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Felzer JR, Montgomery AJ, LeMahieu AM, Finney Rutten LJ, Juhn YJ, Wi CI, Jacobson RM, Kennedy CC. Disparities in Influenza, Pneumococcal, COVID-19 Vaccine Coverage in High-Risk Adults Aged 19 to 64 Years in Southeastern Minnesota, 2010-2021. Chest 2024; 166:49-60. [PMID: 38342164 PMCID: PMC11251077 DOI: 10.1016/j.chest.2024.01.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/17/2023] [Accepted: 01/24/2024] [Indexed: 02/13/2024] Open
Abstract
BACKGROUND Despite effective vaccines against influenza, pneumococcus, and COVID-19, uptake has been suboptimal. RESEARCH QUESTION Although disparities in vaccination by race and ethnicity have been observed, what is the role of other sociodemographic factors in US vaccine uptake? STUDY DESIGN AND METHODS We conducted a population-based study using the Rochester Epidemiology Project (REP), a comprehensive medical records linkage system, to assess effects of sociodemographic factors including race, ethnicity, individual-level socioeconomic status (SES) via the housing-based socioeconomic status index, education, population density (urban or nonurban), and marital status with uptake of influenza, pneumococcal, and COVID-19 vaccination in high-risk adults. Adults at high risk of invasive pneumococcal disease residing in four counties in southeastern Minnesota who were aged 19 to 64 years were identified. Vaccination data were obtained from the Minnesota Immunization Information Connection and REP from January 1, 2010, through December 31, 2021. RESULTS We identified 45,755 residents. Most were White (82%), non-Hispanic (94%), married (56%), and living in an urban setting (81%), with three-quarters obtaining at least some college education (74%). Although 45.1% were up to date on pneumococcal vaccines, 60.1% had completed the primary COVID-19 series. For influenza and COVID-19, higher SES, living in an urban setting, older age, and higher education positively correlated with vaccination. Magnitude of differences in race, education, and SES widened with booster vaccines. INTERPRETATION This high-risk population is undervaccinated against preventable respiratory diseases, especially influenza and pneumococcus. Although national data reported improvement of disparities in COVID-19 vaccination uptake observed early in the pandemic, our data demonstrated gaps related to race, education level, SES, and age that widened with booster vaccines. Communities with high social vulnerabilities often show increased risk of severe disease outcomes, yet demonstrate lower uptake of preventive services. This highlights the need to understand better vaccine compliance and access in rural, lower SES, less-educated, Black, Hispanic, and younger populations, each of which were associated independently with decreased vaccination.
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Affiliation(s)
- Jamie R Felzer
- Division of Pulmonary & Critical Care, Department of Medicine, Mayo Clinic, Rochester, MN; Respiratory Health Equity Clinical Research Laboratory, Mayo Clinic, Rochester, MN
| | | | - Allison M LeMahieu
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Lila J Finney Rutten
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Young J Juhn
- Divisions of Community Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Chung-Il Wi
- Divisions of Community Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Robert M Jacobson
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN; Divisions of Community Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN; Division of Pediatric Infectious Diseases, Department of Pediatric and Adolescent Medicine
| | - Cassie C Kennedy
- Division of Pulmonary & Critical Care, Department of Medicine, Mayo Clinic, Rochester, MN; Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN; Respiratory Health Equity Clinical Research Laboratory, Mayo Clinic, Rochester, MN.
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Barqawi HJ, Samara KA, Haddad ES, Bakkour LM, Amawi FB. Attitudes and practices to adult vaccination among physicians before and after COVID-19 pandemic in the United Arab Emirates. Vaccine X 2024; 17:100455. [PMID: 38356876 PMCID: PMC10865396 DOI: 10.1016/j.jvacx.2024.100455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 01/15/2024] [Accepted: 01/30/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction Vaccination remains underutilised worldwide with low vaccine uptake rates across the board with many adults remaining unprotected. Across the Arab world, attitudes towards vaccines vary but high rates of vaccine hesitancy have been found. This study aims to explore the adult vaccination attitudes and practices by physicians in the UAE, both before and after the introduction of the COVID-19 vaccines. Methodology This cross-sectional, descriptive study used convenience and snowball sampling to collect comprehensive data from UAE physicians. A self-administered questionnaire was distributed in two stages: the first (pre-COVID-19 vaccines) between the months of June and October 2020 and the second between the months of November 2022 and March 2023. Results 1000 responses, 500 from each time period, were collected. Nearly a third were family physicians or internists with more than 70% of the physicians working in governmental hospitals. 95% agreed that vaccines are safe in both cohorts but 74.4% reported not having enough time to advise about vaccines. 80.8% of physicians in the 2022 cohort reported safety concerns as the most common reason for patients to refuse vaccines. The most recommended vaccines were influenza (68.6%), Hepatitis B (66.0%) and HPV (61.4%), with pneumococcal coming in close at 57.8%. Family medicine physicians showed the highest utilisation of preventive practices across both cohorts. Nearly half of all family medicine physicians did not regularly evaluate both the influenza and general immunisation status of their patients. 54.6% of physicians reported having patients with VPDs in the last five years (not including COVID-19) in 2022. Conclusion Physicians have overly positive attitudes, but their practices reflect a more superficial appreciation of vaccines and lack of initiative. Physicians need to adopt a pro-vaccine stance, armed with the proper tools and the right mentality and beliefs.
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Affiliation(s)
- Hiba J. Barqawi
- Department of Clinical Sciences, College of Medicine, University of Sharjah, United Arab Emirates
| | - Kamel A. Samara
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Enad S. Haddad
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Layane M. Bakkour
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Firas B. Amawi
- Dr. Sulaiman Al Habib Hospital, Dubai, United Arab Emirates
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Biasio LR, Zanobini P, Lorini C, Monaci P, Fanfani A, Gallinoro V, Cerini G, Albora G, Del Riccio M, Pecorelli S, Bonaccorsi G. COVID-19 vaccine literacy: A scoping review. Hum Vaccin Immunother 2023; 19:2176083. [PMID: 36794338 PMCID: PMC10026896 DOI: 10.1080/21645515.2023.2176083] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
To address vaccine hesitancy, specific self-rated tools have been developed to assess vaccine literacy (VL) related to COVID-19, including additional variables, such as beliefs, behavior, and willingness to be vaccinated. To explore the recent literature a search was performed selecting articles published between January 2020 and October 2022: 26 papers were identified using these tools in the context of COVID-19. Descriptive analysis showed that the levels of VL observed in the studies were generally in agreement, with functional VL score often lower than the interactive-critical dimension, as if the latter was stimulated by the COVID-19-related infodemic. Factors associated with VL included vaccination status, age, educational level, and, possibly, gender. Effective communication based on VL when promoting vaccination is critical to sustaining immunization against COVID-19 and other communicable diseases. The VL scales developed to date have shown good consistency. However, further research is needed to improve these tools and develop new ones.
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Affiliation(s)
| | - Patrizio Zanobini
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Pietro Monaci
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence, Italy
| | - Alice Fanfani
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence, Italy
| | - Veronica Gallinoro
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence, Italy
| | - Gabriele Cerini
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence, Italy
| | - Giuseppe Albora
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence, Italy
| | - Marco Del Riccio
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Sergio Pecorelli
- Scientific Advisory Committee, Giovanni Lorenzini Foundation, Milan, Italy
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Uthoff SAK, Zinkevich A, Franiel D, Below M, Splieth H, Iwen J, Biedermann M, Heinemeier D, Ansmann L. A complex intervention on vaccination uptake among older adults (≥ 60 years) in Germany - a study protocol with a mixed methods design. BMC PRIMARY CARE 2023; 24:148. [PMID: 37452283 PMCID: PMC10349490 DOI: 10.1186/s12875-023-02101-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND The current uptake of many vaccinations recommended for persons aged 60 and older is unsatisfactory in Germany. Lack of confidence in the safety and efficacy of vaccinations, lack of knowledge and insecurities about possible side effects, and numerous pragmatic barriers are just some of the reasons to be mentioned. General practitioners (GPs) play a central role in the vaccination process. Therefore, effective interventions in this context are needed to address the various barriers and improve the vaccination uptake rates. METHODS A complex intervention will be implemented and evaluated in 1057 GPs' practices in two German federal states. The components include trainings for GPs and medical assistants on communication psychology, medical aspects, and organisational vaccination processes. The primary outcome influenza vaccination rate and the secondary outcomes vaccination uptake rate of other vaccinations as well as vaccine literacy of patients will be examined. The intervention will be evaluated in a mixed methods study with a controlled design. Survey data will be analysed descriptively and by using mean comparisons as well as multivariable multilevel analyses. The qualitative data will be analysed with qualitative content analysis. The secondary data will be analysed by using descriptive statistics, a pre-post comparison by performing mean comparisons, cluster analysis, and subgroup analyses. DISCUSSION In this study, a complex intervention to improve vaccination rates in GP practices for the vaccinations recommended for people aged 60 years and older will be implemented and evaluated. Additionally, improvements in patients' vaccine-related health literacy and knowledge, and patients' intention to get vaccinated are expected. The mixed methods design can deliver results that can be used to improve preventive health care for elderly people and to gain more knowledge on vaccination uptake and the intervention's effectiveness. TRIAL REGISTRATION Trial registration number: DRKS00027252 (retrospectively registered).
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Affiliation(s)
- Sarah A K Uthoff
- Department of Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, Ammerlaender Heerstrasse 140, 29123, Oldenburg, Germany.
| | - Anna Zinkevich
- Department of Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, Ammerlaender Heerstrasse 140, 29123, Oldenburg, Germany
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), Chair of Medical Sociology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Eupener Str. 129, 50933, Cologne, Germany
| | - Dominika Franiel
- Central Research Institute of Ambulatory Health Care in Germany, Salzufer 8, 10587, Berlin, Germany
| | - Maike Below
- Central Research Institute of Ambulatory Health Care in Germany, Salzufer 8, 10587, Berlin, Germany
| | - Helene Splieth
- Association of Substitute Health Funds (Vdek) e.V, Askanischer Platz 1, 10963, Berlin, Germany
| | - Julia Iwen
- Association of Substitute Health Funds (Vdek) e.V, Askanischer Platz 1, 10963, Berlin, Germany
| | - Marc Biedermann
- The National Association of Statutory Health Insurance Physicians, Herbert-Lewin-Platz 2, 10623, Berlin, Germany
| | - Dorothee Heinemeier
- Communication Lab Erfurt, Bahnhofstraße. 16/Büßleber Gasse, 99084, Erfurt, Germany
| | - Lena Ansmann
- Department of Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, Ammerlaender Heerstrasse 140, 29123, Oldenburg, Germany
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), Chair of Medical Sociology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Eupener Str. 129, 50933, Cologne, Germany
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Wu S, Yang S, Li R, Ba X, Jiang C, Xiong D, Xiao L, Sun W. HSV-1 infection-induced herpetic neuralgia involves a CCL5/CCR5-mediated inflammation mechanism. J Med Virol 2023; 95:e28718. [PMID: 37185840 DOI: 10.1002/jmv.28718] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/07/2023] [Accepted: 03/30/2023] [Indexed: 05/17/2023]
Abstract
Herpetic-related neuralgia (HN) caused by varicella-zoster virus (VZV) infection is one of the most typical and common neuropathic pain in the clinic. However, the potential mechanisms and therapeutic approaches for the prevention and treatment of HN are still unclear. This study aims to provide a comprehensive understanding of the molecular mechanisms and potential therapeutic targets of HN. We used an HSV-1 infection-induced HN mouse model and screened the differentially expressed genes (DEGs) in the DRG and spinal cord using an RNAseq technique. Moreover, bioinformatics methods were used to figure out the signaling pathways and expression regulation patterns of the DEGs enriched. In addition, quantitative real-time RT-PCR and western blot were carried out to further confirm the expression of DEGs. HSV-1 inoculation in mice resulted in mechanical allodynia, thermal hyperalgesia, and cold allodynia, following the infection of HSV-1 in both DRG and spinal cord. Besides, HSV-1 inoculation induced an up-regulation of ATF3, CGRP, and GAL in DRG and activation of astrocytes and microglia in the spinal cord. Moreover, 639 genes were upregulated, 249 genes were downregulated in DRG, whereas 534 genes were upregulated and 12 genes were downregulated in the spinal cord of mice 7 days after HSV-1 inoculation. GO and KEGG enrichment analysis suggested that immune responses and cytokine-cytokine receptor interaction are involved in DRG and spinal cord neurons in mice after HSV-1 infection. In addition, CCL5 and its receptor CCR5 were significantly upregulated in DRG and spinal cord upon HSV-1 infection in mice. And blockade of CCR5 exhibited a significant analgesic effect and suppressed the upregulation of inflammatory cytokines in DRG and spinal cord induced by HSV-1 infection in mice. HSV-1 infection-induced allodynia and hyperalgesia in mice through dysregulation of immune response and cytokine-cytokine receptor interaction mechanism. Blockade of CCR5 alleviated allodynia and hyperalgesia probably through the suppression of inflammatory cytokines. Therefore, CCR5 could be a therapeutic target for the alleviation of HSV-1 infection-induced HN.
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Affiliation(s)
- Songbin Wu
- Shenzhen Municipal Key Laboratory for Pain Medicine, Department of Pain Medicine, National Key Clinic of Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
| | - Shaomin Yang
- Shenzhen Municipal Key Laboratory for Pain Medicine, Department of Pain Medicine, National Key Clinic of Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
| | - Rongzhen Li
- Shenzhen Municipal Key Laboratory for Pain Medicine, Department of Pain Medicine, National Key Clinic of Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
| | - Xiyuan Ba
- Shenzhen Municipal Key Laboratory for Pain Medicine, Department of Pain Medicine, National Key Clinic of Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
| | - Changyu Jiang
- Shenzhen Municipal Key Laboratory for Pain Medicine, Department of Pain Medicine, National Key Clinic of Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
| | - Donglin Xiong
- Shenzhen Municipal Key Laboratory for Pain Medicine, Department of Pain Medicine, National Key Clinic of Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
| | - Lizu Xiao
- Shenzhen Municipal Key Laboratory for Pain Medicine, Department of Pain Medicine, National Key Clinic of Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
| | - Wuping Sun
- Shenzhen Municipal Key Laboratory for Pain Medicine, Department of Pain Medicine, National Key Clinic of Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
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Abreu C, Martins A, Silva F, Canelas G, Ribeiro L, Pinto S, Sarmento A, Magro F. Adherence to Vaccines in Adult Patients with Immune-Mediated Inflammatory Diseases: A Two-Year Prospective Portuguese Cohort Study. Vaccines (Basel) 2023; 11:vaccines11030703. [PMID: 36992287 PMCID: PMC10056318 DOI: 10.3390/vaccines11030703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Background: Patients with immune-mediated inflammatory diseases (IMIDs) treated with immunomodulatory therapy present an increased susceptibility to infections. Vaccination is a crucial element in the management of IMID patients; however, rates remain suboptimal. This study intended to clarify the adherence to prescribed vaccines. Materials and methods: This prospective cohort study included 262 consecutive adults with inflammatory bowel disease and rheumatological diseases who underwent an infectious diseases evaluation before initiating or switching immunosuppressive/biological therapy. Vaccine prescription and adherence were assessed during an infectious diseases (ID) consultation using a real-world multidisciplinary clinical project. Results: At baseline, less than 5% had all their vaccines up-to-date. More than 650 vaccines were prescribed to 250 (95.4%) patients. The most prescribed were pneumococcal and influenza vaccines, followed by hepatitis A and B vaccines. Adherence to each of the vaccines ranged from 69.1–87.3%. Complete adherence to vaccines occurred in 151 (60.4%) patients, while 190 (76%) got at least two-thirds of them. Twenty patients (8%) did not adhere to any of the vaccines. No significant differences were found in the adherence rates of patients with different sociodemographic and health-related determinants. Conclusions: ID physicians can play a role in the process of increasing vaccine prescription and adherence. However, more data on patients’ beliefs and vaccine hesitancy, along with mobilization of all health care professionals and adequate local interventions, shall be considered to improve vaccine adherence.
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Affiliation(s)
- Candida Abreu
- Department of Infectious Diseases, São João Hospital Center, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Department of Medicine, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Instituto de Inovação e Investigação em Saúde (I3S), Rua Alfredo Allen 208, 4200-135 Porto, Portugal
- Instituto Nacional de Engenharia Biomédica (INEB), Rua do Campo Alegre 823, 4150-177 Porto, Portugal
- Correspondence:
| | - Antonio Martins
- Department of Infectious Diseases, São João Hospital Center, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Department of Medicine, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Fernando Silva
- Department of Infectious Diseases, São João Hospital Center, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Department of Medicine, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Gabriela Canelas
- Department of Infectious Diseases, São João Hospital Center, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Department of Medicine, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Lucia Ribeiro
- Department of Infectious Diseases, São João Hospital Center, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Department of Medicine, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Stefano Pinto
- Department of Infectious Diseases, São João Hospital Center, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Department of Medicine, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Antonio Sarmento
- Department of Infectious Diseases, São João Hospital Center, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Department of Medicine, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Instituto de Inovação e Investigação em Saúde (I3S), Rua Alfredo Allen 208, 4200-135 Porto, Portugal
- Instituto Nacional de Engenharia Biomédica (INEB), Rua do Campo Alegre 823, 4150-177 Porto, Portugal
| | - Fernando Magro
- Unit of Pharmacology and Therapeutics, Department of Biomedicine, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Department of Gastroenterology, São João Hospital Center, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Clinical Pharmacology Unit, São João Hospital Center, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
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Felzer JR, Finney Rutten LJ, Wi CI, LeMahieu AM, Beam E, Juhn YJ, Jacobson RM, Kennedy CC. Disparities in vaccination rates in solid organ transplant patients. Transpl Infect Dis 2023; 25:e14010. [PMID: 36715676 PMCID: PMC10085850 DOI: 10.1111/tid.14010] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 10/23/2022] [Accepted: 11/06/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Vaccinations against preventable respiratory infections such as Streptococcus pneumoniae and influenza are important in immunosuppressed solid organ transplant (SOT) recipients. Little is known about the role of age, race, ethnicity, sex, and sociodemographic factors including rurality, or socioeconomic status (SES) associated with vaccine uptake in this population. METHODS We conducted a population-based study using the Rochester Epidemiology Project, a medical records linkage system, to assess socioeconomic and demographic factors associated with influenza and pneumococcal vaccination rates among adult recipients of solid organ transplantation (aged 19-64 years) living in four counties in southeastern Minnesota. Vaccination data were obtained from the Minnesota Immunization Information Connection from June 1, 2010 to June 30, 2020. Vaccination rate was assessed with Poisson and logistic regression models. RESULTS A total of 468 SOT recipients were identified with an overall vaccination rate of 57%-63% for influenza and 56% for pneumococcal vaccines. As expected, vaccination for pneumococcal vaccine positively correlated with influenza vaccination. Rural patients had decreased vaccination in both compared to urban patients, even after adjusting for age, sex, race, ethnicity, and SES. Although the population was mostly White and non-Hispanic, neither vaccination differed by race or ethnicity, but influenza vaccination did by SES. Among organ transplant groups, liver and lung recipients were least vaccinated for influenza, and heart recipients were least up-to-date on pneumococcal vaccines. CONCLUSIONS Rates of vaccination were below national goals. Rurality was associated with undervaccination. Further investigation is needed to understand and address barriers to vaccination among transplant recipients.
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Affiliation(s)
- Jamie R Felzer
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Lila J Finney Rutten
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Chung-Il Wi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Allison M LeMahieu
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Elena Beam
- Division of Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Young J Juhn
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Robert M Jacobson
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.,Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Cassie C Kennedy
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.,William J von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota, USA.,Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota, USA
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Clinical Efficacy of Pulsed Radiofrequency Combined with Intravenous Lidocaine Infusion in the Treatment of Subacute Herpes Zoster Neuralgia. Pain Res Manag 2022; 2022:5299753. [PMID: 35450055 PMCID: PMC9017550 DOI: 10.1155/2022/5299753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/04/2022] [Accepted: 03/08/2022] [Indexed: 11/28/2022]
Abstract
Objective Under the guidance of a digital subtraction angiography (DSA) machine, via fluoroscopic imaging techniques, patients diagnosed with herpes zoster neuralgia at the subacute stage, where self-reported pain lasts between 30 and 90 days, were treated with nerve pulsed radiofrequency surgery combined with intravenous lidocaine infusion or saline infusion as control. This study explores the clinical efficacy, safety, and clinical value of the combined treatment compared with nerve pulsed radiofrequency surgery alone. Methods In this study, 72 patients diagnosed with herpes zoster neuralgia at the subacute stage were randomly divided into two groups with matched gender, age, and clinical symptoms. Both groups received pulsed radiofrequency surgery for the affected nerve segments under DSA fluoroscopy. Five days after the operation, 0.9% saline was administered daily for five consecutive days (50 ml per day, intravenous infusion) to group A (n = 36), and lidocaine was administered daily for five consecutive days (3 mg per kg per day, intravenous infusion) to group B (n = 36). Patients with poor pain control during the treatment were given 10 mg morphine tablets for pain relief to reach visual analog scale (VAS) ≤4 points. Data of the following categories were collected: VAS score, self-rating anxiety scale (SAS) score, depression self-rating scale (SDS) score, Pittsburgh sleep quality score (PSQI), 45 body area rating scale score, skin temperature measurement using infrared thermography, analgesic drug use before and after treatment at six different time points: before surgery (T0), one day after surgery (T1), three days after surgery (T2), five days after surgery (T3), one month after surgery (T4), and two months after surgery (T5). Blood was collected from all patients in the morning before surgery and right after the last intravenous infusion of lidocaine at T3. Serum inflammatory indexes including white blood cell count, lymphocyte count, neutrophils count, erythrocyte sedimentation rate count, C-reactive protein (CRP) level, calcitonin gene-related peptide (CGRP) level, and interleukin-6(IL-6) level were determined. Lastly, the incidence of complications and adverse reactions throughout the study was recorded. Results In total, 64 out of 72 patients completed the whole study. Two patients met the exclusion criteria in group A, one patient refused to participate, and one was lost to follow-up. Two patients met the exclusion criteria in group B, and two were lost to follow-up. Three patients in group B experienced vomiting during lidocaine treatment. The adverse symptom was relieved after symptomatic treatment. No patients in the two groups had severe complications such as hematoma at the puncture site, pneumothorax, and nerve injury. Compared with before treatment, the mean of VAS score, SAS score, SDS score, PSQI score, and skin temperature of both groups at each time point after interventional surgery were all significantly reduced. Furthermore, at each time point after surgery, the above indicators of group B patients were significantly lower than those of group A patients. After treatment, the consumption of analgesics in both groups was significantly lower than before treatment. Compared with group A, the consumption of analgesics was also significantly lower in group B. In addition, serum inflammatory indexes at the T3 time point of the two groups of patients were lower than T0. Among them, the erythrocyte sedimentation rate, CRP level, CGRP level, and interleukin-6 level of group B were significantly lower than those of group A. The incidence of postherpetic neuralgia (PHN) in group B patients (6.25%) was also lower than that in group A patients (25%). Conclusion DSA-guided nerve pulse radiofrequency surgery combined with intravenous lidocaine infusion can effectively relieve pain in patients diagnosed with herpes zoster nerves at the subacute stage, reduce the number of analgesic drugs used in patients, reduce postherpetic neuralgia incidence rate, and improve sleep and quality of life.
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Redondo Margüello E, Trilla A, Munguira ILB, Jaramillo López-Herce A, Cotarelo Suárez M. Knowledge, attitudes, beliefs and barriers of healthcare professionals and adults ≥ 65 years about vaccine-preventable diseases in Spain: the ADult Vaccination drIverS and barriErs (ADVISE) study. Hum Vaccin Immunother 2022; 18:2025007. [PMID: 35172691 PMCID: PMC8993072 DOI: 10.1080/21645515.2021.2025007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Since 2018, Spanish National Immunization Guidelines include vaccination recommendations for adults ≥65 years. To determine whether health-care professionals and the ≥65 years target group value the need for these recommendations, a cross-sectional study was conducted to capture and describe their knowledge, attitudes, beliefs and behaviors about vaccination. Online surveys were administered to representative groups of general practitioners (GPs), primary care nurses and adults ≥65 years from six major cities (and surrounding rural areas) in Spain. Main topics were attitudes and awareness of vaccines, perceptions about vaccination in adults ≥65 years, and impact of the COVID-19 pandemic on vaccination uptake. A total of 286 health-care professionals (185 GPs, 101 nurses) and 400 adults aged ≥65 years participated in the survey. GP and nurse groups agreed strongly about the importance of influenza and pneumococcal vaccination in the target population. Longer patient visit times were identified as a key factor toward promoting vaccination. The ≥65 years sample group, especially those ≥75+ years and/or with chronic diseases, was reasonably positive about the effectiveness and benefits of vaccines. Lower vaccination rates for the pneumococcal than influenza vaccine (29% vs. 80%) in the ≥65 years sample group suggest that efforts are needed to improve pneumococcal vaccine uptake. Aligning with other published works, GPs have a key role in promoting vaccination in the target population. The COVID-19 pandemic appears to have heightened awareness about the importance of vaccination among health-care professionals and adults ≥65 years.
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Affiliation(s)
| | - Antoni Trilla
- Servicio de Medicina Preventiva del Hospital Clinic de Barcelona, Barcelona, Spain
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10
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Clinical Characteristics, Treatment Effectiveness, and Predictors of Response to Pharmacotherapeutic Interventions Among Patients with Herpetic-Related Neuralgia: A Retrospective Analysis. Pain Ther 2021; 10:1511-1522. [PMID: 34510386 PMCID: PMC8586103 DOI: 10.1007/s40122-021-00303-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/05/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The treatment for herpetic-related neuralgia focuses on symptom control by use of antiviral drugs, anticonvulsants, and tricyclic antidepressants. We aimed to explore the clinical characteristics associated with medication responsiveness, and to build a classifier for identification of patients who have risk of inadequate pain management. METHODS We recruited herpetic-related neuralgia patients during a 3-year period. Patients were stratified into a medication-resistant pain (MRP) group when the pain decrease in the visual analogue scale (VAS) is < 3 points, and otherwise a medication-sensitive pain (MSP) group. Multivariate logistic regression was performed to determine the factors associated with MRP. We fitted four machine learning (ML) models, namely logistic regression, random forest, supporting vector machines (SVM), and naïve Bayes with clinical characteristics gathered at admission to identify patients with MRP. RESULTS A total of 213 patients were recruited, and 132 (61.97%) patients were diagnosed with MRP. Subacute herpes zoster (HZ) (vs. acute, OR 8.95, 95% CI 3.15-29.48, p = 0.0001), severe lesion (vs. mild lesion, OR 3.84, 95% CI 1.44-10.81, p = 0.0084), depressed mood (unit increase OR 1.10, 95% CI 1.00-1.20, p = 0.0447), and hypertension (hypertension, vs. no hypertension, OR 0.36, 95% CI 0.14-0.87, p = 0.0266) were significantly associated with MRP. Among four ML models, SVM had the highest accuracy (0.917) and receiver operating characteristic-area under the curve (0.918) to discriminate MRP from MSP. Phase of disease is the most important feature when fitting ML models. CONCLUSIONS Clinical characteristics collected before treatment could be adopted to identify patients with MRP.
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11
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Eisenhauer L, Hansen BR, Pandian V. HPV immunization among young adults (HIYA!) in family practice: A quality improvement project. J Adv Nurs 2021; 78:1366-1376. [PMID: 34806202 DOI: 10.1111/jan.15090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/09/2021] [Accepted: 10/16/2021] [Indexed: 11/26/2022]
Abstract
AIMS Thousands of anogenital and oropharyngeal cancers every year might be prevented through increased receipt of vaccination against the human papillomavirus (HPV). This project aimed to (1) increase the rate of HPV vaccination status assessment, and (2) improve HPV vaccine initiation and completion rates among 18 to 26-year-old patients in the family practice setting. DESIGN Quality improvement project, pre/post intervention design. METHODS This project implemented the HIYA! (HPV Immunization among Young Adults) Intervention in a private sports and family practice in central New Jersey. HIYA! implemented 10 pre-, during, and post-visit outcome measures during every family medicine visit with an 18 to 26-year-old patient for HPV. Data collection involved retrospective chart review of every eligible patient during the 12-week implementation period from 17 August to 06 November 2020 and during the same 12-week control period in 2019. RESULTS/FINDINGS One hundred sixteen charts from 2019 and 129 charts from 2020 were reviewed for assessment of HPV vaccination status and HPV vaccine initiation and/or completion. Multivariable logistic regression analysis demonstrated that participants in the control group were 84% less likely to be assessed for HPV vaccination status and were 91% less likely to initiate and complete HPV vaccination compared with the intervention group. CONCLUSION This QI project found HIYA! to be an effective and feasible strategy to improve HPV vaccination rates among 18 to 26-year-old patients in a family practice setting. IMPACT The human papillomavirus (HPV) is the most common sexually transmitted disease in the United States, and causes thousands of cancers annually. Although vaccination against HPV can prevent these cancers, vaccination rates remain low, particularly among young adults ages 18 to 26 years. The positive impact of HIYA! was evident based on its success despite the unique challenges presented during the implementation period due to the COVID-19 pandemic.
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Affiliation(s)
- Lauren Eisenhauer
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Bryan R Hansen
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Vinciya Pandian
- Johns Hopkins University School of Nursing, Outcomes After Critical Illness and Surgery (OACIS), Pulmonary Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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12
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Harpaz R. The Effectiveness of Recombinant Zoster Vaccine: Observations in the Wild. Clin Infect Dis 2021; 73:957-960. [PMID: 33580235 DOI: 10.1093/cid/ciab130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Rafael Harpaz
- Harpaz Herman Consultants, LLC, US Public Health Service (USPHS), Atlanta, Georgia, USA
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13
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Ellingson MK, Oliveira CR, Sheth SS, Sullivan EL, Torres A, Shapiro ED, Niccolai LM. Patterns of recommended vaccine receipt among women ages 24-45 years: a cross-sectional analysis. BMC Public Health 2021; 21:1283. [PMID: 34193100 PMCID: PMC8247221 DOI: 10.1186/s12889-021-11340-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 06/14/2021] [Indexed: 11/10/2022] Open
Abstract
Background Vaccine receipt among mid-adults remains low, with only one quarter of adults being up to date for all recommended vaccines. It is important to understand the myriad factors that influence vaccine receipt among mid-adult women to address these low rates. Methods We conducted a cross-sectional analysis of data from women ages 24–45 years collected as part of an ongoing case-control study of the effectiveness of HPV vaccine. We examined associations between demographic characteristics and healthcare utilization and receipt of individual vaccines and combinations of multiple vaccines using logistic regression analyses for three routinely recommended vaccines: tetanus, influenza and HPV. Results Among the 309 women enrolled in the study, only 19 (6.2%) were up to date for all three recommended vaccines and 41 (13.3%) had not received any of the recommended vaccines. A greater number of health care visits in the past year was associated with receipt of influenza (aOR = 6.37, 95% CI = 2.53, 16.1) and tetanus (aOR = 2.17, 95% CI = 1.14, 4.12) vaccines. White women were more likely to have received HPV vaccine (aOR = 2.39, 95% CI = 1.07, 5.36). Conclusions Uptake of recommended vaccines is low among young and mid-adult women. There is a need for greater understanding of the underlying factors influencing vaccine receipt in this population.
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Affiliation(s)
- Mallory K Ellingson
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Carlos R Oliveira
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | - Sangini S Sheth
- Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
| | - Erin L Sullivan
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Ashlynn Torres
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Eugene D Shapiro
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.,Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | - Linda M Niccolai
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
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14
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Patterson BJ, Buck PO, Curran D, Van Oorschot D, Carrico J, Herring WL, Zhang Y, Stoddard JJ. Estimated Public Health Impact of the Recombinant Zoster Vaccine. Mayo Clin Proc Innov Qual Outcomes 2021; 5:596-604. [PMID: 34195552 PMCID: PMC8240325 DOI: 10.1016/j.mayocpiqo.2021.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
Abstract
OBJECTIVE To investigate the potential public health impact of adult herpes zoster (HZ) vaccination with the adjuvanted recombinant zoster vaccine (RZV) in the United States in the first 15 years after launch. METHODS We used a publicly available model accounting for national population characteristics and HZ epidemiological data, vaccine characteristics from clinical studies, and anticipated vaccine coverage with RZV after launch in 2018. Two scenarios were modeled: a scenario with RZV implemented with 65% coverage after 15 years and a scenario continuing with zoster vaccine live (ZVL) with coverage increasing 10% over the same period. We estimated the numbers vaccinated, and the clinical outcomes and health care use avoided yearly, from January 1, 2018, to December 31, 2032. We varied RZV coverage and investigated the associated impact on HZ cases, complications, and health care resource use. RESULTS With RZV adoption, the numbers of individuals affected by HZ was predicted to progressively decline with an additional 4.6 million cumulative cases avoided if 65% vaccination with RZV was reached within 15 years. In the year 2032, it was predicted that an additional 1.3 million physicians' visits and 14.4 thousand hospitalizations could be avoided, compared with continuing with ZVL alone. These numbers could be reached 2 to 5 years earlier with 15% higher RZV vaccination rates. CONCLUSION Substantial personal and health care burden can be alleviated when vaccination with RZV is adopted. The predicted numbers of HZ cases, complications, physicians' visits, and hospitalizations avoided, compared with continued ZVL vaccination, depends upon the RZV vaccination coverage achieved.
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Affiliation(s)
| | - Philip O. Buck
- GSK, US Health Outcomes & Epidemiology, Philadelphia, PA
| | | | | | - Justin Carrico
- RTI Health Solutions, Health Economics, Research Triangle, NC
| | | | - Yuanhui Zhang
- RTI Health Solutions, Health Economics, Research Triangle, NC
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15
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de Oliveira Costa J, Gianacas C, Beard F, Gonzalez-Chica D, Chidwick K, Osman R, MacIntyre CR, Havard A. Cumulative annual coverage of meningococcal B vaccination in Australian general practice for three at-risk groups, 2014 to 2019. Hum Vaccin Immunother 2021; 17:3692-3701. [PMID: 34047673 DOI: 10.1080/21645515.2021.1923349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Neisseria meningitidis serogroup B (MenB) is the most common cause of meningococcal disease in adolescents and young adults. In Australia, MenB vaccination has been available through private prescription since 2014 and has been recommended for at-risk groups including adolescents, young adults who smoke and people medically at risk. For each of these at-risk groups, we estimated cumulative annual coverage of MenB vaccination between 2014 and 2019. We also evaluated factors associated with vaccination coverage in 2019. Our analyses used electronic health records in the national MedicineInsight database for people regularly attending general practices. Cumulative vaccination coverage increased among the at-risk groups between 2014 and 2019: from 0.09% to 1.65% for adolescents, from 0.01% to 0.15% for young adults who smoke, and from 0.35% to 12.09% for people medically at risk. However, vaccination coverage in 2019 remained very low across these groups. Data sparsity prevented the evaluation of factors associated with vaccination coverage for smokers. We observed variation in the relative risk of being vaccinated by age, sex, socioeconomic and clinical factors for adolescents and people medically at risk. Still, the absolute magnitude of coverage was low across all subgroups examined, and indicates a need for strategies to increase vaccination uptake among at-risk groups irrespective of patient and practice characteristics. Our study provides baseline data for monitoring menB vaccination uptake among recommended groups in light of limited national data, especially for medically at-risk groups.
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Affiliation(s)
- Juliana de Oliveira Costa
- NPS MedicineWise, Sydney, Australia.,Medicines Policy Research Unit, Centre for Big Data Research in Health, UNSW Sydney, Sydney, Australia
| | | | - Frank Beard
- National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Sydney, Australia.,School of Public Health, University of Sydney, Sydney, Australia
| | - David Gonzalez-Chica
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | | | | | - C Raina MacIntyre
- Biosecurity Program, The Kirby Institute, UNSW Sydney, Sydney, Australia
| | - Alys Havard
- NPS MedicineWise, Sydney, Australia.,Medicines Policy Research Unit, Centre for Big Data Research in Health, UNSW Sydney, Sydney, Australia
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16
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Gatwood J, Renfro C, Hagemann T, Chiu CY, Kapan S, Frederick K, Hohmeier KC. Facilitating pneumococcal vaccination among high-risk adults: Impact of an assertive communication training program for community pharmacists. J Am Pharm Assoc (2003) 2021; 61:572-580.e1. [PMID: 33935021 DOI: 10.1016/j.japh.2021.04.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/19/2021] [Accepted: 04/10/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Community pharmacies are vital access points to provide a range of vaccines to adults, including pneumococcal vaccines; however, despite a growth in the number of vaccines given at these sites, the most recent rates of adults being immunized against pneumococcal disease remain below the goals set by Health People 2020. Low patient awareness is a leading reason for suboptimal vaccination rates, suggesting that a need exists to improve provider communication in recommending pneumococcal vaccination in high-risk adults. OBJECTIVES To evaluate the impact of a communication training program to improve pharmacist promotion of the pneumococcal vaccine among high-risk adults in Tennessee. METHODS A multiphase training program was initiated in partnership with 2 regions of a nationwide community pharmacy chain (n = 100) focusing on improving evidence-based, presumptive recommendations related to pneumococcal vaccination. All locations were randomized to one of 3 arms on the basis of training intensity: (1) no training; (2) online training only; and (3) online and in-person simulation training. The program focused on improving evidence-based, pharmacist vaccine recommendations using health behavior theories, sales techniques, and improvisation provided through online and in-person simulation training. Changes in vaccinations (compared with the same 6-month period in the previous year) and provider self-efficacy were evaluated by Mann-Whitney U tests, chi-square tests, and general linear models. RESULTS Completing the full training program led to nominal changes in pharmacist self-efficacy across the 6 items measured (P > 0.05). Overall counts of all pneumococcal vaccines were lower (-11.3%) across all stores in the period after training; however, a small increase (2.1%) was observed in the stores that underwent the full training, versus changes of -22.0% (P = 0.084) and -9.4% (P = 0.199) in control and online-only training comparisons, respectively. CONCLUSIONS Pharmacists' vaccine-related self-efficacy may be improved through an evidence-based communication training program, but a more holistic focus on all recommended adult vaccines may be necessary to realize meaningful improvements.
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17
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Sun W, Gao H, Luo Y, Zheng H, Liao X, Xiong D, Xiao L. Management of Immunity Alteration-Induced Chronic Pain During the Coronavirus Disease-2019 (COVID-19) Pandemic. Front Microbiol 2020; 11:572318. [PMID: 33072033 PMCID: PMC7541845 DOI: 10.3389/fmicb.2020.572318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/03/2020] [Indexed: 12/15/2022] Open
Affiliation(s)
- Wuping Sun
- Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, Shenzhen Nanshan People's Hospital and the 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China.,National Key Clinical Pain Medicine of China, Shenzhen, China
| | - Hong Gao
- Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, Shenzhen Nanshan People's Hospital and the 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China.,National Key Clinical Pain Medicine of China, Shenzhen, China
| | - Yuhui Luo
- Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, Shenzhen Nanshan People's Hospital and the 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China.,National Key Clinical Pain Medicine of China, Shenzhen, China
| | - Hushan Zheng
- Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, Shenzhen Nanshan People's Hospital and the 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China.,National Key Clinical Pain Medicine of China, Shenzhen, China
| | - Xiang Liao
- Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, Shenzhen Nanshan People's Hospital and the 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China.,National Key Clinical Pain Medicine of China, Shenzhen, China
| | - Donglin Xiong
- Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, Shenzhen Nanshan People's Hospital and the 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China.,National Key Clinical Pain Medicine of China, Shenzhen, China
| | - Lizu Xiao
- Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, Shenzhen Nanshan People's Hospital and the 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China.,National Key Clinical Pain Medicine of China, Shenzhen, China
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