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Saelee R, Chandra Murthy N, Patel Murthy B, Zell E, Shaw L, Gibbs-Scharf L, Harris L, Shaw KM. Minority Health Social Vulnerability Index and COVID-19 vaccination coverage - The United States, December 14, 2020-January 31, 2022. Vaccine 2023; 41:1943-1950. [PMID: 36797098 PMCID: PMC9922574 DOI: 10.1016/j.vaccine.2023.02.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 01/25/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023]
Abstract
INTRODUCTION In 2021, HHS Office of Minority Health and CDC developed a composite measure of social vulnerability called the Minority Health Social Vulnerability Index (MHSVI) to assess the needs of communities most vulnerable to COVID-19. The MHSVI extends the CDC Social Vulnerability Index with two new themes on healthcare access and medical vulnerability. This analysis examines COVID-19 vaccination coverage by social vulnerability using the MHSVI. METHODS County-level COVID-19 vaccine administration data among persons aged ≥18 years reported to CDC from 12/14/20 to 01/31/22 were analyzed. U.S. counties from 50 states and DC were categorized into tertiles of vulnerability (low, moderate, and high) for the composite MHSVI measure and each of the 34 indicators. Vaccination coverage (≥1 dose, primary series completion, and receipt of a booster dose) was calculated by tertiles for the composite MHSVI measure and each indicator. RESULTS Counties with lower per capita income, higher proportion of individuals with no high school diploma, living below poverty, ≥65 years of age, with a disability, and in mobile homes had lower vaccination uptake. However, counties with larger proportions of racial/ethnic minorities and individuals speaking English less than "very well" had higher coverage. Counties with fewer primary care physicians and greater medical vulnerabilities had lower ≥ 1 dose vaccination coverage. Furthermore, counties of high vulnerability had lower primary series completion and receipt of a booster dose. There were no clear patterns in COVID-19 vaccination coverage by tertiles for the composite measure. CONCLUSION Results from the new components in the MHSVI identify needs to prioritize persons in counties with greater medical vulnerabilities and limited access to health care, who are at greater risk for adverse COVID-19 outcomes. Findings suggest that using a composite measure to characterize social vulnerability might mask disparities in COVID-19 vaccination uptake that would have otherwise been observed using specific indicators.
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Affiliation(s)
- Ryan Saelee
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, United States; CDC COVID-19 Response Team, United States.
| | - Neil Chandra Murthy
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, United States; CDC COVID-19 Response Team, United States; Commisioned Corps of the United State Public Health Service, United States
| | - Bhavini Patel Murthy
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, United States; CDC COVID-19 Response Team, United States
| | - Elizabeth Zell
- CDC COVID-19 Response Team, United States; Stat-Epi Associates, Inc., Ponte Vedra Beach, FL, United States
| | - Lauren Shaw
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, United States; CDC COVID-19 Response Team, United States
| | - Lynn Gibbs-Scharf
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, United States; CDC COVID-19 Response Team, United States
| | - LaTreace Harris
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, United States; CDC COVID-19 Response Team, United States
| | - Kate M Shaw
- Office of Science, National Center for Injury Prevention and Control, CDC, United States
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Murthy BP, Fast HE, Zell E, Murthy N, Meng L, Shaw L, Vogt T, Chatham-Stephens K, Santibanez TA, Gibbs-Scharf L, Harris LQ. COVID-19 Vaccination Coverage and Demographic Characteristics of Infants and Children Aged 6 Months-4 Years - United States, June 20-December 31, 2022. MMWR Morb Mortal Wkly Rep 2023; 72:183-189. [PMID: 36795658 PMCID: PMC9949848 DOI: 10.15585/mmwr.mm7207a4] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Although severe COVID-19 illness and hospitalization are more common among older adults, children can also be affected (1). More than 3 million cases of COVID-19 had been reported among infants and children aged <5 years (children) as of December 2, 2022 (2). One in four children hospitalized with COVID-19 required intensive care; 21.2% of cases of COVID-19-related multisystem inflammatory syndrome in children (MIS-C) occurred among children aged 1-4 years, and 3.2% of MIS-C cases occurred among infants aged <1 year (1,3). On June 17, 2022, the Food and Drug Administration issued an Emergency Use Authorization (EUA) of the Moderna COVID-19 vaccine for children aged 6 months-5 years and the Pfizer-BioNTech COVID-19 vaccine for children aged 6 months-4 years. To assess COVID-19 vaccination coverage among children aged 6 months-4 years in the United States, coverage with ≥1 dose* and completion of the 2-dose or 3-dose primary vaccination series† were assessed using vaccine administration data for the 50 U.S. states and District of Columbia submitted from June 20 (after COVID-19 vaccine was first authorized for this age group) through December 31, 2022. As of December 31, 2022, ≥1-dose COVID-19 vaccination coverage among children aged 6 months-4 years was 10.1% and was 5.1% for series completion. Coverage with ≥1 dose varied by jurisdiction (range = 2.1% [Mississippi] to 36.1% [District of Columbia]) as did coverage with a completed series (range = 0.7% [Mississippi] to 21.4% [District of Columbia]), respectively. By age group, 9.7 % of children aged 6-23 months and 10.2% of children aged 2-4 years received ≥1 dose; 4.5% of children aged 6-23 months and 5.4% of children aged 2-4 years completed the vaccination series. Among children aged 6 months-4 years, ≥1-dose COVID-19 vaccination coverage was lower in rural counties (3.4%) than in urban counties (10.5%). Among children aged 6 months-4 years who received at least the first dose, only 7.0% were non-Hispanic Black or African American (Black), and 19.9% were Hispanic or Latino (Hispanic), although these demographic groups constitute 13.9% and 25.9% of the population, respectively (4). COVID-19 vaccination coverage among children aged 6 months-4 years is substantially lower than that among older children (5). Efforts are needed to improve vaccination coverage among children aged 6 months-4 years to reduce COVID-19-associated morbidity and mortality.
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Kirtland KA, Raghunathan T, Patel Murthy B, Li J, White K, Gibbs-Scharf L, Harris L, Zell ER. Estimating vaccination coverage for routinely recommended vaccines among children aged 24 months and adolescents aged 13 through 17 years using data from immunization information systems in the United States. Vaccine 2022; 40:7559-7570. [PMID: 36357292 DOI: 10.1016/j.vaccine.2022.10.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/22/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To use a model-based approach to estimate vaccination coverage of routinely recommended childhood and adolescent vaccines for the United States. METHODS We used a hierarchical model with retrospective cohort data from eleven IIS jurisdictions, which contains vaccination records submitted by providers. Numerators included data from 2014 to 2019 at the county level for 2.4 million children at age 24 months and 14.4 million adolescents aged 13-17. Age-appropriate Census populations were used as denominators. Covariates associated with childhood and adolescent vaccinations were included in the model. Model-based estimates for each county were generated and aggregated to the national level to produce national vaccination coverage estimates and compared to National Immunization Survey (NIS) estimates of vaccination coverage. Trends of estimated vaccination coverage were compared between the model-based approach and NIS. RESULTS From 2014 to 18, model-based national vaccination coverage estimates were within ten percentage points of NIS-Child vaccination coverage estimates for most vaccines among children at age 24 months. One notable difference was higher model-based vaccination coverage estimates for hepatitis B birth dose compared to NIS-Child coverage estimates. From 2014 to 19, model-based national vaccination coverage estimates were within ten percentage points of NIS-Teen vaccination coverage estimates for most vaccines among adolescents aged 13-17 years. Model-based vaccination coverage estimates were notably lower for varicella, MMR, and Hepatitis B compared to NIS-Teen coverage estimates among adolescents. Trends in estimates of national vaccination coverage were similar between model-based estimates for children and adolescents as compared to NIS-Child and NIS-Teen, respectively. CONCLUSIONS A hierarchical model applied to data from IIS may be used to estimate coverage for routinely recommended vaccines among children and adolescents and allows for timely analyses of childhood and adolescent vaccines to quickly assess trends in vaccination coverage across the United States. Monitoring real-time vaccination coverage can help promote immunizations to protect children and adolescents against vaccine-preventable diseases.
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Affiliation(s)
| | | | - Bhavini Patel Murthy
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ji Li
- Kapili Services, LLC, Orlando, FL, USA
| | | | - Lynn Gibbs-Scharf
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - LaTreace Harris
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Santibanez TA, Zhou T, Black CL, Vogt TM, Murthy BP, Pineau V, Singleton JA. Sociodemographic Variation in Early Uptake of COVID-19 Vaccine and Parental Intent and Attitudes Toward Vaccination of Children Aged 6 Months-4 Years - United States, July 1-29, 2022. MMWR Morb Mortal Wkly Rep 2022; 71:1479-1484. [PMID: 36395039 PMCID: PMC9707357 DOI: 10.15585/mmwr.mm7146a3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
COVID-19 vaccines are safe and effective for infants and young children, and on June 18, 2022, CDC recommended COVID-19 vaccination for infants and children (children) aged 6 months-4 years (1,2). As of November 9, 2022, based on administrative data reported to CDC,* 5.9% of children aged <2 years and 8.8% of children aged 2-4 years had received ≥1 dose. To better understand reasons for low coverage among children aged <5 years, CDC analyzed data from 4,496 National Immunization Survey-Child COVID Module (NIS-CCM) interviews conducted during July 1-29, 2022, to examine variation in receipt of ≥1 dose of COVID-19 vaccine and parental intent to vaccinate children aged 6 months-4 years by sociodemographic characteristics and by parental beliefs about COVID-19; type of vaccination place was also reported. Among children aged 6 months-4 years, 3.5% were vaccinated; 59.3% were unvaccinated, but the parent was open to vaccination; and 37.2% were unvaccinated, and the parent was reluctant to vaccinate their child. Openness to vaccination was higher among parents of Hispanic or Latino (Hispanic) (66.2%), non-Hispanic Black or African American (Black) (61.1%), and non-Hispanic Asian (Asian) (83.1%) children than among parents of non-Hispanic White (White) (52.9%) children and lower among parents of children in rural areas (45.8%) than among parents of children in urban areas (64.1%). Parental confidence in COVID-19 vaccine safety and receipt of a provider recommendation for COVID-19 vaccination were lower among unvaccinated than vaccinated children. COVID-19 vaccine recommendations from a health care provider, along with dissemination of information about the safety of COVID-19 vaccine by trusted persons, could increase vaccination coverage among young children.
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Havers FP, Pham H, Taylor CA, Whitaker M, Patel K, Anglin O, Kambhampati AK, Milucky J, Zell E, Moline HL, Chai SJ, Kirley PD, Alden NB, Armistead I, Yousey-Hindes K, Meek J, Openo KP, Anderson EJ, Reeg L, Kohrman A, Lynfield R, Como-Sabetti K, Davis EM, Cline C, Muse A, Barney G, Bushey S, Felsen CB, Billing LM, Shiltz E, Sutton M, Abdullah N, Talbot HK, Schaffner W, Hill M, George A, Hall AJ, Bialek SR, Murthy NC, Murthy BP, McMorrow M. COVID-19-Associated Hospitalizations Among Vaccinated and Unvaccinated Adults 18 Years or Older in 13 US States, January 2021 to April 2022. JAMA Intern Med 2022; 182:1071-1081. [PMID: 36074486 PMCID: PMC9459904 DOI: 10.1001/jamainternmed.2022.4299] [Citation(s) in RCA: 67] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/04/2022] [Indexed: 12/24/2022]
Abstract
Importance Understanding risk factors for hospitalization in vaccinated persons and the association of COVID-19 vaccines with hospitalization rates is critical for public health efforts to control COVID-19. Objective To determine characteristics of COVID-19-associated hospitalizations among vaccinated persons and comparative hospitalization rates in unvaccinated and vaccinated persons. Design, Setting, and Participants From January 1, 2021, to April 30, 2022, patients 18 years or older with laboratory-confirmed SARS-CoV-2 infection were identified from more than 250 hospitals in the population-based COVID-19-Associated Hospitalization Surveillance Network. State immunization information system data were linked to cases, and the vaccination coverage data of the defined catchment population were used to compare hospitalization rates in unvaccinated and vaccinated individuals. Vaccinated and unvaccinated patient characteristics were compared in a representative sample with detailed medical record review; unweighted case counts and weighted percentages were calculated. Exposures Laboratory-confirmed COVID-19-associated hospitalization, defined as a positive SARS-CoV-2 test result within 14 days before or during hospitalization. Main Outcomes and Measures COVID-19-associated hospitalization rates among vaccinated vs unvaccinated persons and factors associated with COVID-19-associated hospitalization in vaccinated persons were assessed. Results Using representative data from 192 509 hospitalizations (see Table 1 for demographic information), monthly COVID-19-associated hospitalization rates ranged from 3.5 times to 17.7 times higher in unvaccinated persons than vaccinated persons regardless of booster dose status. From January to April 2022, when the Omicron variant was predominant, hospitalization rates were 10.5 times higher in unvaccinated persons and 2.5 times higher in vaccinated persons with no booster dose, respectively, compared with those who had received a booster dose. Among sampled cases, vaccinated hospitalized patients with COVID-19 were older than those who were unvaccinated (median [IQR] age, 70 [58-80] years vs 58 [46-70] years, respectively; P < .001) and more likely to have 3 or more underlying medical conditions (1926 [77.8%] vs 4124 [51.6%], respectively; P < .001). Conclusions and Relevance In this cross-sectional study of US adults hospitalized with COVID-19, unvaccinated adults were more likely to be hospitalized compared with vaccinated adults; hospitalization rates were lowest in those who had received a booster dose. Hospitalized vaccinated persons were older and more likely to have 3 or more underlying medical conditions and be long-term care facility residents compared with hospitalized unvaccinated persons. The study results suggest that clinicians and public health practitioners should continue to promote vaccination with all recommended doses for eligible persons.
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Affiliation(s)
- Fiona P Havers
- US Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
- Public Health Service Commissioned Corps, Rockville, Maryland
| | - Huong Pham
- US Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
| | - Christopher A Taylor
- US Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
| | - Michael Whitaker
- US Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
| | - Kadam Patel
- US Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
- General Dynamics Information Technology, Atlanta, Georgia
| | - Onika Anglin
- US Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
- General Dynamics Information Technology, Atlanta, Georgia
| | - Anita K Kambhampati
- US Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
| | - Jennifer Milucky
- US Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
| | - Elizabeth Zell
- US Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
- Stat-Epi Associates, Inc, Ponte Vedra Beach, Florida
| | - Heidi L Moline
- US Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
- Public Health Service Commissioned Corps, Rockville, Maryland
| | - Shua J Chai
- Field Services Branch, Division of State and Local Readiness, Center for Preparedness and Response, US Centers for Disease Control and Prevention, Atlanta, Georgia
- California Emerging Infections Program, Oakland
| | | | - Nisha B Alden
- Colorado Department of Public Health and Environment, Denver
| | - Isaac Armistead
- Colorado Department of Public Health and Environment, Denver
| | | | - James Meek
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven
| | - Kyle P Openo
- Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, Georgia
- Georgia Emerging Infections Program, Georgia Department of Public Health, Atlanta
| | - Evan J Anderson
- Georgia Emerging Infections Program, Georgia Department of Public Health, Atlanta
- Departments of Medicine and Pediatrics, Emory School of Medicine, Atlanta, Georgia
- Atlanta Veterans Affairs Medical Center, Atlanta, Georgia
| | - Libby Reeg
- Michigan Department of Health and Human Services, Lansing
| | | | | | | | | | - Cory Cline
- New Mexico Department of Health, Santa Fe
| | | | | | - Sophrena Bushey
- University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Christina B Felsen
- University of Rochester School of Medicine and Dentistry, Rochester, New York
| | | | | | - Melissa Sutton
- Public Health Division, Oregon Health Authority, Portland
| | | | - H Keipp Talbot
- Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Mary Hill
- Salt Lake County Health Department, Salt Lake City, Utah
| | - Andrea George
- Salt Lake County Health Department, Salt Lake City, Utah
| | - Aron J Hall
- US Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
| | - Stephanie R Bialek
- US Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
- Public Health Service Commissioned Corps, Rockville, Maryland
| | - Neil C Murthy
- US Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
- Public Health Service Commissioned Corps, Rockville, Maryland
| | - Bhavini Patel Murthy
- US Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
- Public Health Service Commissioned Corps, Rockville, Maryland
| | - Meredith McMorrow
- US Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
- Public Health Service Commissioned Corps, Rockville, Maryland
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Murthy N, Saelee R, Patel Murthy B, Meng L, Shaw L, Gibbs-Scharf L, Harris L, Chorba T, Zell E. COVID-19 Vaccine Initiation and Dose Completion During the SARS-CoV-2 Delta Variant Surge in the United States, December 2020-October 2021. Public Health Rep 2022; 138:183-189. [PMID: 36129241 PMCID: PMC9494161 DOI: 10.1177/00333549221123584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objectives: In summer 2021, the number of COVID-19–associated hospitalizations in the
United States increased with the surge of the SARS-CoV-2 Delta variant. We
assessed how COVID-19 vaccine initiation and dose completion changed during
the Delta variant surge, based on jurisdictional vaccination coverage before
the surge. Methods: We analyzed COVID-19 vaccination data reported to the Centers for Disease
Control and Prevention. We classified jurisdictions (50 states and the
District of Columbia) into quartiles ranging from high to low first-dose
vaccination coverage among people aged ≥12 years as of June 30, 2021. We
calculated first-dose vaccination coverage as of June 30 and October 31,
2021, and stratified coverage by quartile, age (12-17, 18-64, ≥65 years),
and sex. We assessed dose completion among those who initiated a 2-dose
vaccine series. Results: Of 51 jurisdictions, 15 reached at least 70% vaccination coverage before the
Delta variant surge (ie, as of June 30, 2021), while 35 reached that goal as
of October 31, 2021. Jurisdictions in the lowest quartile of vaccination
coverage (44.9%-54.9%) had the greatest absolute (9.7%-17.9%) and relative
(18.1%-39.8%) percentage increase in vaccination coverage during July
1–October 31, 2021. Of those who received the first dose during this period
across all jurisdictions, nearly 1 in 5 missed the second dose. Conclusions: Although COVID-19 vaccination initiation increased during July 1–October 31,
2021, in jurisdictions in the lowest quartile of vaccination coverage,
coverage remained below that of jurisdictions in the highest quartile of
vaccination coverage before the Delta variant surge. Efforts are needed to
improve access to and increase confidence in COVID-19 vaccines, especially
in low-coverage areas.
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Affiliation(s)
- Neil Murthy
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.,COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Commissioned Corps, US Public Health Service, Rockville, MD, USA
| | - Ryan Saelee
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.,COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Bhavini Patel Murthy
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.,COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Commissioned Corps, US Public Health Service, Rockville, MD, USA
| | - Lu Meng
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lauren Shaw
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.,COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lynn Gibbs-Scharf
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.,COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - LaTreace Harris
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.,COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Terence Chorba
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Division of Tuberculosis Elimination, National Center for HIV, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elizabeth Zell
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.,COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Stat-Epi Associates, Inc, Ponte Vedra Beach, FL, USA
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Fast HE, Murthy BP, Zell E, Meng L, Murthy N, Saelee R, Lu PJ, Kang Y, Shaw L, Gibbs-Scharf L, Harris L. Booster COVID-19 Vaccinations Among Persons Aged ≥5 Years and Second Booster COVID-19 Vaccinations Among Persons Aged ≥50 Years - United States, August 13, 2021-August 5, 2022. MMWR Morb Mortal Wkly Rep 2022; 71:1121-1125. [PMID: 36048732 PMCID: PMC9472775 DOI: 10.15585/mmwr.mm7135a4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
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Meng L, Fast HE, Saelee R, Zell E, Murthy BP, Murthy NC, Lu PJ, Shaw L, Harris L, Gibbs-Scharf L, Chorba T. Using a cloud-based machine-learning classification tree analysis to understand the demographic characteristics associated with COVID-19 booster vaccination among adults in the United States. Open Forum Infect Dis 2022; 9:ofac446. [PMID: 36131845 PMCID: PMC9452182 DOI: 10.1093/ofid/ofac446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/27/2022] [Indexed: 11/14/2022] Open
Abstract
A tree model identified adults age ≤34 years, Johnson & Johnson primary series recipients, people from racial/ethnic minority groups, residents of nonlarge metro areas, and those living in socially vulnerable communities in the South as less likely to be boosted. These findings can guide clinical/public health outreach toward specific subpopulations.
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Affiliation(s)
- Lu Meng
- CDC COVID-19 Response Team, US Centers for Disease Control and Prevention (CDC) , Atlanta, GA , USA
- General Dynamics Information Technology Inc. , Falls Church, VA , USA
| | - Hannah E Fast
- CDC COVID-19 Response Team, US Centers for Disease Control and Prevention (CDC) , Atlanta, GA , USA
- Immunization Services Division, National Center for Immunization and Respiratory Diseases , CDC, Atlanta, GA , USA
| | - Ryan Saelee
- CDC COVID-19 Response Team, US Centers for Disease Control and Prevention (CDC) , Atlanta, GA , USA
- Immunization Services Division, National Center for Immunization and Respiratory Diseases , CDC, Atlanta, GA , USA
| | - Elizabeth Zell
- CDC COVID-19 Response Team, US Centers for Disease Control and Prevention (CDC) , Atlanta, GA , USA
- Stat-Epi Associates, Inc. , Ponte Vedra Beach, FL , USA
| | - Bhavini Patel Murthy
- CDC COVID-19 Response Team, US Centers for Disease Control and Prevention (CDC) , Atlanta, GA , USA
- Immunization Services Division, National Center for Immunization and Respiratory Diseases , CDC, Atlanta, GA , USA
| | - Neil Chandra Murthy
- CDC COVID-19 Response Team, US Centers for Disease Control and Prevention (CDC) , Atlanta, GA , USA
- Immunization Services Division, National Center for Immunization and Respiratory Diseases , CDC, Atlanta, GA , USA
| | - Peng Jun Lu
- CDC COVID-19 Response Team, US Centers for Disease Control and Prevention (CDC) , Atlanta, GA , USA
- Immunization Services Division, National Center for Immunization and Respiratory Diseases , CDC, Atlanta, GA , USA
| | - Lauren Shaw
- CDC COVID-19 Response Team, US Centers for Disease Control and Prevention (CDC) , Atlanta, GA , USA
- Immunization Services Division, National Center for Immunization and Respiratory Diseases , CDC, Atlanta, GA , USA
| | - LaTreace Harris
- CDC COVID-19 Response Team, US Centers for Disease Control and Prevention (CDC) , Atlanta, GA , USA
- Immunization Services Division, National Center for Immunization and Respiratory Diseases , CDC, Atlanta, GA , USA
| | - Lynn Gibbs-Scharf
- CDC COVID-19 Response Team, US Centers for Disease Control and Prevention (CDC) , Atlanta, GA , USA
- Immunization Services Division, National Center for Immunization and Respiratory Diseases , CDC, Atlanta, GA , USA
| | - Terence Chorba
- CDC COVID-19 Response Team, US Centers for Disease Control and Prevention (CDC) , Atlanta, GA , USA
- Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC , Atlanta, GA , USA
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Meng L, Murthy NC, Murthy BP, Zell E, Saelee R, Irving M, Fast HE, Roman PC, Schiller A, Shaw L, Black CL, Gibbs-Scharf L, Harris L, Chorba T. Factors Associated with Delayed or Missed Second-Dose mRNA COVID-19 Vaccination among Persons >12 Years of Age, United States. Emerg Infect Dis 2022; 28:1633-1641. [PMID: 35798008 PMCID: PMC9328898 DOI: 10.3201/eid2808.220557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
To identify demographic factors associated with delaying or not receiving a second dose of the 2-dose primary mRNA COVID-19 vaccine series, we matched 323 million single Pfizer-BioNTech (https://www.pfizer.com) and Moderna (https://www.modernatx.com) COVID-19 vaccine administration records from 2021 and determined whether second doses were delayed or missed. We used 2 sets of logistic regression models to examine associated factors. Overall, 87.3% of recipients received a timely second dose (≤42 days between first and second dose), 3.4% received a delayed second dose (>42 days between first and second dose), and 9.4% missed the second dose. Persons more likely to have delayed or missed the second dose belonged to several racial/ethnic minority groups, were 18–39 years of age, lived in more socially vulnerable areas, and lived in regions other than the northeastern United States. Logistic regression models identified specific subgroups for providing outreach and encouragement to receive subsequent doses on time.
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Saelee R, Zell E, Murthy BP, Castro-Roman P, Fast H, Meng L, Shaw L, Gibbs-Scharf L, Chorba T, Harris LQ, Murthy N. Disparities in COVID-19 Vaccination Coverage Between Urban and Rural Counties - United States, December 14, 2020-January 31, 2022. MMWR Morb Mortal Wkly Rep 2022; 71:335-340. [PMID: 35239636 PMCID: PMC8893338 DOI: 10.15585/mmwr.mm7109a2] [Citation(s) in RCA: 68] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Murthy NC, Zell E, Fast HE, Murthy BP, Meng L, Saelee R, Vogt T, Chatham-Stephens K, Ottis C, Shaw L, Gibbs-Scharf L, Harris L, Chorba T. Disparities in First Dose COVID-19 Vaccination Coverage among Children 5-11 Years of Age, United States. Emerg Infect Dis 2022; 28:986-989. [PMID: 35226801 PMCID: PMC9045440 DOI: 10.3201/eid2805.220166] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
We analyzed first-dose coronavirus disease vaccination coverage among US children 5–11 years of age during November–December 2021. Pediatric vaccination coverage varied widely by jurisdiction, age group, and race/ethnicity, and lagged behind vaccination coverage for adolescents aged 12–15 years during the first 2 months of vaccine rollout.
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Fast HE, Zell E, Murthy BP, Murthy N, Meng L, Scharf LG, Black CL, Shaw L, Chorba T, Harris LQ. Booster and Additional Primary Dose COVID-19 Vaccinations Among Adults Aged ≥65 Years - United States, August 13, 2021-November 19, 2021. MMWR Morb Mortal Wkly Rep 2021; 70:1735-1739. [PMID: 34914672 PMCID: PMC8675661 DOI: 10.15585/mmwr.mm7050e2] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Roman PC, Kirtland K, Zell ER, Jones-Jack N, Shaw L, Shrader L, Sprague C, Schultz J, Le Q, Nalla A, Kuramoto S, Cheng I, Woinarowicz M, Robison S, Robinson S, Meder K, Murphy A, Gibbs-Scharf L, Harris L, Murthy BP. Influenza Vaccinations During the COVID-19 Pandemic - 11 U.S. Jurisdictions, September-December 2020. MMWR Morb Mortal Wkly Rep 2021; 70:1575-1578. [PMID: 34758010 PMCID: PMC8580205 DOI: 10.15585/mmwr.mm7045a3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Murthy BP, Zell E, Saelee R, Murthy N, Meng L, Meador S, Reed K, Shaw L, Gibbs-Scharf L, McNaghten AD, Patel A, Stokley S, Flores S, Yoder JS, Black CL, Harris LQ. COVID-19 Vaccination Coverage Among Adolescents Aged 12-17 Years - United States, December 14, 2020-July 31, 2021. MMWR Morb Mortal Wkly Rep 2021. [PMID: 34473680 DOI: 10.15585/mmwr.mm7035e1external.icon] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Although severe COVID-19 illness and hospitalization are more common among adults, these outcomes can occur in adolescents (1). Nearly one third of adolescents aged 12-17 years hospitalized with COVID-19 during March 2020-April 2021 required intensive care, and 5% of those hospitalized required endotracheal intubation and mechanical ventilation (2). On December 11, 2020, the Food and Drug Administration (FDA) issued Emergency Use Authorization (EUA) of the Pfizer-BioNTech COVID-19 vaccine for adolescents aged 16-17 years; on May 10, 2021, the EUA was expanded to include adolescents aged 12-15 years; and on August 23, 2021, FDA granted approval of the vaccine for persons aged ≥16 years. To assess progress in adolescent COVID-19 vaccination in the United States, CDC assessed coverage with ≥1 dose* and completion of the 2-dose vaccination series† among adolescents aged 12-17 years using vaccine administration data for 49 U.S. states (all except Idaho) and the District of Columbia (DC) during December 14, 2020-July 31, 2021. As of July 31, 2021, COVID-19 vaccination coverage among U.S. adolescents aged 12-17 years was 42.4% for ≥1 dose and 31.9% for series completion. Vaccination coverage with ≥1 dose varied by state (range = 20.2% [Mississippi] to 70.1% [Vermont]) and for series completion (range = 10.7% [Mississippi] to 60.3% [Vermont]). By age group, 36.0%, 40.9%, and 50.6% of adolescents aged 12-13, 14-15, and 16-17 years, respectively, received ≥1 dose; 25.4%, 30.5%, and 40.3%, respectively, completed the vaccine series. Improving vaccination coverage and implementing COVID-19 prevention strategies are crucial to reduce COVID-19-associated morbidity and mortality among adolescents and to facilitate safer reopening of schools for in-person learning.
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Murthy BP, Zell E, Saelee R, Murthy N, Meng L, Meador S, Reed K, Shaw L, Gibbs-Scharf L, McNaghten A, Patel A, Stokley S, Flores S, Yoder JS, Black CL, Harris LQ. COVID-19 Vaccination Coverage Among Adolescents Aged 12-17 Years - United States, December 14, 2020-July 31, 2021. MMWR Morb Mortal Wkly Rep 2021; 70:1206-1213. [PMID: 34473680 PMCID: PMC8422871 DOI: 10.15585/mmwr.mm7035e1] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Moline HL, Whitaker M, Deng L, Rhodes JC, Milucky J, Pham H, Patel K, Anglin O, Reingold A, Chai SJ, Alden NB, Kawasaki B, Meek J, Yousey-Hindes K, Anderson EJ, Farley MM, Ryan PA, Kim S, Nunez VT, Como-Sabetti K, Lynfield R, Sosin DM, McMullen C, Muse A, Barney G, Bennett NM, Bushey S, Shiltz J, Sutton M, Abdullah N, Talbot HK, Schaffner W, Chatelain R, Ortega J, Murthy BP, Zell E, Schrag SJ, Taylor C, Shang N, Verani JR, Havers FP. Effectiveness of COVID-19 Vaccines in Preventing Hospitalization Among Adults Aged ≥65 Years - COVID-NET, 13 States, February-April 2021. MMWR Morb Mortal Wkly Rep 2021; 70:1088-1093. [PMID: 34383730 PMCID: PMC8360274 DOI: 10.15585/mmwr.mm7032e3] [Citation(s) in RCA: 103] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Clinical trials of COVID-19 vaccines currently authorized for emergency use in the United States (Pfizer-BioNTech, Moderna, and Janssen [Johnson & Johnson]) indicate that these vaccines have high efficacy against symptomatic disease, including moderate to severe illness (1-3). In addition to clinical trials, real-world assessments of COVID-19 vaccine effectiveness are critical in guiding vaccine policy and building vaccine confidence, particularly among populations at higher risk for more severe illness from COVID-19, including older adults. To determine the real-world effectiveness of the three currently authorized COVID-19 vaccines among persons aged ≥65 years during February 1-April 30, 2021, data on 7,280 patients from the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) were analyzed with vaccination coverage data from state immunization information systems (IISs) for the COVID-NET catchment area (approximately 4.8 million persons). Among adults aged 65-74 years, effectiveness of full vaccination in preventing COVID-19-associated hospitalization was 96% (95% confidence interval [CI] = 94%-98%) for Pfizer-BioNTech, 96% (95% CI = 95%-98%) for Moderna, and 84% (95% CI = 64%-93%) for Janssen vaccine products. Effectiveness of full vaccination in preventing COVID-19-associated hospitalization among adults aged ≥75 years was 91% (95% CI = 87%-94%) for Pfizer-BioNTech, 96% (95% CI = 93%-98%) for Moderna, and 85% (95% CI = 72%-92%) for Janssen vaccine products. COVID-19 vaccines currently authorized in the United States are highly effective in preventing COVID-19-associated hospitalizations in older adults. In light of real-world data demonstrating high effectiveness of COVID-19 vaccines among older adults, efforts to increase vaccination coverage in this age group are critical to reducing the risk for COVID-19-related hospitalization.
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Patel Murthy B, Zell E, Kirtland K, Jones-Jack N, Harris L, Sprague C, Schultz J, Le Q, Bramer CA, Kuramoto S, Cheng I, Woinarowicz M, Robison S, McHugh A, Schauer S, Gibbs-Scharf L. Impact of the COVID-19 Pandemic on Administration of Selected Routine Childhood and Adolescent Vaccinations - 10 U.S. Jurisdictions, March-September 2020. MMWR Morb Mortal Wkly Rep 2021; 70:840-845. [PMID: 34111058 PMCID: PMC8191867 DOI: 10.15585/mmwr.mm7023a2] [Citation(s) in RCA: 108] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Murthy BP, Sterrett N, Weller D, Zell E, Reynolds L, Toblin RL, Murthy N, Kriss J, Rose C, Cadwell B, Wang A, Ritchey MD, Gibbs-Scharf L, Qualters JR, Shaw L, Brookmeyer KA, Clayton H, Eke P, Adams L, Zajac J, Patel A, Fox K, Williams C, Stokley S, Flores S, Barbour KE, Harris LQ. Disparities in COVID-19 Vaccination Coverage Between Urban and Rural Counties - United States, December 14, 2020-April 10, 2021. MMWR Morb Mortal Wkly Rep 2021; 70:759-764. [PMID: 34014911 PMCID: PMC8136424 DOI: 10.15585/mmwr.mm7020e3] [Citation(s) in RCA: 132] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Whiteman A, Wang A, McCain K, Gunnels B, Toblin R, Lee JT, Bridges C, Reynolds L, Murthy BP, Qualters J, Singleton JA, Fox K, Stokley S, Harris L, Gibbs-Scharf L, Abad N, Brookmeyer KA, Farrall S, Pingali C, Patel A, Link-Gelles R, Dasgupta S, Gharpure R, Ritchey MD, Barbour KE. Demographic and Social Factors Associated with COVID-19 Vaccination Initiation Among Adults Aged ≥65 Years - United States, December 14, 2020-April 10, 2021. MMWR Morb Mortal Wkly Rep 2021; 70:725-730. [PMID: 33983911 PMCID: PMC8118148 DOI: 10.15585/mmwr.mm7019e4] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Compared with other age groups, older adults (defined here as persons aged ≥65 years) are at higher risk for COVID-19-associated morbidity and mortality and have therefore been prioritized for COVID-19 vaccination (1,2). Ensuring access to vaccines for older adults has been a focus of federal, state, and local response efforts, and CDC has been monitoring vaccination coverage to identify and address disparities among subpopulations of older adults (2). Vaccine administration data submitted to CDC were analyzed to determine the prevalence of COVID-19 vaccination initiation among adults aged ≥65 years by demographic characteristics and overall. Characteristics of counties with low vaccination initiation rates were quantified using indicators of social vulnerability data from the 2019 American Community Survey.* During December 14, 2020-April 10, 2021, nationwide, a total of 42,736,710 (79.1%) older adults had initiated vaccination. The initiation rate was higher among men than among women and varied by state. On average, counties with low vaccination initiation rates (<50% of older adults having received at least 1 vaccine dose), compared with those with high rates (≥75%), had higher percentages of older adults without a computer, living in poverty, without Internet access, and living alone. CDC, state, and local jurisdictions in partnerships with communities should continue to identify and implement strategies to improve access to COVID-19 vaccination for older adults, such as assistance with scheduling vaccination appointments and transportation to vaccination sites, or vaccination at home if needed for persons who are homebound.† Monitoring demographic and social factors affecting COVID-19 vaccine access for older adults and prioritizing efforts to ensure equitable access to COVID-19 vaccine are needed to ensure high coverage among this group.
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Hughes MM, Wang A, Grossman MK, Pun E, Whiteman A, Deng L, Hallisey E, Sharpe JD, Ussery EN, Stokley S, Musial T, Weller DL, Murthy BP, Reynolds L, Gibbs-Scharf L, Harris L, Ritchey MD, Toblin RL. County-Level COVID-19 Vaccination Coverage and Social Vulnerability - United States, December 14, 2020-March 1, 2021. MMWR Morb Mortal Wkly Rep 2021; 70:431-436. [PMID: 33764963 PMCID: PMC7993557 DOI: 10.15585/mmwr.mm7012e1] [Citation(s) in RCA: 153] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The U.S. COVID-19 vaccination program began in December 2020, and ensuring equitable COVID-19 vaccine access remains a national priority.* COVID-19 has disproportionately affected racial/ethnic minority groups and those who are economically and socially disadvantaged (1,2). Thus, achieving not just vaccine equality (i.e., similar allocation of vaccine supply proportional to its population across jurisdictions) but equity (i.e., preferential access and administra-tion to those who have been most affected by COVID-19 disease) is an important goal. The CDC social vulnerability index (SVI) uses 15 indicators grouped into four themes that comprise an overall SVI measure, resulting in 20 metrics, each of which has national and state-specific county rankings. The 20 metric-specific rankings were each divided into lowest to highest tertiles to categorize counties as low, moderate, or high social vulnerability counties. These tertiles were combined with vaccine administration data for 49,264,338 U.S. residents in 49 states and the District of Columbia (DC) who received at least one COVID-19 vaccine dose during December 14, 2020-March 1, 2021. Nationally, for the overall SVI measure, vaccination coverage was higher (15.8%) in low social vulnerability counties than in high social vulnerability counties (13.9%), with the largest coverage disparity in the socioeconomic status theme (2.5 percentage points higher coverage in low than in high vulnerability counties). Wide state variations in equity across SVI metrics were found. Whereas in the majority of states, vaccination coverage was higher in low vulnerability counties, some states had equitable coverage at the county level. CDC, state, and local jurisdictions should continue to monitor vaccination coverage by SVI metrics to focus public health interventions to achieve equitable coverage with COVID-19 vaccine.
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Painter EM, Ussery EN, Patel A, Hughes MM, Zell ER, Moulia DL, Scharf LG, Lynch M, Ritchey MD, Toblin RL, Murthy BP, Harris LQ, Wasley A, Rose DA, Cohn A, Messonnier NE. Demographic Characteristics of Persons Vaccinated During the First Month of the COVID-19 Vaccination Program - United States, December 14, 2020-January 14, 2021. MMWR Morb Mortal Wkly Rep 2021; 70:174-177. [PMID: 33539333 PMCID: PMC7861480 DOI: 10.15585/mmwr.mm7005e1] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In December 2020, two COVID-19 vaccines (Pfizer-BioNTech and Moderna) were authorized for emergency use in the United States for the prevention of coronavirus disease 2019 (COVID-19).* Because of limited initial vaccine supply, the Advisory Committee on Immunization Practices (ACIP) prioritized vaccination of health care personnel† and residents and staff members of long-term care facilities (LTCF) during the first phase of the U.S. COVID-19 vaccination program (1). Both vaccines require 2 doses to complete the series. Data on vaccines administered during December 14, 2020-January 14, 2021, and reported to CDC by January 26, 2021, were analyzed to describe demographic characteristics, including sex, age, and race/ethnicity, of persons who received ≥1 dose of COVID-19 vaccine (i.e., initiated vaccination). During this period, 12,928,749 persons in the United States in 64 jurisdictions and five federal entities§ initiated COVID-19 vaccination. Data on sex were reported for 97.0%, age for 99.9%, and race/ethnicity for 51.9% of vaccine recipients. Among persons who received the first vaccine dose and had reported demographic data, 63.0% were women, 55.0% were aged ≥50 years, and 60.4% were non-Hispanic White (White). More complete reporting of race and ethnicity data at the provider and jurisdictional levels is critical to ensure rapid detection of and response to potential disparities in COVID-19 vaccination. As the U.S. COVID-19 vaccination program expands, public health officials should ensure that vaccine is administered efficiently and equitably within each successive vaccination priority category, especially among those at highest risk for infection and severe adverse health outcomes, many of whom are non-Hispanic Black (Black), non-Hispanic American Indian/Alaska Native (AI/AN), and Hispanic persons (2,3).
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Affiliation(s)
- Bhavini Patel Murthy
- Bhavini Patel Murthy, MD, MPH, is a Lieutenant Commander, United States Public Health Service, and a Medical Epidemiologist; Sara J. Vagi, MS, PhD, is Commander, United States Public Health Service, and a Senior Health Scientist; Tanya Telfair LeBlanc, MS, PhD, was a Senior Health Scientist at the time of the study; and Rachel Nonkin Avchen, MS, PhD, is a Captain, United States Public Health Service, and Branch Chief; all in the Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA. Tanya Telfair LeBlanc, MS, PhD, is currently a Senior Health Scientist/Epidemiologist, National Center for Environmental Health/ Division of Environmental Health Science and Practice, Centers for Disease Control and Prevention, Chamblee, GA
| | - Tanya Telfair LeBlanc
- Bhavini Patel Murthy, MD, MPH, is a Lieutenant Commander, United States Public Health Service, and a Medical Epidemiologist; Sara J. Vagi, MS, PhD, is Commander, United States Public Health Service, and a Senior Health Scientist; Tanya Telfair LeBlanc, MS, PhD, was a Senior Health Scientist at the time of the study; and Rachel Nonkin Avchen, MS, PhD, is a Captain, United States Public Health Service, and Branch Chief; all in the Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA. Tanya Telfair LeBlanc, MS, PhD, is currently a Senior Health Scientist/Epidemiologist, National Center for Environmental Health/ Division of Environmental Health Science and Practice, Centers for Disease Control and Prevention, Chamblee, GA
| | - Sara J Vagi
- Bhavini Patel Murthy, MD, MPH, is a Lieutenant Commander, United States Public Health Service, and a Medical Epidemiologist; Sara J. Vagi, MS, PhD, is Commander, United States Public Health Service, and a Senior Health Scientist; Tanya Telfair LeBlanc, MS, PhD, was a Senior Health Scientist at the time of the study; and Rachel Nonkin Avchen, MS, PhD, is a Captain, United States Public Health Service, and Branch Chief; all in the Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA. Tanya Telfair LeBlanc, MS, PhD, is currently a Senior Health Scientist/Epidemiologist, National Center for Environmental Health/ Division of Environmental Health Science and Practice, Centers for Disease Control and Prevention, Chamblee, GA
| | - Rachel Nonkin Avchen
- Bhavini Patel Murthy, MD, MPH, is a Lieutenant Commander, United States Public Health Service, and a Medical Epidemiologist; Sara J. Vagi, MS, PhD, is Commander, United States Public Health Service, and a Senior Health Scientist; Tanya Telfair LeBlanc, MS, PhD, was a Senior Health Scientist at the time of the study; and Rachel Nonkin Avchen, MS, PhD, is a Captain, United States Public Health Service, and Branch Chief; all in the Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA. Tanya Telfair LeBlanc, MS, PhD, is currently a Senior Health Scientist/Epidemiologist, National Center for Environmental Health/ Division of Environmental Health Science and Practice, Centers for Disease Control and Prevention, Chamblee, GA
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Chow NA, Toda M, Pennington AF, Anassi E, Atmar RL, Cox-Ganser JM, Da Silva J, Garcia B, Kontoyiannis DP, Ostrosky-Zeichner L, Leining LM, McCarty J, Al Mohajer M, Murthy BP, Park JH, Schulte J, Shuford JA, Skrobarcek KA, Solomon S, Strysko J, Chiller TM, Jackson BR, Chew GL, Beer KD. Hurricane-Associated Mold Exposures Among Patients at Risk for Invasive Mold Infections After Hurricane Harvey - Houston, Texas, 2017. MMWR Morb Mortal Wkly Rep 2019; 68:469-473. [PMID: 31145717 PMCID: PMC6542480 DOI: 10.15585/mmwr.mm6821a1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
In August 2017, Hurricane Harvey caused unprecedented flooding and devastation to the Houston metropolitan area (1). Mold exposure was a serious concern because investigations after Hurricanes Katrina and Rita (2005) had documented extensive mold growth in flood-damaged homes (2,3). Because mold exposure can cause serious illnesses known as invasive mold infections (4,5), and immunosuppressed persons are at high risk for these infections (6,7), several federal agencies recommend that immunosuppressed persons avoid mold-contaminated sites (8,9). To assess the extent of exposure to mold and flood-damaged areas among persons at high risk for invasive mold infections after Hurricane Harvey, CDC and Texas health officials conducted a survey among 103 immunosuppressed residents in Houston. Approximately half of the participants (50) engaged in cleanup of mold and water-damaged areas; these activities included heavy cleanup (23), such as removing furniture or removing drywall, or light cleanup (27), such as wiping down walls or retrieving personal items. Among immunosuppressed persons who performed heavy cleanup, 43% reported wearing a respirator, as did 8% who performed light cleanup. One participant reported wearing all personal protective equipment (PPE) recommended for otherwise healthy persons (i.e., respirator, boots, goggles, and gloves). Immunosuppressed residents who are at high risk for invasive mold infections were exposed to mold and flood-damaged areas after Hurricane Harvey; recommendations from health care providers to avoid exposure to mold and flood-damaged areas could mitigate the risk to immunosuppressed persons.
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Murthy BP, Krishna N, Jones T, Wolkin A, Avchen RN, Vagi SJ. Public Health Emergency Risk Communication and Social Media Reactions to an Errant Warning of a Ballistic Missile Threat — Hawaii, January 2018. MMWR Morb Mortal Wkly Rep 2019; 68:174-176. [PMID: 30789877 PMCID: PMC6385709 DOI: 10.15585/mmwr.mm6807a2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Murthy BP, Vagi S, Desamu-Thorpe R, Avchen R. Assessment of State, Local, and Territorial Zika Planning and Preparedness Activities - United States, June 2016-July 2017. MMWR Morb Mortal Wkly Rep 2018; 67:969-973. [PMID: 30188883 PMCID: PMC6132181 DOI: 10.15585/mmwr.mm6735a2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Murthy BP, Molinari NAM, LeBlanc TT, Vagi SJ, Avchen RN. Progress in Public Health Emergency Preparedness-United States, 2001-2016. Am J Public Health 2017; 107:S180-S185. [PMID: 28892440 DOI: 10.2105/ajph.2017.304038] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVES To evaluate the Public Health Emergency Preparedness (PHEP) program's progress toward meeting public health preparedness capability standards in state, local, and territorial health departments. METHODS All 62 PHEP awardees completed the Centers for Disease Control and Prevention's self-administered PHEP Impact Assessment as part of program review measuring public health preparedness capability before September 11, 2001 (9/11), and in 2014. We collected additional self-reported capability self-assessments from 2016. We analyzed trends in congressional funding for public health preparedness from 2001 to 2016. RESULTS Before 9/11, most PHEP awardees reported limited preparedness capabilities, but considerable progress was reported by 2016. The number of jurisdictions reporting established capability functions within the countermeasures and mitigation domain had the largest increase, almost 200%, by 2014. However, more than 20% of jurisdictions still reported underdeveloped coordination between the health system and public health agencies in 2016. Challenges and barriers to building PHEP capabilities included lack of trained personnel, plans, and sustained resources. CONCLUSIONS Considerable progress in public health preparedness capability was observed from before 9/11 to 2016. Support, sustainment, and advancement of public health preparedness capability is critical to ensure a strong public health infrastructure.
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Affiliation(s)
- Bhavini Patel Murthy
- All authors are with the Division of State and Local Readiness, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Bhavini Patel Murthy is also with Epidemic Intelligence Service, CDC, Atlanta. Tanya T. LeBlanc and Rachel N. Avchen are also guest editors for this supplement issue
| | - Noelle-Angelique M Molinari
- All authors are with the Division of State and Local Readiness, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Bhavini Patel Murthy is also with Epidemic Intelligence Service, CDC, Atlanta. Tanya T. LeBlanc and Rachel N. Avchen are also guest editors for this supplement issue
| | - Tanya T LeBlanc
- All authors are with the Division of State and Local Readiness, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Bhavini Patel Murthy is also with Epidemic Intelligence Service, CDC, Atlanta. Tanya T. LeBlanc and Rachel N. Avchen are also guest editors for this supplement issue
| | - Sara J Vagi
- All authors are with the Division of State and Local Readiness, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Bhavini Patel Murthy is also with Epidemic Intelligence Service, CDC, Atlanta. Tanya T. LeBlanc and Rachel N. Avchen are also guest editors for this supplement issue
| | - Rachel N Avchen
- All authors are with the Division of State and Local Readiness, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Bhavini Patel Murthy is also with Epidemic Intelligence Service, CDC, Atlanta. Tanya T. LeBlanc and Rachel N. Avchen are also guest editors for this supplement issue
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Crews KR, Murthy BP, Hussey EK, Passannante AN, Palmer JL, Maixner W, Brouwer KL. Lack of effect of ondansetron on the pharmacokinetics and analgesic effects of morphine and metabolites after single-dose morphine administration in healthy volunteers. Br J Clin Pharmacol 2001; 51:309-16. [PMID: 11318765 PMCID: PMC2014461 DOI: 10.1046/j.1365-2125.2001.01369.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AIMS The purpose of this investigation was to study the influence of ondansetron on the single-dose pharmacokinetics and the analgesic effects elicited by morphine and the 3- and 6-glucuronide metabolites of morphine in healthy volunteers. METHODS This was a randomized, double-blind, placebo-controlled, two-way crossover study in which six male and six female subjects were administered a single 10 mg intravenous dose of morphine sulphate, followed 30 min later by a single 16 mg intravenous dose of ondansetron hydrochloride or placebo. Serum and urine concentrations of morphine, morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G) samples were quantified over 48 h using high performance liquid chromatography with detection by mass spectrometry. Analgesia was assessed in the volunteers with a contact thermode device to provide a thermal pain stimulus. Four analgesic response variables were measured including thermal pain threshold, thermal pain tolerance, temporal summation of pain and mood state. RESULTS The two treatments appeared to be equivalent based on the 90% confidence intervals (0.6, 1.67) of the least squares means ratio. All least squares means ratio confidence intervals for each parameter, for each analyte fell within the specified range, demonstrating a lack of an interaction. CONCLUSIONS The results of this study suggest that administration of ondansetron (16 mg i.v.) does not alter the pharmacokinetics of morphine and its 3- or 6-glucuronide metabolites to a clinically significant extent, nor does it affect the overall analgesic response to morphine as measured by the contact thermode system.
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Affiliation(s)
- K R Crews
- GlaxoSmithKline Inc., Research Triangle Park, NC, USA
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