scholarly journals Healthcare workers benefit from second dose of COVID-19 mRNA vaccine: Effects of partial and full vaccination on sick leave duration and symptoms

2021 ◽  
Author(s):  
Earl M Strum ◽  
Yolee Casagrande ◽  
Kim I Newton ◽  
Jennifer B Unger
Keyword(s):  
Return To Work ◽  
Healthcare Workers ◽  
Vaccination Status ◽  
Work Time ◽  
Initial Interview ◽  
Design Data ◽  
Symptom Profiles ◽  
Asian Pacific Islander ◽  
Race Ethnicity ◽  
Asian Pacific

Importance: In addition to morbidity and mortality of individuals, COVID-19 can affect staffing among organizations. It is important to determine whether vaccination can mitigate this burden. Objective: This study examined the association between COVID-19 vaccination status and time until return to work among 952 healthcare workers (HCW) who tested positive for COVID-19. Design: Data were collected prospectively between December 2020 and July 2021. HCW who tested positive for COVID-19 completed an initial interview and were followed until they returned to work. Setting: An academic campus in Southern California consisting of two large hospitals and multiple outpatient clinics and other facilities. Participants: Clinical and nonclinical HCW who tested positive for COVID-19 during the study period (N=952, mean age=39.2 years, 69% female, 45% Hispanic, 14% white, 14% Asian/Pacific Islander, 5% African American, and 21% other race/ethnicity). Exposure: COVID-19 vaccination status (unvaccinated, partially vaccinated, or fully vaccinated) Main Outcome Measures: Days until return to work, presenting symptom Results: Return-to-work time for fully vaccinated HCWs (mean=10.9 days) was significantly shorter than that of partially vaccinated HCWs (15.5 days), which in turn was significantly shorter than that of unvaccinated HCWs (18.0 days). Fully vaccinated HCWs also showed milder symptom profiles compared to partially vaccinated and unvaccinated HCWs. Conclusions and Relevance: COVID-19 vaccination has the potential to prevent long absences from work and the adverse financial, staffing, and managerial consequences of these long absences.

Haemophilus influenzaetype b infection, vaccination, andH. influenzaecarriage in children in Minnesota, 2008–2009

2011 ◽  
Vol 140 (3) ◽  
pp. 566-574 ◽  
Author(s):  
S. A. LOWTHER ◽  
N. SHINODA ◽  
B. A. JUNI ◽  
M. J. THEODORE ◽  
X. WANG ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Children ◽  
Haemophilus Influenzae ◽  
Pacific Islander ◽  
Type B ◽  
Asian Pacific Islander ◽  
Male Sex ◽  
Race Ethnicity ◽  
Asian Pacific ◽  
Vaccine Shortage

SUMMARYAn increase in invasiveHaemophilus influenzaetype b (Hib) cases occurred in Minnesota in 2008 after the recommended deferral of the 12–15 months Hib vaccine boosters during a US vaccine shortage. Five invasive Hib cases (one death) occurred in children; four had incomplete Hib vaccination (three refused/delayed); one was immunodeficient. Subsequently, we evaluated Hib carriage and vaccination. From 18 clinics near Hib cases, children (aged 4 weeks–60 months) were surveyed for pharyngeal Hib carriage. Records were compared for Hib, diphtheria-tetanus-acellular pertussis (DTaP), and pneumococcal (PCV-7) vaccination. Parents completed questionnaires on carriage risk factors and vaccination beliefs. In 1631 children (February–March 2009), no Hib carriage was detected; Hib vaccination was less likely to be completed than DTaP and PCV-7. Non-type bH. influenzae, detected in 245 (15%) children, was associated with: male sex, age 24–60 months, daycare attendance >15 h/week, a household smoker, and Asian/Pacific Islander race/ethnicity. In 2009, invasive Hib disease occurred in two children caused by the same strain that circulated in 2008. Hib remains a risk for vulnerable/unvaccinated children, although Hib carriage is not widespread in young children.

Comorbidity and racial differences in risk of mortality of men with breast cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 1554-1554
Author(s):  
Carol Parise ◽  
Vincent Caggiano
Keyword(s):  
Breast Cancer ◽  
Black Men ◽  
Pacific Islander ◽  
White Men ◽  
Concomitant Disease ◽  
Asian Pacific Islander ◽  
Risk Of Mortality ◽  
Comorbidity Burden ◽  
Race Ethnicity ◽  
Asian Pacific

1554 Background: Black men with breast cancer have more concomitant disease and worse survival than white men. Less is known about concomitant disease and survival in Hispanic and Asian/Pacific Islander (API) men with breast cancer. The purpose of this study was to compare differences in survival and risk of mortality of white, black, Hispanic, and Asian/Pacific Islander (API) men with breast cancer with increasing comorbidity. Methods: We identified 1,497 cases of first primary male invasive breast cancer from the California Cancer Registry 2000-2015 with a documented Charlson Comorbidity Index (CCI). The CCI is a weighted index based on the presence of certain comorbid conditions following a cancer diagnosis and weighted by the severity of these conditions. A score of 0 indicates no significant comorbidity and scores of 2 or more are interpreted as a high comorbidity burden. Bivariate associations between race and AJCC stage, tumor grade, estrogen receptor (ER) status, human epidermal growth factor 2 (HER2), and socioeconomic status (SES) were compared using the χ2 Test of Independence. Kaplan Meier Survival analysis was used to compare unadjusted survival among the races. Cox Regression was used to assess risk of mortality for each race when adjusted for factors that had a statistically significant (p < 0.10) bivariate association with race/ethnicity. Analyses were conducted within each level of the CCI (0, 1, and 2 or more). Results: Among men with a CCI of 0 or 2, blacks had worse unadjusted survival than whites. There were no differences in survival for men with a CCI of 1. Stage, SES, ER, and type of surgery all had statistically significant bivariate associations with race/ethnicity. For men with a CCI of 0, Hispanics (HR = 0.367; 95% CI = 0.167, 0.801) and APIs (HR = 0.422; 95% CI = 0.189, 0.941) had a reduced risk of mortality when compared with whites. Black men had the same risk of mortality as white men. There were no differences in risk of mortality by race for men with a CCI of 1 or 2. Conclusions: Black men with breast cancer and no comorbidity have the same risk of mortality as white men while Hispanic and API men have lower risk of mortality. There are no racial disparities in adjusted risk of mortality in men with breast cancer with any concomitant disease.

scholarly journals GERM-04. PRIMARY INTRACRANIAL GERM CELL TUMORS ARE MORE PREVALENT AMONG PEDIATRIC PATIENTS OF ASIAN/PACIFIC ISLANDER RACE/ETHNICITY IN THE UNITED STATES

2021 ◽  
Vol 23 (Supplement_1) ◽  
pp. i16-i17
Author(s):  
Nayan Lamba ◽  
Bryan Iorgulescu
Keyword(s):  
Pediatric Patients ◽  
Pacific Islander ◽  
Germ Cell Tumors ◽  
The United States ◽  
Asian Pacific Islander ◽  
Intracranial Germ Cell Tumors ◽  
Hispanic Patients ◽  
Race Ethnicity ◽  
Asian Pacific ◽  
The U.S

Abstract Introduction Primary intracranial germ cell tumors (GCTs) appear to be more prevalent among pediatric patients in eastern Asia than in the U.S. Herein we use cancer registry data to evaluate whether GCT prevalence differs by race/ethnicity among U.S. pediatric patients. Methods Pediatric patients (age≤14) presenting between 2004–2017 with a primary intracranial GCT were identified by ICD-O-3 histological and topographical coding from the National Cancer Database (comprising &gt;70% of cancers newly-diagnosed cancers in the U.S.), and categorized by NICHD age stages. Patients’ age, sex, race/ethnicity, and overall survival, and tumor location and size were evaluated. Results 889 pediatric patients with primary intracranial GCTs were identified, which were overwhelmingly male (64.8%) and pure germinomas (64.0%). Non-germinomatous (24.5%) and mixed (11.5%) tumor types were in the minority. Overall, primary GCTs comprised 4.9% of intracranial tumors in pediatric males and 2.9% of intracranial tumors in pediatric females. Asian/Pacific Islander pediatric patients in the U.S. had a notably higher prevalence of GCTs: among Asian/Pacific Islander males, 10.6% of all brain tumors were GCTs, compared to only 4.5% in White non-Hispanic patients, 2.8% in Black non-Hispanic patients, and 6.0% in Hispanic patients. Despite the much lower prevalence of GCTs among female patients overall, this predominance also persisted for Asian/Pacific Islander females, among whom 7.5% of brain tumors were GCTs, compared to only 2.5% in White non-Hispanic patients, 2.4% in Black non-Hispanic patients, and 4.1% in Hispanic patients. Overall, 9.4% of pediatric primary intracranial GCTs occurred in patients of Asian/Pacific Islander race/ethnicity, in contrast to 4.0% of diffuse astrocytic/oligodendroglial tumors, 2.8% of other astrocytic tumors, or 4.6% of embryonal tumors. Conclusions Primary intracranial GCTs affect a substantially larger proportion of both male and female pediatric patients of Asian/Pacific Islander race/ethnicity in the United States.

scholarly journals Contemporary Reevaluation of Race and Ethnicity With Outcomes in Heart Failure

2021 ◽  
Vol 10 (3) ◽  
Author(s):  
Samuel T. Savitz ◽  
Thomas Leong ◽  
Sue Hee Sung ◽  
Keane Lee ◽  
Jamal S. Rana ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Pacific Islander ◽  
Left Ventricular Ejection ◽  
Asian Pacific Islander ◽  
Black Patients ◽  
Hispanic Patients ◽  
Race Ethnicity ◽  
Asian Pacific ◽  
White Patients

Background Variation in outcomes by race/ethnicity in adults with heart failure (HF) has been previously observed. Identifying factors contributing to these variations could help target interventions. We evaluated the association of race/ethnicity with HF outcomes and potentially contributing factors within a contemporary HF cohort. Methods and Results We identified members of Kaiser Permanente Northern California, a large integrated healthcare delivery system, who were diagnosed with HF between 2012 and 2016 and had at least 1 year of prior continuous membership and left ventricular ejection fraction data. We used Cox regression with time‐dependent covariates to evaluate the association of self‐identified race/ethnicity with HF or all‐cause hospitalization and all‐cause death, with backward selection for potential explanatory variables. Among 34 621 patients with HF, compared with White patients, Black patients had a higher rate of HF hospitalization (adjusted hazard ratio [HR], 1.28; 95% CI, 1.18–1.38) but a lower rate of death (adjusted HR, 0.78; 95% CI, 0.72–0.85). In contrast, Asian/Pacific Islander patients had similar rates of HF hospitalization, but lower rates of all‐cause hospitalization (adjusted HR, 0.89; 95% CI, 0.85–0.93) and death (adjusted HR, 0.75; 95% CI, 0.69–0.80). Hispanic patients also had a lower rate of death (adjusted HR, 0.85; 95% CI, 0.80–0.91). Sensitivity analyses showed that effect sizes for Black patients were larger among patients with reduced ejection fraction. Conclusions In a contemporary and diverse population with HF, Black patients experienced a higher rate of HF hospitalization and a lower rate of death compared with White patients. In contrast, selected outcomes for Asian/Pacific Islander and Hispanic patients were more favorable compared with White patients. The observed differences were not explained by measured potentially modifiable factors, including pharmacological treatment. Future research is needed to identify explanatory mechanisms underlying ongoing racial/ethnic variation to target potential interventions.

scholarly journals Evaluation of a city-wide school-located influenza vaccination program in Oakland, California with respect to race and ethnicity: a matched cohort study

2021 ◽  
Author(s):  
Anna T Nguyen ◽  
Benjamin F Arnold ◽  
Chris J Kennedy ◽  
Kunal Mishra ◽  
Nolan Pokpongkiat ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Vaccination Coverage ◽  
Race And Ethnicity ◽  
Latino Students ◽  
Comparison Site ◽  
Multiracial Students ◽  
Asian Pacific Islander ◽  
Race Ethnicity ◽  
Asian Pacific ◽  
Intervention District

Objectives: To evaluate the effectiveness of city-wide school-located influenza vaccination by race/ethnicity from 2014-2018. Methods: We used multivariate matching to pair schools in the intervention district in Oakland, CA with schools in West Contra Costa County, CA, a comparison district. We estimated difference-in-differences (DIDs) in caregiver-reported influenza vaccination coverage and laboratory-confirmed influenza hospitalization incidence. Results: Differences in influenza vaccination coverage in the intervention vs. comparison site were larger among White and Latino students than Asian/Pacific Islander (API), Black, and multiracial students. Concerns about vaccine effectiveness or safety were more common among Black and multiracial caregivers; logistical barriers to vaccination were more common among White, API, and Latinos. In both sites, hospitalization in 2017-18 was higher in Blacks vs. other races/ethnicities. All-age influenza hospitalization incidence was lower in the intervention site vs. comparison site among White/API individuals in 2016-17 and 2017-18 and Black older adults in 2017-18, but not in other groups. Conclusions: SLIV was associated with higher vaccination coverage and lower influenza hospitalization, but associations varied by race/ethnicity. SLIV alone may be insufficient to ensure equitable health outcomes for influenza.

Who gets treated at commission on cancer-approved programs and does it make a difference in survival?

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 114-114
Author(s):  
Vincent Caggiano ◽  
Carol Parise
Keyword(s):  
Cox Regression ◽  
The United States ◽  
Asian Pacific Islander ◽  
California Cancer Registry ◽  
Risk Of Mortality ◽  
Cancer Specific Mortality ◽  
Race Ethnicity ◽  
Asian Pacific ◽  
Risk Of Cancer ◽  
Urban Versus

114 Background: Commission on Cancer (CoC) approval has promoted improvements in cancer care in the United States. The purpose of this study is to determine if there are differences in who is treated at CoC approved versus non-approved sites and if CoC approval is associated with survival. Methods: We examined 130,655 cases of stages I-IV first primary female invasive breast cancer from the California Cancer Registry diagnosed between 2000-2010. Odds ratios (95% CI) adjusted for stage, age, grade, year of diagnosis, and ER/PR/HER2 were computed to determine if there were differences by race: white, black, Hispanic, Asian/Pacific Islander (API) and American Indian (AI); SES (low, intermediate, high) or location (urban versus rural) in the likelihood of treatment at CoC sites. Cox regression was used to assess the risk of cancer specific mortality at CoC approved versus non-approved sites. Results: CoC-approved hospitals were more likely to be urban (89%) than rural (11.2%). Race and SES were associated with being treated at CoC sites. In the lowest SES group, blacks (OR=0.82; 95% CI=0.77, 0.89) and Hispanics (OR=0.90; 95%CI=0.86, 0.95) were less likely than whites to be treated at CoC sites. Similar ORs were seen in the intermediate SES group for blacks and Hispanics. In the highest SES stratum, blacks (OR=0.67; 95%CI=0.62, 0.74), Hispanics (OR=0.76; 95%CI=0.72,0.81), and APIs (OR=0.79; 95%CI=0.75,0.83) were less likely to be treated at CoC sites. Unadjusted survival was better for CoC sites (87% vs 85%). For Stage I, only whites treated at CoC approved sites had decreased risk of mortality (HR=0.86; 95%CI=0.79, 0.95). For Stage 2, whites (HR=0.87; 95%CI=0.82, 0.93) and APIs (HR=0.71; 95%CI=0.59, 0.86) had decreased risk of mortality. Blacks (HR=0.82; 95%CI=0.70,0.99) had slightly decreased risk of mortality. For stages III and IV, no difference in risk of mortality was apparent for any race at CoC-approved sites. Conclusions: Patients treated at CoC approved sites vary by race/ethnicity and SES. While the risk of mortality is reduced for some race/ethnicities in Stages 1 and 2 when treated at CoC-approved sites, for stages III and IV patients, CoC-approval does not make a difference in risk of mortality.

scholarly journals COVID-19 Mortality in California Based on Death Certificates: Disproportionate Impacts Across Racial/Ethnic Groups and Nativity

2021 ◽  
Author(s):  
Erika Garcia ◽  
Sandrah P. Eckel ◽  
Zhanghua Chen ◽  
Kenan Li ◽  
Frank D. Gilliland
Keyword(s):  
Ethnic Groups ◽  
Age Groups ◽  
Initial Step ◽  
Death Certificates ◽  
Foreign Born ◽  
Asian Pacific Islander ◽  
Race Ethnicity ◽  
Asian Pacific ◽  
Rate Ratios ◽  
Racial Ethnic

ABSTRACTPurposeTo examine characteristics of coronavirus disease 2019 (COVID-19) decedents in California (CA) and evaluate for disproportionate mortality across race/ethnicity and ethnicity/nativity.MethodsCOVID-19 deaths were identified from death certificates. Age-adjusted mortality rate ratios (MRR) were compared across race/ethnicity. Proportionate mortality rates (PMR) were compared across race/ethnicity and by ethnicity/nativity.ResultsWe identified 10,200 COVID-19 deaths in CA occurring February 1 through July 31, 2020. Decedents tended to be older, male, Hispanic, foreign-born, and have lower educational attainment. MRR indicated elevated COVID-19 morality rates among Asian/Pacific Islander, Black, and Hispanic groups compared with the White group, with Black and Hispanic groups having the highest MRR at 2.75 (95%CI:2.54-2.97) and 4.18 (95%CI: 3.99-4.37), respectively. Disparities were larger at younger ages. Similar results were observed with PMR, which remained in analyses stratified by education. Elevated PMR were observed in all ethnicity/nativity groups, especially foreign-born Hispanic individuals, relative to U.S.-born non-Hispanic individuals, were generally larger at younger ages, and persisted after stratifying by education.ConclusionsDifferential COVID-19 mortality was observed in California across racial/ethnic groups and by ethnicity/nativity groups with evidence of greater disparities among younger age groups. Identifying COVID-19 disparities is an initial step towards mitigating disease impacts in vulnerable communities.

scholarly journals Incidence rates of systemic lupus erythematosus in the USA: estimates from a meta-analysis of the Centers for Disease Control and Prevention national lupus registries

2021 ◽  
Vol 8 (1) ◽  
pp. e000614
Author(s):  
Peter M Izmirly ◽  
Elizabeth D Ferucci ◽  
Emily C Somers ◽  
Lu Wang ◽  
S Sam Lim ◽  
...  
Keyword(s):  
Disease Control ◽  
Meta Analysis ◽  
Population Based ◽  
Incidence Rates ◽  
Newly Diagnosed ◽  
Asian Pacific Islander ◽  
Control And Prevention ◽  
The Usa ◽  
Race Ethnicity ◽  
Asian Pacific

ObjectiveTo estimate the annual incidence rate of SLE in the USA.MethodsA meta-analysis used sex/race/ethnicity-specific data spanning 2002–2009 from the Centers for Disease Control and Prevention network of four population-based state registries to estimate the incidence rates. SLE was defined as fulfilling the 1997 revised American College of Rheumatology classification criteria. Given heterogeneity across sites, a random effects model was employed. Applying sex/race/ethnicity-stratified rates, including data from the Indian Health Service registry, to the 2018 US Census population generated estimates of newly diagnosed SLE cases.ResultsThe pooled incidence rate per 100 000 person-years was 5.1 (95% CI 4.6 to 5.6), higher in females than in males (8.7 vs 1.2), and highest among black females (15.9), followed by Asian/Pacific Islander (7.6), Hispanic (6.8) and white (5.7) females. Male incidence was highest in black males (2.4), followed by Hispanic (0.9), white (0.8) and Asian/Pacific Islander (0.4) males. The American Indian/Alaska Native population had the second highest race-specific SLE estimates for females (10.4 per 100 000) and highest for males (3.8 per 100 000). In 2018, an estimated 14 263 persons (95% CI 11 563 to 17 735) were newly diagnosed with SLE in the USA.ConclusionsA network of population-based SLE registries provided estimates of SLE incidence rates and numbers diagnosed in the USA.

The Impact of Race and Socioeconomic Status (SES) on Survival in Non-Hodgkin’s Lymphoma (NHL): A Population-Based Study from the California Cancer Registry (CCR).

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3580-3580
Author(s):  
James M. Foran ◽  
Theresa H. Keegan ◽  
Christina A. Clarke ◽  
Sandra J. Horning
Keyword(s):  
Pacific Islander ◽  
Relative Survival ◽  
B Cell Lymphoma ◽  
Census Bureau ◽  
Asian Pacific Islander ◽  
Race Ethnicity ◽  
Asian Pacific ◽  
Us Census ◽  
Hispanic White ◽  
Neighborhood Ses

Abstract Background: Despite the existence of well-established clinical prognostic indices for diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL), the 2 most common subtypes of NHL, significant heterogeneity in survival remains even within prognostic groups. SES has not previously been evaluated as a prognostic factor for NHL, particularly using an unselected patient population. We therefore used the large multiethnic CCR to examine NHL survival according to histology, race/ethnicity and neighborhood SES. Methods: NHL pts were identified from the CCR for the period 1988–97 using standardized ICD-0-3 classifications (morphology codes 9690–99 for FL & 9680–84 for DLBCL). Patients with evidence of HIV/AIDS were excluded. Neighborhood SES was assigned based on the address of residence at diagnosis, according to 1990 US Census Bureau census block group (each block contains about 1500 residents), and is based upon principal components of 7 indicator variables of SES (education level, proportion with blue collar job, proportion unemployed, median household income, proportion below 200% of poverty line, median rent & median home value). Using this index, we assigned each patient into an SES quintile (SES-1 lowest, SES-5 highest) based on the statewide distribution of neighborhood SES. We computed 5-year relative survival ± standard error (SE) with SEER*Stat software using customized race and SES-specific life tables based on US Census Bureau estimates for California residents. Results: Unselected DLBCL pts [n=13,604; comprising 73% non-Hispanic White (W), 4% Black (B), 14% Hispanic (H), 8% Asian/Pacific Islander (A)] & FL pts (n=7372; 82% W, 3% B, 11% H, 4% A) were identified. The overall 5 yr relative survival for DLBCL was 45.5% (SE 0.5) and for FL was 71.1% (SE 0.6); females had a better survival than males for DLBCL [F 48.3% (SE 0.7) vs. M 42.3% (SE 0.6)] but not for FL. Lower SES was associated with inferior survival for both DLBCL & FL (Table 1). Within SES groups there were not significant racial/ethnic differences in survival. However, in DLBCL, B (34%) and H (33%) pts were proportionally more likely to be in SES-1 than W (9%) or A pts (15%), and less likely to be in SES-5 (9% B, 10% H) than W (27%) or A (22%) pts. Similarly, in FL, B (39%) & H (26%) pts were also more likely than W (8%) & A (10%) pts to be in SES-1 and less likely to be in SES-5 (W-29%, A-32%, B-10%, H-11%). Conclusion: SES predicts survival in DLBCL and FL. Race/ethnicity differences in SES distribution are apparent in NHL patients, but when stratified by SES, race/ethnicity does not appear to predict for significant differences in NHL survival. 5 Year Relative Survival in DLBCL & FL by SES & Race SES-1 (%) SE (%) n SES-5 (%) SE (%) n W-non-Hispanic White; A-Asian/Pacific Islander; B-Black; H-Hispanic DLBCL 40.6 1.3 1905 49.4 1.0 3192 W 38.4 1.9 915 49.4 1.1 2701 A 44.0 4.2 168 48.2 3.5 244 B 45.0 4.2 185 54.3 7.3 51 H 41.6 2.1 637 48.9 4.0 196 FL 66.4 2.1 823 76.6 1.2 1959 W 66.3 2.7 502 77.1 1.2 1753 A 65.4 10.0 30 72.0 5.0 93 B 69.1 6.5 85 76.1 10.0 22 H 65.9 3.8 206 71.8 5.4 91

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