scholarly journals 580. Hesitancy in Uptake and Recommendation of COVID-19 Vaccines by US Healthcare Workers

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S392-S392
Author(s):  
Steven S Spires ◽  
Rebecca Rayburn-Reeves ◽  
Elizabeth Dodds Ashley ◽  
Jenna Clark ◽  
Avani P Desai ◽  
...  
Keyword(s):  
Medical Information ◽  
Vaccine Development ◽  
Vaccine Safety ◽  
Vaccine Hesitancy ◽  
Effective Vaccine ◽  
Research Support ◽  
Hospital Employees ◽  
Significant Difference ◽  
Support Research ◽  
Research Grant

Abstract Background The COVID-19 pandemic has brought vaccination to the forefront of discourse on public health. The rapid speed of COVID-19 vaccine development, utilization of novel technology, and an atmosphere of politicized misinformation have created a perfect storm for vaccine hesitancy. As early adopters of vaccination, HCWs set an example for the general population; as trusted sources of medical information, they educate and inform. However, comparatively little work has investigated HCWs' attitudes toward vaccination and how those attitudes drive their recommendation behavior. Methods We surveyed hospital employees about their personal reasons for hesitancy and beliefs about patient hesitancies and randomly assigned them to see one of three messages aimed at increasing vaccine confidence. Message themes included an appeal to return to normal life (Normalcy), a risk comparison between vaccinating or not (SDT), and an explanation of the speed of safe and effective vaccine development (Process). Results Of the 674 NC hospital employees who completed our survey in February 2021, 98% had been offered the COVID-19 vaccine, and 80% had already accepted. For the 20% who had not received the vaccine, the top reasons for hesitancy involved the speed of development and testing, and concerns of vaccine safety and effectiveness. We also found differences in susceptibility to misinformation and vaccine hesitancy across political affiliation, which was higher in Republicans compared to Democrats. HCWs were generally very comfortable recommending the COVID-19 vaccine to patients and supported the idea of sharing the message they read. Although the risk comparison message was most trusted personally, the process message was rated as both the most helpful to patients and the most likely to be shared with them (see Figure 1). This suggests that what is most appealing on a personal level is not necessarily what a HCW would recommend to their patients. Rating of personal opinions of the passages. On a scale from 1 to 7 with 1 = Strongly Disagree and 7 = Strongly Agree. This chart shows the average message ratings across the board when answering whether they thought the passages were understandable, helpful, correct, believable, and trustworthy. (Error bars are 95% CI) There was no significant difference across the messages. The Process message is seen as most helpful and is most likely to be shared with patient than the other messages On left, the average answer on a scale from 1 to 5 for “Do you think the passage you just read would help your patients feel more comfortable about getting the vaccine?” and on right, the average answer for “Would you share this passage with your patients?” Conclusion HCWs' high uptake and minimal hesitancy in recommending the COVID-19 vaccine is encouraging and merits further exploration for how to increase confidence in HCW who are hesitant to discuss and recommend vaccines to patients, as several highlighted the importance of respecting patient autonomy. Disclosures Rebecca Rayburn-Reeves, PhD, Centene Corporation (Grant/Research Support, Research Grant or Support) Jenna Clark, PhD, Centene Corporation (Grant/Research Support, Research Grant or Support) Jan Lindemans, PhD, Centene Corportation (Grant/Research Support, Scientific Research Study Investigator)

scholarly journals Faster than warp speed: early attention to COVD-19 by anti-vaccine groups on Facebook

2021 ◽  
Author(s):  
Seth C Kalichman ◽  
Lisa A Eaton ◽  
Valerie A Earnshaw ◽  
Natalie Brousseau
Keyword(s):  
Social Media ◽  
Vaccine Development ◽  
Rapid Development ◽  
Development Program ◽  
Vaccine Safety ◽  
Vaccine Hesitancy ◽  
Conspiracy Theories ◽  
The Us ◽  
Us Government ◽  
Vaccine Information

Abstract Background The unprecedented rapid development of COVID-19 vaccines has faced SARS-CoV- (COVID-19) vaccine hesitancy, which is partially fueled by the misinformation and conspiracy theories propagated by anti-vaccine groups on social media. Research is needed to better understand the early COVID-19 anti-vaccine activities on social media. Methods This study chronicles the social media posts concerning COVID-19 and COVID-19 vaccines by leading anti-vaccine groups (Dr Tenpenny on Vaccines, the National Vaccine Information Center [NVIC] the Vaccination Information Network [VINE]) and Vaccine Machine in the early months of the COVID-19 pandemic (February–May 2020). Results Analysis of 2060 Facebook posts showed that anti-vaccine groups were discussing COVID-19 in the first week of February 2020 and were specifically discussing COVID-19 vaccines by mid-February 2020. COVID-19 posts by NVIC were more widely disseminated and showed greater influence than non-COVID-19 posts. Early COVID-19 posts concerned mistrust of vaccine safety and conspiracy theories. Conclusion Major anti-vaccine groups were sowing seeds of doubt on Facebook weeks before the US government launched its vaccine development program ‘Operation Warp Speed’. Early anti-vaccine misinformation campaigns outpaced public health messaging and hampered the rollout of COVID-19 vaccines.

scholarly journals 913. Distribution of Respiratory Viral Pathogens in Infants Across Different Clinical Settings from December 2019 to April 2020

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S491-S492
Author(s):  
Zaid Haddadin ◽  
Danielle A Rankin ◽  
loren lipworth ◽  
Jon Fryzek ◽  
Mina Suh ◽  
...  
Keyword(s):  
Clinical Setting ◽  
Respiratory Viruses ◽  
Clinical Settings ◽  
Research Support ◽  
Viral Pathogens ◽  
Abrupt Decrease ◽  
Nasal Swabs ◽  
Viral Testing ◽  
Support Research ◽  
Research Grant

Abstract Background Acute respiratory infections (ARI) are a major cause of morbidity and mortality in young children, with viral pathogens being the most common etiologies. However, due to limited and inconsistent clinical diagnostic viral testing in the outpatient (OP) setting compared to the inpatient (IP) setting, the actual burden and distribution of viral pathogens across these clinical settings remain largely underreported. We aimed to evaluate the frequency of common respiratory viruses in medically attended ARI in infants. Methods We conducted a prospective viral surveillance study in Davidson County, TN. Eligible infants under one year presenting with fever and/or respiratory symptoms were enrolled from OP, emergency department (ED), or IP settings. Nasal swabs were collected and tested for common viral pathogens using Luminex® NxTAG Respiratory Pathogen Panel and for SARS-CoV-2 using Luminex® NxTAG CoV extended panel. Results From 12/16/2019 to 4/30/2020, 364 infants were enrolled, and 361 (99%) had nasal swabs collected and tested. Of those, 295 (82%) had at least one virus detected; rhinovirus/enterovirus (RV/EV) [124 (42%)], respiratory syncytial virus (RSV) [101 (32%)], and influenza (flu) [44 (15%)] were the three most common pathogens detected. No samples tested positive for SARS-CoV-2. Overall, the mean age was 6.1 months, 50% were male, 45% White and 27% Hispanic. Figure 1 shows the total number of PCR viral testing results by month. RSV was the most frequent virus detected in the IP (63%) and ED (37%) settings, while RV/EV was the most common in the OP setting (Figure 2). Figure 3 displays viral seasonality by clinical setting, showing an abrupt decrease in virus-positive cases following the implementation of a stay-at-home order on March 23, 2020 in Nashville, TN. Distribution of Respiratory Viruses in Different Settings Distribution of Respiratory Viruses in Different Settings by Season Conclusion Most medical encounters in infants are due to viral pathogens, with RSV, RV/EV, and flu being the most common. However, distributions differed by clinical setting, with RSV being the most frequently detected in the IP and ED settings, and second to RV/EV in the OP setting. Continued active viral ARI surveillance in various clinical settings is warranted. Preventative measures such as vaccines and infection control measures deserve study to reduce viral ARI burden. Disclosures Zaid Haddadin, MD, CDC (Grant/Research Support, Research Grant or Support)Quidel Corporation (Grant/Research Support, Research Grant or Support)sanofi pasteur (Grant/Research Support, Research Grant or Support) Danielle A. Rankin, MPH, CIC, Sanofi Pasteur (Grant/Research Support, Research Grant or Support) Jon Fryzek, PhD, MPH, EpidStrategies (Employee) Mina Suh, MPH, International Health, EpidStrategies (Employee) Donald S. Shepard, PhD, Sanofi Pasteur (Grant/Research Support) Natasha B. Halasa, MD, MPH, Genentech (Other Financial or Material Support, I receive an honorarium for lectures - it’s a education grant, supported by genetech)Karius (Consultant)Moderna (Consultant)Quidel (Grant/Research Support, Research Grant or Support)Sanofi (Grant/Research Support, Research Grant or Support)

scholarly journals 1507. Clinical Characteristics of Common Respiratory Viruses Detected in Infants Across Different Clinical Settings

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S756-S757
Author(s):  
Zaid Haddadin ◽  
Danielle A Rankin ◽  
loren lipworth ◽  
Jon Fryzek ◽  
Mina Suh ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Disease Severity ◽  
Clinical Characteristics ◽  
Respiratory Viruses ◽  
Control Measures ◽  
Clinical Settings ◽  
Research Support ◽  
Nasal Swabs ◽  
Support Research ◽  
Research Grant

Abstract Background Viral acute respiratory infections (ARI) continues to be a significant cause of healthcare visits in young children. We evaluated the clinical presentation and disease severity of common respiratory viruses associated with medically attended ARI in infants. Methods We conducted a prospective viral surveillance study in Davidson County, TN. Infants under one year with fever and/or respiratory symptoms were enrolled from the outpatient (OP), emergency department (ED), or inpatient (IP) settings from 12/16/2019 through 4/30/2020. Nasal swabs were collected and tested for common viral pathogens using Luminex® NxTAG Respiratory Pathogen Panel. Demographic and clinical characteristics were collected through parent/guardian interviews and medical chart abstractions. Results In total, 364 participants were enrolled, and 361 (99%) had nasal swabs collected and tested. Overall, mean age was 6±3.3 months, 50% were female, 45% White, and 27% Hispanic. Of the 295 (82%) virus-positive specimens; the three most common viruses were rhinovirus/enterovirus (RV/EV), respiratory syncytial virus (RSV), and influenza (flu) [124, 101, and 44, respectively]. Compared to virus-negative infants, virus-positive infants were more likely to have more severe ARI symptoms and to be admitted to the intensive care unit (Table 1). Compared to other virus-positive infants: RV/EV-positive infants were more likely to be White, attend daycare, but less likely to present with respiratory distress, or require oxygen or admission; flu-positive infants were older and more likely to have systemic symptoms rather than ARI symptoms, and RSV-positive infants were more likely to present with respiratory distress, receive oxygen and be hospitalized (Table 1). Table 1. Demographic and Clinical Characteristics of Study Subjects Conclusion The majority of ARI in infants are due to respiratory viruses, with RSV, RV/EV, and flu accounting for over three-quarters of these viruses. The clinical presentations and disease severity differed across the clinical settings and the three main viruses, with RSV being most severe. To decrease the burden of medically attended viral ARI, preventive measures (i.e., developing new vaccines and antivirals), refining current vaccination strategies, and infection control measures are needed. Disclosures Zaid Haddadin, MD, CDC (Grant/Research Support, Research Grant or Support)Quidel Corporation (Grant/Research Support, Research Grant or Support)sanofi pasteur (Grant/Research Support, Research Grant or Support) Danielle A. Rankin, MPH, CIC, Sanofi Pasteur (Grant/Research Support, Research Grant or Support) Jon Fryzek, PhD, MPH, EpidStrategies (Employee) Mina Suh, MPH, International Health, EpidStrategies (Employee) Donald S. Shepard, PhD, Sanofi Pasteur (Grant/Research Support) Natasha B. Halasa, MD, MPH, Genentech (Other Financial or Material Support, I receive an honorarium for lectures - it’s a education grant, supported by genetech)Karius (Consultant)Moderna (Consultant)Quidel (Grant/Research Support, Research Grant or Support)Sanofi (Grant/Research Support, Research Grant or Support)

scholarly journals Intention to Be Vaccinated for COVID-19 among Italian Nurses during the Pandemic

Vaccines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 500
Author(s):  
Marco Trabucco Aurilio ◽  
Francesco Saverio Mennini ◽  
Simone Gazzillo ◽  
Laura Massini ◽  
Matteo Bolcato ◽  
...  
Keyword(s):  
Vaccine Efficacy ◽  
Online Survey ◽  
Vaccine Development ◽  
Vaccine Coverage ◽  
World Health ◽  
Vaccine Hesitancy ◽  
Effective Vaccine ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Female Sex

Background: While the COVID-19 pandemic has spread globally, health systems are overwhelmed by both direct and indirect mortality from other treatable conditions. COVID-19 vaccination was crucial to preventing and eliminating the disease, so vaccine development for COVID-19 was fast-tracked worldwide. Despite the fact that vaccination is commonly recognized as the most effective approach, according to the World Health Organization (WHO), vaccine hesitancy is a global health issue. Methods: We conducted a cross-sectional online survey of nurses in four different regions in Italy between 20 and 28 December 2020 to obtain data on the acceptance of the upcoming COVID-19 vaccination in order to plan specific interventions to increase the rate of vaccine coverage. Results: A total of 531 out of the 5000 nurses invited completed the online questionnaire. Most of the nurses enrolled in the study (73.4%) were female. Among the nurses, 91.5% intended to accept vaccination, whereas 2.3% were opposed and 6.2% were undecided. Female sex and confidence in vaccine efficacy represent the main predictors of vaccine intention among the study population using a logistic regression model, while other factors including vaccine safety concerns (side effects) were non-significant. Conclusions: Despite the availability of a safe and effective vaccine, intention to be vaccinated was suboptimal among nurses in our sample. We also found a significant number of people undecided as to whether to accept the vaccine. Contrary to expectations, concerns about the safety of the vaccine were not found to affect the acceptance rate; nurses’ perception of vaccine efficacy and female sex were the main influencing factors on attitudes toward vaccination in our sample. Since the success of the COVID-19 immunization plan depends on the uptake rate, these findings are of great interest for public health policies. Interventions aimed at increasing employee awareness of vaccination efficacy should be promoted among nurses in order to increase the number of vaccinated people.

scholarly journals 986. Evaluation of Moderate-to-Severe Influenza Disease in Children 6 Months to 8 Years of Age in Colorado

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S291-S292
Author(s):  
Suchitra Rao ◽  
Molly Lamb ◽  
Angela Moss ◽  
Emad Yanni ◽  
Rafik Bekkat-Berkani ◽  
...  
Keyword(s):  
Risk Difference ◽  
Antimicrobial Use ◽  
Clinical Endpoint ◽  
Research Support ◽  
Mild Disease ◽  
Significant Difference ◽  
Ed Visits ◽  
Emergency Room Care ◽  
Negative Controls ◽  
Research Grant

Abstract Background A clinical endpoint of moderate-to-severe (M/S) influenza has been proposed in children, defined as fever >39°C, otitis media, lower respiratory tract infection, or serious extrapulmonary manifestations. This definition has not been evaluated against clinically relevant outcomes like hospitalization, emergency room care, antimicrobial use, and child/parental absenteeism. Methods We conducted a prospective observational study of children aged 6 months–8 years with influenza at the Children’s Hospital Colorado Emergency Department (ED) and its affiliates during two influenza seasons (2016–2017 and 2017–2018). Children with influenza-like-illness (ILI) were enrolled and tested for influenza by polymerase chain reaction (PCR). Parents of influenza cases and matched influenza-negative controls were contacted 2 weeks later for follow-up. The primary outcome was hospitalization for M/S influenza vs. mild influenza. Secondary outcomes included recurrent ED visits, antimicrobial use, child/parental absenteeism. Interim analyses were conducted using SAS v9.4. Results Among the 1,480 enrolled children with ILI, 410 (28%) tested positive for influenza by PCR. The median age of influenza cases was 4.0 years (IQR 2.2–6.1), and 20% were considered high-risk for influenza complications. Of influenza cases, 284 (69%) met the definition for M/S influenza. Among M/S influenza subjects, 8.4% were hospitalized, compared with 1.6% with mild influenza (risk difference (RD) 6.9%; 95% CI: 3.0–10.8, P < 0.01). Subjects with M/S influenza were more likely to receive antibiotics (RD 12.0%, 95% CI: 3.4–20.6, P < 0.01) with a trend to higher antiviral use (RD 6.9%, 95% CI: −0.7–14.5, P = 0.09). There was no significant difference for recurrent ED visits nor child/parental absenteeism. After adjusting for comorbidities, age, and influenza strain, the relative risk (RR) of hospitalization or recurrent ED visits was higher among those with M/S influenza vs. mild influenza (RR 2.18, 95% CI: 1.02–4.64, P = 0.04). Conclusion Children with M/S influenza have a higher risk of hospitalization compared with mild disease. This proposed definition is a useful clinical endpoint to study the public health and clinical impact of influenza interventions in children. Disclosures S. Rao, GSK: Investigator, Research grant. E. Yanni, GSK: Employee, Salary. R. Bekkat-Berkani, GSK: Employee, Salary. A. Schuind, GSK: Employee, Salary. B. Innis, GSK: Employee, Salary. R. Mistry, GSK: Investigator, Research support. E. J. Asturias, GSK: Investigator, Research grant and Research support.

scholarly journals 866. Adherence to F/TDF for PrEP in Dried Blood Spots and HIV Infection Rates: A Pooled Analysis of Global PrEP Studies

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S524-S525
Author(s):  
Albert Liu ◽  
Albert Liu ◽  
Robert Grant ◽  
Raphael J Landovitz ◽  
Raphael J Landovitz ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Confidence Intervals ◽  
Pooled Analysis ◽  
Incidence Rates ◽  
Hiv Incidence ◽  
Research Support ◽  
High Background ◽  
Material Support ◽  
Support Research ◽  
Research Grant

Abstract Background The use of daily F/TDF for HIV pre-exposure prophylaxis (PrEP) substantially reduces HIV acquisition. Dried blood spot (DBS) tenofovir-diphosphate (TFV-DP) levels reflect TDF use over the past 6-8 weeks, providing an objective measure of adherence in people taking PrEP. Methods In a pooled analysis of 19 PrEP demonstration projects and clinical studies, 6,613 participants had at least one TFV-DP measurement in DBS and followed for at least 48 weeks and up to 96 weeks. We used a piecewise linear mixed-effects model to plot the least-square means with corresponding 95% confidence intervals (CI) of TFV-DP for adherence over time, and Poisson regressions to calculate HIV incidence rates (IR) by level of weighted average of TFV-DP. Results Of 6,613 participants, median age was 30 years (interquartile range 24−38), 5,449 (82%) were cisgender men, 806 (12%) were cisgender women, and 349 (5%) were transgender (316 transgender women, 2 transgender men, 31 unspecified). Adherence based on TFV-DP in DBS was consistently higher among participants who did not acquire HIV compared to those who did (Figure). Among all participants, 21%, 14%, 36%, and 29% has DBS consistent with taking < 2, 2−3, 4−6, and ≥7 tablets of F/TDF PrEP per week (Table). Sixty-nine participants acquired HIV, with a median PrEP exposure of 0.82 years and an overall HIV IR (95% CI) of 1.16 (0.92, 1.47) per 100 person years. There was a strong association between adherence and HIV incidence [among individuals who took < 2, 2−3, 4−6, and ≥7 tablets/week, the HIV IRs (95% CI) were 5.20 (4.03, 6.71), 0.38 (0.12, 1.18), 0.28 (0.12, 0.61), and 0.06 (0.01, 0.39), respectively. Overall IR (95% CI) of HIV infection among cisgender men was 1.25 (0.98, 1.60) per 100 patient-years. Four cisgender women and 2 transgender participants acquired HIV, corresponding to IRs (95% CI) of 0.71 (0.27, 1.90) and 0.63 (0.16, 2.53). Adherence by TFV-DP in DBS for F/TDF users who acquired HIV compared to those who did not. Note: ‘x’ on the Figure represents visit week when a new HIV infection was detected. HIV incidence rates (95% confidence intervals) by adherence to PrEP measured by level of TFV-DP in DBS up to 96 weeks after PrEP Initiation Conclusion This diverse, multi-national pooled analysis of F/TDF PrEP use provides the largest assessment to date of the adherence-HIV incidence relationship in people taking F/TDF for PrEP. The results suggest a high background HIV incidence in the pooled cohort and high efficacy in those adherent to PrEP. These findings support ongoing efforts to increase PrEP use among people who would benefit. Disclosures Albert Liu, MD, MPH, Gilead Sciences (Individual(s) Involved: Self): Gilead has donated study drug for studies I have led., Grant/Research Support, Other Financial or Material Support, Research Grant or Support; IAS-USA (Individual(s) Involved: Self): Honorarium for manuscript writing, Other Financial or Material Support; Viiv Healthcare (Individual(s) Involved: Self): Grant/Research Support, Research Grant or Support Raphael J. Landovitz, MD, MSc, Gilead Sciences (Individual(s) Involved: Self): Consultant; Janssen (Individual(s) Involved: Self): Consultant; Merck Inc (Individual(s) Involved: Self): Consultant; Roche (Individual(s) Involved: Self): Consultant Jared Baeten, MD, PHD, Gilead Sciences Inc. (Employee, Shareholder) David Magnuson, PharmD, Gilead Sciences Inc (Employee, Shareholder) Moupali Das, MD, Gilead Sciences Inc. (Employee, Shareholder) Christoph C. Carter, MD, Gilead Sciences Inc. (Employee, Shareholder) Li Tao, MD, PhD, Gilead Sciences Inc (Employee, Shareholder)

scholarly journals Attitude, Familiarity and Religious Beliefs about Vaccination among Health Science and Non-Health Science Students in a Malaysian Public University

2021 ◽  
Vol 11 (4) ◽  
pp. 1462-1473
Author(s):  
Ramdan M. Elkalmi ◽  
Eman Dyab ◽  
Azyyati Mohd Suhaimi ◽  
Ali Qais Blebil ◽  
Mohamed Hassan Elnaem ◽  
...  
Keyword(s):  
Religious Beliefs ◽  
Vaccine Safety ◽  
Cross Sectional Study ◽  
Health Science ◽  
Vaccine Hesitancy ◽  
Attitude Score ◽  
Cross Sectional ◽  
The Public ◽  
Significant Difference ◽  
The Mean

Vaccine hesitancy has surfaced globally within the last few decades, and the fears and misconceptions of people about vaccine safety and effectiveness have been identified as key factors for their under-utilization. The familiarity, attitudes, and religious beliefs of the public and of future healthcare practitioners regarding vaccination are extensive areas needing exploration. The present exploratory cross-sectional study was designed, planned and carried out on students enrolled in health science and non-health science courses in one of the public universities of Malaysia. A research instrument that had been formulated, validated and subjected to reliability testing was used to collect the data, which were analyzed using descriptive and inferential statistics. A response rate of 80.8% (n = 202) was obtained: the majority were female (n = 161, 79.7%), and had been vaccinated before (n = 190, 97.5%), while a mere 2% did not support vaccination for reasons pertaining to safety issues. The vaccine familiarity score was 10.79 ± 1.4, which significantly differed among the study disciplines (p < 0.001). The mean of the total attitude score was 14.95 ± 1.5, with no significant difference among demographics being noted. The mean of the total religious beliefs score was 24.29 ± 2.8 and significantly differed based on gender (p = 0.040) and study disciplines (p < 0.001). The current findings showed that the participants were familiar with vaccines and had generally positive attitudes and positive religious beliefs toward vaccination; thus, one can expect that their inclusion in immunization campaigns will generate positive outcomes of the immunization program. Although the current research reported few knowledge gaps, these may be handled with the introduction of a specialized immunization course at an undergraduate level.

scholarly journals 480. Outbreak of COVID-19 Among School Auction Attendees: Was it a “Silent Auction” or “Silent Transmission”?

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S306-S307
Author(s):  
Danielle A Rankin ◽  
Leigh Howard ◽  
Kailee N Fernandez ◽  
Rana Talj ◽  
Zaid Haddadin ◽  
...  
Keyword(s):  
Mitigation Strategies ◽  
Chest Tightness ◽  
Research Support ◽  
State Of Emergency ◽  
Social Events ◽  
Community Transmission ◽  
Social Gathering ◽  
Church Service ◽  
Support Research ◽  
Research Grant

Abstract Background One day after the pandemic was announced, Tennessee declared a state of emergency on March 12, 2020 with implementation of a stay-at-home order on March 23, 2020. Data regarding the routes and patterns of community transmission of SARS-CoV-2 are limited. We initiated an investigation after clusters of confirmed COVID-19 cases attended a large social gathering. Methods We were notified of clinical providers who attended a “Silent School Auction” on March 7, 2020, of which several confirmed-cases were identified as targeted participants. To derive a standardized REDCap web-survey, we conducted a hypothesis-generating interview with three confirmed attendees to collect event details. Once finalized, enrollment included collecting sociodemographic, epidemiologic, and clinical data. Attendees were classified as: 1) confirmed if they had a positive SARS-CoV-2 test; 2) suspected if they developed symptoms 21-days before or after the auction; and 3) asymptomatic if no symptoms were noted. Results From March 20-June 16, 100/166 (60%) of attendees were enrolled, with a median age of 41 years, 54% female, and 99% white. Of those, 34 and 32 were confirmed- and suspect-cases, respectively. Table 1 compares sociodemographic behaviors of all attendees, with the majority of confirmed-cases eating late in the evening. From March 6 to March 8, 58 participants reported attending other social events, of which three (i.e., church service, women’s retreat, and a birthday party) were common among 43 attendees and five individuals reported onset of mild respiratory symptoms prior to the event (Figure 1). Confirmed-cases were more likely to report having shortness of breath, chest tightness, loss of taste, loss of smell, and fever compared to suspect-cases (Figure 2) and no one required hospitalization. Dining tables from the school auction depicted a clustering of cases occurring at each table, with some individuals visiting more than one table during the event (Figure 3). Conclusion We identified several COVID-19 cases from a single event that occurred prior to social mitigation strategies. Our investigation highlights the importance of staying home when sick and the significance of social distancing to halt transmission of COVID-19. Disclosures Danielle A. Rankin, MPH, CIC, Sanofi Pasteur (Grant/Research Support, Research Grant or Support) Zaid Haddadin, MD, CDC (Grant/Research Support, Research Grant or Support)Quidel Corporation (Grant/Research Support, Research Grant or Support)sanofi pasteur (Grant/Research Support, Research Grant or Support) Natasha B. Halasa, MD, MPH, Genentech (Other Financial or Material Support, I receive an honorarium for lectures - it’s a education grant, supported by genetech)Karius (Consultant)Moderna (Consultant)Quidel (Grant/Research Support, Research Grant or Support)Sanofi (Grant/Research Support, Research Grant or Support)

scholarly journals 432. High concordance between self-collected nasal swabs and saliva samples for detection of SARS-CoV-2

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S283-S283
Author(s):  
Carlos G Grijalva ◽  
Yuwei Zhu ◽  
Natasha B Halasa ◽  
Ahra Kim ◽  
Melissa A Rolfes ◽  
...  
Keyword(s):  
Research Support ◽  
Altman Plot ◽  
Bland Altman Plot ◽  
Transport Medium ◽  
Qrt Pcr ◽  
Nasal Swabs ◽  
Household Members ◽  
Index Cases ◽  
Support Research ◽  
Research Grant

Abstract Background Shortages of swabs and transport medium for sample collection have made identification of SARS-CoV-2 infections challenging. We examined the agreement in SARS-CoV-2 detection between two types of self-collected samples: nasal swabs (NS) and saliva (SA). Figure 1. Bland-Altman plot of SARS-CoV-2-N1 CT values for SA and NS samples Figure 2. Bland-Altman plot of SARS-CoV-2-N2 CT values for SA and NS samples Methods Paired daily self-collected NS and SA samples were collected in May 2020 in an ongoing case-ascertained study of SARS-CoV-2 household transmission in Nashville, TN. After informed consent was obtained, index cases and household members were remotely trained in the self-collection of daily nasal swabs (from both nares and preserved in transport medium) and saliva samples (participants were asked to spit in a sterile urine cup approximately 6 times during a minute). Samples were refrigerated in closed double bags and delivered to the laboratory within ~72–96 hours of collection. NS and SA samples were tested using qRT-PCR at a research laboratory. We computed the agreement in detections between sample types using the McNemar test and compared median qRT-PCR cycle threshold (CT) values between sample types for 2 targets (SARS-CoV-2-N1 and SARS-CoV-2-N2) using a Wilcoxon signed rank test. Bland-Altman plots were used to visually inspect agreement between NS and SA CT values. Results Among 144 self-collected samples (72 pairs) from 13 unique participants (5 index cases and 8 household members), there were 30 pairs with concordant positive detections in both sample types, 35 with concordant negative detections in both samples, 1 pair with positive NS only, and 6 pairs with positive SA only. The overall agreement between NS and SA was 90.3% (p=0.1). The median SARS-CoV-2-N1 CT value for NS samples was 33.3 (interquartile range: 30.2–35.3) and for SA samples was 30.5 (29.8–33.3, p=0.04); the median CT value for SARS-CoV-2-N2 was 34.4 (31.5–37.5) and 31.5 (30.4–34.9), respectively (p=0.01). Bland-Altman plots indicated that most observations were contained within the limits of agreement but suggested NS tended to have higher CT values than SA samples (Figures). Conclusion Self-collection of saliva samples provides a simple, non-invasive, and practical strategy for identification of SARS-CoV-2 infections. Disclosures Carlos G. Grijalva, MD, MPH, AHRQ (Grant/Research Support)Campbell Alliance (Grant/Research Support)CDC (Grant/Research Support)FDA (Grant/Research Support)Merck (Consultant)NIH (Scientific Research Study Investigator)Pfizer (Consultant)Sanofi (Consultant)Sanofi (Grant/Research Support) Natasha B. Halasa, MD, MPH, Genentech (Other Financial or Material Support, I receive an honorarium for lectures - it’s a education grant, supported by genetech)Karius (Consultant)Moderna (Consultant)Quidel (Grant/Research Support, Research Grant or Support)Sanofi (Grant/Research Support, Research Grant or Support)

scholarly journals 290. Persistence of Long COVID in SARS-CoV-2 Confirmed Cases One-Year Post Infection

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S252-S253
Author(s):  
Harrison L Howe ◽  
Danielle A Rankin ◽  
Sean M Bloos ◽  
Kailee N Fernandez ◽  
Seifein Salib ◽  
...  
Keyword(s):  
Post Infection ◽  
Antibody Testing ◽  
Research Support ◽  
Material Support ◽  
Future Studies ◽  
Illness Onset ◽  
One Year ◽  
The One ◽  
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Abstract Background Regardless of severity of acute SARS-CoV-2 illness, adults infected with SARS-CoV-2 are at risk for post-acute sequelae of COVID-19. Long COVID is typically classified as symptoms lasting greater than four weeks post-infection. We aimed to evaluate the frequency of resolved and unresolved long COVID symptoms in adults residing in greater Nashville, TN. Methods We conducted a longitudinal cohort study of SARS-CoV-2-positive and exposed individuals from March 20 to May 15, 2020. Participants for this analysis were included if: 1) ≥18 years; 2) SARS-CoV-2 positive by molecular or antibody testing; and 3) completed a one-year visit. Demographic and illness information were collected at enrollment, and long COVID symptoms were systematically collected at the one-year survey. Long COVID symptoms are defined as an adult experiencing at least one of the following symptoms four weeks post-infection: fatigue, confusion, loss of smell or taste, shortness of breath, chest pain, cough, muscle aches, inability to exercise, or heart palpitations. Unresolved symptoms are defined as an individual with long COVID still experiencing symptoms at the one-year visit. Results A total of 115 adults enrolled and completed the one-year survey, of which 63 (54.8%) were SARS-CoV-2-positive, with one asymptomatic individual. Of SARS-CoV-2-positive symptomatic adults, 32 (51%) were female, 5 (88%) were of Hispanic ethnicity, and 58 (92%) were white. At the one-year visit, 33 (52%) reported having long COVID, of which 17 (52%) reported having unresolved symptoms. Fatigue (89%), headache (89%), muscle aches (79%), and cough (77%) were the most common symptoms reported at illness onset (Figure 1). Among 33 adults with long COVID, fatigue (42%), loss of smell (39%), and loss of taste (33%) were most common (Figure 2A). In the 17 individuals with unresolved symptoms, loss of smell (29%) and loss of taste (24%) were commonly reported (Figure 2B). Figure 1. COVID-19 symptoms reported at enrollment (n=62) Figure 2. Long COVID (symptoms lasting ≥ 4 weeks) (n=33) (A) and unresolved long COVID symptoms one-year post-infection (n=17) (B) reported on the one-year survey Conclusion Half of the adults in our cohort reported long COVID symptoms, with more than quarter of symptoms persisting one-year post-illness. Our findings support that prolonged symptoms up to year after SARS-CoV-2 exposure occur, and future studies should investigate the residual impacts of long COVID symptoms and conditions. Disclosures Natasha B. Halasa, MD, MPH, Genentech (Other Financial or Material Support, I receive an honorarium for lectures - it’s a education grant, supported by genetech)Quidel (Grant/Research Support, Other Financial or Material Support, Donation of supplies/kits)Sanofi (Grant/Research Support, Other Financial or Material Support, HAI/NAI testing) Natasha B. Halasa, MD, MPH, Genentech (Individual(s) Involved: Self): I receive an honorarium for lectures - it’s a education grant, supported by genetech, Other Financial or Material Support, Other Financial or Material Support; Sanofi (Individual(s) Involved: Self): Grant/Research Support, Research Grant or Support

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