COVID-19 vaccine intentions and uptake in a tertiary care healthcare system: A longitudinal study

Objective Healthcare workers (HCWs) are a high priority group for COVID-19 vaccination and serve as sources for information for the public. This analysis assessed vaccine intentions, factors associated with intentions, and change in uptake over time in HCWs. Methods A prospective cohort study of COVID-19 seroprevalence was conducted with HCWs in a large healthcare system in the Chicago area. Participants completed surveys (November 25, 2020-January 9, 2021 and April 24-July 12, 2021) on COVID-19 exposures, diagnosis and symptoms, demographics, and vaccination status. Results Of 4,180 HCWs who responded to a survey, 77.1% indicated they intended to get the vaccine; in this group, 23.2% had already received at least one dose of the vaccine (23.2%), 17.4% were unsure, and 5.5% reported that they would not get the vaccine. Factors associated with intention or vaccination were being exposed to clinical procedures (vs no procedures) and having a negative serology test for COVID-19 (vs no test) (adjusted odds ratio (AOR)=1.39, 95% Confidence Interval (CI) 1.16-1.65, AOR=1.46, 95% CI 1.24-1.73, respectively). Nurses (vs physicians, AOR=0.24 95% CI 0.17-0.33), non-Hispanic Black (vs Asians, AOR=0.35, 95% CI 0.21-0.59), and women (vs men, AOR=0.38, 95% CI 0.30-0.50) had lower odds of intention to get vaccinated. By 6-months follow-up, over 90% of those who had previously been unsure were vaccinated, while 59.7% of those who previously reported no intention of getting vaccinated, were vaccinated. Conclusions COVID-19 vaccination in HCWs was high, but variability in vaccination intention exists. Targeted messaging coupled with vaccine mandates can support uptake.

Using Human-Centered Design in Personalized Anticipatory Guidance: Enriching Anticipatory Guidance on Early Cognitive and Language Development

In this study, we aimed to create a novel tool to assist providers at 2 Chicago-area Federally Qualified Health Centers in giving guidance on early cognitive and language development during well-child visits. We utilized a human-centered design (HCD) process to address specific barriers to providing this guidance and create a tool shaped by the needs of providers and parents. Phase I involved collaborative prototype design; phase II involved implementation, feedback gathering, and responsive iterations of the tool; and phase III involved a collective review of the HCD process. The final version of the tool was a concise, colorful, and parent-accessible “Brain Building Guide” intended for interactive provider and parent use. It featured personalized information about parental knowledge and suggested areas for guidance. It was both satisfactory to stakeholders and efficacious in improving parental knowledge immediately post-visit and 1 month out. It should be further evaluated in a randomized controlled trial.

Ridesourcing and urban inequality in Chicago: Connecting mobility disparities to unequal development, gentrification, and displacement

Ridesourcing advocates and companies promise many benefits to cities, such as increased accessibility, a solution to the last-mile transit problem, and even reduced need for automobiles. However, an important body of research has indicated that ridesourcing is more heavily used by more privileged consumers and in more affluent and whiter neighborhoods. Questions have also emerged about the effects of ridesourcing on public transportation. This study builds on a mobility disparities perspective by analyzing ridesourcing in the context of urban inequality, including gentrification and displacement. Using a large data set from the Chicago area, this study shows that ridesourcing is associated with areas that have seen rising rents and have become whiter and more educated. The results also show that ridesourcing is more prevalent in areas that are accessible by public transportation. Although the causal relationship between ridesourcing and gentrification is complex, the study suggests a new direction in the literature that embeds the analysis of ridesourcing in the broader frameworks of unequal urban development and neoliberalization. The study also suggests policy approaches that could help to reduce some of the connections between ridesourcing and urban inequity.

Serologic Status and SARS CoV-2 Infection over 6-Months of Follow-Up in Healthcare Workers in Chicago: A Cohort Study

Objective: To determine the changes in SARS-CoV-2 serologic status and SARS-CoV-2 infection rates in healthcare workers (HCW) over 6-months of follow-up. Design: Prospective cohort study Setting and Participants: HCW in the Chicago area, USA Methods: Cohort participants were recruited in May/June 2020 for baseline serology testing (Abbott anti-Nucleocapsid IgG) and were then invited for follow-up serology testing 6 months later. Participants completed monthly online surveys which assessed demographics, medical history, COVID-19 illness, and exposures to SARS-CoV-2. The electronic medical record was used to identify SARS-CoV-2 PCR positivity during follow-up. Serologic conversion and SARS-CoV-2 infection or possible reinfection rates (cases per 10,000 person*days) by antibody status at baseline and follow-up were assessed. Results: 6510 HCW were followed for a total of 1,285,395 person*days (median follow-up, 216 days). For participants who had baseline and follow-up serology checked, 285 (6.1%) of the 4681 seronegative participants at baseline seroconverted to positive at follow-up; 138 (48%) of the 263 who were seropositive at baseline were seronegative at follow-up. When analyzed by baseline serostatus alone, 519 (8.4%) of 6194 baseline seronegative cohort participants had a positive PCR after baseline serology testing (rate = 4.25/10,000 person days). Of 316 participants who were seropositive at baseline, 8 (2.5%) met criteria for possible SARS-CoV-2 reinfection (PCR+ more than 90 days after baseline serology) during follow-up representing a rate of 1.27/10,000 days at risk. The adjusted rate ratio for possible reinfection in baseline seropositive compared to infection in baseline seronegative participants was 0.26, (95%CI: 0.13 – 0.53). Conclusions: Seropositivity in HCWs is associated with moderate protection from future SARS-CoV-2 infection.

EDWARD EVERETT GORE: CONTRIBUTIONS OF AN EARLY 20TH CENTURY CPA AND CIVIC LEADER

Edward Everett Gore was the president of the American Institute of Accountants from 1922-1924. At the same time he was leading the accounting profession, he was the president of the Chicago Association of Commerce. He was later founder and president of the Chicago Crime Commission during the era when Alphonse Capone was terrorizing the city. He was responsible for the passage of the first Illinois CPA law and the establishment of the Journal of Accountancy and the AICPA Benevolent Fund . He wrote portions of the 1913 tax law and campaigned for the establishment of the Internal Revenue’s Board of Tax Appeals (Tax Court). He played an important leadership role in professionalizing public accounting during the first quarter of the twentieth century, and his civic work in the Chicago area extended his legacy beyond the realm of accountancy.

Dynamics of data availability in disease modeling: An example evaluating the trade-offs of ultra-fine-scale factors applied to human West Nile virus disease models in the Chicago area, USA

Background Since 1999, West Nile virus (WNV) has moved rapidly across the United States, resulting in tens of thousands of human cases. Both the number of human cases and the minimum infection rate (MIR) in vector mosquitoes vary across time and space and are driven by numerous abiotic and biotic forces, ranging from differences in microclimates to socio-demographic factors. Because the interactions among these multiple factors affect the locally variable risk of WNV illness, it has been especially difficult to model human disease risk across varying spatial and temporal scales. Cook and DuPage Counties, comprising the city of Chicago and surrounding suburbs, experience some of the highest numbers of human neuroinvasive cases of WNV in the United States. Despite active mosquito control efforts, there is consistent annual WNV presence, resulting in more than 285 confirmed WNV human cases and 20 deaths from the years 2014–2018 in Cook County alone. Methods A previous Chicago-area WNV model identified the fifty-five most high and low risk locations in the Northwest Mosquito Abatement District (NWMAD), an enclave ¼ the size of the combined Cook and DuPage county area. In these locations, human WNV risk was stratified by model performance, as indicated by differences in studentized residuals. Within these areas, an additional two-years of field collections and data processing was added to a 12-year WNV dataset that includes human cases, MIR, vector abundance, and land-use, historical climate, and socio-economic and demographic variables, and was assessed by an ultra-fine-scale (1 km spatial x 1 week temporal resolution) multivariate logistic regression model. Results Multivariate statistical methods applied to the ultra-fine-scale model identified fewer explanatory variables while improving upon the fit of the previous model. Beyond MIR and climatic factors, efforts to acquire additional covariates only slightly improved model predictive performance. Conclusions These results suggest human WNV illness in the Chicago area may be associated with fewer, but increasingly critical, key variables at finer scales. Given limited resources, these findings suggest large variations in model performance occur, depending on covariate availability, and provide guidance in variable selection for optimal WNV human illness modeling.