Trends in primary, booster, and updated COVID-19 vaccine readiness in the United States, January 2021-April 2023: Implications for 2023-2024 updated COVID-19 vaccines.

OBJECTIVE: COVID-19 vaccines have mitigated the severity of COVID-19 and its sequelae. The emergence of new SARS-CoV-2 variants and waning immunity conferred by COVID-19 vaccination have necessitated booster and updated COVID-19 vaccines. This study examined trends in vaccine readiness-a composite measure of intention and uptake-for the primary, booster, and 2022-2023 updated (bivalent) COVID-19 vaccines among U.S. adults. METHODS: Data from the nationally-representative U.S. Department of Health and Human Services' COVID-19 Monthly Outcome Survey from January 2021 to April 2023 were analyzed (N = 140,180). We conducted pairwise comparisons (weighted t-tests) to assess for significant between-month differences in the proportion of participants in each vaccine-readiness category (vaccine ready, wait and see, and no vaccine intention) for the following outcomes: (1) primary; (2) booster; and (3) updated COVID-19 vaccine readiness. RESULTS: From January 2021 to April 2023, significant increases in the primary vaccine ready group were accompanied by decreases in the wait and see and no vaccine intention groups (p < 0.001). From January to September 2022, the no booster intention group notably increased (p < 0.001), whereas the booster ready group decreased (p < 0.001), and the wait and see group remained stable (p = 0.116). From October 2022 to April 2023, the no updated vaccine intention group increased (p < 0.001), the wait and see group decreased (p < 0.01), and the updated vaccine ready group remained unchanged (p = 0.357). CONCLUSIONS: Findings show decreased vaccine readiness for the booster and 2022-2023 updated (bivalent) COVID-19 vaccines relative to the primary COVID-19 vaccines. Implications for the 2023-2024 updated COVID-19 vaccines are discussed.

The Association Between the We Can Do This Campaign and Vaccination Beliefs in the United States, January 2021-March 2022.

Public health campaigns addressing COVID-19 vaccination beliefs may be effective in changing COVID-19 vaccination behaviors, particularly among people who remain vaccine hesitant. The "We Can Do This" COVID-19 public education campaign (the Campaign) was designed to increase COVID-19 vaccine confidence and uptake. This study aims to evaluate whether Campaign dose was associated with changes in vaccination beliefs related to COVID-19 vaccine concerns and perceived risks, the importance of COVID-19 vaccines, the perceived benefits of COVID-19 vaccination, normative beliefs about COVID-19 vaccination, and perceptions about general vaccine safety and effectiveness. The study linked data from four waves of a nationally representative longitudinal panel of U.S. adults (January 2021-March 2022) with Campaign paid digital media data (April 2021-May 2022). We used mixed-effects linear regressions to examine the association between Campaign paid digital impressions and changes in vaccination beliefs. The results provide evidence that Campaign digital impressions were significantly associated with changes in respondent beliefs regarding COVID-19 vaccine concerns and perceived risks, perceived benefits of COVID-19 vaccination, and perceptions about general vaccine safety and effectiveness. Findings suggest that public education campaigns may influence vaccine confidence and uptake by increasing positive vaccination beliefs and reducing vaccine concerns.

Child Sexual Abuse and Intimate Partner Violence Victimization in Adulthood: Sex-Differences in the Mediating Influence of Age of Sexual Initiation.

Child sexual abuse is a major public health concern in the United States with devastating sequelae. Although the relationship between child sexual abuse and intimate partner violence victimization in adulthood is known, little is known about the mediating influence of the age of sexual initiation on the association, or whether sex differences exist. Using data from waves I, III, and IV of the National Longitudinal Study of Adolescent to Adult Health (N = 1,163), we aimed to examine the mediating influence of age of sexual initiation on the association between child sexual abuse and intimate partner violence victimization in adulthood and identify sex differences. Findings reveal that in female survivors, age of sexual initiation partially mediated the association between child sexual abuse and physical intimate partner violence victimization in adulthood. In male survivors, no mediational effect was observed. Public health practitioners should be aware of sex differences in the effect of early sexual initiation on intimate partner violence victimization in adulthood among child sexual abuse survivors.

Racial and ethnic differences in COVID-19 vaccine readiness among adults in the United States, January 2021-April 2023.

Racial and ethnic minority groups have been disproportionately affected by COVID-19 and have experienced systemic, attitudinal, and access-related barriers to COVID-19 vaccination. We examined differences in COVID-19 vaccine readiness-a composite measure of vaccination intention and behavior-between non-Hispanic White, non-Hispanic Black, Hispanic, non-Hispanic Asian American/Pacific Islander, and American Indian/Alaska Native U.S. adults. Using data from a cross-sectional survey administered to nationally representative samples of âˆ¼ 5,000 U.S. adults each month from January 2021 to April 2023 (n = 135,989), we conducted weighted ttests comparing the monthly percentage of participants from racial/ethnic groups who were "Vaccine Ready." Initial racial/ethnic disparities in vaccine readiness were attenuated within a 7-month period, after which adults from most minority racial/ethnic groups became equally or more vaccine ready compared to non-Hispanic White adults (p < 0.05). Findings suggest that barriers to vaccine readiness that were more prevalent in non-White racial/ethnic groups may have largely been addressed.

Association between vaccination beliefs and COVID-19 vaccine uptake in a longitudinal panel survey of adults in the United States, 2021-2022.

COVID-19 vaccine hesitancy has been a major limiting factor to the widespread uptake of COVID-19 vaccination in the United States. A range of interventions, including mass media campaigns, have been implemented to encourage COVID-19 vaccine confidence and uptake. Such interventions are often guided by theories of behavior change, which posit that behavioral factors, including beliefs, influence behaviors such as vaccination. Although previous studies have examined relationships between vaccination beliefs and COVID-19 vaccination behavior, they come with limitations, such as the use of cross-sectional study designs and, for longitudinal studies, few survey waves. To account for these limitations, we examined associations between vaccination beliefs and COVID-19 vaccine uptake using data from six waves of a nationally representative, longitudinal survey of U.S. adults (N = 3,524) administered over a nearly 2-year period (January 2021-November 2022). Survey-weighted lagged logistic regression models were used to examine the association between lagged reports of vaccination belief change and COVID-19 vaccine uptake, using five belief scales: (1) importance of COVID-19 vaccines, (2) perceived benefits of COVID-19 vaccination, (3) COVID-19 vaccine concerns and risks, (4) normative beliefs about COVID-19 vaccination, and (5) perceptions of general vaccine safety and effectiveness. Analyses controlled for confounding factors and accounted for within-respondent dependence due to repeated measures. In individual models, all vaccination belief scales were significantly associated with increased COVID-19 vaccine uptake. In a combined model, all belief scales except the benefits of COVID-19 vaccination were significant predictors of vaccine uptake. Overall, belief scales indicating the importance of COVID-19 vaccines and normative beliefs about COVID-19 vaccination were the strongest predictors of COVID-19 vaccine uptake. Findings demonstrate that changes in vaccination beliefs influence subsequent COVID-19 vaccine uptake, with implications for the development of future interventions to increase COVID-19 vaccination.

Association Between Bully Victimization and Vaping Among Texas High School Students.

INTRODUCTION: Bullying and vaping among adolescents in Texas is a major public health concern. Bully victimization has been associated with substance use in adolescents; however, research examining the association between bully victimization and vaping in adolescents is sparse. This study aims to examine the independent association between bully victimization and vaping among Texas high school students. METHODS: Pooled data from the 2017 and 2019 Texas Youth Risk Behavior Survey (N=3,486) were analyzed in July 2020. Past-year bully victimization was categorized into 4 mutually exclusive groups: no bully victimization, school bully victimization only, cyberbully victimization only, and both school bully and cyberbully victimization. Current vape use was measured as a binary variable. Multivariable logistic regression was used to examine the association. RESULTS: In the total sample, the past-year prevalence of school bully victimization only, cyberbully victimization only, and both school bully and cyberbully victimization was 8.3%, 4.6%, and 7.7%, respectively. Approximately 1 in 7 students (14.5%) reported vaping during the past 30 days. Female students who experienced both school bullying and cyberbullying had 68% greater odds of vaping than female students who did not experience bullying (AOR=1.68, 95% CI=1.02, 3.41). Bully victimization was not significantly associated with vaping in male students. CONCLUSIONS: Female Texas high school students who are victims of both school bullying and cyberbullying have a greater likelihood of vaping. Healthcare providers, school counselors, and educators should be aware of the association and sex differences that exist while developing intervention programs to address bullying and vaping in high school students.

Effectiveness of shortened time interval to postpartum visit in improving postpartum attendance: Design and rationale for a randomized controlled trial.

BACKGROUND/AIMS: Recent evidence suggests that there are numerous benefits to scheduling postpartum visits as early as 3 weeks post-delivery. However, findings are not conclusive due to methodological limitations. This report discusses the unique aspects of a randomized controlled trial's (RCT) design, intervention, and strategies to maintain participant retention. METHODS: This study was a four-year, prospective, open-label RCT conducted at the Virginia Commonwealth University Medical Center. Women who recently delivered a healthy, full-term baby vaginally, were randomized to receive a 3-4 or 6-8 weeks postpartum appointment and were followed for 18 months. RESULTS: A total of 364 women participated in this study. A large proportion of women were retained in the study as demonstrated by the high completion rates at the 18-month follow-up interview (Total sample: 87.6%; 3-4 weeks group: 88.0%; 6-8 weeks group: 87.3%). Similarly, high adherence to the protocol-directed postpartum visit schedule was reported in the overall study sample (79.7%), as well as in the 3-4 (70.5%) and 6-8 (90.0%) week postpartum groups. CONCLUSION: The study design offered unique features which ensured excellent participant completion and adherence rates, despite the presence of hard-to-track women who typically do not return for their postpartum visits.

Changes in the Use of Long-Acting Reversible Contraceptive Methods Among U.S. Nulliparous Women: Results from the 2006-2010, 2011-2013, and 2013-2015 National Survey of Family Growth.

OBJECTIVE: Nulliparous women in the United States have high rates of unintended pregnancy comparable with parous women. Long-acting reversible contraceptives (LARCs) are recommended as first-line contraceptive choices to reduce unintended pregnancy. However, use of LARCs among nulliparous women has been low. This study aims to examine changes in the prevalence of current LARC use among sexually experienced U.S. nulliparous women across the time period of 2006-2010, 2011-2013, and 2013-2015, and examine correlates of use. MATERIALS AND METHODS: Sexually experienced nulliparous women (15-44 years) from the 2006-2010, 2011-2013, and 2013-2015 rounds of the National Survey of Family Growth (N = 7463) were examined. Changes in the prevalence of current use of LARCs were examined and correlates of current LARC use were evaluated using multiple logistic regression. RESULTS: Increases in the prevalence of current LARC use from 2008 to 2012 (0.8% vs. 3.8%, p < 0.0001) and from 2012 to 2014 (3.8% vs. 5.7%, p = 0.09) were observed among sexually experienced nulliparous women. Significant increases were also observed across different subgroups of nulliparous women. Maternal age, education, future birth intention, sexual activity, and discontinuation of non-LARC hormonal contraceptives due to dissatisfaction were significant correlates of current LARC use. CONCLUSION: Although current use of LARCs among sexually experienced U.S. nulliparous women shows an increasing trend, prevalence of use still remains low. There is the need to increase awareness of LARCs as an effective contraceptive choice for nulliparous women.

Short interpregnancy interval and adverse birth outcomes in women of advanced age: a population-based study.

PURPOSE: Short interpregnancy interval (IPI) has been linked with adverse birth outcomes. However, the association in advanced age women needs further investigation. This study aims to examine the association between short IPI and adverse birth outcomes including preterm birth, post-term birth, low birth weight, and macrosomia, in a population of advanced age U.S. women. METHODS: The 2016 U.S. public-use natality data was analyzed. Analysis was restricted to women with second-order singleton live births who were ≥35 years at first live birth (n = 46,684). Multinomial logistic regression analysis was used to examine the association between short IPI and adverse birth outcomes. RESULTS: Short IPI in advanced age women was significantly associated with higher odds of extremely preterm birth (0-5 months IPI: adjusted odds ratio [AOR] = 2.43, 95% confidence interval [CI] = 1.07-5.52; 6-11 months IPI: AOR = 2.17, 95% CI = 1.09-4.31), very preterm birth (0-5 months IPI: AOR = 1.63, 95% CI = 1.04-2.56), and extremely low birth weight (0-5 months IPI: AOR = 2.43, 95% CI = 1.28-4.60) in the second delivery. An inverse relationship between short IPI and post-term birth was observed and no significant association between short IPI and macrosomia was found. CONCLUSIONS: Short IPI in advanced age women increases the odds of adverse birth outcomes in the second delivery.

Do Successive Preterm Births Increase the Risk of Postpartum Depressive Symptoms?

BACKGROUND: Postpartum depression and preterm birth (PTB) are major problems affecting women's health. PTB has been associated with increased risk of postpartum depressive symptoms (PDS). However, it is unclear if PTB in women with a prior history of PTB is associated with an incremental risk of PDS. This study aims to determine if PTB in women with a prior history of PTB is associated with an incremental risk of PDS. METHODS: Data come from the 2009-2011 national Pregnancy Risk Assessment Monitoring System. Study sample included 55,681 multiparous women with singleton live births in the index delivery. Multiple logistic regression was used to examine the association between PTB and PDS. RESULTS: The risk of PDS was 55% higher in women with PTB in both deliveries (aRR = 1.55; 95% CI = 1.28-1.88) and 74% higher in women with PTB in the index delivery only (aRR = 1.74; 95% CI = 1.49-2.05), compared to women with term deliveries. CONCLUSIONS: Preterm birth is a risk factor for PDS. PTB in women with a prior history of PTB is not associated with an incremental risk of PDS. Routine screening for PDS should be conducted for all women and closer monitoring should be done for high risk women with PTB.

Racial/Ethnic Differences in the Modifying Effect of Community Violence on the Association between Paternity Status and Preterm Birth.

Preterm birth (PTB) is a major public health concern in the US. Lack of established paternity has been linked with increased risk of PTB. Community violence (CV) may modify the association, and racial/ethnic differences may exist. Using a geographically defined cohort of women in Richmond, Virginia (N = 27,518), we examined racial/ethnic differences in the modifying effect of CV on the association between paternity status and PTB. Results showed that lack of established paternity was associated with incremental greater odds of PTB across CV quartiles in NH-Whites (quartile-1: AOR = 1.42, 95% CI = 0.95-2.12; quartile-2: AOR = 1.45, 95% CI = 0.57-3.71; quartile-3: AOR = 3.12, 95% CI = 2.67-6.32), NH-Blacks (quartile-1: AOR = 1.16, 95% CI = 0.85-1.58; quartile-2: AOR = 1.32, 95% CI = 0.82-2.12; quartile-3: AOR = 1.64, 95% CI = 1.24-2.16), and Hispanics (quartile-1: AOR = 1.29, 95% CI = 0.65-2.55; quartile-2: AOR = 1.34, 95% CI = 0.67-2.69). Odds of PTB were highest among NH-White women. Public health practitioners should be aware of the negative effect of lack of paternal presence on PTB in women resident in high violence rate communities and racial/ethnic differences that exist.

Age of Sexual Debut and Physical Dating Violence Victimization: Sex Differences Among US High School Students.

BACKGROUND: Research has shown that early age of sexual debut is associated with physical dating violence (PDV), but sex-specific associations are sparse. We estimated the prevalence of PDV victimization in high school students who have initiated sexual intercourse and examined sex-specific association between age of sexual debut and PDV victimization. METHODS: Data on 8637 students in grades 9 through 12 who had initiated sex was obtained from the 2009-2011 national Youth Risk Behavior Survey. The association was examined using multiple logistic regression, accounting for the complex survey design, and stratified by sex. RESULTS: Approximately 15% of sexually active students reported past-year PDV victimization. The odds of PDV victimization among girls who had sexual debut at <12 years was 2.46 (95% CI = 1.50-4.02) and 2.20 (95% CI = 1.42-3.41) for boys, compared to those who initiated sex at 16 years and older. CONCLUSIONS: Evidence supports the belief that early sexual debut is associated with higher odds of PDV victimization, particularly for girls. Healthcare providers, school counselors, and educators should be aware of this sex difference in the association between early sexual debut age and PDV victimization while focusing PDV interventions on adolescents with early sexual debut age.

Prevalence, correlates and patterns of heroin use among young adults in the United States.

INTRODUCTION: The prevalence of heroin use, abuse, and dependence has increased considerably over the past decade. This increase has largely been driven by young adults (18-25years). This study aims to improve the understanding of heroin use among young adults by determining the prevalence, correlates, patterns and attitude of heroin use among young adults in the US. METHODS: The 2011-2013 National Survey on Drug Use and Health was analyzed. Study population included 55,940 young adults with valid interviews. Self-reported lifetime, past-year and past-month use of heroin were examined. Descriptive statistics and adjusted odds ratios were estimated in accordance with the complex survey design. RESULTS: Of the respondents, 18.4 per 1000 (95% CI=16.8-20.0) used heroin at some time in their lives, and 7.3 per 1000 (95% CI=6.3-8.3) and 3.3 per 1000 (95% CI=2.6-4.0) used heroin in the past year and past month, respectively. The single most common route of heroin use was by sniffing. Majority of young adults reported using heroin in combination with other substances. Users of non-prescribed opioid pain relievers, cigarette smokers, illicit drug users and those arrested and booked for breaking the law, had higher odds of using heroin during their lifetime, in the past-year and past-month. CONCLUSION: Fewer than 2% reported ever using heroin, and 82% of those reported no use in the past month. Majority were polysubstance users and sniffed heroin in combination with other routes of use. Comprehensive programs that target young adult heroin users and address important risk factors for heroin use are needed.

Racial and Gender Differences in Dating Violence Victimization and Disordered Eating Among U.S. High Schools.

BACKGROUND: In 2013, 1 in every 10 students who dated or went out with someone in the previous 12 months reported some form of dating violence (DV). Only a few studies have evaluated the relationship between DV and disordered eating (DE). This study aims to evaluate gender differences in the association between DV victimization and DE behaviors using a nationally representative sample of high school students in the United States. MATERIALS AND METHODS: Data came from the 2013 National Youth Risk Behavior Survey. Students who reported dating or going out with anyone in the previous 12 months and responded to DV and DE questions were included (N = 9,677). DV was categorized as physical DV, sexual DV, physical and sexual DV, and none. The outcome, or DE, was determined by questions about unhealthy weight control behaviors. Multiple logistic regression models provided odds ratios (ORs) and 95% confidence intervals. Race/ethnicity was an effect modifier; thus, stratified analyses assessed for gender and racial/ethnic differences. RESULTS: The prevalence of past-year physical DV, sexual DV, both physical and sexual DV, and any DV was 5.4%, 5.4%, 4.7%, and 15.5%, respectively. OR estimates were more robust in males than in females. Victims of physical and sexual DV were significantly more likely to report DE, namely among Hispanic and non-Hispanic White males and all female race/ethnic groups, with the exception of non-Hispanic Black females. CONCLUSIONS: Findings strengthen support for routine DV screening. Adolescent violence prevention programs should consider risky behaviors, such as DE. Interventions should account for gender and racial/ethnic differences.