not correlated (p = 0.231). Interestingly, both male and female POIA had equivalent rates of vaccination (3.12% and 2.81%, respectively, p = 0.949). Conclusions: POIA are significantly less likely to receive HPV vaccination than the general US population but are equally likely to complete the vaccine series if initiated. Age, insurance status, being born in the US, English speaking proficiency, and marital status significantly influence HPV vaccine initiation among POIA. These data suggest that public health measures promoting HPV vaccination among POIA immigrants may significantly improve vaccination rates among this population.


Author(s):  
Azad Kabir ◽  
Raeed Kabir ◽  
Jebun Nahar ◽  
Ritesh Sengar

The objective of the study was to evaluate the risk factors associated with lower COVID-19 vaccination rates in the United States. The study evaluated the effect of red-blue political affiliation and the effect of the US state's average educational aptitude score and per capita income on states' vaccination rates. The study found that states with concomitantly lower income along with lower educational aptitude scores are less vaccinated while the states with higher income have higher vaccination rates even among those with lower educational aptitude scores. These findings stayed significant after adjusting for red-blue political affiliation where states with red political affiliation have lower vaccination rates. Further study is needed to evaluate how to stop online misinformation among states with low income and low educational aptitude scores; and whether such an effort will increase overall vaccination rates in the United States.


Author(s):  
S. Loomba ◽  
A. de Figueiredo ◽  
S. J. Piatek ◽  
K. de Graaf ◽  
H. J. Larson

The successful development and widespread acceptance of a SARS-CoV-2 vaccine will be a major step in fighting the pandemic, yet obtaining high uptake will be a challenging task, worsened by online misinformation. To help inform successful COVID-19 vaccination campaigns in the UK and US, we conducted a survey to quantify how online misinformation impacts COVID-19 vaccine uptake intent and identify socio-economic groups that are most at-risk of non-vaccination and most susceptible to online misinformation. Here, we report findings from nationally representative surveys in the UK and the US conducted in September 2020. We show that recent misinformation around a COVID-19 vaccine induces a fall in vaccination intent among those who would otherwise “definitely” vaccinate by 6.4 (3.8, 9.0) percentages points in the UK and 2.4 (0.1, 5.0) in the US, with larger decreases found in intent to vaccinate to protect others. We find evidence that socio-econo-demographic, political, and trust factors are associated with low intent to vaccinate and susceptibility to misinformation: notably, older age groups in the US are more susceptible to misinformation. We find evidence that scientific-sounding misinformation relating to COVID-19 and vaccines COVID-19 vaccine misinformation lowers vaccination intent, while corresponding factual information does not. These findings reveal how recent COVID-19 misinformation can impact vaccination rates and suggest pathways to robust messaging campaigns.


2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Robert Böhm ◽  
Cornelia Betsch ◽  
Lars Korn ◽  
Cindy Holtmann

Influenza vaccination for health care personnel (HCP) is recommended particularly because it indirectly protects patients from contracting the disease. Vaccinating can therefore be interpreted as a prosocial act. However, HCP vaccination rates are often far too low to prevent nosocomial infections. Effective interventions are needed to increase HCP’s influenza vaccine uptake. Here we devise a novel tool to experimentally test interventions that aim at increasing prosocially motivated vaccine uptake under controlled conditions. We conducted a large-scale and cross-cultural experiment with participants from countries with either a collectivistic (South Korea) or an individualistic (USA) cultural background. Results showed that prosocially motivated vaccination was more likely in South Korea compared to the US, mediated by a greater perception of vaccination as a social act. However, changing the default of vaccination, such that participants had to opt out rather than to opt in, increased vaccine uptake in the US and therefore compensated for the lower level of prosocial vaccination. In sum, the present study provides both a novel method to investigate HCP influenza vaccination behavior and interventions to increase their vaccine uptake.


BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e048778
Author(s):  
McKaylee M Robertson ◽  
Sarah Gorrell Kulkarni ◽  
Madhura Rane ◽  
Shivani Kochhar ◽  
Amanda Berry ◽  
...  

PurposeThe Communities, Households and SARS-CoV-2 Epidemiology (CHASING) COVID Cohort Study is a community-based prospective cohort study launched during the upswing of the USA COVID-19 epidemic. The objectives of the cohort study are to: (1) estimate and evaluate determinants of the incidence of SARS-CoV-2 infection, disease and deaths; (2) assess the impact of the pandemic on psychosocial and economic outcomes and (3) assess the uptake of pandemic mitigation strategies.ParticipantsWe began enrolling participants from 28 March 2020 using internet-based strategies. Adults≥18 years residing anywhere in the USA or US territories were eligible. 6740 people are enrolled in the cohort, including participants from all 50 US states, the District of Columbia, Puerto Rico and Guam. Participants are contacted regularly to complete study assessments, including interviews and dried blood spot specimen collection for serologic testing.Findings to dateParticipants are geographically and sociodemographically diverse and include essential workers (19%). 84.2% remain engaged in cohort follow-up activities after enrolment. Data have been used to assess SARS-CoV-2 cumulative incidence, seroincidence and related risk factors at different phases of the US pandemic; the role of household crowding and the presence of children in the household as potential risk factors for severe COVID-19 early in the US pandemic; to describe the prevalence of anxiety symptoms and its relationship to COVID-19 outcomes and other potential stressors; to identify preferences for SARS-CoV-2 diagnostic testing when community transmission is on the rise via a discrete choice experiment and to assess vaccine hesitancy over time and its relationship to vaccine uptake.Future plansThe CHASING COVID Cohort Study has outlined a research agenda that involves ongoing monitoring of the incidence and determinants of SARS-CoV-2 outcomes, mental health outcomes and economic outcomes. Additional priorities include assessing the incidence, prevalence and correlates of long-haul COVID-19.


2020 ◽  
Vol 133 (2) ◽  
pp. 403-410 ◽  
Author(s):  
Travis J. Atchley ◽  
Nicholas M. B. Laskay ◽  
Brandon A. Sherrod ◽  
A. K. M. Fazlur Rahman ◽  
Harrison C. Walker ◽  
...  

OBJECTIVEInfection and erosion following implantable pulse generator (IPG) placement are associated with morbidity and cost for patients with deep brain stimulation (DBS) systems. Here, the authors provide a detailed characterization of infection and erosion events in a large cohort that underwent DBS surgery for movement disorders.METHODSThe authors retrospectively reviewed consecutive IPG placements and replacements in patients who had undergone DBS surgery for movement disorders at the University of Alabama at Birmingham between 2013 and 2016. IPG procedures occurring before 2013 in these patients were also captured. Descriptive statistics, survival analyses, and logistic regression were performed using generalized linear mixed effects models to examine risk factors for the primary outcomes of interest: infection within 1 year or erosion within 2 years of IPG placement.RESULTSIn the study period, 384 patients underwent a total of 995 IPG procedures (46.4% were initial placements) and had a median follow-up of 2.9 years. Reoperation for infection occurred after 27 procedures (2.7%) in 21 patients (5.5%). No difference in the infection rate was observed for initial placement versus replacement (p = 0.838). Reoperation for erosion occurred after 16 procedures (1.6%) in 15 patients (3.9%). Median time to reoperation for infection and erosion was 51 days (IQR 24–129 days) and 149 days (IQR 112–285 days), respectively. Four patients with infection (19.0%) developed a second infection requiring a same-side reoperation, two of whom developed a third infection. Intraoperative vancomycin powder was used in 158 cases (15.9%) and did not decrease the infection risk (infected: 3.2% with vancomycin vs 2.6% without, p = 0.922, log-rank test). On logistic regression, a previous infection increased the risk for infection (OR 35.0, 95% CI 7.9–156.2, p < 0.0001) and a lower patient BMI was a risk factor for erosion (BMI ≤ 24 kg/m2: OR 3.1, 95% CI 1.1–8.6, p = 0.03).CONCLUSIONSIPG-related infection and erosion following DBS surgery are uncommon but clinically significant events. Their respective timelines and risk factors suggest different etiologies and thus different potential corrective procedures.


2020 ◽  
Vol 25 (45) ◽  
pp. 4827-4834 ◽  
Author(s):  
Limin Zhang ◽  
Xingang Li ◽  
Dongzhi Wang ◽  
Hong Lv ◽  
Xuezhong Si ◽  
...  

Background: A considerable proportion of acute noncardiogenic ischemic stroke patients continue to experience recurrent ischemic events after standard therapy. Aim: We aimed to identify risk factors for recurrent ischemic event prediction at an early stage. Methods : 286 non-cardioembolic ischemic stroke patients with the onset of symptoms within 24 hours were enrolled. Vascular risk factors, routine laboratory data on admission, thromboelastography test seven days after clopidogrel therapy and any recurrent events within one year were assessed. Patients were divided into case group (patients with clinical adverse events, including ischemic stokes, transient ischemic attack, myocardial infarction and vascular related mortality) and control group (events-free patients). The risk of the recurrent ischemic events was determined by the receiver operating characteristic curve and multivariable logistic regression analysis. Results: Clinical adverse events were observed in 43 patients (case group). The mean levels of Mean Platelet Volume (MPV), Platelet/Lymphocyte Ratio (PLR), Lymphocyte Count (LY) and Fibrinogen (Fib) on admission were significantly higher in the case group as compared to the control group (P<0.001). Seven days after clopidogrel therapy, the ADP-induced platelet inhibition rate (ADP%) level was lower in the case group, while the Maximum Amplitude (MA) level was higher in the case group as compared to the control group (P<0.01). The Area Under the Curve (AUC) of receiver operating characteristic(ROC) curve of LY, PLR, , Fib, MA, ADP% and MPV were 0.602, 0.614, 0.629, 0.770, 0.800 and 0.808, respectively. The logistic regression analysis showed that MPV, ADP% and MA were indeed predictive factors. Conclusion: MPV, ADP% and MA were risk factors of recurrent ischemic events after acute noncardiogenic ischemic stroke. Urgent assessment and individual drug therapy should be offered to these patients as soon as possible.


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