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Banas JA, Bessarabova E, Penkauskas MC, Talbert N. Inoculating Against Anti-Vaccination Conspiracies. HEALTH COMMUNICATION 2024; 39:1760-1768. [PMID: 37489099 DOI: 10.1080/10410236.2023.2235733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
This study examined the efficacy of inoculation treatments in preventing anti-vaccination propaganda. Study predictions were tested in an independent-group experiment (N = 165), wherein participants were randomly assigned to a fact-based inoculation or a logic-based inoculation or a control message, with an excerpt from an anti-vaccination conspiracy film, Vaxxed, used as a counterattitudinal attack message. The results indicated that both inoculation treatments (fact-based and logic-based) were effective at instilling resistance to counter-persuasion, as compared to the control condition, and both types of inoculation messages were equal in their potential to facilitate resistance. In addition, we tested whether inoculating participants against an anti-vaccination conspiracy would help prevent the endorsement of other conspiracy theories. The data revealed that inoculating against one type of a conspiracy did not foster protection against other types of conspiratorial ideas, and, similar to previous research, endorsing one type of a conspiracy theory was positively associated with the endorsement of other conspiracies. These and other results are discussed along with their implications, limitations, and future research directions.
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Affiliation(s)
- John A Banas
- Department of Communication, University of Oklahoma
| | | | | | - Neil Talbert
- Department of Communication, University of Oklahoma
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2
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Thongseiratch T, Khantee P, Jaroenmark N, Nuttapasit N, Thonglua N. "Anees Has Measles": Storytelling and Singing to Enhance MMR Vaccination in Child Care Centers Amid Religious Hesitancy. Vaccines (Basel) 2024; 12:819. [PMID: 39066456 PMCID: PMC11281558 DOI: 10.3390/vaccines12070819] [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: 04/30/2024] [Revised: 07/05/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
This study explores the enhancement of MMR vaccination rates in the deep south of Thailand through a culturally tailored intervention that incorporates storytelling and singing, aligning with local cultural and religious values. The "Anees has Measles" intervention, developed with input from community stakeholders including health workers, religious leaders, and parents, featured traditional melodies in its singing activities. The intervention comprised two main components: storytelling sessions and singing activities, both utilizing culturally resonant content and formats to effectively engage the community. Conducted from December 2019 to March 2020 across eight districts in five provinces, the study targeted children aged 18 months to 5 years in government child care centers. Results indicated a substantial increase in MMR vaccination coverage from 44.3% to 72.0% twelve months post-intervention, and further to 77.0% at 48 months post-intervention, representing a significant and sustained improvement (p < 0.001). This marked and continuous increase demonstrates the effectiveness of culturally adapted health education in areas with significant vaccine hesitancy. The findings highlight the importance of integrating culturally and religiously sensitive methods into public health strategies, significantly enhancing vaccine acceptance and coverage in diverse and conservative settings. This approach suggests a broader applicability for similar interventions in comparable contexts globally.
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Affiliation(s)
- Therdpong Thongseiratch
- Child Development Unit, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand; (N.J.); (N.N.); (N.T.)
| | - Puttichart Khantee
- Infectious Disease Unit, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
| | - Naphat Jaroenmark
- Child Development Unit, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand; (N.J.); (N.N.); (N.T.)
| | - Napatsaree Nuttapasit
- Child Development Unit, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand; (N.J.); (N.N.); (N.T.)
| | - Nithida Thonglua
- Child Development Unit, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand; (N.J.); (N.N.); (N.T.)
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Jiter N, Dykstra A, Loper O, Kuramoto S, Schultz J. Tri-State Evaluation of the Effects of the COVID-19 Pandemic on Routine Vaccine Uptake in Iowa, Minnesota, and North Dakota, 2017-2021. J Community Health 2024:10.1007/s10900-024-01355-4. [PMID: 38581625 DOI: 10.1007/s10900-024-01355-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2024] [Indexed: 04/08/2024]
Abstract
The objective of this analysis was to evaluate and compare the effects of the COVID-19 pandemic on routine and annual influenza vaccination in Iowa, Minnesota, and North Dakota. Routine and annual influenza vaccination uptake and coverage between 2017 and 2021 was collected from each state's immunization information system (IIS) by age group and stratified by provider and vaccine type. Data from 2017 to 2019 were averaged to obtain a pre-pandemic baseline and compared to 2020 and 2021 data. Percent changes were calculated to evaluate differences in uptake and coverage. Changes in coverage and administration varied by state, but each state had some level of decreased administration across the different age groups and vaccine types. The most consistent decreases in vaccine administration occurred in the 15-year-old cohort with each state finding decreased administrations in 2020 and 2021. The 12-year-old age group had decreased administration of hepatitis B, measles, mumps, and rubella, and varicella vaccine while the 2-year-old age group had the most consistent decrease in coverage across all vaccines analyzed. Trends by provider type were also noted in all three states, with local public health (LPH) experiencing the largest and most consistent declines in vaccine administrations by age group. Adult influenza coverage improved to varying degrees in 2020 (+ 14.1% IA, + 2.1% MN, + 1.5% ND), but either decreased or approached the 2017-19 average in 2021. All three states saw some level of decreased vaccine administration across the age groups, vaccines, and provider types assessed. The COVID-19 pandemic affected how many children and adults received recommended immunizations, leaving communities vulnerable to vaccine-preventable diseases.
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Affiliation(s)
- Naomi Jiter
- Minnesota Department of Health, 625 Robert St N, PO Box 64975, St. Paul, MN, 55164, USA
| | - Allison Dykstra
- North Dakota Department of Health and Human Services, Public Health Division, 600 E Boulevard Ave, Bismarck, ND, 58505, USA
| | - Ona Loper
- Iowa Department of Health and Human Services, Public Health Division, 321 E 12th St, Des Moines, IA, 50319, USA.
| | - Sydney Kuramoto
- Minnesota Department of Health, 625 Robert St N, PO Box 64975, St. Paul, MN, 55164, USA
| | - Jessica Schultz
- Iowa Department of Health and Human Services, Public Health Division, 321 E 12th St, Des Moines, IA, 50319, USA
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Rocha HAL, Solha EZM, Furtado V, Justino FL, Barreto LAL, da Silva RG, de Oliveira ÍM, Bates DW, de Góes Cavalcanti LP, Lima Neto AS, de Oliveira EA. COVID-19 outbreaks surveillance through text mining applied to electronic health records. BMC Infect Dis 2024; 24:359. [PMID: 38549109 PMCID: PMC10976796 DOI: 10.1186/s12879-024-09250-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/24/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has caused significant disruptions to everyday life and has had social, political, and financial consequences that will persist for years. Several initiatives with intensive use of technology were quickly developed in this scenario. However, technologies that enhance epidemiological surveillance in contexts with low testing capacity and healthcare resources are scarce. Therefore, this study aims to address this gap by developing a data science model that uses routinely generated healthcare encounter records to detect possible new outbreaks early in real-time. METHODS We defined an epidemiological indicator that is a proxy for suspected cases of COVID-19 using the health records of Emergency Care Unit (ECU) patients and text mining techniques. The open-field dataset comprises 2,760,862 medical records from nine ECUs, where each record has information about the patient's age, reported symptoms, and the time and date of admission. We also used a dataset where 1,026,804 cases of COVID-19 were officially confirmed. The records range from January 2020 to May 2022. Sample cross-correlation between two finite stochastic time series was used to evaluate the models. RESULTS For patients with age 18 years, we find time-lag () = 72 days and cross-correlation () ~ 0.82, = 25 days and ~ 0.93, and = 17 days and ~ 0.88 for the first, second, and third waves, respectively. CONCLUSIONS In conclusion, the developed model can aid in the early detection of signs of possible new COVID-19 outbreaks, weeks before traditional surveillance systems, thereby anticipating in initiating preventive and control actions in public health with a higher likelihood of success.
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Affiliation(s)
- Hermano Alexandre Lima Rocha
- Department of Community Health, Federal University of Ceará, Street Papi Júnior, 1223, 5th. Floor, Fortaleza, CE, Brazil.
| | - Erik Zarko Macêdo Solha
- Postgraduate Program in Applied Informatics, University of Fortaleza, Fortaleza, CE, 60811-905, Brazil
| | - Vasco Furtado
- Postgraduate Program in Applied Informatics, University of Fortaleza, Fortaleza, CE, 60811-905, Brazil
| | - Francion Linhares Justino
- Postgraduate Program in Applied Informatics, University of Fortaleza, Fortaleza, CE, 60811-905, Brazil
| | - Lucas Arêa Leão Barreto
- Department of Community Health, Federal University of Ceará, Street Papi Júnior, 1223, 5th. Floor, Fortaleza, CE, Brazil
| | - Ronaldo Guedes da Silva
- Department of Community Health, Federal University of Ceará, Street Papi Júnior, 1223, 5th. Floor, Fortaleza, CE, Brazil
| | | | | | - Luciano Pamplona de Góes Cavalcanti
- Department of Community Health, Federal University of Ceará, Street Papi Júnior, 1223, 5th. Floor, Fortaleza, CE, Brazil
- School of Public Health of Ceará, Fortaleza, CE, Brazil
- Faculty of Medicine, Christus University Center, Fortaleza, CE, Brazil
| | - Antônio Silva Lima Neto
- Postgraduate Program in Applied Informatics, University of Fortaleza, Fortaleza, CE, 60811-905, Brazil
- Health Secretariat, Ceará State Government, Fortaleza, CE, Brazil
| | - Erneson Alves de Oliveira
- Postgraduate Program in Applied Informatics, University of Fortaleza, Fortaleza, CE, 60811-905, Brazil
- Laboratory of Data Science and Artificial Intelligence, University of Fortaleza, Fortaleza, Ceará, 60811-905, Brazil
- Professional Masters in City Science, University of Fortaleza, Fortaleza, Ceará, 60811-905, Brazil
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Conceição PB, San Pedro A, Praça HLF, dos Santos YT, Reis LNM, Gibson G. [Stratification of risk areas for measles transmission: a systematic reviewEstratificación de las zonas de riesgo de transmisión del sarampión: revisión sistemática]. Rev Panam Salud Publica 2024; 48:e1. [PMID: 38226153 PMCID: PMC10787521 DOI: 10.26633/rpsp.2024.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/17/2023] [Indexed: 01/17/2024] Open
Abstract
Objective To perform a systematic review of scientific publications addressing the use of stratification methods to define risk areas for measles transmission. Method Articles published in English, Portuguese, and Spanish in journals indexed in the SciELO, PubMed, and LILACS databases were selected. The search terms risk assessment AND measles were used without date limits. Editorials, opinion articles, individual-level observational studies, and publications that did not focus on the application of methods to stratify measles transmission risk areas were excluded. Year of publication, authorship, country where the study was performed, objective, geographic level of analysis, method used, indicators, and limitations were recorded in a data form. Results Thirteen articles published between 2011 and 2022 in nine countries from the six World Health Organization (WHO) regions were selected. Of these, 10 referred to the Measles Risk Assessment Tool developed by the WHO/Centers for Disease Control and Prevention. Only one study adapted the tool to the local context. The risk stratification indicators used in the selected studies focused on a combination of the following dimensions: population immunity, quality of surveillance systems, and epidemiologic status. The systematic output of data with adequate quality and coverage was a noteworthy aspect hindering risk stratification. Conclusion There seems to be limited dissemination of measles risk stratification strategies, especially at local levels. The need to train human resources to process and interpret risk analyses as part of the routine of surveillance services is emphasized.
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Affiliation(s)
- Paula Barbosa Conceição
- Universidade Federal do Rio de Janeiro (UFRJ)Instituto de Estudos em Saúde ColetivaRio de Janeiro (RJ)BrasilUniversidade Federal do Rio de Janeiro (UFRJ), Instituto de Estudos em Saúde Coletiva, Rio de Janeiro (RJ), Brasil.
| | - Alexandre San Pedro
- Universidade Federal do Rio de Janeiro (UFRJ)Instituto de Estudos em Saúde ColetivaRio de Janeiro (RJ)BrasilUniversidade Federal do Rio de Janeiro (UFRJ), Instituto de Estudos em Saúde Coletiva, Rio de Janeiro (RJ), Brasil.
| | - Heitor Levy Ferreira Praça
- Universidade Federal do Rio de Janeiro (UFRJ)Instituto de Estudos em Saúde ColetivaRio de Janeiro (RJ)BrasilUniversidade Federal do Rio de Janeiro (UFRJ), Instituto de Estudos em Saúde Coletiva, Rio de Janeiro (RJ), Brasil.
| | - Yasmin Toledo dos Santos
- Universidade Federal do Rio de Janeiro (UFRJ)Instituto de Estudos em Saúde ColetivaRio de Janeiro (RJ)BrasilUniversidade Federal do Rio de Janeiro (UFRJ), Instituto de Estudos em Saúde Coletiva, Rio de Janeiro (RJ), Brasil.
| | - Larissa Nunes Moreira Reis
- Universidade Federal do Rio de Janeiro (UFRJ)Instituto de Estudos em Saúde ColetivaRio de Janeiro (RJ)BrasilUniversidade Federal do Rio de Janeiro (UFRJ), Instituto de Estudos em Saúde Coletiva, Rio de Janeiro (RJ), Brasil.
| | - Gerusa Gibson
- Universidade Federal do Rio de Janeiro (UFRJ)Instituto de Estudos em Saúde ColetivaRio de Janeiro (RJ)BrasilUniversidade Federal do Rio de Janeiro (UFRJ), Instituto de Estudos em Saúde Coletiva, Rio de Janeiro (RJ), Brasil.
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Steffen R, Chen LH, Leggat PA. Travel vaccines-priorities determined by incidence and impact. J Travel Med 2023; 30:taad085. [PMID: 37341307 DOI: 10.1093/jtm/taad085] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Infectious disease epidemiology is continuously shifting. While travel has been disrupted by the COVID-19 pandemic and travel-related epidemiological research experienced a pause, further shifts in vaccine-preventable diseases (VPDs) relevant for travellers have occurred. METHODS We conducted a literature search on the epidemiology of travel-related VPD and synthesized data for each disease with a focus on symptomatic cases and on the impact of the respective infection among travellers, considering the hospitalization rate, disease sequela and case fatality rate. We present new data and revised best estimates on the burden of VPD relevant for decisions on priorities in travel vaccines. RESULTS COVID-19 has emerged to be a top travel-related risk and influenza remains high in the ranking with an estimated incidence at 1% per month of travel. Dengue is another commonly encountered infection among international travellers with estimated monthly incidence of 0.5-0.8% among non-immune exposed travellers; the hospitalized proportion was 10 and 22%, respectively, according to two recent publications. With recent yellow fever outbreaks particularly in Brazil, its estimated monthly incidence has risen to >0.1%. Meanwhile, improvements in hygiene and sanitation have led to some decrease in foodborne illnesses; however, hepatitis A monthly incidence remains substantial in most developing regions (0.001-0.01%) and typhoid remains particularly high in South Asia (>0.01%). Mpox, a newly emerged disease that demonstrated worldwide spread through mass gathering and travel, cannot be quantified regarding its travel-related risk. CONCLUSION The data summarized may provide a tool for travel health professionals to prioritize preventive strategies for their clients against VPD. Updated assessments on incidence and impact are ever more important since new vaccines with travel indications (e.g. dengue) have been licensed or are undergoing regulatory review.
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Affiliation(s)
- Robert Steffen
- Epidemiology, Biostatistics and Prevention Institute, Department of Public and Global Health, Division of Infectious Diseases, World Health Organization Collaborating Centre for Travelers' Health, University of Zurich, Zurich 8001, Switzerland
- Division of Epidemiology, Human Genetics & Environmental Sciences, University of Texas School of Public Health, Houston, TX 77030, USA
| | - Lin H Chen
- Division of Infectious Diseases and Travel Medicine, Mount Auburn Hospital, Cambridge, MA 02138, USA
- Faculty of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Peter A Leggat
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland 4810, Australia
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
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Kim CL, Agampodi S, Marks F, Kim JH, Excler JL. Mitigating the effects of climate change on human health with vaccines and vaccinations. Front Public Health 2023; 11:1252910. [PMID: 37900033 PMCID: PMC10602790 DOI: 10.3389/fpubh.2023.1252910] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/04/2023] [Indexed: 10/31/2023] Open
Abstract
Climate change represents an unprecedented threat to humanity and will be the ultimate challenge of the 21st century. As a public health consequence, the World Health Organization estimates an additional 250,000 deaths annually by 2030, with resource-poor countries being predominantly affected. Although climate change's direct and indirect consequences on human health are manifold and far from fully explored, a growing body of evidence demonstrates its potential to exacerbate the frequency and spread of transmissible infectious diseases. Effective, high-impact mitigation measures are critical in combating this global crisis. While vaccines and vaccination are among the most cost-effective public health interventions, they have yet to be established as a major strategy in climate change-related health effect mitigation. In this narrative review, we synthesize the available evidence on the effect of climate change on vaccine-preventable diseases. This review examines the direct effect of climate change on water-related diseases such as cholera and other enteropathogens, helminthic infections and leptospirosis. It also explores the effects of rising temperatures on vector-borne diseases like dengue, chikungunya, and malaria, as well as the impact of temperature and humidity on airborne diseases like influenza and respiratory syncytial virus infection. Recent advances in global vaccine development facilitate the use of vaccines and vaccination as a mitigation strategy in the agenda against climate change consequences. A focused evaluation of vaccine research and development, funding, and distribution related to climate change is required.
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Affiliation(s)
- Cara Lynn Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - Suneth Agampodi
- International Vaccine Institute, Seoul, Republic of Korea
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Florian Marks
- International Vaccine Institute, Seoul, Republic of Korea
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
- Madagascar Institute for Vaccine Research, University of Antananarivo, Antananarivo, Madagascar
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Jerome H. Kim
- International Vaccine Institute, Seoul, Republic of Korea
- College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
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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.
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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
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Lapidus M. Free Consumer Web Resources on Immunization and Vaccination. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2023. [DOI: 10.1080/15398285.2023.2167455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Affiliation(s)
- Mariana Lapidus
- Henrietta DeBenedictis Library, Massachusetts College of Pharmacy and Health Sciences, Boston, Massachusetts, USA
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10
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Morgans HA, Schuster JE, Warady BA. Pediatric Vaccine Hesitancy and COVID-19. Am J Kidney Dis 2023; 81:13-14. [PMID: 36334987 PMCID: PMC9630134 DOI: 10.1053/j.ajkd.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 07/23/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Heather A. Morgans
- Division of Nephrology, Children’s Mercy Kansas City, Kansas City, Missouri,Department of Pediatrics, University of Missouri–Kansas City School of Medicine, Kansas City, Missouri
| | - Jennifer E. Schuster
- Division of Infectious Diseases, Children’s Mercy Kansas City, Kansas City, Missouri,Department of Pediatrics, University of Missouri–Kansas City School of Medicine, Kansas City, Missouri
| | - Bradley A. Warady
- Division of Nephrology, Children’s Mercy Kansas City, Kansas City, Missouri,Department of Pediatrics, University of Missouri–Kansas City School of Medicine, Kansas City, Missouri,Address for Correspondence: Bradley A. Warady, MD, Division of Nephrology, Children’s Mercy Kansas City, 2401 Gillham Rd, Kansas City, MO 64108
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11
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Xia S, Gullickson CC, Metcalf CJE, Grenfell BT, Mina MJ. Assessing the Effects of Measles Virus Infections on Childhood Infectious Disease Mortality in Brazil. J Infect Dis 2022; 227:133-140. [PMID: 35767276 PMCID: PMC10205611 DOI: 10.1093/infdis/jiac233] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/29/2022] [Accepted: 06/26/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Measles virus infection induces acute immunosuppression for weeks following infection, and also impairs preexisting immunological memory, resulting in "immune amnesia" that can last for years. Both mechanisms predispose the host to severe outcomes of subsequent infections. Therefore, measles dynamics could potentially affect the epidemiology of other infectious diseases. METHODS To examine this hypothesis, we analyzed the annual mortality rates of children aged 1-9 years in Brazil from 1980 to 1995. We calculated the correlation between nonmeasles infectious disease mortality rates and measles mortality rates using linear and negative-binomial models, with 3 methods to control the confounding effects of time. We also estimated the duration of measles-induced immunomodulation. RESULTS The mortality rates of nonmeasles infectious diseases and measles virus infection were highly correlated. This positive correlation remained significant after removing the time trends. We found no evidence of long-term measles immunomodulation beyond 1 year. CONCLUSIONS These results support that measles virus infection could increase the mortality of other infectious diseases. The short lag identified for measles effects (<1 year) implies that acute immunosuppression was potentially driving this effect in Brazil. Overall, our study indicates disproportionate contributions of measles to childhood infectious disease mortality, highlighting the importance of measles vaccination.
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Affiliation(s)
- Siyang Xia
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Cricket C Gullickson
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, USA
| | - C Jessica E Metcalf
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, USA
- Princeton School of Public and International Affairs, Princeton University, Princeton, New Jersey, USA
| | - Bryan T Grenfell
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, USA
- Princeton School of Public and International Affairs, Princeton University, Princeton, New Jersey, USA
| | - Michael J Mina
- Department of Pathology at Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Turaiche M, Grigoras ML, Bratosin F, Bogdan I, Bota AV, Cerbu B, Gurban CV, Wulandari PH, Gurumurthy S, Hemaswini K, Citu C, Marincu I. Disease Progression, Clinical Features, and Risk Factors for Pneumonia in Unvaccinated Children and Adolescents with Measles: A Re-Emerging Disease in Romania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13165. [PMID: 36293745 PMCID: PMC9603068 DOI: 10.3390/ijerph192013165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/09/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Measles causes in vaccinated children, with some exceptions, a mild disease, while the unvaccinated can suffer complications that result in serious consequences and even death. Although the introduction of the measles vaccine has reduced the number of cases and the viral spread, the current downward vaccination trend has resulted in the resurgence of the disease. Currently, Romania has a measles vaccination coverage below the 95% safety threshold. Thus, an outbreak started in 2016 and still ongoing in Romania, many cases being identified in the Western region in the pediatric population. Our objective was to conduct a thorough examination of clinical characteristics, evolution, and risk factors in vaccinated and unvaccinated children in this region. To reach our objectives we used a retrospective cohort analysis. The authors reviewed clinical and laboratory data from patients hospitalized at "Victor Babes" Hospital for Infectious Diseases and Pulmonology in Timisoara. We found a total of 136 qualifying cases of measles among the children admitted to this facility. The two comparison groups consisted of 104 children under 10 years and 32 patients between 10 and 18 years. An important characteristic of both study groups was the high prevalence of patients from the Roma ethnicity, which, although represents a minority in Romania, the prevalence was over 40% in the current study. The infection source was in 40.4% of children under 10 years inside the family, while 71.9% of infections in the group of adolescents were isolated (p-value = 0.047). The multivariate risk factor analysis identified as independent risk factors for the development of pneumonia the older age of patients (OR = 1.62), poor nutritional status (OR = 1.25), Roma ethnicity (OR = 2.44), presence of anemia (OR = 1.58), and procalcitonin (OR = 3.09). It is essential to handle these risk factors in a patient with measles, especially in conjunction with an unknown vaccination status. To achieve a vaccination rate greater than 95 percent for Romanian children, measles vaccination awareness must be promoted, moreover in the Roma population. More comprehensive preventative methods must be developed promptly with the objective of eradicating measles in Romania via a vigorous vaccination campaign.
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Affiliation(s)
- Mirela Turaiche
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Mirela Loredana Grigoras
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Anatomy and Embryology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Felix Bratosin
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Iulia Bogdan
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Adrian Vasile Bota
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Bianca Cerbu
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Camelia Vidita Gurban
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Biochemistry, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | | | | | - Kakarla Hemaswini
- Malla Reddy Institute of Medical Sciences, Suraram Main Road 138, Hyderabad 500055, India
| | - Cosmin Citu
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Iosif Marincu
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
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13
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Talbird SE, Carrico J, La EM, Carias C, Marshall GS, Roberts CS, Chen YT, Nyaku MK. Impact of Routine Childhood Immunization in Reducing Vaccine-Preventable Diseases in the United States. Pediatrics 2022; 150:188495. [PMID: 35821599 DOI: 10.1542/peds.2021-056013] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/01/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Current routine immunizations for children aged ≤10 years in the United States in 2019 cover 14 vaccine-preventable diseases. We characterize the public-health impact of vaccination by providing updated estimates of disease incidence with and without universally recommended pediatric vaccines. METHODS Prevaccine disease incidence was obtained from published data or calculated using annual case estimates from the prevaccine period and United States population estimates during the same period. Vaccine-era incidence was calculated as the average incidence over the most recent 5 years of available surveillance data or obtained from published estimates (if surveillance data were not available). We adjusted for underreporting and calculated the percent reduction in overall and age-specific incidence for each disease. We multiplied prevaccine and vaccine-era incidence rates by 2019 United States population estimates to calculate annual number of cases averted by vaccination. RESULTS Routine immunization reduced the incidence of all targeted diseases, leading to reductions in incidence ranging from 17% (influenza) to 100% (diphtheria, Haemophilus influenzae type b, measles, mumps, polio, and rubella). For the 2019 United States population of 328 million people, these reductions equate to >24 million cases of vaccine-preventable disease averted. Vaccine-era disease incidence estimates remained highest for influenza (13 412 per 100 000) and Streptococcus pneumoniae-related acute otitis media (2756 per 100 000). CONCLUSIONS Routine childhood immunization in the United States continues to yield considerable sustained reductions in incidence across all targeted diseases. Efforts to maintain and improve vaccination coverage are necessary to continue experiencing low incidence levels of vaccine-preventable diseases.
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Affiliation(s)
| | - Justin Carrico
- RTI Health Solutions, Research Triangle Park, North Carolina
| | - Elizabeth M La
- RTI Health Solutions, Research Triangle Park, North Carolina
| | | | - Gary S Marshall
- Norton Children's and University of Louisville School of Medicine, Louisville, Kentucky
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14
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A model-based opinion dynamics approach to tackle vaccine hesitancy. Sci Rep 2022; 12:11835. [PMID: 35821508 PMCID: PMC9276809 DOI: 10.1038/s41598-022-15082-0] [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: 07/14/2021] [Accepted: 06/17/2022] [Indexed: 01/07/2023] Open
Abstract
Uncovering the mechanisms underlying the diffusion of vaccine hesitancy is crucial in fighting epidemic spreading. Toward this ambitious goal, we treat vaccine hesitancy as an opinion, whose diffusion in a social group can be shaped over time by the influence of personal beliefs, social pressure, and other exogenous actions, such as pro-vaccine campaigns. We propose a simple mathematical model that, calibrated on survey data, can predict the modification of the pre-existing individual willingness to be vaccinated and estimate the fraction of a population that is expected to adhere to an immunization program. This work paves the way for enabling tools from network control towards the simulation of different intervention plans and the design of more effective targeted pro-vaccine campaigns. Compared to traditional mass media alternatives, these model-based campaigns can exploit the structural properties of social networks to provide a potentially pivotal advantage in epidemic mitigation.
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15
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Makarenko C, San Pedro A, Paiva NS, Santos JPCD, Medronho RDA, Gibson G. Measles resurgence in Brazil: analysis of the 2019 epidemic in the state of São Paulo. Rev Saude Publica 2022; 56:50. [PMID: 35703604 PMCID: PMC9239333 DOI: 10.11606/s1518-8787.2022056003805] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/08/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To analyze the epidemiological profile of cases and the pattern of spatial diffusion of the largest measles epidemic in Brazil that occurred in the post-elimination period in the state of São Paulo. METHOD A cross-sectional study based on confirmed measles cases in 2019. Bivariate analysis was performed for socioeconomic, clinical, and epidemiological variables, according to prior vaccination and hospitalization, combined with an analysis of spatial diffusion of cases using the Inverse Distance Weighting (IDW) method. RESULTS Of the 15,598 confirmed cases, 2,039 were hospitalized and 17 progressed to death. The epidemic peak occurred in epidemiological week 33, after confirmation of the first case, in the epidemiological week 6. Most cases were male (52.1%), aged between 18 and 29 years (38.7%), identified as whites (70%). Young adults (39.7%) and children under five years (32.8%) were the most affected age groups. A higher proportion of previous vaccination was observed in whites as compared to Blacks, browns, yellows and indigenous people (p < 0.001), as well as in the most educated group compared to the other categories (p < 0.001). The risk of hospitalization was higher in children than in the older age group (RI = 2.19; 95%CI: 1.66-2.88), as well as in the unvaccinated than in the vaccinated (RI = 1.59; 95%CI: 1.45-1.75). The pattern of diffusion by contiguity combined with diffusion by relocation followed the urban hierarchy of the main cities' regions of influence. CONCLUSION In addition to routine vaccination in children, the findings indicate the need for immunization campaigns for young adults. In addition, studies that seek to investigate the occurrence of clusters of vulnerable populations, prone to lower vaccination coverage, are essential to broaden the understanding of the dynamics of transmission and, thus, reorienting control strategies that ensure disease elimination.
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Affiliation(s)
- Cristina Makarenko
- Universidade Federal do Rio de Janeiro. Instituto de Estudos em Saúde Coletiva. Rio de Janeiro, RJ, Brasil
| | - Alexandre San Pedro
- Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Centro de Estudos, Políticas e Informação sobre Determinantes Sociais da Saúde. Rio de Janeiro, RJ, Brasil
| | - Natalia Santana Paiva
- Universidade Federal do Rio de Janeiro. Instituto de Estudos em Saúde Coletiva. Rio de Janeiro, RJ, Brasil
| | | | | | - Gerusa Gibson
- Universidade Federal do Rio de Janeiro. Instituto de Estudos em Saúde Coletiva. Rio de Janeiro, RJ, Brasil
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16
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A Case Report of Secondary Syphilis Co-Infected with Measles: A Diagnostic Dilemma with Fever and Rash. Trop Med Infect Dis 2022; 7:tropicalmed7050070. [PMID: 35622697 PMCID: PMC9144679 DOI: 10.3390/tropicalmed7050070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/04/2022] [Accepted: 05/07/2022] [Indexed: 11/26/2022] Open
Abstract
Fever and rash as manifestations of infection by microorganisms are collectively known as febrile exanthem. Since viruses are more frequently associated with fever and rash, these symptoms are thus impetuously termed viral exanthem. However, bacteria represent a frequently overlooked infectious etiology causing rash in humans. In addition, certain microbes may exhibit pathognomonic features that erupt during illness and facilitate clinical diagnosis. Conversely, coinfections often obscure the clinical characteristics of the primary disease and further challenge clinicians attempting to reach a diagnosis. We retrospectively looked at de-identified clinical data of a patient who presented to the Hospital for Tropical Diseases in Bangkok in July 2019 with complaints of fever and rash. The case involved a 35-year-old who presented with a 3-day history of fever, respiratory symptoms, myalgia, conjunctivitis, diarrhea, and a generalized maculopapular rash. On examination, the patient was febrile, tachycardic, and tachypneic, with a mean arterial pressure of 95 mmHg. A differential white blood cell count showed: leukocytes, 5800/µL; neutrophils, 4408/µL; lymphocytes, 406/µL; and platelets, 155,000/µL. Striking findings involving the integumentary system included Koplik’s spots and generalized maculopapular rash. Further serology revealed positive immunoglobulin (Ig)M and IgG for both measles and rubella virus, including reactive serology for Treponema pallidum. Here we describe the clinical course and management of this patient.
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17
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Robert A, Kucharski AJ, Funk S. The impact of local vaccine coverage and recent incidence on measles transmission in France between 2009 and 2018. BMC Med 2022; 20:77. [PMID: 35264161 PMCID: PMC8907007 DOI: 10.1186/s12916-022-02277-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/25/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Subnational heterogeneity in immunity to measles can create pockets of susceptibility and result in long-lasting outbreaks despite high levels of national vaccine coverage. The elimination status defined by the World Health Organization aims to identify countries where the virus is no longer circulating and can be verified after 36 months of interrupted transmission. However, since 2018, numerous countries have lost their elimination status soon after reaching it, showing that the indicators defining elimination may not be associated with lower risks of outbreaks. METHODS We quantified the impact of local vaccine coverage and recent levels of incidence on the dynamics of measles in each French department between 2009 and 2018, using mathematical models based on the "Endemic-Epidemic" regression framework. After fitting the models using daily case counts, we simulated the effect of variations in the vaccine coverage and recent incidence on future transmission. RESULTS High values of local vaccine coverage were associated with fewer imported cases and lower risks of local transmissions, but regions that had recently reported high levels of incidence were also at a lower risk of local transmission. This may be due to additional immunity accumulated during recent outbreaks. Therefore, the risk of local transmission was not lower in areas fulfilling the elimination criteria. A decrease of 3% in the 3-year average vaccine uptake led to a fivefold increase in the average annual number of cases in simulated outbreaks. CONCLUSIONS Local vaccine uptake was a reliable indicator of the intensity of transmission in France, even if it only describes yearly coverage in a given age group, and ignores population movements. Therefore, spatiotemporal variations in vaccine coverage, caused by disruptions in routine immunisation programmes, or lower trust in vaccines, can lead to large increases in both local and cross-regional transmission. The incidence indicator used to define the elimination status was not associated with a lower number of local transmissions in France, and may not illustrate the risks of imminent outbreaks. More detailed models of local immunity levels or subnational seroprevalence studies may yield better estimates of local risk of measles outbreaks.
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Affiliation(s)
- Alexis Robert
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK. .,Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK.
| | - Adam J Kucharski
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK.,Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK
| | - Sebastian Funk
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK.,Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK
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18
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Majumder MS, Rose S. A generalizable data assembly algorithm for infectious disease outbreaks. JAMIA Open 2021; 4:ooab058. [PMID: 34350393 PMCID: PMC8327373 DOI: 10.1093/jamiaopen/ooab058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/23/2021] [Accepted: 07/12/2021] [Indexed: 11/13/2022] Open
Abstract
During infectious disease outbreaks, health agencies often share text-based information about cases and deaths. This information is rarely machine-readable, thus creating challenges for outbreak researchers. Here, we introduce a generalizable data assembly algorithm that automatically curates text-based, outbreak-related information and demonstrate its performance across 3 outbreaks. After developing an algorithm with regular expressions, we automatically curated data from health agencies via 3 information sources: formal reports, email newsletters, and Twitter. A validation data set was also curated manually for each outbreak, and an implementation process was presented for application to future outbreaks. When compared against the validation data sets, the overall cumulative missingness and misidentification of the algorithmically curated data were ≤2% and ≤1%, respectively, for all 3 outbreaks. Within the context of outbreak research, our work successfully addresses the need for generalizable tools that can transform text-based information into machine-readable data across varied information sources and infectious diseases.
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Affiliation(s)
- Maimuna S Majumder
- Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Sherri Rose
- Center for Health Policy and Center for Primary Care and Outcomes Research, Stanford University, Stanford, California, USA
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19
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Woodfield MC, Pergam SA, Shah PD. Cocooning against COVID-19: The argument for vaccinating caregivers of patients with cancer. Cancer 2021; 127:2861-2863. [PMID: 33891713 PMCID: PMC8251451 DOI: 10.1002/cncr.33598] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 12/22/2022]
Abstract
Current national COVID‐19 vaccination guidelines and recommendations focus vaccine guidance on patients with cancer. In this COVID‐19 vaccination race, “cocoon vaccination” strategies, which include informal caregivers and household contacts as priority groups for SARS‐CoV‐2 vaccination, could be an additional strategy used to protect patients with cancer who may have limited immune responses to current vaccinations. Medical systems specializing in cancer care should support education and vaccination campaigns which target informal caregivers and household contacts in addition to cancer patients.
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Affiliation(s)
| | - Steven A Pergam
- University of Washington School of Medicine, Seattle, Washington.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.,Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Parth D Shah
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
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