1
|
Charania NA, Tonumaipe'a D, Barbarich-Unasa TW, Iusitini L, Davis G, Pacheco G, Wilson D. Exploring the impact of the COVID-19 pandemic on perceptions of national scheduled childhood vaccines among Māori and Pacific caregivers, whānau, and healthcare professionals in Aotearoa New Zealand. Hum Vaccin Immunother 2024; 20:2301626. [PMID: 38205779 DOI: 10.1080/21645515.2023.2301626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024] Open
Abstract
In Aotearoa New Zealand, there has been a marked decrease in the uptake of routine childhood vaccinations since the onset of the COVID-19 pandemic, particularly among Māori and Pacific children. This Māori and Pacific-centered research used an interpretive description methodology. We undertook culturally informed interviews and discussions with Māori and Pacific caregivers (n = 24) and healthcare professionals (n = 13) to understand their perceptions of routine childhood vaccines. Data were analyzed using reflexive thematic analysis and privileged respective Māori and Pacific worldviews. Four themes were constructed. "We go with the norm" reflected how social norms, health personnel and institutions promoted (and sometimes coerced) participants' acceptance of routine vaccines before the pandemic. "Everything became difficult" explains how the pandemic added challenges to the daily struggles of whānau (extended family networks) and healthcare professionals. Participants noted how information sources influenced disease and vaccine perceptions and health behaviors. "It needed to have an ethnic-specific approach" highlighted the inappropriateness of Western-centric strategies that dominated during the initial pandemic response that did not meet the needs of Māori and Pacific communities. Participants advocated for whānau-centric vaccination efforts. "People are now finding their voice" expressed renewed agency among whānau about vaccination following the immense pressure to receive COVID-19 vaccines. The pandemic created an opportune time to support informed parental vaccine decision-making in a manner that enhances the mana (authority, control) of whānau. Māori and Pacific-led vaccination strategies should be embedded in immunization service delivery to improve uptake and immunization experiences for whānau.
Collapse
Affiliation(s)
- Nadia A Charania
- Department of Public Health, Auckland University of Technology, Auckland, New Zealand
| | - Daysha Tonumaipe'a
- New Zealand Work Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Te Wai Barbarich-Unasa
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, Auckland, New Zealand
| | - Leon Iusitini
- New Zealand Work Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Georgina Davis
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, Auckland, New Zealand
| | - Gail Pacheco
- New Zealand Work Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Denise Wilson
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, Auckland, New Zealand
| |
Collapse
|
2
|
Shah R, Hassan N, Harris S. Impact of a Vision Photoscreener in Very Young Children in an Inner-City Pediatric Clinic in Detroit. Clin Pediatr (Phila) 2024; 63:625-632. [PMID: 37568267 DOI: 10.1177/00099228231191950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
Pediatric vision screening is important because approximately 80% of visual impairments, including amblyopia, can be prevented or cured, especially if caught early. This retrospective study aims to determine whether the implementation of a machine photoscreener improves vision outcomes in 1- to 4-year-old children in an urban clinic. Before the vision screener, 91 patients were seen (control group), while 205 were seen following its implementation (study group). The number of children screened increased by 27.4% after implementing the photoscreener (57.1% study, 29.7% control, P < .001). All patients who failed the screening, 14.6% in the study period, were referred to ophthalmology (n = 30); 40% (n = 12) were evaluated, and 9 were diagnosed with a true vision abnormality. Instrument vision screening allows children as young as 1 year to be screened and allows for early intervention for potential vision-threatening pathologies in a vulnerable urban population.
Collapse
Affiliation(s)
- Riya Shah
- School of Medicine, Wayne State University, Detroit, MI, USA
| | - Nimra Hassan
- School of Medicine, Wayne State University, Detroit, MI, USA
| | - Susan Harris
- Department of Pediatrics, School of Medicine, Wayne State University, Detroit, MI, USA
- Wayne Pediatrics, Detroit, MI, USA
| |
Collapse
|
3
|
Romem S, Katusic M, Wi CI, Hentz R, Lynch BA. A retrospective cohort study analyzing the changes in early childhood development during the COVID-19 pandemic. Early Hum Dev 2024; 192:105991. [PMID: 38552329 DOI: 10.1016/j.earlhumdev.2024.105991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 05/04/2024]
Abstract
OBJECTIVE To investigate early childhood development (ECD) outcomes in different subgroups before and during the COVID-19 pandemic. STUDY DESIGN A retrospective cohort study of children 3-58 months of age whose caregivers completed a Survey of Well-being of Young Children (SWYC) as part of a well child visit (WCC). The data were divided into two phases: pre-pandemic (September 2018 - February 2020), and during pandemic (September 2020 - February 2022). The difference in the proportion of forms with Meets Expectations interpreted scores on the SWYC Developmental Milestones pre-pandemic versus during the pandemic timeframe overall and among subgroups were reported. Hypotheses were tested using logistic regression with repeated measures. RESULTS 14,550 patients were included in the sample for analysis with 52,558 SWYC form observations. There was no difference in the odds of a Meets Expectations interpreted score before and after the pandemic for the entire sample, OR 0.99 (95 % CI: 0.94-1.04). There was evidence of decreased odds of an interpreted score of Meets Expectations for the following subgroups: male, Hispanic/Latino ethnicity, ages of 24, 30 or 36 months at WCC, Medicaid insurance, 2nd HOUSES Quartile, requiring interpreter, single parent household, young maternal age, maternal substance abuse, and race identified as Native Hawaiian/Pacific Islander, American Indian/Native Alaskan or Other. CONCLUSION Decreased odds of meeting developmental milestones during the pandemic were evident in certain high risk sub-groups revealing unequal distribution of suboptimal developmental outcomes within our population during the pandemic that may be exacerbating existing inequities impacting development in children.
Collapse
Affiliation(s)
- Sahar Romem
- Division of Pediatric Hospital Medicine; Mayo Clinic, 200 First St SW, Rochester, MN, 55905, United States of America.
| | - Maja Katusic
- Division of Developmental and Behavioral Pediatrics; Mayo Clinic, 200 First St SW, Rochester, MN, 55905, United States of America.
| | - Chung-Il Wi
- Division of Community Pediatric and Adolescent Medicine; Mayo Clinic, 200 First St SW, Rochester, MN, 55905, United States of America.
| | - Roland Hentz
- Division of Clinical Trials and Biostatistics; Mayo Clinic, 200 First St SW, Rochester, MN, 55905, United States of America.
| | - Brian A Lynch
- Division of Community Pediatric and Adolescent Medicine; Mayo Clinic, 200 First St SW, Rochester, MN, 55905, United States of America.
| |
Collapse
|
4
|
Thompson ESJ, Howe E, Kenworthy LaMarca T, Natale R, Jent JF. Diverse Parents Decision-Making to Vaccinate Their Child under Five Attending Childcare Programs. J Clin Med 2024; 13:2299. [PMID: 38673572 PMCID: PMC11051460 DOI: 10.3390/jcm13082299] [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: 01/30/2024] [Revised: 02/29/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
Background: On 18 June 2022, Moderna and Pfizer-BioNTech COVID-19 vaccines were authorized under an Emergency Use Authorization by the United States Food and Drug Administration to prevent severe coronavirus disease in children six months to four years of age. Despite approval of the COVID-19 vaccinations for young children, there remain ongoing challenges reaching widespread coverage due to parental decision-making. Parental decision-making plays a pivotal, yet understudied, role governing vaccine adoption among this priority demographic. Methods: This cross-sectional analysis examined COVID-19 vaccine intentions for 320 predominately Hispanic parents of two to five-year-olds attending Miami-Dade County childcare programs in Florida USA, several months following the June 2022 emergency authorization. Parent's self-reported survey data encompassed vaccine choices and rationales, social determinants of health, and parent immigrant status. Data analyses illustrate the associations between parent decision-making and these variables. Regression modeling and tests of independence identified predicting factors for parental vaccine decision-making. Results: Only 25% of parents intended to vaccinate their young child, while 34% resisted and 41% felt unsure, despite 70% personal vaccination rates. Household income under $25,000, identifying as a migrant, or testing COVID-19-positive significantly predicted unsure decision-making. The majority of hesitant groups expressed concerns around side effects (20%), safety (2.9%), and sufficiency of vaccine knowledge (3.3%). Conclusions: In this sample, the predominance of parents were unsure and resistant rather than accepting of having their child vaccinated despite emergency approval of the pediatric vaccine. Associations and predictive factors are examined.
Collapse
Affiliation(s)
| | | | | | | | - Jason F. Jent
- Mailman Center for Child Development, Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, FL 33136, USA (T.K.L.)
| |
Collapse
|
5
|
Patil UP, Gupta A, Heringman K, Hickman C, Paudel U, Wachtel EV. Post-discharge Care Practices, Challenges, and Outcomes in Newborn Infants of Mothers With SARS-CoV-2 Infection: Insights From Public Hospitals. Cureus 2024; 16:e58734. [PMID: 38779231 PMCID: PMC11110691 DOI: 10.7759/cureus.58734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2024] [Indexed: 05/25/2024] Open
Abstract
Background The data regarding the care at home and outcomes in infants of mothers infected with SARS-CoV-2 continue to evolve. There is a paucity of studies beyond the immediate newborn period. Our research aims to improve the understanding in these areas by studying the newborn population discharged from public hospitals in several boroughs of New York City (NYC) through the first year of the COVID-19 pandemic. Objective The objective of this study is to assess parental perspective and describe post-discharge care practices, patterns of healthcare utilization, challenges in obtaining care, and outcomes in infants between six and 12 months of age born to mothers infected with SARS-CoV-2 at the time of delivery. Methods We conducted an institutional review board (IRB)-approved multi-center retrospective cohort study of infants born to SARS-CoV-2-positive mothers at five NYC public hospitals between March and December of 2020. Clinical and demographic data were collected from electronic medical records. A phone interview of the caregivers using a standard questionnaire was conducted to collect data about care at home, healthcare utilization patterns, and challenges with access to healthcare. Results Our study cohort included 216 infants born to SARS-CoV-2-positive mothers with 16 (7.4%) mothers being symptomatic at discharge. Ten infants tested positive, and two showed symptoms before discharge. Two hundred seven (95.8%) infants were discharged home to their parents, and eight (3.7%) were transferred to other facilities. One hundred thirty-eight (66%) infants had at least one visit to the emergency room (ER) for various complaints where two were found to have COVID-19 with one needing hospitalization. One hundred seventy-two (79.6%) families responded to the phone interview. Most mothers (78%) cohabitated with their infants at home, and 70.3% elected to breastfeed. However, only 56.3% of mothers reported using all the recommended infection prevention practices at home. More than half (57%) of the families reported financial hardship related to the pandemic. Although 46.2% of patients missed their in-person health maintenance visits, telemedicine was highly utilized for follow-up with most being phone visits (70.3%). The majority of the infants (95.5%) remained up-to-date with their routine immunizations. Conclusions Our results suggest that infants born to SARS-CoV-2-infected mothers showed increased utilization of medical care and telemedicine between six and 12 months of age. Mothers reported low adherence to infection prevention practices at home; however, infants rarely showed clinically significant SARS-CoV-2 infection while maintaining high breastfeeding rates after discharge.
Collapse
Affiliation(s)
- Uday P Patil
- Neonatal-Perinatal Medicine/Pediatrics, New York City (NYC) Health + Hospitals/Elmhurst and Icahn School of Medicine at Mount Sinai, New York, USA
| | - Arpit Gupta
- Neonatal-Perinatal Medicine/Pediatrics, New York City (NYC) Health + Hospitals/Metropolitan, New York, USA
| | - Kevin Heringman
- Pediatrics, New York City (NYC) Health + Hospitals/Elmhurst, New York, USA
| | - Cherbrale Hickman
- Neonatal-Perinatal Medicine/Pediatrics, New York City (NYC) Health + Hospitals/South Brooklyn Health, New York, USA
| | - Umesh Paudel
- Neonatal-Perinatal Medicine/Pediatrics, New York City (NYC) Health + Hospitals/Harlem, New York, USA
| | - Elena V Wachtel
- Neonatal-Perinatal Medicine/Pediatrics, New York City (NYC) Health + Hospitals/Bellevue and New York University (NYU) Grossman School of Medicine, New York, USA
| |
Collapse
|
6
|
Nguyen KH, Chen S, Zhao R, Vasudevan L, Beninger P, Bednarczyk RA. Vaccination patterns and up-to-date status of children 19-35 months, 2011-2021. Vaccine 2024; 42:1617-1629. [PMID: 38341291 DOI: 10.1016/j.vaccine.2024.01.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/27/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024]
Abstract
INTRODUCTION Being up-to-date with all recommended vaccines is needed to protect children from vaccine preventable diseases. Understanding vaccination patterns is needed to develop messaging and strategies to increase vaccination uptake and confidence. METHODS Data from the 2011 to 2021 National Immunization Surveys was used to assess trends and disparities in vaccination patterns, zero vaccination status, and up-to-date status of U.S. children by 19-35 months. RESULTS From 2011 to 2021, adherence to the recommended schedule using the stringent definition increased from 35.7 % to 52.2 % (p < 0.01), adherence to the alternate schedule decreased from 28.2 % to 15.1 % (p < 0.01), and proportion of children who were not up-to-date decreased from 49.0 % to 33.3 % (p < 0.01). However, the proportion of children who had zero vaccinations did not change from 2011 (0.9 %) to 2021 (0.9 %; p = 0.08). In 2021, children 19-23 months were less likely to follow the recommended schedule than children 24-29 months (49.2 % compared to 56.4 %, p < 0.01). Adherence to the recommended schedule among children 19-23 months decreased in 2021 compared to 2020 overall and for some subpopulations (e.g. those with non-Hispanic (NH) Black parents (33.2 % compared to 44.9 %, p < 0.01). Furthermore, it was lowest among children of NH Black parents living at or below the federal poverty level (31.2 %) compared to their respective NH White counterparts (43.6 %, p < 0.01). CONCLUSIONS While there were overall increases in adherence to the recommended schedule from 2011 to 2021, a sustained catch-up program is needed to prevent missed vaccinations and achieve equitable vaccination coverage for all children.
Collapse
Affiliation(s)
- Kimberly H Nguyen
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA; Department of Epidemiology, George Washington University School of Public Health, Washington, DC 20037, USA.
| | - Siyu Chen
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Ruitong Zhao
- Tufts Medical Center, Institute for Clinical Research and Health Policy Studies, Boston, MA, USA
| | - Lavanya Vasudevan
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
| | - Paul Beninger
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Robert A Bednarczyk
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA; Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA; Emory Vaccine Center, Emory University, Atlanta, GA, USA
| |
Collapse
|
7
|
Pampati S, Liddon N, Stuart EA, Waller LA, Mpofu JJ, Lopman B, Adkins SH, Guest JL, Jones J. Disparities in Unmet Health Care Needs Among US Children During the COVID-19 Pandemic. Ann Fam Med 2024; 22:130-139. [PMID: 38527826 PMCID: PMC11237210 DOI: 10.1370/afm.3079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 03/27/2024] Open
Abstract
PURPOSE The COVID-19 pandemic disrupted pediatric health care in the United States, and this disruption layered on existing barriers to health care. We sought to characterize disparities in unmet pediatric health care needs during this period. METHODS We analyzed data from Wave 1 (October through November 2020) and Wave 2 (March through May 2021) of the COVID Experiences Survey, a national longitudinal survey delivered online or via telephone to parents of children aged 5 through 12 years using a probability-based sample representative of the US household population. We examined 3 indicators of unmet pediatric health care needs as outcomes: forgone care and forgone well-child visits during fall 2020 through spring 2021, and no well-child visit in the past year as of spring 2021. Multivariate models examined relationships of child-, parent-, household-, and county-level characteristics with these indicators, adjusting for child's age, sex, and race/ethnicity. RESULTS On the basis of parent report, 16.3% of children aged 5 through 12 years had forgone care, 10.9% had forgone well-child visits, and 30.1% had no well-child visit in the past year. Adjusted analyses identified disparities in indicators of pediatric health care access by characteristics at the level of the child (eg, race/ethnicity, existing health conditions, mode of school instruction), parent (eg, childcare challenges), household (eg, income), and county (eg, urban-rural classification, availability of primary care physicians). Both child and parent experiences of racism were also associated with specific indicators of unmet health care needs. CONCLUSIONS Our findings highlight the need for continued research examining unmet health care needs and for continued efforts to optimize the clinical experience to be culturally inclusive.
Collapse
Affiliation(s)
- Sanjana Pampati
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia
- Emory University, Rollins School of Public Health, Atlanta, Georgia
| | - Nicole Liddon
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia
| | - Elizabeth A Stuart
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland
| | - Lance A Waller
- Emory University, Rollins School of Public Health, Atlanta, Georgia
| | - Jonetta J Mpofu
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia
- US Public Health Service Commissioned Corps, Rockville, Maryland
| | - Benjamin Lopman
- Emory University, Rollins School of Public Health, Atlanta, Georgia
| | - Susan Hocevar Adkins
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia
- US Public Health Service Commissioned Corps, Rockville, Maryland
| | - Jodie L Guest
- Emory University, Rollins School of Public Health, Atlanta, Georgia
| | - Jeb Jones
- Emory University, Rollins School of Public Health, Atlanta, Georgia
| |
Collapse
|
8
|
Stults CD, Liang SY, Wilcox J, Nyong’o OL. Amblyopia Care Trends Following Widespread Photoscreener Adoption. JAMA Ophthalmol 2024; 142:188-197. [PMID: 38300546 PMCID: PMC10835608 DOI: 10.1001/jamaophthalmol.2023.6434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/28/2023] [Indexed: 02/02/2024]
Abstract
Importance Amblyopia can result in permanent vision loss if not properly treated before age 7 years. In 2017, the US Preventive Services Task Force recommended that vision screening should occur at least once in all children aged 3 to 5 years to detect amblyopia. Objective To understand trends and factors associated with screening, referral, or diagnosis of amblyopia before and after photoscreening expansion across a relatively large health care system in late 2017. Design, Setting, and Participants This is a retrospective cohort study of electronic health record data from patients with a well child care visit at approximately age 3 years (ages 2.75-3.25 years) in a relatively large, multispecialty group practice in Northern California and linked census data between 2015 and 2022. Data were extracted and analyzed from October 2022 through August 2023. Exposures Patient sex, race and ethnicity, immunization records, previous well child care visits, and census-level median household income. Main Outcomes and Measures Vision screening, pediatric ophthalmology referral, or amblyopia diagnosis, compared using adjusted odds ratios (AORs). Results The study included 2015-2017 data from 23 246 patients aged 3 years with at least 1 well child care visit (11 206 [48.2%] female) compared with 2018-2022 postexpansion data from 34 281 patients (16 517 [48.2%] female). The screening rate increased from 5.7% (424 of 7505) in 2015 to 72.1% (4578 of 6354) in 2022. The referral rate increased from 17.0% (1279 of 7505) in 2015 to 23.6% (1836 of 7792) in 2018. The diagnosis rate was 2.7% (200 of 7505) in 2015, peaked at 3.4% (263 of 7792) in 2018, and decreased to 1.4% (88 of 6354) in 2022. Compared with White patients, patients who were Asian, Black, or Hispanic were less likely to be screened (Asian: AOR, 0.80; 95% CI, 0.72-0.88; Black: AOR, 0.71; 95% CI, 0.53-0.96; Hispanic: AOR, 0.88; 95% CI, 0.80-0.97). Compared with White patients, patients who were Asian or Hispanic were more likely to be referred (Asian: AOR, 1.49; 95% CI, 1.36-1.62; Hispanic: AOR, 1.32; 95% CI, 1.18-1.48) and were more likely to be diagnosed (Asian: AOR, 1.29; 95% CI, 1.07-1.56; Hispanic: AOR, 1.67; 95% CI, 1.33-2.11). Conclusions and Relevance In this study, increased availability of photoscreeners was associated with an increase in overall rates of vision screening for children aged 3 years in a relatively large health care system. Given that US rates of visual impairment are predicted to increase, additional targeted interventions would be needed to address remaining disparities in amblyopia care along patient- and clinician-level factors.
Collapse
Affiliation(s)
- Cheryl D. Stults
- Palo Alto Medical Foundation Research Institute, Center for Health Systems Research, Sutter Health, Palo Alto, California
| | - Su-Ying Liang
- Palo Alto Medical Foundation Research Institute, Center for Health Systems Research, Sutter Health, Palo Alto, California
| | - Joseph Wilcox
- Center for Health Systems Research, Sutter Health, Walnut Creek, California
| | - Omondi L. Nyong’o
- Crescendo MD, Portola Valley, California
- Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California
| |
Collapse
|
9
|
Sahli S, Størdal K. Systematic review of socioeconomic factors and COVID-19 in children and adolescents. Acta Paediatr 2024; 113:384-393. [PMID: 38193593 DOI: 10.1111/apa.17091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/10/2024]
Abstract
AIM To systematically review the evidence on Covid-19 infection risk, severity and vaccination uptake among children and adolescents by socioeconomic status. METHODS We conducted a systematic literature review, using the PubMed database. We searched for articles published from January 2020 to January 2022 using "MeSH" words and titles. The key terms were "COVID", "social status", "socioeconomic factor" and "children". We also searched secondary sources such as published reports and other databases. RESULTS The search identified 15 relevant articles and reports. This review shows that children of lower socioeconomic status have a higher risk of COVID-19 infection and a higher risk of being hospitalised. Mortality in a global setting was also higher in children with low socioeconomic status, though not observed in high-resourced countries. These children are also less likely to be vaccinated against the SARS-CoV-2 virus. CONCLUSIONS The higher risk of COVID-19 infection and hospitalisation and lower vaccination coverage in children and adolescents from lower socioeconomic backgrounds demonstrate health disparities also in young age. These disparities should inform health authorities in planning for future pandemics.
Collapse
Affiliation(s)
- Sarah Sahli
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ketil Størdal
- Department of Paediatric Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
10
|
Cox RM, Plemper RK. Design and Execution of In Vitro Polymerase Assays for Measles Virus and Related Mononegaviruses. Methods Mol Biol 2024; 2808:19-33. [PMID: 38743360 DOI: 10.1007/978-1-0716-3870-5_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Morbilliviruses such as measles virus (MeV) are responsible for major morbidity and mortality worldwide, despite the availability of an effective vaccine and global vaccination campaigns. MeV belongs to the mononegavirus order of viral pathogens that store their genetic information in non-segmented negative polarity RNA genomes. Genome replication and viral gene expression are carried out by a virus-encoded RNA-dependent RNA polymerase (RdRP) complex that has no immediate host cell analog. To better understand the organization and regulation of the viral RdRP and mechanistically characterize antiviral candidates, biochemical RdRP assays have been developed that employ purified recombinant polymerase complexes and synthetic RNA templates to monitor the initiation of RNA synthesis and RNA elongation in vitro. In this article, we will discuss strategies for the efficient expression and preparation of mononegavirus polymerase complexes, provide detailed protocols for the execution and optimization of RdRP assays, evaluate alternative options for the choice of template and detection system, and describe the application of the assay for the characterization of inhibitor candidates. Although MeV RdRP assays are the focus of this article, the general strategies and experimental approaches are readily transferable to related viruses in the mononegavirus order.
Collapse
Affiliation(s)
- Robert M Cox
- Center for Translational Antiviral Research, Institute for Biomedical Sciences, Georgia State University, Atlanta, GA, USA
| | - Richard K Plemper
- Center for Translational Antiviral Research, Institute for Biomedical Sciences, Georgia State University, Atlanta, GA, USA.
| |
Collapse
|
11
|
Finney Rutten LJ, Griffin JM, St Sauver JL, MacLaughlin K, Austin JD, Jenkins G, Herrin J, Jacobson RM. Multilevel Implementation Strategies for Adolescent Human Papillomavirus Vaccine Uptake: A Cluster Randomized Clinical Trial. JAMA Pediatr 2024; 178:29-36. [PMID: 37983062 PMCID: PMC10957109 DOI: 10.1001/jamapediatrics.2023.4932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Importance Despite availability of a safe and effective vaccine, an estimated 36 500 new cancers in the US result from human papillomavirus (HPV) annually. HPV vaccine uptake falls short of national public health goals and lags other adolescent vaccines. Objective To evaluate the individual and combined impact of 2 evidence-based interventions on HPV vaccination rates among 11- and 12-year-old children. Design, Setting, and Participants The study team conducted a cluster randomized clinical trial with a stepped-wedge factorial design at 6 primary care practices affiliated with Mayo Clinic in southeastern Minnesota. Using block randomization to ensure balance of patient volumes across interventions, each practice was allocated to a sequence of four 12-month steps with the initial baseline step followed by 2 intermediate steps (none, 1, or both interventions) and a final step wherein all practices implemented both interventions. Each month, all eligible children who turned 11 or 12 years in the 2 months prior were identified and followed until the end of the step. Data were analyzed from April 2018 through March 2019. Participants included children who turned 11 or 12 years old and were due for a dose of the HPV vaccine. Interventions Parents of eligible patients were mailed reminder/recalls following their child's birthdays. Health care professionals received confidential audit/feedback on their personal in-office success with HPV vaccine uptake via intra-campus mail. These 2 interventions were assessed separately and in combination. Main Outcomes and Measures Eligible patients' receipt of any valid dose of HPV vaccine during the study step. Results The cohort was comprised of 9242 11-year-olds (5165 [55.9%]) and 12-year-olds (4077 [44.1%]), and slightly more males (4848 [52.5%]). Parent reminder/recall resulted in 34.6% receiving a dose of HPV vaccine, health care professional audit/feedback, 30.4%, both interventions together resulted in 39.7%-all contrasted to usual care, 21.9%. Compared with usual care, the odds of HPV vaccination were higher for parent reminder/recall (odds ratio [OR], 1.56; 95% CI, 1.23-1.97) and for the combination of parent reminder/recall and health care professional audit/feedback (OR, 2.03; 95% CI, 1.44-2.85). Health care professional audit/feedback alone did not differ significantly from usual care (OR, 1.19; 95% CI, 0.94-1.51). Conclusions and Relevance In this cluster randomized trial, the combination of parent reminder/recall and health care professional audit/feedback increased the odds of HPV vaccination compared with usual care. These findings underscore the value of simultaneous implementation of evidence-based strategies to improve HPV vaccination.
Collapse
Affiliation(s)
| | - Joan M Griffin
- Division of Health Care Delivery Research and Robert D. and Patricia E. Kern Center for Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | | | | | | | - Gregory Jenkins
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Jeph Herrin
- Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut
- Flying Buttress Associates, Charlottesville, Virginia
| | - Robert M Jacobson
- Division of Epidemiology, Mayo Clinic, Rochester, Minnesota
- Division of Community Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
- Division of Pediatric Infectious Diseases, Mayo Clinic, Rochester, Minnesota
| |
Collapse
|
12
|
Sielaty R, Boutzoukas AE, Zimmerman KO, Caison B, Charles CO, CoyneSmith T, Darden T, Overman RA, Benjamin DK, Brookhart MA. Trends in Pediatric Emergency and Inpatient Healthcare Use for Mental and Behavioral Health Among North Carolinians During the Early COVID-19 Pandemic. J Pediatric Infect Dis Soc 2023; 12:S20-S27. [PMID: 38146861 PMCID: PMC10750307 DOI: 10.1093/jpids/piad092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/18/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Widespread school closures and health care avoidance during the COVID-19 pandemic led to disruptions in access to pediatric mental health care. METHODS We conducted a retrospective study of emergency and inpatient administrative claims from privately insured children aged 6-20 years in North Carolina between January 2019 and December 2020. We compared rates of emergency department (ED) visits (per 100 000 person-days) and risks of hospitalizations (per 100 000 persons) with diagnosis codes in each category (mental/behavioral health; suicidal ideation, suicide attempt, and intentional self-harm [SI/SA/ISH]; and social issues) across 3 time periods (pre-pandemic, lockdown, and reopening). We calculated the proportion and 95% confidence intervals (CI) of total ED visits and total hospitalizations attributable to mental/behavioral health and SI/SA/ISH across the 3 time periods. RESULTS Rates of all categories of ED visits decreased from pre-pandemic to the lockdown period; from pre-pandemic to the reopening period, mental/behavioral health visits decreased but rates of SI/SA/ISH visits were unchanged. The proportion of ED visits attributable to mental/behavioral health increased from 3.5% (95% CI 3.2%-3.7%) pre-pandemic to 4.0% (95% CI 3.7%-4.3%) during reopening, and the proportion of SI/SA/ISH diagnoses increased from 1.6% (95% CI 1.4%-1.8%) pre-pandemic to 2.4% (95% CI 2.1%-2.7%) during the reopening period. Emergency care use for social issues and hospital admissions for mental/behavioral health and SI/SA/ISH diagnoses were unchanged across the study periods. CONCLUSIONS In the early pandemic, pediatric mental health care and acute suicidal crises accounted for increased proportions of emergency care. During pandemic recovery, understanding the populations most impacted and increasing access to preventative mental health care is critical.
Collapse
Affiliation(s)
| | - Angelique E Boutzoukas
- Duke Clinical Research Institute, Durham, NC, USA
- Department of Pediatrics, Duke University, Durham, NC, USA
| | - Kanecia O Zimmerman
- Duke Clinical Research Institute, Durham, NC, USA
- Department of Pediatrics, Duke University, Durham, NC, USA
| | - Bria Caison
- Duke Clinical Research Institute, Durham, NC, USA
| | | | | | - Toni Darden
- Duke Clinical Research Institute, Durham, NC, USA
| | | | - Daniel K Benjamin
- Duke Clinical Research Institute, Durham, NC, USA
- Department of Pediatrics, Duke University, Durham, NC, USA
| | - M Alan Brookhart
- Department of Population Health Sciences, Duke University, Durham, NC, USA
| |
Collapse
|
13
|
Lyu W, Wehby GL. Changes in Children's Health Care Access and Utilization in the United States in the First 2 Years of the COVID-19 Pandemic. Acad Pediatr 2023; 23:1572-1578. [PMID: 37482298 DOI: 10.1016/j.acap.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/29/2023] [Accepted: 07/15/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE To compare children's access to and utilization of health care services in the United States during the first 2 years of the pandemic to prepandemic levels. METHODS This cross-sectional study used data from the 2017 to 2021 National Survey of Children's Health. Access to care was measured by having a usual place for sick and preventive care, having a personal doctor or nurse, and unmet care needs. Utilization measures included preventive, mental health, specialist, and emergency department (ED) visits, and hospital admissions in the past 12months. Outcomes were reported by parents or other caregivers. Multivariate logistic regressions were employed adjusting for sociodemographic factors and state of residence. The study sample included 163,353 children aged 0 to 17years. RESULTS Compared to 2019, there were declines in the probability of having a usual place for sick care in 2020 (-1.5 percentage-points) and a usual place for preventive care in 2021 (-2.1 percentage-points), and greater probability of unmet care needs in 2020 (+1.2 percentage-points) and 2021 (+0.8 percentage-points). The probability of having any preventive, specialist, and ED visits and hospitalizations remained lower in 2021 than 2019 (-7.5, 2.2, 5.4 and 0.9 percentage-points, respectively). These differences were not explained by prepandemic trends and were observed across a range of sociodemographic subgroups. CONCLUSIONS Children's health care access and utilization declined noticeably over the first 2years of the pandemic. Evaluating these outcomes in subsequent years and addressing barriers to care continue to be critical to reduce unmet needs.
Collapse
Affiliation(s)
- Wei Lyu
- Division of Health Systems Management and Policy (W Lyu), University of Memphis, Memphis, Tenn
| | - George L Wehby
- Department of Health Management and Policy (GL Wehby), University of Iowa, Iowa City, Iowa; Department of Economics (GL Wehby), University of Iowa, Iowa City, Iowa; Department of Preventive & Community Dentistry (GL Wehby), University of Iowa, Iowa City, Iowa; Public Policy Center (GL Wehby), University of Iowa, Iowa City, Iowa; National Bureau of Economic Research (GL Wehby), Cambridge, Mass.
| |
Collapse
|
14
|
Cunniff L, Alyanak E, Fix A, Novak M, Peterson M, Mevis K, Eiden AL, Bhatti A. The impact of the COVID-19 pandemic on vaccination uptake in the United States and strategies to recover and improve vaccination rates: A review. Hum Vaccin Immunother 2023; 19:2246502. [PMID: 37671468 PMCID: PMC10484032 DOI: 10.1080/21645515.2023.2246502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/17/2023] [Accepted: 08/06/2023] [Indexed: 09/07/2023] Open
Abstract
The COVID-19 pandemic disrupted routine healthcare delivery, causing declines in CDC-recommended vaccination rates across the life-course in the United States (US). Ensuring protection against disease outbreaks and associated morbidity and mortality depends on improving vaccine coverage rates (VCRs) and uptake. The authors conducted a targeted literature review to assess the pandemic's effects on routine vaccination rates across different populations, evaluating VCR recovery and improvement efforts. The review highlights articles published with data measuring or evaluating VCR decline across the US during the COVID-19 pandemic from January 2020 to April 2022, associated health impacts, and policy and programmatic strategies to recover routine VCRs. While vaccination rates stagnated or declined across some populations pre-pandemic, the review indicated there were further VCR declines in 2020 and 2021 compared to 2019 across numerous CDC-recommended vaccines, ages, and geographies, with some vaccines and sub-populations disproportionally impacted. The review additionally identified declines in patient healthcare visit frequency and increases in morbidity and mortality associated with vaccine-preventable disease (VPD) complications. Reviewed publications highlighted multifaceted strategies that could aid in recovering VCRs. Overall, findings demonstrate a significant reduction in VCRs across all age groups and highlight promising solutions to inform vaccine uptake efforts and ensure broader protection against VPDs.
Collapse
Affiliation(s)
- Luke Cunniff
- Global Vaccines Public Policy and Partnerships, Merck & Co., Inc., . Rahway, NJ, USA
| | | | | | | | | | - Kate Mevis
- Global Vaccines Public Policy and Partnerships, Merck & Co., Inc., . Rahway, NJ, USA
| | - Amanda L. Eiden
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Rahway, NJ, USA
| | - Alexandra Bhatti
- Global Vaccines Public Policy and Partnerships, Merck & Co., Inc., . Rahway, NJ, USA
| |
Collapse
|
15
|
Bello RS, Walsh MT, Harper B, Amos CE, Oestman K, Nutt S, Galindez M, Block K, Rechis R, Bednar EM, Tektiridis J, Foxhall L, Moreno M, Shete S, Hawk E. Creating and Activating an Implementation Community to Drive HPV Vaccine Uptake in Texas: The Role of an NCI-Designated Cancer Center. Vaccines (Basel) 2023; 11:1128. [PMID: 37376517 DOI: 10.3390/vaccines11061128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/09/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
The University of Texas MD Anderson Cancer Center, a comprehensive cancer center designated by the National Cancer Institute (NCI), defines its service population area as the State of Texas (29.1 M), the second most populous state in the country and the state with the greatest number of uninsured residents in the United States. Consistent with a novel and formal commitment to prevention as part of its core mission, alongside clear opportunities in Texas to drive vaccine uptake, MD Anderson assembled a transdisciplinary team to develop an institutional Framework to increase adolescent HPV vaccination and reduce HPV-related cancer burden. The Framework was developed and activated through a four-phase approach aligned with the NCI Cancer Center Support Grant Community Outreach and Engagement component. MD Anderson identified collaborators through data-driven outreach and constructed a portfolio of collaborative multi-sector initiatives through review processes designed to assess readiness, impact and sustainability. The result is an implementation community of 78 institutions collaboratively implementing 12 initiatives within a shared measurement framework impacting 18 counties. This paper describes a structured and rigorous process to set up the implementation of a multi-year investment in evidence-based strategies to increase HPV vaccination that solves challenges preventing implementation of recommended strategies and to encourage similar initiative replication.
Collapse
Affiliation(s)
- Rosalind S Bello
- The HPV Vaccination Initiative, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Office of Health Policy, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Michael T Walsh
- The HPV Vaccination Initiative, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Impact Evaluation Core, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Joint Center on Geospatial Analysis & Health, Houston, TX 77030, USA
| | - Blake Harper
- The HPV Vaccination Initiative, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Charles E Amos
- The HPV Vaccination Initiative, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Office of Health Policy, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Katherine Oestman
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Stephanie Nutt
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Impact Evaluation Core, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Joint Center on Geospatial Analysis & Health, Houston, TX 77030, USA
| | - Marcita Galindez
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Impact Evaluation Core, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Joint Center on Geospatial Analysis & Health, Houston, TX 77030, USA
| | - Kaitlyn Block
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ruth Rechis
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Impact Evaluation Core, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Erica M Bednar
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jennifer Tektiridis
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Lewis Foxhall
- Office of Health Policy, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Mark Moreno
- Government Relations, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Sanjay Shete
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ernest Hawk
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| |
Collapse
|
16
|
Badeh SM, Elam-Evans LD, Hill HA, Fredua B. Disrupted Routine Medical Visits in Children and Adolescents During the COVID-19 Pandemic, January-June 2021. AJPM FOCUS 2023; 2:100119. [PMID: 37362397 PMCID: PMC10247587 DOI: 10.1016/j.focus.2023.100119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Introduction Recent studies have indicated the coronavirus disease 2019 (COVID-19) pandemic has disrupted routine vaccinations. This study describes the prevalence and characteristics of children and adolescents experiencing disrupted routine vaccination and other medical visits in the United States between January and June 2021. Methods The National Immunization Surveys were the source of data for this cross-sectional analysis (n= 86,893). Parents/guardians of children aged 6 months through 17 years were identified through random digit dialing of cellular phone numbers and interviewed. Disrupted visits were assessed by asking, "In the last two months, was a medical check-up, well child visit, or vaccination appointment for the child delayed, missed, or not scheduled for any reason?" Respondents answering yes were asked "Was it because of COVID-19?" Sociodemographic characteristics of children/adolescents with (1) COVID-19-related missed visits and (2) non-COVID-19-related missed visits were examined. Statistical differences within demographic subgroups were determined using t-tests, with p<0.05 considered statistically significant. Linear regression models were used to examine trends in disrupted visits over time. Results An estimated 7.9% of children/adolescents had a missed visit attributed to COVID-19; 5.2% had a missed visit that was not COVID-19-related. Among children/adolescents with a COVID-19-related missed visit, a higher percentage were of minority race or ethnicity, lived below the poverty level, had a mother without a college degree, and lived in the western United States. There was a significant decline in COVID-19-related missed visits over time. Conclusion COVID-19 disrupted routine vaccination or other medical visits inequitably. Catch-up immunizations are essential for achieving adequate vaccination of all children/adolescents.
Collapse
Affiliation(s)
- Samira M. Badeh
- Project Imhotep, Morehouse College, Atlanta, Georgia
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Immunization Services Division, Atlanta, Georgia
| | - Laurie D. Elam-Evans
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Immunization Services Division, Atlanta, Georgia
| | - Holly A. Hill
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Immunization Services Division, Atlanta, Georgia
| | - Benjamin Fredua
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Immunization Services Division, Atlanta, Georgia
- Leidos Health, Atlanta, Georgia
| |
Collapse
|
17
|
Varela EG, Zeldman J, Bolivar I, Mobley AR. A Qualitative Study to Compare Barriers to Improving Food Security among Households with Young Children in the U.S. as Perceived by Different Types of Stakeholders before and during COVID-19. Nutrients 2023; 15:nu15061438. [PMID: 36986168 PMCID: PMC10055020 DOI: 10.3390/nu15061438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 03/19/2023] Open
Abstract
This qualitative study aimed to determine the perceived barriers of different community stakeholders’ to providing resources for improving food security in households with young children in the U.S. Community stakeholders working with low-income families with children 0–3 years of age in Florida were recruited to represent healthcare (n = 7), community/policy development (n = 6), emergency food assistance (n = 6), early childhood education (n = 7), and nutrition education (n = 6) sectors. In 2020, one-on-one interviews were conducted with each stakeholder in via Zoom, using an interview script based on the PRECEDE–PROCEED model and questions to capture the impacts of COVID-19. The interviews were audio-recorded, transcribed verbatim, and analyzed using a deductive thematic approach. A cross-tab qualitative analysis was used to compare data across categories of stakeholders. Healthcare professionals and nutrition educators indicated stigma, community/policy development stakeholders indicated a lack of time, emergency food assistance personnel indicated a limited access to food, and early childhood professionals indicated a lack of transportation as the main barriers to food security prior to COVID-19. COVID-19 impacts included the fear of virus exposure, new restrictions, lack of volunteers, and a lack of interest in virtual programming as barriers to food security. As perceived barriers may vary with respect to providing resources to improve food security in families with young children and the COVID-19 impacts persist, coordinated policy, systems, and environmental changes are needed.
Collapse
|
18
|
Katato GK, Sitaula P, Gupte A, Al-Antary ET. The Impact of COVID-19 on Pediatric Malignancy Diagnosis and Treatment: Never the Same but Lessons Learned. Vaccines (Basel) 2023; 11:vaccines11030667. [PMID: 36992251 DOI: 10.3390/vaccines11030667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 03/18/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic affected the pediatric oncology population globally. Over the course of 2 years, increasing reports have been made to better understand this entity and its pathologic complications on these patients. The pandemic has allowed healthcare providers, hospital systems, and leading oncologic societies to quickly adapt and formulate new guidelines for the effective understanding, management, and treatment of patients with pediatric malignancy.
Collapse
Affiliation(s)
- Ghadir K Katato
- Division of Hematology/Oncology, Children's Hospital of Michigan, Detroit, MI 48201, USA
- Department of Pediatrics, Central Michigan University College of Medicine, Mt Clemons, MI 48603, USA
| | - Prasiksha Sitaula
- Division of Hematology/Oncology, Children's Hospital of Michigan, Detroit, MI 48201, USA
- Department of Pediatrics, Central Michigan University College of Medicine, Mt Clemons, MI 48603, USA
| | - Avanti Gupte
- Division of Hematology/Oncology, Children's Hospital of Michigan, Detroit, MI 48201, USA
- Department of Pediatrics, Central Michigan University College of Medicine, Mt Clemons, MI 48603, USA
- Pediatric Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Barbara Ann Karmanos Cancer Center, Children's Hospital of Michigan, Detroit, MI 48201, USA
| | - Eman T Al-Antary
- Division of Hematology/Oncology, Children's Hospital of Michigan, Detroit, MI 48201, USA
- Department of Pediatrics, Central Michigan University College of Medicine, Mt Clemons, MI 48603, USA
- Pediatric Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Barbara Ann Karmanos Cancer Center, Children's Hospital of Michigan, Detroit, MI 48201, USA
| |
Collapse
|
19
|
Nguyen KH, Zhao R, Mullins C, Corlin L, Beninger P, Bednarczyk RA. Trends in vaccination schedules and up-to-date status of children 19-35 months, United States, 2015-2020. Vaccine 2023; 41:467-475. [PMID: 36481107 DOI: 10.1016/j.vaccine.2022.11.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To estimate trends in, and factors associated with, vaccination patterns and up-to-date immunization status of U.S. children by 19 to 35 months of age. METHODS Data from the 2015 to 2020 National Immunization Surveys were used to assess trends in vaccination patterns, up-to-date status, and zero vaccination status of U.S. children by 19-35 months. Vaccination patterns were categorized as: 1) recommended, 2) alternate, or 3) unknown or unclassifiable. Multivariable analyses were conducted to examine factors associated with each vaccination pattern and up-to-date status for all recommended vaccines. RESULTS From 2015 to 2020, the proportion of U.S. children completing the recommended schedule increased from 62.5% to 69.4%, alternative schedule decreased from 21.6% to 16.2%, and unknown or unclassifiable schedules decreased from 15.9% to 14.3%. In addition, being not up-to-date decreased from 39.7% to 35.6%. There was no change in the percentage of children receiving zero vaccinations from 2015 to 2020 (0.9% to 0.9%). Respondents with lower household income or who were uninsured were more likely to follow an alternate or unknown/unclassifiable schedule, or not be up-to-date with vaccines. CONCLUSION Following any schedule other than the recommended schedule was associated with not being up-to-date on immunizations. Increased efforts to catch up on recommended vaccines is important for protecting children's health. Further efforts should be made to improve timely adherence to recommended vaccination schedules, particularly among populations with the largest disparities in coverage through a tailored approach to increase confidence in and access to vaccines.
Collapse
Affiliation(s)
- Kimberly H Nguyen
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA.
| | - Ruitong Zhao
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Corey Mullins
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Laura Corlin
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA; Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, MA, USA
| | - Paul Beninger
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Robert A Bednarczyk
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA; Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA; Emory Vaccine Center, Emory University, Atlanta, GA, USA
| |
Collapse
|
20
|
Sandoval T, Bisht A, Maurice ADS. The impact of COVID-19 and masking practices on pertussis cases at a large academic medical center (2019-2021). Am J Infect Control 2022:S0196-6553(22)00811-2. [PMID: 36417951 PMCID: PMC9675934 DOI: 10.1016/j.ajic.2022.11.012] [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: 08/31/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/21/2022]
Abstract
We reviewed cases of Bordatella pertussis (B. pertussis) cases in ambulatory clinics at a large academic health care institution in Los Angeles from 2019-2021. Public health prevention measures during the Coronavirus disease 19 (COVID-19) pandemic impacted the number of pertussis cases identified.
Collapse
Affiliation(s)
- Tessa Sandoval
- Department of Clinical Epidemiology and Infection Prevention, UCLA Health, Los Angeles, CA,Address correspondence to Tessa Sandoval, Department of Clinical Epidemiology and Infection Prevention, UCLA Health, 924 Westwood Blvd. Ste. 900, Los Angeles, CA 90095
| | - Anjali Bisht
- Department of Clinical Epidemiology and Infection Prevention, UCLA Health, Los Angeles, CA
| | - Annabelle de St Maurice
- Department of Clinical Epidemiology and Infection Prevention, UCLA Health, Los Angeles, CA,Division of Pediatric Infectious Disease, David Geffen School of Medicine, UCLA, Los Angeles, CA
| |
Collapse
|
21
|
Shah MD, Szilagyi PG, Shetgiri R, Delgado JR, Vangala S, Thomas K, Dudovitz RN, Vizueta N, Darling J, Kapteyn A. Trends in Parents' Confidence in Childhood Vaccines During the COVID-19 Pandemic. Pediatrics 2022; 150:188519. [PMID: 35831931 PMCID: PMC10038210 DOI: 10.1542/peds.2022-057855] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Megha D. Shah
- Los Angeles County Department of Public Health, Office of Health Assessment and Epidemiology, Los Angeles, CA
| | - Peter G. Szilagyi
- Department of Pediatrics, UCLA Mattel Children’s Hospital, University of California at Los Angeles, Los Angeles, CA
| | - Rashmi Shetgiri
- Los Angeles County Department of Public Health, Office of Health Assessment and Epidemiology, Los Angeles, CA
| | - Jeanne R. Delgado
- National Clinician Scholars Program, Division of General Internal Medicine and Health Services Research, University of California at Los Angeles, Los Angeles, CA
| | - Sitaram Vangala
- Department of Medicine Statistics Core, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA
| | - Kyla Thomas
- Dornsife College of Letters Arts and Sciences, Center for Economic and Social Research, University of Southern California, Los Angeles, CA
| | - Rebecca N. Dudovitz
- Department of Pediatrics, UCLA Mattel Children’s Hospital, University of California at Los Angeles, Los Angeles, CA
| | - Nathalie Vizueta
- Department of Pediatrics, UCLA Mattel Children’s Hospital, University of California at Los Angeles, Los Angeles, CA
| | - Jill Darling
- Dornsife College of Letters Arts and Sciences, Center for Economic and Social Research, University of Southern California, Los Angeles, CA
| | - Arie Kapteyn
- Dornsife College of Letters Arts and Sciences, Center for Economic and Social Research, University of Southern California, Los Angeles, CA
| |
Collapse
|