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Parsons Leigh J, FitzGerald EA, Moss SJ, Cherak MS, Brundin-Mather R, Dodds A, Stelfox HT, Dubé È, Fiest KM, Halperin DM, Ahmed SB, MacDonald SE, Straus SE, Manca T, Ng Kamstra J, Soo A, Longmore S, Kupsch S, Sept B, Halperin SA. The evolution of vaccine hesitancy through the COVID-19 pandemic: A semi-structured interview study on booster and bivalent doses. Hum Vaccin Immunother 2024; 20:2316417. [PMID: 38390696 PMCID: PMC10896168 DOI: 10.1080/21645515.2024.2316417] [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: 11/27/2023] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
We sought in-depth understanding on the evolution of factors influencing COVID-19 booster dose and bivalent vaccine hesitancy in a longitudinal semi-structured interview-based qualitative study. Serial interviews were conducted between July 25th and September 1st, 2022 (Phase I: univalent booster dose availability), and between November 21st, 2022 and January 11th, 2023 (Phase II: bivalent vaccine availability). Adults (≥18 years) in Canada who had received an initial primary series and had not received a COVID-19 booster dose were eligible for Phase I, and subsequently invited to participate in Phase II. Twenty-two of twenty-three (96%) participants completed interviews for both phases (45 interviews). Nearly half of participants identified as a woman (n = 11), the median age was 37 years (interquartile range: 32-48), and most participants were employed full-time (n = 12); no participant reported needing to vaccinate (with a primary series) for their workplace. No participant reported having received a COVID-19 booster dose at the time of their interview in Phase II. Three themes relating to the development of hesitancy toward continued vaccination against COVID-19 were identified: 1) effectiveness (frequency concerns; infection despite vaccination); 2) necessity (less threatening, low urgency, alternate protective measures); and 3) information (need for data, contradiction and confusion, lack of trust, decreased motivation). The data from interviews with individuals who had not received a COVID-19 booster dose or bivalent vaccine despite having received a primary series of COVID-19 vaccines highlights actionable targets to address vaccine hesitancy and improve public health literacy.
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Affiliation(s)
- Jeanna Parsons Leigh
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
- Canadian Center for Vaccinology & IWK Health Center, Halifax, Nova Scotia, Canada
| | - Emily A FitzGerald
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Stephana Julia Moss
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
- CRISMA Center, Department of Critical Care, University of Pittsburgh, Pittsburgh, USA
| | - Michal S Cherak
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology & IWK Health Center, Halifax, Nova Scotia, Canada
| | | | - Alexandra Dodds
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Henry T Stelfox
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Ève Dubé
- Centre de Recherche du CHU de Québec, Université Laval, Québec, Canada
- Département d'anthropologie, Université Laval, Québec, Canada
| | - Kirsten M Fiest
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- Department of Psychiatry & Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Donna M Halperin
- Canadian Center for Vaccinology & IWK Health Center, Halifax, Nova Scotia, Canada
- Rankin School of Nursing, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Sofia B Ahmed
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Shannon E MacDonald
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Sharon E Straus
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Terra Manca
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
- Sociology and Social Anthropology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Josh Ng Kamstra
- Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Andrea Soo
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Health Services, Calgary, Alberta, Canada
| | - Shelly Longmore
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Shelly Kupsch
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Bonnie Sept
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Scott A Halperin
- Canadian Center for Vaccinology & IWK Health Center, Halifax, Nova Scotia, Canada
- Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Microbiology and Immunology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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Nguyen KH, Chung EL, McChesney C, Vasudevan L, Allen JD, Bednarczyk RA. Changes in general and COVID-19 vaccine hesitancy among U.S. adults from 2021 to 2022. Ann Med 2024; 56:2357230. [PMID: 38813804 PMCID: PMC11141308 DOI: 10.1080/07853890.2024.2357230] [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: 01/11/2024] [Accepted: 04/26/2024] [Indexed: 05/31/2024] Open
Abstract
INTRODUCTION Understanding changes in vaccine hesitancy, overall and by sociodemographic characteristics, may highlight sub-populations for whom more intensive efforts are needed to increase vaccine uptake and confidence. METHODS We analyzed data using the CDC's Research and Development Survey (RANDS), a nationally representative survey of U.S. adults ≥18 years, collected from 17 May 2021-30 June 2021 (n = 5,458) and 3 November 2022-12 December 2022 (n = 6,821). We assessed changes in vaccine hesitancy, changes in vaccine attitudes and attitudes, and factors associated with hesitancy toward both vaccines in general and COVID-19 vaccines among a nationally representative sample of U.S. adults. RESULTS Although COVID-19 vaccination (≥1 dose) increased from 67.2% (2021) to 74.7% (2022), COVID-19 vaccine hesitancy increased from 40.7% to 44.6% during the same period. During the same period, hesitancy toward both COVID-19 vaccines and vaccines in general increased among those who were aged ≥65 years and who were non-Hispanic White. However, COVID-19 vaccine hesitancy decreased among non-Hispanic Black adults. Current or former smokers were more hesitant toward vaccines in general (aPR = 1.13, 95%CI: 1.03-1.24) and toward COVID-19 vaccines (aPR = 1.08, 95%CI: 1.01-1.16) compared to never smokers. Among adults who did not receive any COVID-19 vaccines, COVID-19 vaccine hesitancy increased from 86.6% in 2021 to 92.4% in 2022. Furthermore, belief in the overall social benefit of the COVID-19 vaccine decreased from 47.5% to 25.1%. CONCLUSION This study highlights concerning trends in vaccine hesitancy and uptake of the COVID-19 and other recommended vaccines. We found that some high-risk groups (e.g. smokers) and population subgroups have become more vaccine hesitant, suggesting the need for improved and intensified strategies to increase vaccine confidence and uptake. Future research may focus on qualitative inquiry to understand specific concerns and determinants contributing to increased hesitancy among these groups to help inform interventions and communication campaigns to support vaccination.
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Affiliation(s)
- Kimberly H. Nguyen
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - E. Lisa Chung
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Cheyenne McChesney
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Lavanya Vasudevan
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, 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
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Shea L, Cooper D, Ventimiglia J, Frisbie S, Carlton C, Song W, Salzer M, Lee B, Hotez E, Vanness DJ. Self-Reported COVID-19 Vaccine and Booster Acceptance and Hesitancy Among Autistic Adults in Pennsylvania: Cross-Sectional Analysis of Survey Data. JMIR Public Health Surveill 2024; 10:e51054. [PMID: 39196609 PMCID: PMC11391151 DOI: 10.2196/51054] [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: 07/19/2023] [Revised: 01/30/2024] [Accepted: 06/21/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND The autistic population is rapidly increasing; meanwhile, autistic adults face disproportionate risks for adverse COVID-19 outcomes. Limited research indicates that autistic individuals have been accepting of initial vaccination, but research has yet to document this population's perceptions and acceptance of COVID-19 boosters. OBJECTIVE This study aims to identify person-level and community characteristics associated with COVID-19 vaccination and booster acceptance among autistic adults, along with self-reported reasons for their stated preferences. Understanding this information is crucial in supporting this vulnerable population given evolving booster guidelines and the ending of the public health emergency for the COVID-19 pandemic. METHODS Data are from a survey conducted in Pennsylvania from April 11 to September 12, 2022. Demographic characteristics, COVID-19 experiences, and COVID-19 vaccine decisions were compared across vaccination status groups. Chi-square analyses and 1-way ANOVA were conducted to test for significant differences. Vaccination reasons were ranked by frequency; co-occurrence was identified using phi coefficient correlation plots. RESULTS Most autistic adults (193/266, 72.6%) intended to receive or received the vaccine and booster, 15% (40/266) did not receive or intend to receive any vaccine, and 12.4% (33/266) received or intended to receive the initial dose but were hesitant to accept booster doses. Reasons for vaccine acceptance or hesitancy varied by demographic factors and COVID-19 experiences. The most significant were previously contracting COVID-19, desire to access information about COVID-19, and discomfort with others not wearing a mask (all P=.001). County-level factors, including population density (P=.02) and percentage of the county that voted for President Biden (P=.001) were also significantly associated with differing vaccination acceptance levels. Reasons for accepting the initial COVID-19 vaccine differed among those who were or were not hesitant to accept a booster. Those who accepted a booster were more likely to endorse protecting others and trusting the vaccine as the basis for their acceptance, whereas those who were hesitant about the booster indicated that their initial vaccine acceptance came from encouragement from someone they trusted. Among the minority of those hesitant to any vaccination, believing that the vaccine was unsafe and would make them feel unwell were the most often reported reasons. CONCLUSIONS Intention to receive or receiving the COVID-19 vaccination and booster was higher among autistic adults than the population that received vaccines in Pennsylvania. Autistic individuals who accepted vaccines prioritized protecting others, while autistic individuals who were vaccine hesitant had safety concerns about vaccines. These findings inform public health opportunities and strategies to further increase vaccination and booster rates among generally accepting autistic adults, to better support the already strained autism services and support system landscape. Vaccination uptake could be improved by leveraging passive information diffusion to combat vaccination misinformation among those not actively seeking COVID-19 information to better alleviate safety concerns.
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Affiliation(s)
- Lindsay Shea
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Dylan Cooper
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Jonas Ventimiglia
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Shelby Frisbie
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Conner Carlton
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Wei Song
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Mark Salzer
- College of Public Health, Temple University, Philadelphia, PA, United States
| | - Brian Lee
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Emily Hotez
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - David J Vanness
- College of Health and Human Development, Pennsylvania State University, University Park, PA, United States
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Hammond J, Yunis C, Fountaine RJ, Luscan G, Burr AM, Zhang W, Wisemandle W, Soares H, Baniecki ML, Hendrick VM, Kalfov V, Pypstra R, Rusnak JM. Oral Nirmatrelvir-Ritonavir as Postexposure Prophylaxis for Covid-19. N Engl J Med 2024; 391:224-234. [PMID: 39018532 DOI: 10.1056/nejmoa2309002] [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: 07/19/2024]
Abstract
BACKGROUND Clinical trials of treatments for coronavirus disease 2019 (Covid-19) have not shown a significant benefit of postexposure prophylaxis. METHODS We conducted a phase 2-3 double-blind trial to assess the efficacy and safety of nirmatrelvir-ritonavir in asymptomatic, rapid antigen test-negative adults who had been exposed to a household contact with Covid-19 within 96 hours before randomization. The participants were randomly assigned in a 1:1:1 ratio to receive nirmatrelvir-ritonavir (300 mg of nirmatrelvir and 100 mg of ritonavir) every 12 hours for 5 days or for 10 days or matching placebo for 5 or 10 days. The primary end point was the development of symptomatic SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection, confirmed on reverse-transcriptase-polymerase-chain-reaction (RT-PCR) or rapid antigen testing, through 14 days in participants who had a negative RT-PCR test at baseline. RESULTS A total of 2736 participants were randomly assigned to a trial group - 921 to the 5-day nirmatrelvir-ritonavir group, 917 to the 10-day nirmatrelvir-ritonavir group, and 898 to the placebo group. Symptomatic, confirmed SARS-CoV-2 infection developed by day 14 in 2.6% of the participants in the 5-day nirmatrelvir-ritonavir group, 2.4% of those in the 10-day nirmatrelvir-ritonavir group, and 3.9% of those in the placebo group. In each nirmatrelvir-ritonavir group, the percentage of participants in whom symptomatic, confirmed SARS-CoV-2 infection developed did not differ significantly from that in the placebo group, with risk reductions relative to placebo of 29.8% (95% confidence interval [CI], -16.7 to 57.8; P = 0.17) in the 5-day nirmatrelvir-ritonavir group and 35.5% (95% CI, -11.5 to 62.7; P = 0.12) in the 10-day nirmatrelvir-ritonavir group. The incidence of adverse events was similar across the trial groups, with dysgeusia being the most frequently reported adverse event (in 5.9% and 6.8% of the participants in the 5-day and 10-day nirmatrelvir-ritonavir groups, respectively, and in 0.7% of those in the placebo group). CONCLUSIONS In this placebo-controlled trial, postexposure prophylaxis with nirmatrelvir-ritonavir for 5 or 10 days did not significantly reduce the risk of symptomatic SARS-CoV-2 infection. (Funded by Pfizer; ClinicalTrials.gov number, NCT05047601.).
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Affiliation(s)
- Jennifer Hammond
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Carla Yunis
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Robert J Fountaine
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Gerald Luscan
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Aimee M Burr
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Wuyan Zhang
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Wayne Wisemandle
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Holly Soares
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Mary Lynn Baniecki
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Victoria M Hendrick
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Veselin Kalfov
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - Rienk Pypstra
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
| | - James M Rusnak
- From Global Product Development, Pfizer, Collegeville, PA (J.H.); Global Product Development, Pfizer, Lake Mary (C.Y.), and Global Product Development, Pfizer, Tampa (J.M.R.) - both in Florida; Global Product Development, Pfizer, Groton, CT (R.J.F., H.S.); Global Product Development, Pfizer International Organization, Paris (G.L.); Pfizer, Chicago (A.M.B.); Global Product Development, Pfizer, Lake Forest, IL (W.Z., W.W.); Early Clinical Development, Pfizer, Cambridge, MA (M.L.B.); Medical and Safety, Pfizer Research and Development UK, Sandwich, United Kingdom (V.M.H.); Specialized Hospital for Active Treatment of Pneumo-Phthisiatric Diseases, Haskovo, Bulgaria (V.K.); and Global Product Development, Pfizer, New York (R.P.)
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5
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Intimayta-Escalante C, Tapia-Sequeiros G, Rojas-Bolivar D. Sociodemographic Inequalities in COVID-19 Booster Dose Vaccination Coverage: a Retrospective Study of 196 Provinces in Peru. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02060-7. [PMID: 38914811 DOI: 10.1007/s40615-024-02060-7] [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: 04/20/2024] [Revised: 06/05/2024] [Accepted: 06/17/2024] [Indexed: 06/26/2024]
Abstract
BACKGROUND The COVID-19 vaccination coverage shows variability in booster doses between residency areas or ethnicity. The aim of this study was to evaluate how sociodemographic conditions influence unequal vaccination coverage with booster doses against COVID-19 in Peru. METHODS A retrospective, ecological study with an evaluation of 196 provinces in Peru. The sociodemographic conditions were evaluated as sources of inequality (sex, age group, educational level, residence area, and ethnic group). The inequality measure used was the GINI, an index that show the inequal vaccination coverage with third and fourth booster doses against COVID-19 in Peruvians provinces. The index allow determinate a higher inequality when the value is near to 1, and a lower inequality when the value is near to 0. Also, the impact of each sociodemographic condition in the general inequality was evaluate with a decomposition analysis of GINI coefficient into Sk (composition effect), Gk (redistribution effect), Rk (differential effect). RESULTS In provinces evaluated the mean vaccine coverage for the third and fourth booster doses was 57.00% and 22.19%, respectively at twelve months since the beginning of vaccination campaign. The GINI coefficient was 0.33 and 0.31, for the third and fourth booster doses coverage, respectively. In the decomposition analysis, twelve months after the start of the third and fourth dose vaccination campaign, revealed higher Sk values for people living in rural areas (Sk = 0.94 vs. Sk = 2.39, respectively for third and fourth dose), while higher Gk values for Aymara (Gk = 0.92 vs. Gk = 0.92, respectively), Quechua (Gk = 0.53 vs. Gk = 0.53, respectively), and Afro-Peruvians (Gk = 0.61 vs. Gk = 0.61, respectively). Also, higher negative correlation in Rk values for people with elementary education (Rk=-0.43 vs. Rk=-0.33, respectively), aged between 15 and 19 years (Rk=-0.49 vs. Rk=-0.37, respectively), and Aymara (Rk=-0.51 vs. Rk=-0.66, respectively). CONCLUSION The rural residency area, lower education and Quechua, Aymara or Afro-Peruvians ethnicity determinated inequalities in vaccination coverage with booster doses against COVID-19 in Peruvian provinces.
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Affiliation(s)
| | | | - Daniel Rojas-Bolivar
- Asociación para el Desarrollo de la Investigación Estudiantil en Ciencias de la Salud, Lima, Peru
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Kolakowska A, Marshall E, Krastinova E, Cros A, Duvivier C, Leroy P, Caby F, Zucman D, Maka A, Salmon D, Chéret A. Insufficient vaccine coverage and vaccine hesitancy in people living with HIV: A prospective study in outpatient clinics in the Paris region. Vaccine 2024; 42:3655-3663. [PMID: 38714445 DOI: 10.1016/j.vaccine.2024.04.077] [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: 02/16/2024] [Revised: 04/18/2024] [Accepted: 04/25/2024] [Indexed: 05/09/2024]
Abstract
Vaccine prevention strategies play a crucial role in the management of people living with HIV (PLWH). The aim of this study was to assess vaccination coverage and identify barriers to vaccine uptake in PLWH in the Paris region. A cross-sectional survey was conducted in PLWH in 16 hospitals in the Paris region. The vaccination status, characteristics, opinions, and behaviors of participants were collected using a face-to-face questionnaire and from medical records. A total of 338 PLWH were included (response rate 99.7 %). The median age of participants was 51 years (IQR: 41-58). Vaccination coverage was 77.3 % for hepatitis B (95 % CI: 72.3-81.8 %), 62.7 % for hepatitis A (57.3-67.9 %), 61.2 % for pneumococcal vaccines (55.8-66.5 %), 56.5 % for diphtheria/tetanus/poliomyelitis (DTP) (51.0-61.9 %), 44.7 % for seasonal influenza (39.3-50.1 %), 31.4 % for measles/mumps/rubella (26.4-36.6 %) and 38.5 % for meningococcal vaccine (13.9-68.4 %). The main reason for vaccine reluctance was related to the lack of vaccination proposals/reminders. The overall willingness to get vaccinated was 71.0 % (65.9-75.8 %). In the multivariable analysis, several factors were associated with a higher vaccine uptake; for DTP vaccine: higher education level, having vaccination records, being registered with a general practitioner; for seasonal influenza vaccine: age > 60 years, higher education level, being employed. The overall vaccination coverage was suboptimal. Development of strategies reducing missed opportunity to offer vaccines is needed.
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Affiliation(s)
| | - Esaïe Marshall
- COREVIH Île-de-France Sud, Paris, France; Pierre Louis Institute of Epidemiology and Public Health, University of Paris Sorbonne, INSERM U1136, Paris, France
| | - Evguenia Krastinova
- Pierre Louis Institute of Epidemiology and Public Health, University of Paris Sorbonne, INSERM U1136, Paris, France; Prevention and Community Health, Creteil Hospital, France
| | - Agnès Cros
- COREVIH Île-de-France Sud, Paris, France
| | - Claudine Duvivier
- Paris Cité University, Necker Hospital, AP-HP, Infectious Diseases Department, Necker-Pasteur Infectiology Center, Paris, France; Inserm U1016, CNRS UMR 8104, Université Paris Descartes, Institut Cochin, Paris, France
| | - Pierre Leroy
- Department of Infectious Diseases, Public Health Unit, Groupe Hospitalier Sud Île-de-France, Melun, France
| | - Fabienne Caby
- HIV and STI department, Victor-Dupouy Hospital, Argenteuil, France
| | - David Zucman
- Department of Internal Medicine, Foch Hospital, Suresnes, France
| | - Arthur Maka
- Departement of Infectious Diseases, Bastia Hospital, France
| | - Dominique Salmon
- Department of Infectious Diseases, Hôtel Dieu Hospital, Paris, France; Department of Infectious Diseases, Institut Fournier, Paris, France
| | - Antoine Chéret
- Service de Plateforme de Diagnostic et Thérapeutique pluridisciplinaires, CHU, Guadeloupe; Inserm U1016, CNRS UMR 8104, Université Paris Descartes, Institut Cochin, Paris, France; INSERM-CIC-1424, CHU, Guadeloupe.
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Abad N, Bonner KE, Huang Q, Baack B, Petrin R, Das D, Hendrich MA, Gosz MS, Lewis Z, Lintern DJ, Fisun H, Brewer NT. Behavioral and social drivers of COVID-19 vaccination initiation in the US: a longitudinal study March─ October 2021. J Behav Med 2024; 47:422-433. [PMID: 38587765 PMCID: PMC11026250 DOI: 10.1007/s10865-024-00487-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/15/2024] [Indexed: 04/09/2024]
Abstract
Many studies have examined behavioral and social drivers of COVID-19 vaccination initiation, but few have examined these drivers longitudinally. We sought to identify the drivers of COVID-19 vaccination initiation using the Behavioral and Social Drivers of Vaccination (BeSD) Framework. Participants were a nationally-representative sample of 1,563 US adults who had not received a COVID-19 vaccine by baseline. Participants took surveys online at baseline (spring 2021) and follow-up (fall 2021). The surveys assessed variables from BeSD Framework domains (i.e., thinking and feeling, social processes, and practical issues), COVID-19 vaccination initiation, and demographics at baseline and follow-up. Between baseline and follow-up, 65% of respondents reported initiating COVID-19 vaccination. Vaccination intent increased from baseline to follow-up (p < .01). Higher vaccine confidence, more positive social norms towards vaccination, and receiving vaccine recommendations at baseline predicted subsequent COVID-19 vaccine initiation (all p < .01). Among factors assessed at follow-up, social responsibility and vaccine requirements had the greatest associations with vaccine initiation (all p < .01). Baseline vaccine confidence, social norms, and vaccination recommendations were associated with subsequent vaccine initiation, all of which could be useful targets for behavioral interventions. Furthermore, interventions that highlight social responsibility to vaccinate or promote vaccination requirements could also be beneficial.
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Affiliation(s)
- Neetu Abad
- Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | | | - Qian Huang
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Brittney Baack
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Dhiman Das
- Ipsos US Public Affairs, Washington, DC, USA
| | | | | | | | | | - Helen Fisun
- Ipsos US Public Affairs, Washington, DC, USA
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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8
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Moore R, Purvis RS, Willis DE, Li J, Selig JP, Ross J, McElfish PA. Influences on COVID-19 booster uptake among adults intending to receive a booster: a qualitative study. Health Promot Int 2024; 39:daae067. [PMID: 38902983 PMCID: PMC11190055 DOI: 10.1093/heapro/daae067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024] Open
Abstract
Bivalent COVID-19 vaccine boosters have been recommended for all Americans 12 years of age and older. However, uptake remains suboptimal with only 17% of the United States (US) population boosted as of May 2023. This is a critical public health challenge for mitigating the ongoing effects of COVID-19 infection. COVID-19 booster uptake is not currently well understood, and few studies in the US have explored the vaccination process for booster uptake in a 'post-pandemic' context. This study fills gaps in the literature through qualitative analysis of interviews with a racially/ethnically diverse sample of Arkansans who received the COVID-19 vaccine main series and expressed intent to receive a booster (n = 14), but had not yet received the COVID-19 booster at the time we recruited them. All but one did not receive the booster by the time of the interview. Participants described influences on their vaccination behavior and uptake of boosters including reduced feelings of urgency; continued concerns about the side effects; social contagion as a driver of urgency; increasing practical barriers to access and missing provider recommendations. Our findings highlight the importance of considering vaccination as an ongoing, dynamic process drawing on past/current attitudes, prior experience, perceptions of risk and urgency and practical barriers. Based on these findings, healthcare providers should continue to provide strong, consistent recommendations for COVID-19 boosters to patients, even among those with histories of vaccine uptake.
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Affiliation(s)
- Ramey Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA
| | - Rachel S Purvis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA
| | - Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA
| | - Ji Li
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA
| | - James P Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA
| | - Jeanne Ross
- College of Medicine, University of Arkansas for Medical Sciences Northeast, 311 E. Matthews St., Jonesboro, AR 72401, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA
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Fisher KA, Mazor KM, Epstein MM, Goldthwait L, Abu Ghazaleh H, Zhou Y, Crawford S, Marathe J, Linas BP. Long COVID awareness and receipt of medical care: a survey among populations at risk for disparities. Front Public Health 2024; 12:1360341. [PMID: 38873310 PMCID: PMC11173587 DOI: 10.3389/fpubh.2024.1360341] [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: 12/22/2023] [Accepted: 05/08/2024] [Indexed: 06/15/2024] Open
Abstract
Introduction The COVID-19 pandemic has been characterized by disparities in disease burden and medical care provision. Whether these disparities extend to long COVID awareness and receipt of medical care is unknown. We aimed to characterize awareness of long COVID and receipt of medical care for long COVID symptoms among populations who experience disparities in the United States (US). Methods We conducted a cross-sectional survey among a national sample of US adults between January 26-February 5, 2023. We surveyed approximately 2,800 adults drawn from the Ipsos probability-based KnowledgePanel® who identify as White, Black, or Hispanic, with over-sampling of Black, Hispanic, and Spanish-proficient adults. Awareness of long COVID was assessed with the question, "Have you heard of long COVID? This is also referred to as post-COVID, Long-haul COVID, Post-acute COVID-19, or Chronic COVID." Respondents reporting COVID-19 symptoms lasting longer than 1 month were classified as having long COVID and asked about receipt of medical care. Results Of the 2,828 respondents, the mean age was 50.4 years, 52.8% were female, 40.2% identified as Hispanic, 29.8% as Black, and 26.7% as White. 18% completed the survey in Spanish. Overall, 62.5% had heard of long COVID. On multivariate analysis, long COVID awareness was lower among respondents who identified as Black (OR 0.64; 95% CI 0.51, 0.81), Hispanic and completed the survey in English (OR 0.59; 95% CI 0.46, 0.76), and Hispanic and completed the survey in Spanish (OR 0.31, 95% C.I. 0.23, 0.41), compared to White respondents (overall p < 0.001). Long COVID awareness was also associated with educational attainment, higher income, having health insurance, prior history of COVID-19 infection, and COVID-19 vaccination. Among those reporting symptoms consistent with long COVID (n = 272), 26.8% received medical care. Older age, longer symptom duration and greater symptom impact were associated with receipt of medical care for long COVID symptoms. Of those who received care, most (77.8%) rated it as less than excellent on a 5-point scale. Discussion This survey reveals limited awareness of long COVID and marked disparities in awareness according to race, ethnicity, and language. Targeted public health campaigns are needed to raise awareness.
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Affiliation(s)
- Kimberly A. Fisher
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Kathleen M. Mazor
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Mara M. Epstein
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Lydia Goldthwait
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Hiba Abu Ghazaleh
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Yanhua Zhou
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Sybil Crawford
- Tan Chingfen Graduate School of Nursing, UMass Chan Medical School, Worcester, MA, United States
| | - Jai Marathe
- Boston Medical Center, Boston, MA, United States
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, United States
| | - Benjamin P. Linas
- Boston Medical Center, Boston, MA, United States
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, United States
- Boston University School of Public Health, Boston, MA, United States
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10
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Khezri M, McKnight C, Weng CA, Kimball S, Des Jarlais D. COVID-19 vaccination uptake and determinants of booster vaccination among persons who inject drugs in New York City. PLoS One 2024; 19:e0303394. [PMID: 38743729 PMCID: PMC11093290 DOI: 10.1371/journal.pone.0303394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/24/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Persons who inject drugs (PWID) may be unengaged with healthcare services and face an elevated risk of severe morbidity and mortality associated with COVID-19 due to chronic diseases and structural inequities. However, data on COVID-19 vaccine uptake, particularly booster vaccination, among PWID are limited. We examined COVID-19 vaccine uptake and factors associated with booster vaccination among PWID in New York City (NYC). METHODS We recruited PWID using respondent-driven sampling from October 2021 to November 2023 in a survey that included HIV and SARS-CoV-2 antibodies testing. The questionnaire included demographics, COVID-19 vaccination and attitudes, and drug use behaviors. RESULTS Of 436 PWID, 80% received at least one COVID-19 vaccine dose. Among individuals who received at least one COVID-19 vaccine dose, 95% were fully vaccinated. After excluding participants recruited before booster authorization for general adults started in NYC, and those who had never received an initial vaccination, 41% reported having received a COVID-19 booster vaccine dose. COVID-19 booster vaccination was significantly associated with having a high school diploma or GED (adjusted odds ratio (aOR) 1.93; 95% confidence interval (CI) 1.09, 3.48), ever received the hepatitis A/B vaccine (aOR 2.23; 95% CI 1.27, 3.96), main drug use other than heroin/speedball, fentanyl and stimulants (aOR 14.4; 95% CI 2.32, 280), number of non-fatal overdoses (aOR 0.35; 95% CI 0.16, 0.70), and mean vaccination attitude score (aOR 0.94; 95% CI 0.89, 0.98). CONCLUSIONS We found a suboptimal level of COVID-19 booster vaccination among PWID, which was consistent with the rates observed in the general population in NYC and the U.S. Community-based interventions are needed to improve COVID-19 booster vaccination access and uptake among PWID. Attitudes towards vaccination were significant predictors of both primary and booster vaccination uptake. Outreach efforts focusing on improving attitudes towards vaccination and educational programs are essential for reducing hesitancy and increasing booster vaccination uptake among PWID.
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Affiliation(s)
- Mehrdad Khezri
- Department of Epidemiology, School of Global Public Health, New York University, New York, NY, United States of America
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Courtney McKnight
- Department of Epidemiology, School of Global Public Health, New York University, New York, NY, United States of America
- Center for Drug Use and HIV/HCV Research, New York, NY, United States of America
| | - Chenziheng Allen Weng
- Department of Epidemiology, School of Global Public Health, New York University, New York, NY, United States of America
| | - Sarah Kimball
- Department of Epidemiology, School of Global Public Health, New York University, New York, NY, United States of America
| | - Don Des Jarlais
- Department of Epidemiology, School of Global Public Health, New York University, New York, NY, United States of America
- Center for Drug Use and HIV/HCV Research, New York, NY, United States of America
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11
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Lee YK, Jeong SA, Park HC, Kim DH, Yoo KD, Yoon HE, Kim YG, Cho A. SARS-CoV-2 vaccine effectiveness and clinical outcomes in hemodialysis patients: the NHIS-COVID-19 cohort study in South Korea. Front Public Health 2024; 12:1372525. [PMID: 38784571 PMCID: PMC11111925 DOI: 10.3389/fpubh.2024.1372525] [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: 01/18/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
Background Patients undergoing hemodialysis (HD) have a high risk of novel coronavirus disease 2019 (COVID-19) and poor clinical outcomes. This study aimed to investigate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine effectiveness against infection and deaths in the South Korean population undergoing HD. Methods We conducted a retrospective cohort study to compare the incidence of COVID-19 and post-diagnosis mortality between patients who were either never vaccinated or fully or partially vaccinated. The Korean nationwide COVID-19 registry and the Korean National Health Insurance Service databases were used. Adult patients without a history of COVID-19 were included between October 8, 2020, and December 31, 2021. The study outcomes were COVID-19 diagnosis, severe clinical COVID-19-related events, and post-diagnosis death. Results Eighty-five thousand eighteen patients undergoing HD were included, of whom 69,601 were fully vaccinated, 2,213 were partially vaccinated and 13,204 were unvaccinated. Compared with the unvaccinated group, the risk of being diagnosed with COVID-19 in patients who were fully vaccinated decreased during the study period (adjusted odds ratio [aOR] = 0.147; 95% confidence interval [CI] = 0.135-0.159). There were 1,140 (1.3%) patients diagnosed with COVID-19. After diagnosis, fully vaccinated patients were significantly less likely to die than unvaccinated patients (aOR = 0.940; 95% CI = 0.901-0.980) and to experience severe clinical events (aOR = 0.952; 95% CI = 0.916-0.988). Conclusion Full vaccination against COVID-19 was associated with a reduced risk of both infection and severe clinical outcomes in the South Korean population undergoing HD. These findings support the use of vaccination against SARS-CoV-2 among patients undergoing HD.
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Affiliation(s)
- Young-Ki Lee
- Department of Internal Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
- Hallym Kidney Research Institute, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Seon A. Jeong
- Korean Society of Nephrology, Seoul, Republic of Korea
| | - Hayne Cho Park
- Department of Internal Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
- Hallym Kidney Research Institute, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Do Hyoung Kim
- Department of Internal Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
- Hallym Kidney Research Institute, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Kyung Don Yoo
- Basic-Clinical Convergence Research Institute, University of Ulsan, Dong-Gu, Ulsan, Republic of Korea
| | - Hye Eun Yoon
- Department of Internal Medicine, Incheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea
| | - Yang Gyun Kim
- Division of Nephrology, Department of Internal Medicine, KyungHee University, Seoul, Republic of Korea
| | - Ajin Cho
- Department of Internal Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
- Hallym Kidney Research Institute, Hallym University College of Medicine, Seoul, Republic of Korea
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12
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Lorent D, Nowak R, Figlerowicz M, Handschuh L, Zmora P. Anti-SARS-CoV-2 Antibodies Level and COVID-19 Vaccine Boosters among Healthcare Workers with the Highest SARS-CoV-2 Infection Risk-Follow Up Study. Vaccines (Basel) 2024; 12:475. [PMID: 38793726 PMCID: PMC11126039 DOI: 10.3390/vaccines12050475] [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: 04/17/2024] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 05/26/2024] Open
Abstract
During the COVID-19 pandemic, several vaccines were developed to limit the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, due to SARS-CoV-2 mutations and uneven vaccination coverage among populations, a series of COVID-19 waves have been caused by different variants of concern (VOCs). Despite the updated vaccine formulations for the new VOC, the benefits of additional COVID-19 vaccine doses have raised many doubts, even among high-risk groups such as healthcare workers (HCWs). We examined the factors underlying hesitancy to receive COVID-19 booster vaccine doses and analysed the anti-SARS-CoV-2 IgG antibody response after booster vaccination among HCWs. Our study found that 42% of the HCWs were hesitant about the second booster dose, while 7% reported no intent to get vaccinated with any additional doses. As reasons for not vaccinating, participants most frequently highlighted lack of time, negative experiences with previous vaccinations, and immunity conferred by past infections. In addition, we found the lowest post-vaccination antibody titres among HCWs who did not receive any vaccine booster dose and the highest among HCWs vaccinated with two booster doses.
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Affiliation(s)
- Dagny Lorent
- Institute of Bioorganic Chemistry Polish Academy of Sciences, 61-704 Poznan, Poland; (D.L.); (R.N.); (L.H.)
| | - Rafał Nowak
- Institute of Bioorganic Chemistry Polish Academy of Sciences, 61-704 Poznan, Poland; (D.L.); (R.N.); (L.H.)
| | - Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
| | - Luiza Handschuh
- Institute of Bioorganic Chemistry Polish Academy of Sciences, 61-704 Poznan, Poland; (D.L.); (R.N.); (L.H.)
| | - Paweł Zmora
- Institute of Bioorganic Chemistry Polish Academy of Sciences, 61-704 Poznan, Poland; (D.L.); (R.N.); (L.H.)
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13
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Meng L, Harris L, Shaw L, Lymon H, Reses H, Bell J, Lu PJ, Gibbs-Scharf L, Chorba T. Social and demographic factors associated with receipt of a COVID-19 vaccine initial booster dose and with interval between primary series completion and initial booster dose uptake among persons aged ≥ 12 years, United States, August 2021-October 2022. Vaccine 2024; 42:2122-2126. [PMID: 38453621 PMCID: PMC11187615 DOI: 10.1016/j.vaccine.2024.02.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 03/09/2024]
Abstract
COVID-19 booster dose vaccination has been crucial in ensuring protection against COVID-19 including recently predominant Omicron variants. Because vaccines against newer SARS-CoV- 2 variants are likely to be recommended in future, it will be valuable to understand past booster dose uptake among different demographic groups. Using U.S. vaccination data, this study examined intervals between primary series completion and receipt of first booster dose (monovalent or bivalent) during August 2021 - October 2022 among persons ≥12 years of age who had completed a COVID-19 vaccine primary series by October 2021. Sub-populations who were late booster recipients (received a booster dose ≥12 months after the primary series) or received no booster dose included persons <35 years old, Johnson & Johnson/Janssen vaccine primary dose recipients, persons in certain racial and ethnic groups, and persons living in rural and more socially vulnerable areas, and in the South region of the United States; these groups may benefit the most from public health outreach efforts to achieve timely COVID-19 vaccination completion in future.
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Affiliation(s)
- Lu Meng
- CDC COVID-19 Response Team, USA; Division of Health Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, 1600 Clifton Rd NE, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.
| | - LaTreace Harris
- CDC COVID-19 Response Team, USA; Immunization Services Division, National Center for Immunization and Respiratory Diseases, 1600 Clifton Rd NE, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Lauren Shaw
- CDC COVID-19 Response Team, USA; Immunization Services Division, National Center for Immunization and Respiratory Diseases, 1600 Clifton Rd NE, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Hoody Lymon
- Division of Health Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, 1600 Clifton Rd NE, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Hannah Reses
- Division of Health Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, 1600 Clifton Rd NE, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Jeneita Bell
- Division of Health Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, 1600 Clifton Rd NE, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Peng-Jun Lu
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, 1600 Clifton Rd NE, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Lynn Gibbs-Scharf
- CDC COVID-19 Response Team, USA; Immunization Services Division, National Center for Immunization and Respiratory Diseases, 1600 Clifton Rd NE, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Terence Chorba
- CDC COVID-19 Response Team, USA; Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, 1600 Clifton Rd NE, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.
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14
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Ezeamii VC, Ofochukwu VC, Iheagwara C, Asibu T, Ayo-Farai O, Gebeyehu YH, Kaglo EO, Odoeke MC, Adeyemi OM, Shittu HO, Okobi OE. COVID-19 Vaccination Rates and Predictors of Uptake Among Adults With Coronary Heart Disease: Insight From the 2022 National Health Interview Survey. Cureus 2024; 16:e52480. [PMID: 38371067 PMCID: PMC10873900 DOI: 10.7759/cureus.52480] [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] [Accepted: 01/17/2024] [Indexed: 02/20/2024] Open
Abstract
INTRODUCTION COVID-19 has become a burden to all nations across the globe, and vaccination currently remains the most effective means of fighting the SARS-COV-2 pandemic. From the time of approval and subsequent distribution of the various COVID-19 vaccines, nearly 72.3% (5.5 billion) of the globe's population have been vaccinated, leaving slightly more than a quarter of the globe's population at risk. With the approval and availability of booster vaccine dosages to individuals with chronic conditions, including coronary heart disease (CHD), it is vital to comprehend the factors underlying the uptake of COVID-19 vaccination in such subgroups. Further, the American Heart Association recommends vaccination against COVID-19 in populations with coronary heart disease (CHD). This is because they are more likely to experience severe outcomes due to COVID-19 infection. This study assesses the uptake of COVID-19 vaccines as well as predictors of its uptake. METHODS Using the 2022 survey data from the National Health Interview Survey (NHIS), 1,708 adults ≥ 40 years with CHD who responded yes/no to whether they had received the vaccine were identified. A Pearson's chi-square test was used to ascertain differences among those who had received the vaccine and those who had not. A logistic regression (multivariate regression) was used to evaluate predictors of COVID-19 vaccination. RESULTS About 1,491/1,708 (86.8%) adults ≥ 40 years reported being vaccinated against COVID-19. Among them, 1,065/1,491 (68.4%) had received more than two vaccination doses. The predictors of COVID-19 vaccination were older age (odds ratio (OR): 2.01 (95% confidence interval (CI): 1.40-2.89), p < 0.001), ratio of family income to poverty threshold of 1 and above (OR: 2.40 (95% CI: 1.58-3.64), p < 0.001), having a college degree (OR: 3.09 (95% CI: 1.85-5.14), p < 0.001), and being insured (OR: 3.26 (95% CI: 1.03-10.26), p = 0.044). CONCLUSION The findings of the study have indicated that 68.4% of adults 40 years and above with CHD have been vaccinated against COVID-19 and have received more than two doses of vaccines. More than half have followed recommendations and have received booster doses of the vaccine. Old age (above 40 years) and a higher socioeconomic class are associated with being more likely to follow COVID-19 vaccination guidelines. Despite the higher vaccination rate of 68.4% in the adults with heart diseases group, strategies for improving booster vaccine awareness alongside accessibility are needed to enhance additional dosage uptake, protect them against novel COVID-19 variants, and ensure the development of sustained immunity.
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Affiliation(s)
- Victor C Ezeamii
- Public Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, USA
| | - Victor C Ofochukwu
- Medicine, Ebonyi State University, Abakaliki, NGA
- Medicine and Surgery, Hospital Corporation of America (HCA) Hospital Pearland, Pearland, USA
| | | | - Tracy Asibu
- Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, USA
| | - Oluwatoyin Ayo-Farai
- Epidemiology and Public Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, USA
| | | | - Eunice O Kaglo
- General Practice, Southwestern University School of Medicine, Calgary, CAN
| | - Moses C Odoeke
- Internal Medicine, Al Ruwaydah General Hospital, Riyadh, SAU
| | - Olaoluwa M Adeyemi
- Internal Medicine, Afe Babalola University, Ado, NGA
- Internal Medicine/Nephrology, William Osler Health System - Etobicoke General Hospital, Toronto, CAN
- Internal Medicine, Richmond Gabriel University, Kingstown, VCT
| | | | - Okelue E Okobi
- Family Medicine, Larkin Community Hospital Palm Springs Campus, Miami, USA
- Family Medicine, Medficient Health Systems, Laurel, USA
- Family Medicine, Lakeside Medical Center, Belle Glade, USA
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15
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Oliver SE, Wallace M, Twentyman E, Moulia DL, Godfrey M, Link-Gelles R, Meyer S, Fleming-Dutra KE, Hall E, Wolicki J, MacNeil J, Bell BP, Lee GM, Daley MF, Cohn A, Wharton M. Development of COVID-19 vaccine policy - United States, 2020-2023. Vaccine 2023:S0264-410X(23)01466-4. [PMID: 38158297 DOI: 10.1016/j.vaccine.2023.12.022] [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: 09/29/2023] [Revised: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024]
Abstract
COVID-19 vaccines represent a great scientific and public health achievement in the face of overwhelming pressures from a global pandemic, preventing millions of hospitalizations and deaths due to COVID-19 vaccines in the United States. Over 675 million doses of COVID-19 vaccines have been administered in the United States, and over 80% of the U.S. population has had at least 1 dose of a COVID-19 vaccine. Over the course of the COVID-19 pandemic in the United States, over one million people died from COVID-19, and over six million were hospitalized. It has been estimated that COVID-19 vaccines prevented more than 18 million additional hospitalizations and more than 3 million additional deaths due to COVID-19 in the United States. From the beginning of the COVID-19 pandemic in 2020 through June 2023, ACIP had 35 COVID-19 focused meetings and 24 votes for COVID-19 vaccine recommendations. ACIP had the critical task of rapidly and thoroughly reviewing emerging and evolving data on COVID-19 epidemiology and vaccines, as well as making comprehensive population-based recommendations for vaccine policy and considerations for implementation through a transparent and evidence-based framework. Safe and effective COVID-19 vaccines, recommended through transparent policy discussions with ACIP, remain the best tool we have to prevent serious illness, hospitalization and death from COVID-19.
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Affiliation(s)
- Sara E Oliver
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Megan Wallace
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Evelyn Twentyman
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Danielle L Moulia
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Monica Godfrey
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ruth Link-Gelles
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sarah Meyer
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Katherine E Fleming-Dutra
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elisha Hall
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - JoEllen Wolicki
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jessica MacNeil
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Grace M Lee
- Stanford University School of Medicine, Stanford, CA, USA
| | - Matthew F Daley
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA
| | - Amanda Cohn
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Melinda Wharton
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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16
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Nguyen KH, Levisohn A, McChesney C, Vasudevan L, Bednarczyk RA, Corlin L. Disparities in child and adolescent COVID-19 vaccination coverage and parental intent toward vaccinations for their children and adolescents. Ann Med 2023; 55:2232818. [PMID: 37449878 PMCID: PMC10351440 DOI: 10.1080/07853890.2023.2232818] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 06/22/2023] [Accepted: 06/29/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION Despite recommendations for COVID-19 primary series completion and booster doses for children and adolescents, coverage has been less than optimal, particularly in some subpopulations. This study explored disparities in childhood/adolescent COVID-19 vaccination, parental intent to vaccinate their children and adolescents, and reasons for non-vaccination in the US. METHODS Using the U.S. Census Bureau's Household Pulse Survey (HPS), we analyzed households with children aged <18 years using data collected from September 14 to November 14, 2022 (n = 44,929). Child and adolescent COVID-19 vaccination coverage (≥1 dose, completed primary series, and booster vaccination) and parental intentions toward vaccination were assessed by sociodemographic characteristics. Factors associated with child and adolescent vaccination coverage were examined using multivariable regression models. Reasons for non-vaccination were assessed overall, by the child's age group and respondent's age group. RESULTS Overall, approximately half (50.1%) of children aged < 18 years were vaccinated against COVID-19 (≥1 dose). Completed primary series vaccination was 44.2% among all children aged <18 years. By age group, completed primary series was 13.2% among children <5 years, 43.9% among children 5-11 years, and 63.3% among adolescents 12-17 years. Booster vaccination among those who completed the primary series was 39.1% among children 5-11 years and 55.3% among adolescents 12-17 years. Vaccination coverage differed by race/ethnicity, educational attainment, household income, region, parental COVID-19 vaccination status, prior COVID-19 diagnosis, child's age group, and parental age group. Parental reluctance was highest for children aged <5 years (46.8%). Main reasons for non-vaccination among reluctant parents were concerns about side effects (53.3%), lack of trust in COVID-19 vaccines (48.7%), and the belief that children do not need a COVID-19 vaccine (38.8%). CONCLUSION Disparities in COVID-19 vaccination coverage among children and adolescents continue to exist. Further efforts are needed to increase COVID-19 primary series and booster vaccination and parental confidence in vaccines.
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Affiliation(s)
- Kimberly H. Nguyen
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Ariella Levisohn
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Cheyenne McChesney
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Lavanya Vasudevan
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, 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
| | - 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
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17
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Quinn KG, Hunt B, Jacobs J, Valencia J, Hirschtick J, Walsh JL. Community Cohesion, Social Support, and Mental Health among Black Individuals in Chicago: A Cross-Sectional Examination of the Effects on COVID-19 Vaccination. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01837-6. [PMID: 37872464 DOI: 10.1007/s40615-023-01837-6] [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] [Received: 08/04/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023]
Abstract
The COVID-19 pandemic put a significant strain on communities, social resources, and personal relationships, disproportionately impacting Black and low-income communities in the United States. Community cohesion and social support are positively associated with numerous health outcomes and preventive health measures, yet were strained during the pandemic due to COVID mitigation measures. This study examined the relationships between social cohesion, social support, mental health, and COVID-19 vaccination to understand whether community cohesion and social support were associated with increased likelihood of receiving a COVID-19 vaccination. Data are from a cross-sectional survey of 537 Black Chicagoans that was disseminated between September 2021 and March 2022. Structural equation modeling was used to test associations between community cohesion, social support, loneliness, anxiety, stress, and having received a COVID-19 vaccination. Results demonstrated that social support mediated associations between community cohesion and loneliness, anxiety, and stress, but was not associated with COVID-19 vaccination. These results demonstrate the importance of community cohesion and social support on mental health and suggest there are other potential pathways that may link community cohesion and vaccination.
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Affiliation(s)
- Katherine G Quinn
- Medical College of Wisconsin, Center for AIDS Intervention Research, Milwaukee, WI, 53202, USA.
| | - Bijou Hunt
- Sinai Health System, Sinai Urban Health Institute, Chicago, IL, USA
| | - Jacquelyn Jacobs
- Sinai Health System, Sinai Urban Health Institute, Chicago, IL, USA
| | - Jesus Valencia
- Sinai Health System, Sinai Urban Health Institute, Chicago, IL, USA
| | | | - Jennifer L Walsh
- Medical College of Wisconsin, Center for AIDS Intervention Research, Milwaukee, WI, 53202, USA
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18
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Larsen SL, Shin I, Joseph J, West H, Anorga R, Mena GE, Mahmud AS, Martinez PP. Quantifying the impact of SARS-CoV-2 temporal vaccination trends and disparities on disease control. SCIENCE ADVANCES 2023; 9:eadh9920. [PMID: 37531439 PMCID: PMC10396293 DOI: 10.1126/sciadv.adh9920] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/30/2023] [Indexed: 08/04/2023]
Abstract
SARS-CoV-2 vaccines have been distributed at unprecedented speed. Still, little is known about temporal vaccination trends, their association with socioeconomic inequality, and their consequences for disease control. Using data from 161 countries/territories and 58 states, we examined vaccination rates across high and low socioeconomic status (SES), showing that disparities in coverage exist at national and subnational levels. We also identified two distinct vaccination trends: a rapid initial rollout, quickly reaching a plateau, or sigmoidal and slow to begin. Informed by these patterns, we implemented an SES-stratified mechanistic model, finding profound differences in mortality and incidence across these two vaccination types. Timing of initial rollout affects disease outcomes more substantially than final coverage or degree of SES disparity. Unexpectedly, timing is not associated with wealth inequality or GDP per capita. While socioeconomic disparity should be addressed, accelerating initial rollout for all over focusing on increasing coverage is an accessible intervention that could minimize the burden of disease across socioeconomic groups.
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Affiliation(s)
- Sophie L. Larsen
- Program in Ecology, Evolution, and Conservation Biology, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Ikgyu Shin
- Department of Statistics, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Jefrin Joseph
- Department of Microbiology, School of Molecular and Cellular Biology, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Haylee West
- Department of Microbiology, School of Molecular and Cellular Biology, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Rafael Anorga
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL, USA
| | | | - Ayesha S. Mahmud
- Department of Demography, University of California, Berkeley, CA, USA
| | - Pamela P. Martinez
- Department of Statistics, University of Illinois Urbana-Champaign, Urbana, IL, USA
- Department of Microbiology, School of Molecular and Cellular Biology, University of Illinois Urbana-Champaign, Urbana, IL, USA
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19
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O’Gara D, Rosenblatt SF, Hébert-Dufresne L, Purcell R, Kasman M, Hammond RA. TRACE-Omicron: Policy Counterfactuals to Inform Mitigation of COVID-19 Spread in the United States. ADVANCED THEORY AND SIMULATIONS 2023; 6:2300147. [PMID: 38283383 PMCID: PMC10812885 DOI: 10.1002/adts.202300147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Indexed: 01/30/2024]
Abstract
The Omicron wave was the largest wave of COVID-19 pandemic to date, more than doubling any other in terms of cases and hospitalizations in the United States. In this paper, we present a large-scale agent-based model of policy interventions that could have been implemented to mitigate the Omicron wave. Our model takes into account the behaviors of individuals and their interactions with one another within a nationally representative population, as well as the efficacy of various interventions such as social distancing, mask wearing, testing, tracing, and vaccination. We use the model to simulate the impact of different policy scenarios and evaluate their potential effectiveness in controlling the spread of the virus. Our results suggest the Omicron wave could have been substantially curtailed via a combination of interventions comparable in effectiveness to extreme and unpopular singular measures such as widespread closure of schools and workplaces, and highlight the importance of early and decisive action.
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Affiliation(s)
- David O’Gara
- Division of Computational and Data Sciences, Washington University in St. Louis
| | - Samuel F. Rosenblatt
- Vermont Complex Systems Center, University of Vermont
- Department of Computer Science, University of Vermont
| | - Laurent Hébert-Dufresne
- Vermont Complex Systems Center, University of Vermont
- Department of Computer Science, University of Vermont
| | - Rob Purcell
- Center On Social Dynamics and Policy, Brookings Institution
| | - Matt Kasman
- Center On Social Dynamics and Policy, Brookings Institution
| | - Ross A. Hammond
- Center On Social Dynamics and Policy, Brookings Institution
- Division of Computational and Data Sciences, Washington University in St. Louis
- Brown School, Washington University in St. Louis
- Santa Fe Institute
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20
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Masterson JM, Luu M, Dallas KB, Daskivich LP, Spiegel B, Daskivich TJ. Disparities in COVID-19 Disease Incidence by Income and Vaccination Coverage - 81 Communities, Los Angeles, California, July 2020-September 2021. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2023; 72:728-731. [PMID: 37384567 DOI: 10.15585/mmwr.mm7226a5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
COVID-19 has disproportionately affected socially vulnerable communities characterized by lower income, lower education attainment, and higher proportions of minority populations, among other factors (1-4). Disparities in COVID-19 incidence and the impact of vaccination on incidence disparities by community income were assessed among 81 communities in Los Angeles, California. Median community vaccination coverage and COVID-19 incidence were calculated across household income strata using a generalized linear mixed effects model with Poisson distribution during three COVID-19 surge periods: two before vaccine availability (July 2020 and January 2021) and the third after vaccines became widely available in April 2021 (September 2021). Adjusted incidence rate ratios (aIRRs) during the peak month of each surge were compared across communities grouped by median household income percentile. The aIRR between communities in the lowest and highest median income deciles was 6.6 (95% CI = 2.8-15.3) in July 2020 and 4.3 (95% CI = 1.8-9.9) in January 2021. However, during the September 2021 surge that occurred after vaccines became widely availabile, model estimates did not identify an incidence disparity between the highest- and lowest-income communities (aIRR = 0.80; 95% CI = 0.35-1.86). During this surge, vaccination coverage was lowest (59.4%) in lowest-income communities and highest (71.5%) in highest-income communities (p<0.001). However, a significant interaction between income and vaccination on COVID-19 incidence (p<0.001) indicated that the largest effect of vaccination on disease incidence occured in the lowest-income communities. A 20% increase in community vaccination was estimated to have resulted in an additional 8.1% reduction in COVID-19 incidence in the lowest-income communities compared with that in the highest-income communities. These findings highlight the importance of improving access to vaccination and reducing vaccine hesitancy in underserved communities in reducing disparities in COVID-19 incidence.
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21
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Gómez de la Torre JC, Hueda-Zavaleta M, Cáceres-DelAguila JA, Muro-Rojo C, Cruz-Escurra NDL, Benítes-Zapata VA. Humoral Response after a Fourth Dose with mRNA-1273 in Healthcare Workers with and without a History of SARS-CoV-2 Infection and Previously Vaccinated with Two Doses of BBIBP-CorV Plus BNT162b2 Vaccine. Vaccines (Basel) 2023; 11:vaccines11050894. [PMID: 37242998 DOI: 10.3390/vaccines11050894] [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] [Received: 01/24/2023] [Revised: 02/26/2023] [Accepted: 03/01/2023] [Indexed: 05/28/2023] Open
Abstract
There is limited information on the kinetics of the humoral response elicited by a fourth dose with a heterologous mRNA1273 booster in patients who previously received a third dose with BNT162b2 and two doses of BBIBP-CorV as the primary regimen. We conducted a prospective cohort study to assess the humoral response using Elecsys® anti-SARS-CoV-2 S (anti-S-RBD) of 452 healthcare workers (HCWs) in a private laboratory in Lima, Peru at 21, 120, 210, and 300 days after a third dose with a BNT162b2 heterologous booster in HCW previously immunized with two doses of BBIBP-CorV, depending on whether or not they received a fourth dose with the mRNA1273 heterologous vaccine and on the history of previous SARS infection -CoV-2. Of the 452 HCWs, 204 (45.13%) were previously infected (PI) with SARS-CoV-2, and 215 (47.57%) received a fourth dose with a heterologous mRNA-1273 booster. A total of 100% of HCWs presented positive anti-S-RBD 300 days after the third dose. In HCWs receiving a fourth dose, GMTs 2.3 and 1.6 times higher than controls were observed 30 and 120 days after the fourth dose. No statistically significant differences in anti-S-RBD titers were observed in those HCWs PI and NPI during the follow-up period. We observed that HCWs who received a fourth dose with the mRNA1273 and those previously infected after the third dose with BNT162b2 (during the Omicron wave) presented higher anti-S-RBD titers (5734 and 3428 U/mL, respectively). Further studies are required to determine whether patients infected after the third dose need a fourth dose.
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Affiliation(s)
| | - Miguel Hueda-Zavaleta
- Hospital III Daniel Alcides Carrión, Essalud, Calana Road, Km 6.5, Calana, Tacna 23000, Peru
- Facultad de Ciencias de la Salud, Universidad Privada de Tacna, Bolognesi Avenue Number 1177, Tacna 23003, Peru
| | | | - Cecilia Muro-Rojo
- Roe Clinical Laboratory, Dos de Mayo Avenue, 1741, San Isidro, Lima 15076, Peru
| | | | - Vicente A Benítes-Zapata
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, La Fontana Avenue 550, La Molina, Lima 15024, Peru
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