Effectiveness of COVID-19 Vaccines among Incarcerated People in California State Prisons: A Retrospective Cohort Study

ABSTRACTBackgroundPrisons and jails are high-risk settings for COVID-19 transmission, morbidity, and mortality. COVID-19 vaccines may substantially reduce these risks, but evidence is needed of their effectiveness for incarcerated people, who are confined in large, risky congregate settings.MethodsWe conducted a retrospective cohort study to estimate effectiveness of mRNA vaccines, BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna), against confirmed SARS-CoV-2 infections among incarcerated people in California prisons from December 22, 2020 through March 1, 2021. The California Department of Corrections and Rehabilitation provided daily data for all prison residents including demographic, clinical, and carceral characteristics, as well as COVID-19 testing, vaccination status, and outcomes. We estimated vaccine effectiveness using multivariable Cox models with time-varying covariates that adjusted for resident characteristics and infection rates across prisons.FindingsAmong 60,707 residents in the cohort, 49% received at least one BNT162b2 or mRNA-1273 dose during the study period. Estimated vaccine effectiveness was 74% (95% confidence interval [CI], 64−82%) from day 14 after first dose until receipt of second dose and 97% (95% CI, 88−99%) from day 14 after second dose. Effectiveness was similar among the subset of residents who were medically vulnerable (74% [95% CI, 62−82%] and 92% [95% CI, 74−98%] from 14 days after first and second doses, respectively), as well as among the subset of residents who received the mRNA-1273 vaccine (71% [95% CI, 58−80%] and 96% [95% CI, 67−99%]).ConclusionsConsistent with results from randomized trials and observational studies in other populations, mRNA vaccines were highly effective in preventing SARS-CoV-2 infections among incarcerated people. Prioritizing incarcerated people for vaccination, redoubling efforts to boost vaccination and continuing other ongoing mitigation practices are essential in preventing COVID-19 in this disproportionately affected population.FundingHorowitz Family Foundation, National Institute on Drug Abuse, Centers for Disease Control and Prevention, National Science Foundation, Open Society Foundation, Advanced Micro Devices.

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Influenza Vaccine Effectiveness in Preventing Severe Outcomes in Patients Hospitalized with Laboratory-Confirmed Influenza during the 2017–2018 Season. A Retrospective Cohort Study in Catalonia (Spain)

Viruses ◽

10.3390/v13081465 ◽

2021 ◽

Vol 13 (8) ◽

pp. 1465

Author(s):

Lesly Acosta ◽

Nuria Soldevila ◽

Nuria Torner ◽

Ana Martínez ◽

Xavier Ayneto ◽

...

Keyword(s):

Cohort Study ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Vaccine Effectiveness ◽

Public Hospitals ◽

Categorical Variables ◽

Type B ◽

Icu Admission

Seasonal influenza is a common cause of hospital admission, especially in older people and those with comorbidities. The objective of this study was to determine influenza vaccine effectiveness (VE) in preventing intensive care admissions and shortening the length of stay (LOS) in hospitalized laboratory-confirmed influenza cases (HLCI) in Catalonia (Spain). A retrospective cohort study was carried out during the 2017–2018 season in HLCI aged ≥18 years from 14 public hospitals. Differences in means and proportions were assessed using a t-test or a chi-square test as necessary and the differences were quantified using standardized effect measures: Cohen’s d for quantitative and Cohen’s w for categorical variables. Adjusted influenza vaccine effectiveness in preventing severity was estimated by multivariate logistic regression where the adjusted VE = (1 − adjusted odds ratio) · 100%; adjustment was also made using the propensity score. We analyzed 1414 HLCI aged ≥18 years; 465 (33%) were vaccinated, of whom 437 (94%) were aged ≥60 years, 269 (57.8%) were male and 295 (63.4%) were positive for influenza type B. ICU admission was required in 214 (15.1%) cases. There were 141/1118 (12.6%) ICU admissions in patients aged ≥60 years and 73/296 (24.7%) in those aged <60 years (p < 0.001). The mean LOS and ICU LOS did not differ significantly between vaccinated and unvaccinated patients. There were 52/465 (11.2%) ICU admissions in vaccinated cases vs. 162/949 (17.1%) in unvaccinated cases. Patients admitted to the ICU had a longer hospital LOS (mean: 22.4 [SD 20.3] days) than those who were not (mean: 11.1 [SD 14.4] days); p < 0.001. Overall, vaccination was associated with a lower risk of ICU admission. Taking virus types A and B together, the estimated adjusted VE in preventing ICU admission was 31% (95% CI 1–52; p = 0.04). When stratified by viral type, the aVE was 40% for type A (95% CI -11–68; p = 0.09) and 25% for type B (95% CI -18–52; p = 0.21). Annual influenza vaccination may prevent ICU admission in cases of HLCI. A non-significantly shorter mean hospital stay was observed in vaccinated cases. Our results support the need to increase vaccination uptake and public perception of the benefits of influenza vaccination in groups at a higher risk of hospitalization and severe outcomes.

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Does biologic therapy impact the development of PsA among patients with psoriasis?

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-220761 ◽

2021 ◽

Vol 81 (1) ◽

pp. 80-86

Author(s):

Elana Meer ◽

Joseph F Merola ◽

Robert Fitzsimmons ◽

Thorvardur Jon Love ◽

Shiyu Wang ◽

...

Keyword(s):

Cohort Study ◽

Propensity Score ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Oral Therapy ◽

Biologic Therapy ◽

Therapy Group ◽

Time Varying ◽

Confounding By Indication ◽

Cox Models

ObjectiveTo examine the association of biologic therapy use for psoriasis with incident psoriatic arthritis (PsA) diagnosis.MethodsA retrospective cohort study was conducted in the OptumInsights Electronic Health Record Database between 2006 and 2017 among patients with psoriasis between the ages of 16 and 90 initiating a therapy for psoriasis (oral, biologic or phototherapy). The incidence of PsA was calculated within each therapy group. Multivariable Cox models were used to calculate the HR for biologic versus oral or phototherapy using biologics as a time-varying exposure and next in a propensity score-matched cohort.ResultsAmong 1 93 709 patients with psoriasis without PsA, 14 569 biologic and 20 321 cumulative oral therapy and phototherapy initiations were identified. Mean age was lower among biologic initiators compared with oral/phototherapy initiators (45.9 vs 49.8). The incidence of PsA regardless of therapy exposure was 9.75 per 1000 person-years compared with 77.26 among biologic users, 61.99 among oral therapy users, 26.11 among phototherapy users and 5.85 among those without a prescription for one of the target therapies. Using a multivariable adjustment approach with time-varying exposure, adjusted HR (95% CI) for biologic users was 4.48 (4.23 to 4.75) compared with oral or phototherapy users. After propensity score matching, the HR (95% CI) was 2.14 (2.00 to 2.28).ConclusionsIn this retrospective cohort study, biologic use was associated with the development of PsA among patients with psoriasis. This may be related to confounding by indication and protopathic bias. Prospective studies are needed to address this important question.

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Impact of B.1.351 (beta) SARS-CoV-2 variant on BNT162b2 mRNA vaccine effectiveness in long-term care facilities of eastern France: a retrospective cohort study

10.1101/2021.07.28.21261285 ◽

2021 ◽

Author(s):

Benjamin Lefevre ◽

Laura Tondeur ◽

Yoann Madec ◽

Rebecca Grant ◽

Bruno Lina ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Long Term Care ◽

Multivariable Analysis ◽

Winter Season ◽

Vaccine Effectiveness ◽

Term Care ◽

Care Facilities

Abstract Background: We aimed to assess the effectiveness of the BNT162b2 mRNA vaccine against B.1.351 (beta) variant among residents of long-term care facilities (LCTFs) in eastern France. Methods: We used routinely collected surveillance and COVID-19 vaccination data to conduct a retrospective cohort study of SARS-CoV-2 B.1.351 infection incidence and vaccine effectiveness among LCTFs residents in eastern France between 15 January and 19 May 2021. Data from secondary RT-PCR screening were used to identify B.1.351 variants. Findings: Included in our analysis were 378 residents from five LCTFs: 287 (76%) females, with median (IQR) age of 89 (83-92) years. Two B.1.351 outbreaks took place in LTCFs in which more than 70% of residents had received two doses of BNT162b2 mRNA vaccine, which included 11 cases of severe disease and six deaths among those who had received two doses. Vaccine effectiveness (95% CI) seven days after the second dose of vaccine was 49% (14-69) against any infection with B.1.351 and 86% (67-94) against severe forms of COVID-19. In multivariable analysis, females were less likely to develop severe forms of disease (IRR = 0.35, 95% CI = 0.20-0.63). Interpretation: We observed reduced vaccine effectiveness associated with B.1.351, as well as B.1.351 outbreaks in two LTCFs among individuals who had received two doses of vaccine. Our findings highlight the need to maintain SARS-CoV-2 surveillance in these high-risk settings beyond the current COVID-19 mass vaccination campaign, and advocate for a booster vaccine dose prior to the next winter season.

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Incidence of New-Onset Hypertension in Cancer Patients: A Retrospective Cohort Study

International Journal of Hypertension ◽

10.1155/2013/379252 ◽

2013 ◽

Vol 2013 ◽

pp. 1-10 ◽

Cited By ~ 13

Author(s):

Kathy H. Fraeman ◽

Beth L. Nordstrom ◽

Weixiu Luo ◽

Sarah H. Landis ◽

Sumitra Shantakumar

Keyword(s):

Cohort Study ◽

Cancer Patients ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Fold Increase ◽

Incidence Rates ◽

Cox Models ◽

Relative Risks ◽

Line Of Therapy ◽

New Onset

This retrospective cohort study was conducted to estimate incidence rates of new-onset hypertension in adult cancer patients identified from the Varian Medical Oncology outpatient database. Incidence rates of increasing levels of hypertension severity were calculated overall and for periods of chemotherapy exposure and nonexposure. Cox models sought predictors of new-onset hypertension severity among baseline and chemotherapy exposure variables. New-onset hypertension was observed in about one-third of 25,090 patients with various cancer types. The incidence rates (IR) of severe and crisis-level hypertension, respectively, were the highest in patients with gastric (18.5 cases per 100 person-years (PY), 5.6 per 100 PY) and ovarian cancer (20.2 per 100 PY, 4.8 per 100 PY). The highest IR of moderate hypertension was observed in patients with renal cancer (46.7 per 100 PY). Across all cancers, chemotherapy exposure was associated with a 2–3.5-fold increase in risk of any degree of hypertension compared to periods of no chemotherapy; higher hypertension levels showed greater variability in relative risks by type and line of therapy but indicated an overall increase associated with chemotherapy exposure. These results help to elucidate the factors influencing HTN among cancer patients and the incidence of HTN relative to chemotherapy exposure.

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Effectiveness of BNT162b2 and ChAdOx1 vaccines against symptomatic COVID-19 among Healthcare Workers in Kuwait: A retrospective cohort study

10.1101/2021.07.25.21261083 ◽

2021 ◽

Author(s):

Walid Q Alali ◽

Lamiaa A Ali ◽

Mohammad AlSeaidan ◽

Mohammad Al-Rashidi

Keyword(s):

Cohort Study ◽

Incidence Rate ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Cox Regression ◽

Vaccine Coverage ◽

Significant Proportion ◽

Vaccine Dose ◽

Vaccine Effectiveness ◽

Infection Prevalence

Background: The COVID–19 BNT162b2 vaccination rollout in Kuwait started on 24 December 2020 followed by ChAdOx1 on 3 February 2021. The study objectives were to assess the factors associated with vaccine coverage and determine vaccine effectiveness (VE) against SARSCoV2 infection in a healthcare worker (HCW) population. Methods: This retrospective cohort study was conducted among HCW working at a public secondary hospital in Kuwait. The follow–up period was from 24 December 2020 to 15 June 2021. The primary outcomes were vaccine coverage and PCR–confirmed SARS–CoV–2 infection for the VE analysis. Data on new SARS–CoV–2 infections (with or without symptoms) during study period in addition to HCWs characteristics (sex, age, nationality, and occupation) were extracted from the hospital records. The vaccine coverage and PCR confirmed SARS–CoV–2 infections were cross–tabulated by the HCWs characteristics. Furthermore, we used Cox regression to estimate time to infection hazard ratios in vaccinated (first and second dose) compared to unvaccinated HCWs. Only one ChAdOx1 dose was given during the study period. Results: There were 3246 HCWs included in the analysis. The median age was 38 years (IQR = 33 – 44), 63.4% were females, 46.8% aged 31 – 40, and 82.3% were non-Kuwaitis. Overall, 82.1% of HCWs received at least one vaccine dose (50.4% received only one dose of ChAdOx1, 3.3% received one dose of BNT162b2, and 28.3% received two doses of BNT162b2). 17.9% of HCWs remained unvaccinated by the end of the study. A significantly lower vaccination coverage percentage was amongst female HCWs, younger age group (20 – 30 years old), and administrative/executive staff. Symptomatic SARS–CoV–2 PCR confirmed infection prevalence was 7.3%. No asymptomatic infections were reported. The SARS–CoV–2 infection incidence rate was 126 per 100,000 person–days in the unvaccinated group; the incidence rates in partially vaccinated groups (≥ 28 days after ChAdOx1 first dose) and (≥ 14 days after receiving BNT162b2 through receipt of second dose) were 31.4 and 10.9 per 100,000 person–days, respectively. In the fully vaccinated group (≥ 14 days after BNT162b2 second dose), the incidence rate was 6.3 per 100,000 person–days. The estimated adjusted vaccine effectiveness of fully vaccinated was 94.5% (95% confidence interval [CI] = 89.4%–97.2%). The VE of partially vaccinated for ChAdOx1 and BNT162b2 was 75.4% (95% CI = 67.2%–81.6%) and 91.4% (95% CI = 65.1% – 97.9%), respectively. Conclusions: Both BNT162b2 and ChAdOx1 vaccines prevented most symptomatic infections in this population across age groups, nationalities, and occupations. A significant proportion (17.9%) of HCWs were unvaccinated despite the vaccine accessibility. The findings complement other VE studies and demonstrate the vaccine benefit for HCWs.

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Pirfenidone vs. nintedanib in patients with idiopathic pulmonary fibrosis: a retrospective cohort study

Respiratory Research ◽

10.1186/s12931-021-01857-y ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Pavo Marijic ◽

Larissa Schwarzkopf ◽

Lars Schwettmann ◽

Thomas Ruhnke ◽

Franziska Trudzinski ◽

...

Keyword(s):

Cohort Study ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Individual Risk ◽

Guideline Recommendation ◽

Cox Models ◽

All Cause Mortality ◽

Antifibrotic Drugs

Abstract Background Two antifibrotic drugs, pirfenidone and nintedanib, are licensed for the treatment of patients with idiopathic pulmonary fibrosis (IPF). However, there is neither evidence from prospective data nor a guideline recommendation, which drug should be preferred over the other. This study aimed to compare pirfenidone and nintedanib-treated patients regarding all-cause mortality, all-cause and respiratory-related hospitalizations, and overall as well as respiratory-related health care costs borne by the Statutory Health Insurance (SHI). Methods A retrospective cohort study with SHI data was performed, including IPF patients treated either with pirfenidone or nintedanib. Stabilized inverse probability of treatment weighting (IPTW) based on propensity scores was applied to adjust for observed covariates. Weighted Cox models were estimated to analyze mortality and hospitalization. Weighted cost differences with bootstrapped 95% confidence intervals (CI) were applied for cost analysis. Results We compared 840 patients treated with pirfenidone and 713 patients treated with nintedanib. Both groups were similar regarding two-year all-cause mortality (HR: 0.90 95% CI: 0.76; 1.07), one-year all cause (HR: 1.09, 95% CI: 0.95; 1.25) and respiratory-related hospitalization (HR: 0.89, 95% CI: 0.72; 1.08). No significant differences were observed regarding total (€− 807, 95% CI: €− 2977; €1220) and respiratory-related (€− 1282, 95% CI: €− 3423; €534) costs. Conclusion Our analyses suggest that the patient-related outcomes mortality, hospitalization, and costs do not differ between the two currently available antifibrotic drugs pirfenidone and nintedanib. Hence, the decision on treatment with pirfenidone versus treatment with nintedanib ought to be made case-by-case taking clinical characteristics, comorbidities, comedications, individual risk of side effects, and patients’ preferences into account.

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Time to death from chronic heart failure among outpatient Treatment: a retrospective cohort study

10.21203/rs.2.13198/v1 ◽

2019 ◽

Author(s):

Habtamu Deissie Mitiku ◽

Yenefenta Wubie Bayileyegn ◽

Belete Adelo Wobesie ◽

Eskeziaw Abebe Kassahun

Keyword(s):

Heart Failure ◽

Cohort Study ◽

Chronic Heart Failure ◽

Retrospective Cohort Study ◽

Outpatient Treatment ◽

Retrospective Cohort ◽

Clinical Syndrome ◽

Proportional Hazard ◽

Cox Models

Abstract Abstract Objective: Chronic heart failure is a complex clinical syndrome of functional or structural impairment in the heart. Even though the occurrences of heart failure is increasing in the world, there has been limited researches on the management of chronic heart failure in outpatient, particularly in the study area. Therefore, this studywas amed for the management of outpatients with chronic heart failure. A Retrospective cohort study was conducted from January 1, 2010, to December 30, 2016,on outpatient’s follow-up at Wollo governmental hospitals. A required sample of 487 patients were selected by using a simple random sampling method. Proportional hazard with weibull distribution was modelled since its coefficients more precise than other parametric Cox models. Result: Weibull proportional hazard model result showed that risk factors related to mortality were Age (HR=1.04,p=0.000),Rural in residence (HR=1.74,p=0.003),having poor Nutritional status(HR=3.12, p=0.000),Systolic blood pressure(HR=1.01,p=0.037),having Coronary Artery disease (HR=3.70, p=0.006), having Pneumonia (HR=1.91, p=0.015 and infection with Tuberculosis bacillus (HR=1.87, p=0.000) were found statistically significant. Hence, early identifying and treating of Chronic heart failure and improving a strategies of frequent monitoring and follow up for outpatients is highly recommended . Keywords:Chronic heart failure, Retrospective cohort study, Outpatient, treatment, Wollo, Ethiopia

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1831 Rubella-Vaccine Effectiveness 5Yrs after Mass Vaccination: Multi-Center Sera-Epidemiology Retrospective Cohort Study

Archives of Disease in Childhood ◽

10.1136/archdischild-2012-302724.1831 ◽

2012 ◽

Vol 97 (Suppl 2) ◽

pp. A518-A518

Author(s):

E. Ahmadnezhad ◽

F. Jahani ◽

M. Karamyyar

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Vaccine Effectiveness ◽

Mass Vaccination ◽

Rubella Vaccine

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Effectiveness of a Group B outer Membrane Vesicle Meningococcal Vaccine in Preventing Hospitalization from Gonorrhea in New Zealand: a Retrospective Cohort Study

10.20944/preprints201806.0495.v1 ◽

2018 ◽

Author(s):

Janine Paynter ◽

Felicity Goodyear-Smith ◽

Jane Morgan ◽

Peter Saxton ◽

Steve Black ◽

...

Keyword(s):

Cohort Study ◽

New Zealand ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Membrane Vesicle ◽

Public Health Problem ◽

Vaccine Effectiveness ◽

Effective Vaccine ◽

Multiple Drug ◽

Global Public Health

Gonorrhea is a major global public health problem with emergence of multiple drug-resistant strains with no effective vaccine. This retrospective cohort study aimed to estimate the effectiveness of the New Zealand meningococcal B vaccine against gonorrhea associated hospitalization. The cohort consisted of individuals born 1984-1999 residing in New Zealand, therefore eligible for meningococcal B vaccination during 2004-2008. Administrative datasets of demographics, customs, hospitalization, education, income tax and immunization, were linked using the national Integrated Data Infrastructure. The primary outcome was hospitalization with a primary diagnosis of gonorrhea. Cox’s proportional hazards models were applied with a Firth correction for rare outcomes to generate estimates of hazard ratios. Vaccine effectiveness estimates were calculated as 1-Hazard Ratio expressed as percent. There were 1,143,897 eligible cohort members, with 135 missing information on gender, 16,245 missing ethnicity and/or 197,502 missing deprivation hence 935,496 were included in the analysis. After adjustment for gender, ethnicity and deprivation, vaccine effectiveness (MeNZB™) against hospitalization caused by gonorrhea was estimated to be 24% (95% CI 1-42%). In conclusion, vaccination with MeNZB™ significantly reduced the rate of hospitalization from gonorrhea. This supports prior research indicating possible cross protection of this vaccine against gonorrhea acquisition and disease in the outpatient setting.

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