Patient receptivity to receiving vaccinations in the dental clinic at a rural federally qualified health center.

BACKGROUND: More than 28 million people in the United States visited their dentists but not a physician in 2018, yet only a few states allow dentists to administer vaccines to patients, and those vaccines are limited to influenza, COVID-19, and human papillomavirus. METHODS: To assess the receptiveness of adult dental patients and caregivers of pediatric dental patients to receive necessary vaccines during their dental appointment, a survey was distributed to patients attending a dental visit at a rural federally qualified health center from June 28, 2021, through December 31, 2021. RESULTS: Among the responses from 643 adult patients and 625 pediatric caregivers, approximately one-half (54.2% and 49.9%, respectively) reported being receptive to receiving vaccines in the dental clinic, with 28.5% and 21.8% not being receptive to vaccines, respectively. Primary language, age group, number of children, and primary care center all were associated significantly with reported likelihood of receiving vaccines (P < .05). The most reported concern about receiving vaccines at a dental clinic was a preference for their primary care physician to provide all vaccinations, according to 22.2% of adult patients and 39.8% of pediatric caregivers. CONCLUSIONS: The authors' findings support efforts to administer vaccines during dental visits to improve immunization rates among adults and children. Ongoing communication with primary care physicians regarding administration of vaccines in the dental clinic could reduce concerns by adult patients and pediatric caregivers. PRACTICAL IMPLICATIONS: Strategies and policies that establish protocols to ensure the safe and effective administration of vaccines in dental visits should be implemented and supported.

Vaccine hesitancy and the willingness to recommend the COVID-19 vaccine to children in a rural country on the United States-Mexico border.

Introduction: As of October 26, 2022, only 9% of children in the United States aged 6 months to 4 years have received at least one dose of COVID-19 vaccine despite FDA approval since June 17, 2022. Rates are better yet still low for children aged 5 to 11 years as nearly 30% were fully vaccinated as of August 23, 2022. Vaccine hesitancy among adults is one of the major factors affecting low vaccine uptake rates in children against COVID-19, yet most studies examining vaccine hesitancy have targeted school-age and adolescent children. Methods: With the aim of assessing the willingness to recommend the COVID-19 vaccination to children under 5 years compared to children 5 to 12 years of age, a county-wide survey was conducted between January 11 and March 7, 2022, among adults on the United States-Mexico border. Results: Among the 765 responses, 72.5% were female and 42.3% were Latinx. The most significant factor associated with likelihood to recommend the COVID-19 vaccine to children less than 5 years and 5-12 years of age was adult vaccination status. Ordinal logistic regression also indicated that ethnicity, primary language, being a parent, previous COVID-19 infection, and concern about getting COVID-19 in the future were significantly associated with likelihood of COVID-19 vaccine recommendation to children < 5 years and 5-12 years old. Discussion: This study found high consistency among respondents in their willingness to vaccinate children aged < 5 years compared with children aged 5-12 years. Our findings support public health strategies that target adult vaccinations as an avenue to improve childhood vaccinations for young children.

Plasminogen Activator Inhibitor-1 Predicts Quantity of Hepatic Steatosis Independent of Insulin Resistance and Body Weight.

OBJECTIVE: The aim of the present study was to examine the association between plasminogen activator inhibitor-1 (PAI-1), an acute phase protein strongly associated with cardiovascular disease risk, and adiposity, insulin resistance, and inflammation among overweight and obese children with a wide range of hepatic steatosis. METHODS: Plasma PAI-1 levels were measured in a prospectively recruited cohort of 39 overweight or obese children who underwent comprehensive anthropometric assessment and metabolic measurements. Hepatic steatosis was quantified using magnetic resonance spectroscopy and participants were divided into 3 groups based on whether they had normal hepatic steatosis (<5%), low hepatic steatosis (≥5%-10%), and high hepatic steatosis (>10%). RESULTS: Plasma PAI-1 levels significantly increased across the severity of hepatic steatosis in overweight and obese children, and this association was independent of body mass index z score, visceral fat, insulin resistance, and inflammatory markers (P < 0.05). CONCLUSION: Hepatic steatosis in children is positively associated with circulating levels of PAI-1 independent of body mass index, insulin resistance, and inflammatory markers. Further studies are needed to clarify the potential role of PAI-1 as a therapeutic target in pediatric nonalcoholic fatty liver disease.