Change in age distribution of COVID-19 deaths with the introduction of COVID-19 vaccination

Background. Most countries initially deployed COVID-19 vaccines preferentially in elderly populations. Population-level vaccine effectiveness may be heralded by an increase in the proportion of deaths among non-elderly populations that were less covered by vaccination programs. Methods. We collected data from 40 countries on age-stratified COVID-19 deaths during the vaccination period (1/14/2021-5/31/2021) and two control periods (entire pre-vaccination period and excluding the first wave). We meta-analyzed the proportion of deaths in different age groups in vaccination versus control periods in countries with low vaccination rates; (2) countries with age-independent vaccination policies; and (3) countries with standard age-dependent vaccination policies. Findings. Countries that prioritized vaccination among older people saw an increasing share of deaths among 0-69 year old people in the vaccination versus the two control periods (summary prevalence ratio 1.32 [95 CI% 1.24-1.41] and 1.35 [95 CI% 1.26-1.44)]. No such change was seen on average in countries with age-independent vaccination policies (1.05 [95 CI% 0.78-1.41 and 0.97 [95 CI% 0.95- 1.00], respectively) and limited vaccination (0.93 [95 CI% 0.85-1.01] and 0.95 [95 CI% 0.87-1.03], respectively). Prevalence ratios were associated with the difference of vaccination rates in elderly versus non-elderly people. No significant changes occurred in the share of deaths in age 0-49 among all 0-69 deaths in the vaccination versus pre-vaccination periods. Interpretation. The substantial shift in the age distribution of COVID-19 deaths in countries that rapidly implemented vaccination predominantly among elderly may herald the population level-effectiveness of COVID-19 vaccination and a favorable evolution of the pandemic towards endemicity with fewer elderly deaths. Funding. This study received no specific funding.

Download Full-text

Monitoring sociodemographic inequality in COVID-19 vaccination coverage in England: a national linked data study

10.1101/2021.10.07.21264681 ◽

2021 ◽

Author(s):

Ted Dolby ◽

Katie Finning ◽

Allan Baker ◽

Leigh Dowd ◽

Kamlesh Khunti ◽

...

Keyword(s):

Language Proficiency ◽

Vaccination Coverage ◽

English Language ◽

Age Groups ◽

Population Level ◽

Lower Percentage ◽

Area Deprivation ◽

Sociodemographic Characteristics ◽

Age Group ◽

Vaccination Rates

Background: The UK began an ambitious COVID-19 vaccination programme on 8th December 2020. This study describes variation in vaccination coverage by sociodemographic characteristics between December 2020 and August 2021. Methods: Using population-level administrative records linked to the 2011 Census, we estimated monthly first dose vaccination rates by age group and sociodemographic characteristics amongst adults aged 18 years or over in England. We also present a tool to display the results interactively. Findings: Our study population included 35,223,466 adults. A lower percentage of males than females were vaccinated in the young and middle age groups (18-59 years) but not in the older age groups. Vaccination rates were highest among individuals of White British and Indian ethnic backgrounds and lowest among Black Africans (aged ≥80 years) and Black Caribbeans (18-79 years). Differences by ethnic group emerged as soon as vaccination roll-out commenced and widened over time. Vaccination rates were also lower among individuals who identified as Muslim, lived in more deprived areas, reported having a disability, did not speak English as their main language, lived in rented housing, belonged to a lower socio-economic group, and had fewer qualifications. Interpretation: We found inequalities in COVID-19 vaccination rates by sex, ethnicity, religion, area deprivation, disability status, English language proficiency, socio-economic position, and educational attainment, but some of these differences varied by age group. Research is urgently needed to understand why these inequalities exist and how they can be addressed.

Download Full-text

Secular trends in testosterone- findings from a large state-mandate care provider

10.21203/rs.2.20358/v1 ◽

2020 ◽

Author(s):

Gabriel Chodick ◽

Shdema Epstein ◽

Varda Shalev

Keyword(s):

Age Groups ◽

Population Level ◽

Serum Testosterone ◽

Secular Trends ◽

Total Testosterone ◽

Study Objective ◽

Testosterone Levels ◽

State Mandate ◽

The Us ◽

Age Independent

Abstract Background Several studies from the US and Europe have shown a population-level decline in serum testosterone in men from 1970's to early 2000's. However, to the best of our knowledge, no study examining population-level decline in testosterone has been published in more recent years. The study objective was therefore to examine secular trends in testosterone levels among Israeli men in the first and second decades of the 21 st century,Methods All incident total testosterone performed between1/2006 and 3/2019 among 102,334 male members of a large health organization.Results A prominent trend of age-independent decline in the testosterone levels for most age groups. The results were highly significant ( Common.EditSubmissionSteps.Transform.EquationText )Conclusions The results show a highly significant age-independent decline in total testosterone that is unlikely to be explained by increasing rates of obesity.

Download Full-text

The Epidemic Process of Measles with Different Strategies of Vaccination in a Large Industrial Center of the Middle Urals

Epidemiology and Vaccinal Prevention ◽

10.31631/2073-3046-2019-18-1-34-42 ◽

2019 ◽

Vol 18 (1) ◽

pp. 34-42

Author(s):

A. A. Golubkova ◽

T. A. Platonova ◽

S. S. Smirnova ◽

S. A. Kovyazina

Keyword(s):

Age Distribution ◽

Age Groups ◽

Routine Vaccination ◽

Middle Urals ◽

Vaccination Rates ◽

Epidemic Process ◽

Study Materials ◽

Before School ◽

Almost All ◽

Measles Outbreaks

Relevance. Measles infection still does not lose its relevance, as experts everywhere register outbreaks of the disease. The aim of the study is characterization of the measles epidemic process in the context of different strategies for its vaccination in a large industrial city to make adequate management decisions.Materials and methods. The authors used the data of statistical reports on measles incidence in Yekaterinburg in 1950–2017 as the study materials. The authors analyzed data for six periods: pre-vaccination (1950–1961), selective immunization (1962–1965), routine vaccination of children under 8 years (1966–1972), vaccination of children under 14 years (1973–1986), the introduction of mass revaccination of children (1987–2001) and the period of universal vaccination at the stage of elimination of infection (2002–2017).Results. In the pre-vaccination period, the average annual incidence rate was 1381.7 ± 162.9 per 100 ths population, the seasonal increase in the incidence was in december–may, in the structure of age groups dominated by children. During the period of selective immunization, at the stage of testing of the domestic vaccine, there was a slight decrease in the incidence to 1082.8 ± 189.1 per 100 ths population, intra-annual dynamics and age distribution of patients remained virtually unchanged. During routine vaccination of children up to 8 years of age, there was a significant reduction in the incidence to the level of 219.8 ± 110.8 per 100 ths population , which was observed in almost all age groups, with the exception of children 10–14 years and adults. Seasonal manifestations of the epidemic process were similar to previous periods. With an increase in the cohort for vaccination at the expense of children up to 14 years, there was a further decrease in the incidence to 89.9 ± 39.1 per 100 ths population, but in some years measles outbreaks were registered, with an active spread of infection among schoolchildren in educational institutions. The decision to introduce a second vaccination for 6-year olds before school made it possible to achieve a sporadic level of morbidity and to change the main parameters characterizing the epidemic process in all previous periods. The epidemic process has become intermittent. Periodic rises disappeared. When the infection was not spread, the population immunity and vaccination rates were consistent with the recommendations of who experts. However, against this background, 2016 was registered a major outbreak of measles.Conclusion. The use of different tactics of vaccination led to significant changes in the parameters of the epidemic process of measles. However, at the present stage immunization schemes do not control the situation. In this regard, it is necessary to raise the issue of introduction of revaccination against adult measles every 10 years, as well as changes in the antigenic composition of the live measles vaccine, taking into account data on circulating strains of the virus of genetic lines D and H.

Download Full-text

Secular trends in testosterone- findings from a large state-mandate care provider

10.21203/rs.2.20358/v2 ◽

2020 ◽

Author(s):

Gabriel Chodick ◽

Shdema Epstein ◽

Varda Shalev

Keyword(s):

Age Groups ◽

Population Level ◽

Serum Testosterone ◽

Secular Trends ◽

Total Testosterone ◽

Study Objective ◽

Testosterone Levels ◽

The Us ◽

Health Organization ◽

Age Independent

Abstract Background: Several studies from the US and Europe have shown a population-level decline in serum testosterone in men from 1970's to early 2000's. However, to the best of our knowledge, no study examining population-level decline in testosterone has been published in more recent years. The study objective was therefore to examine secular trends in testosterone levels among Israeli men in the first and second decades of the 21st century, Methods: All incident total testosterone performed between1/2006 and 3/2019 among 102,334 male members of a large health organization. Results: A significant (p<0.001) and prominent trend of age-independent decline in the testosterone levels was recorded during the study period for most age groups. Conclusions: There was a highly significant age-independent decline in total testosterone in the first and second decades of the 21st century. The decline was unlikely to be explained by increasing rates of obesity.

Download Full-text

High Estrogen in Men After Injectable Testosterone Therapy

American Journal of Men s Health ◽

10.1177/1557988314539000 ◽

2014 ◽

Vol 9 (3) ◽

pp. 229-234 ◽

Cited By ~ 12

Author(s):

Robert S. Tan ◽

Kelly R. Cook ◽

William G. Reilly

Keyword(s):

Age Distribution ◽

Age Groups ◽

The United States ◽

Testosterone Therapy ◽

Chi Square ◽

Receptor Modulator ◽

Chi Square Test ◽

The Difference ◽

Estradiol Levels

Testosterone replacement improves quality of life and is aromatized in men in adipose tissues to estrogen. Hyperestrogenism is believed to be harmful to male sexuality. This is a description of our experience of screening 34,016 men in the Low T Centers, of which approximately 50% were converted to treatment. Men were treated with injectable testosterone, and we have available data from 2009 to 2014. The data were extracted from our electronic health record (AdvancedMD) of 35 Low T Centers across the United States. In all, 7,215 (20.2%) out of the 34,016 patients had high estradiol levels defined as ≥42.6 pg/ml. Estradiol was measured using electro-chemiluminescence immunoassay. Of the patients who had high estradiol levels, the age distribution was as follows: 132/989 (13.3%) were older than 65 years, 3,753/16,955 (22.1%) were between 45 and 65 years; 2,968/15,857 (18.7%) were between 25 and 44 years, 7/215 (3.3%) were younger than 25 years. The difference between extreme age groups (<25 and ≥65) was statistically significant using a chi-square test ( p = .013). The correlation coefficient of serum estradiol to age was .53, SD = 8.21. It was observed that practitioners used aromatase inhibitor and selective estrogen receptor modulator to treat symptoms of hyperestrogenism, irrespective of blood estradiol levels. Gynecomastia was rarely documented as a reason for the prescription. Our finding was that high estradiol levels were not associated with higher rates of low libido but established higher rates of documented low libido with those with normal or lower estradiol levels. The difference was statistically significant ( p < .05).

Download Full-text

Transmission roles of symptomatic and asymptomatic COVID-19 cases: a modeling study

10.1101/2021.05.11.21257060 ◽

2021 ◽

Author(s):

Jianbin Tan ◽

Yang Ge ◽

Leonardo Martinez ◽

Zhiping Chen ◽

Changwei Li ◽

...

Keyword(s):

Age Groups ◽

Population Level ◽

Population Based ◽

Limited Data ◽

Surveillance Network ◽

Age Dependent ◽

Average Proportion ◽

The Difference ◽

Asymptomatic Case

Objective Age-dependent asymptomatic and symptomatic transmission dynamics of COVID-19 have not been well quantified due to limited data. Methods Through a population-based surveillance network, we collected data on 1342 confirmed cases with a 90-days follow-up for all asymptomatic cases. Results The difference in transmissibility of a symptomatic and asymptomatic case depended on age and was most distinct for the middle-age groups. The asymptomatic cases had a 66.72% lower transmissibility rate than symptomatic cases, and 74.10% (95%CI: 65.85% - 80.72%) of all asymptomatic cases were missed in detection. The average proportion of asymptomatic cases was 28.22% (95%CI: 22.97% - 34.56%). Simulation showed that the burden of asymptomatic transmission increased as the epidemic continued and could potentially dominate the spreading. Conclusion Asymptomatic COVID-19 cases play a significant role in transmission. Vaccine Strategies prioritizing the population between 30-60 years old are likely to have the most population-level benefits.

Download Full-text

One hundred thirty-three observed COVID-19 deaths in 10 months: unpacking lower than predicted mortality in Rwanda

BMJ Global Health ◽

10.1136/bmjgh-2020-004547 ◽

2021 ◽

Vol 6 (2) ◽

pp. e004547

Author(s):

Clarisse Musanabaganwa ◽

Vincent Cubaka ◽

Etienne Mpabuka ◽

Muhammed Semakula ◽

Ernest Nahayo ◽

...

Keyword(s):

Infection Control ◽

Age Structure ◽

Control Strategies ◽

Age Distribution ◽

Age Groups ◽

Case Fatality ◽

Population Level ◽

African Region ◽

Risk Of Death ◽

First Case

The African region was predicted to have worse COVID-19 infection and death rates due to challenging health systems and social determinants of health. However, in the 10 months after its first case, Rwanda recorded 10316 cases and 133 COVID-19-related deaths translating to a case fatality rate (CFR) of 1.3%, which raised the question: why does Rwanda have a low COVID-19 CFR? Here we analysed COVID-19 data and explored possible explanations to better understand the disease burden in the context of Rwanda’s infection control strategies.We investigated whether the age distribution plays a role in the observed low CFR in Rwanda by comparing the expected number of deaths for 10-year age bands based on the CFR reported in other countries with the observed number of deaths for each age group. We found that the age-specific CFRs in Rwanda are similar to or, in some older age groups, slightly higher than those in other countries, suggesting that the lower population level CFR reflects the younger age structure in Rwanda, rather than a lower risk of death conditional on age. We also accounted for Rwanda’s comprehensive SARS-CoV-2 testing strategies and reliable documentation of COVID-19-related deaths and deduced that these measures may have allowed them to likely identify more asymptomatic or mild cases than other countries and reduced their reported CFR.Overall, the observed low COVID-19 deaths in Rwanda is likely influenced by the combination of effective infection control strategies, reliable identification of cases and reporting of deaths, and the population’s young age structure.

Download Full-text

Age Differences in Eye Movements During Reading: Degenerative Problems or Compensatory Strategy?

European Psychologist ◽

10.1027/1016-9040/a000344 ◽

2019 ◽

Vol 24 (4) ◽

pp. 297-311

Author(s):

José David Moreno ◽

José A. León ◽

Lorena A. M. Arnal ◽

Juan Botella

Keyword(s):

Eye Movements ◽

Eye Movement ◽

Meta Analysis ◽

Age Groups ◽

Behavioral Changes ◽

Aging Effects ◽

Movement Data ◽

Sentence Reading ◽

The Difference ◽

Eye Movements During Reading

Abstract. We report the results of a meta-analysis of 22 experiments comparing the eye movement data obtained from young ( Mage = 21 years) and old ( Mage = 73 years) readers. The data included six eye movement measures (mean gaze duration, mean fixation duration, total sentence reading time, mean number of fixations, mean number of regressions, and mean length of progressive saccade eye movements). Estimates were obtained of the typified mean difference, d, between the age groups in all six measures. The results showed positive combined effect size estimates in favor of the young adult group (between 0.54 and 3.66 in all measures), although the difference for the mean number of fixations was not significant. Young adults make in a systematic way, shorter gazes, fewer regressions, and shorter saccadic movements during reading than older adults, and they also read faster. The meta-analysis results confirm statistically the most common patterns observed in previous research; therefore, eye movements seem to be a useful tool to measure behavioral changes due to the aging process. Moreover, these results do not allow us to discard either of the two main hypotheses assessed for explaining the observed aging effects, namely neural degenerative problems and the adoption of compensatory strategies.

Download Full-text

Cranial crassicaudiasis in two coastal dolphin species from South Africa is predominantly a disease of immature individuals

Diseases of Aquatic Organisms ◽

10.3354/dao03468 ◽

2020 ◽

Vol 139 ◽

pp. 93-102 ◽

Cited By ~ 3

Author(s):

MF Van Bressem ◽

P Duignan ◽

JA Raga ◽

K Van Waerebeek ◽

N Fraijia-Fernández ◽

...

Keyword(s):

South Africa ◽

Bone Development ◽

Bottlenose Dolphins ◽

Fatal Outcome ◽

Population Level ◽

Cape Coast ◽

Osteolytic Lesions ◽

Immune Mediated ◽

Significant Difference ◽

The Difference

Crassicauda spp. (Nematoda) infest the cranial sinuses of several odontocetes, causing diagnostic trabecular osteolytic lesions. We examined skulls of 77 Indian Ocean humpback dolphins Sousa plumbea and 69 Indo-Pacific bottlenose dolphins Tursiops aduncus, caught in bather-protecting nets off KwaZulu-Natal (KZN) from 1970-2017, and skulls of 6 S. plumbea stranded along the southern Cape coast in South Africa from 1963-2002. Prevalence of cranial crassicaudiasis was evaluated according to sex and cranial maturity. Overall, prevalence in S. plumbea and T. aduncus taken off KZN was 13 and 31.9%, respectively. Parasitosis variably affected 1 or more cranial bones (frontal, pterygoid, maxillary and sphenoid). No significant difference was found by gender for either species, allowing sexes to be pooled. However, there was a significant difference in lesion prevalence by age, with immature T. aduncus 4.6 times more likely affected than adults, while for S. plumbea, the difference was 6.5-fold. As severe osteolytic lesions are unlikely to heal without trace, we propose that infection is more likely to have a fatal outcome for immature dolphins, possibly because of incomplete bone development, lower immune competence in clearing parasites or an over-exuberant inflammatory response in concert with parasitic enzymatic erosion. Cranial osteolysis was not observed in mature males (18 S. plumbea, 21 T. aduncus), suggesting potential cohort-linked immune-mediated resistance to infestation. Crassicauda spp. may play a role in the natural mortality of S. plumbea and T. aduncus, but the pathogenesis and population level impact remain unknown.

Download Full-text

Tower Running—Participation, Performance Trends, and Sex Difference

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17061902 ◽

2020 ◽

Vol 17 (6) ◽

pp. 1902 ◽

Cited By ~ 1

Author(s):

Daniel Stark ◽

Stefania Di Gangi ◽

Caio Victor Sousa ◽

Pantelis Nikolaidis ◽

Beat Knechtle

Keyword(s):

Sex Differences ◽

Statistical Model ◽

Sex Difference ◽

Random Effects ◽

Age Groups ◽

Repeated Measurements ◽

Stair Climbing ◽

Age Group ◽

Performance Trends ◽

The Difference

Though there are exhaustive data about participation, performance trends, and sex differences in performance in different running disciplines and races, no study has analyzed these trends in stair climbing and tower running. The aim of the present study was therefore to investigate these trends in tower running. The data, consisting of 28,203 observations from 24,007 climbers between 2014 and 2019, were analyzed. The effects of sex and age, together with the tower characteristics (i.e., stairs and floors), were examined through a multivariable statistical model with random effects on intercept, at climber’s level, accounting for repeated measurements. Men were faster than women in each age group (p < 0.001 for ages ≤69 years, p = 0.003 for ages > 69 years), and the difference in performance stayed around 0.20 km/h, with a minimum of 0.17 at the oldest age. However, women were able to outperform men in specific situations: (i) in smaller buildings (<600 stairs), for ages between 30 and 59 years and >69 years; (ii) in higher buildings (>2200 stairs), for age groups <20 years and 60–69 years; and (iii) in buildings with 1600–2200 stairs, for ages >69 years. In summary, men were faster than women in this specific running discipline; however, women were able to outperform men in very specific situations (i.e., specific age groups and specific numbers of stairs).

Download Full-text