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1.
Am J Epidemiol ; 191(4): 570-583, 2022 Mar 24.
Article in English | MEDLINE | ID: mdl-34999751

ABSTRACT

We estimated the trends and correlates of vaccine hesitancy and its association with subsequent vaccine uptake among 5,458 adults in the United States. Participants belonged to the Communities, Households, and SARS-CoV-2 Epidemiology COVID (CHASING COVID) Cohort, a national longitudinal study. Trends and correlates of vaccine hesitancy were examined longitudinally in 8 interview rounds from October 2020 to July 2021. We also estimated the association between willingness to vaccinate and subsequent vaccine uptake through July 2021. Vaccine delay and refusal decreased from 51% and 8% in October 2020 to 8% and 6% in July 2021, respectively. Compared with non-Hispanic (NH) White participants, NH Black and Hispanic participants had higher adjusted odds ratios (aOR) for both vaccine delay (for NH Black, aOR = 2.0 (95% confidence interval (CI): 1.5, 2.7), and for Hispanic, 1.3 (95% CI: 1.0, 1.7)) and vaccine refusal (for NH Black, aOR = 2.5 (95% CI: 1.8, 3.6), and for Hispanic, 1.4 (95% CI: 1.0, 2.0)) in June 2021. COVID-19 vaccine hesitancy, compared with vaccine-willingness, was associated with lower odds of subsequent vaccine uptake (for vaccine delayers, aOR = 0.15, 95% CI: 0.13, 0.18; for vaccine refusers, aOR = 0.02; 95% CI: 0.01, 0.03 ), adjusted for sociodemographic factors and COVID-19 history. Vaccination awareness and distribution efforts should focus on vaccine delayers.


Subject(s)
COVID-19 , Vaccines , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Longitudinal Studies , SARS-CoV-2 , United States/epidemiology , Vaccination
2.
BMC Public Health ; 22(1): 907, 2022 05 06.
Article in English | MEDLINE | ID: mdl-35524229

ABSTRACT

BACKGROUND: Vaccination is a powerful tool in the fight against seasonal influenza, among underserved, middle-age and older, Latinx adults. Yet, vaccine hesitancy and inconsistent uptake in this population continues to represent a substantial challenge to public health. A better understanding of factors impacting influenza vaccination behaviors in this group could result in more effective messaging and initiatives promoting universal vaccination among Latinx. METHODS: In this cross-sectional survey, we explore correlates of influenza vaccination uptake among underserved, Latinx, older adults. Our focus was on the role of socio-demographics, living arrangements, financial strain, access and satisfaction with medical care, and the presence of major chronic conditions in terms of vaccine uptake. Middle-aged and older Latinx residents diagnosed with diabetes and/or hypertension (n=165), were recruited from the South Los Angeles Service Plan Area (SPA), a historically under-resourced community. Bi-variate and multi-variate logistical regression were performed on survey data to explore independent correlates of influenza vaccination. RESULTS: Almost half of underserved Latinx older adults in our study (45%) reported influenza vaccination within the 12 months prior to the study. The majority (~85%) reported receiving this recommendation from their primary care provider. However, thirty percent (30%) of those receiving this advice did not get the vaccine. A decreased likelihood of vaccination was significantly associated with living alone (p-value=0.026), lacking Medicare coverage (0.028), or higher levels of financial strain (0.020). Difficulty accessing medical care (p-value=0.008) or dissatisfaction with these experiences (p-value=0.001) were also strongly associated with decreased likelihood of vaccination. Participants diagnosed with COPD had 9.5 (CI: 1.76 - 51.3) higher odds of being vaccinated compared to those without; no correlation was detected for other chronic conditions. CONCLUSION: The high number of unvaccinated Latinx participants receiving a vaccine recommendation from a provider is consistent with studies among other ethnic/racial minority older adults and highlights the pivotal role of the provider in influenza vaccine adoption. Additional findings reflect negative impact of Social Determinates of Health on preventive care efforts in this group. Further efforts to quantify these associations are needed to explore structural and human factors impacting influenza vaccine uptake.


Subject(s)
Influenza Vaccines , Influenza, Human , Aged , Chronic Disease , Cross-Sectional Studies , Humans , Influenza Vaccines/therapeutic use , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Medicare , Middle Aged , United States , Vaccination
6.
Am J Case Rep ; 23: e936217, 2022 May 06.
Article in English | MEDLINE | ID: mdl-35514081

ABSTRACT

BACKGROUND Considering the ongoing coronavirus disease 2019 (COVID-19) pandemic, sufficient information about common and serious adverse events is needed to rapidly distribute COVID-19 vaccines worldwide. We report a case of neuroleptic malignant syndrome (NMS) with adrenal insufficiency after initial vaccination with Pfizer/BioNTech BNT162b2. CASE REPORT A 48-year-old man presented to the Emergency Department with fever and an altered mental status 7 days after receiving the first dose of the BNT162b2 COVID-19 vaccine. The patient had a history of end-stage renal disease and epilepsy treated with valproate. He was diagnosed with NMS based on the clinical findings of hyperthermia, muscular rigidity, and an elevated creatine kinase level. Additionally, a reduction in the response of cortisol to adrenocorticotropic hormone (ACTH) stimulation was observed in the rapid ACTH stimulation test. The patient was treated with dantrolene, bromocriptine, and hydrocortisone, and he responded well to treatment. Dantrolene and bromocriptine were tapered off over 4 weeks. Hydrocortisone was also tapered, and the patient was discharged on oral hydrocortisone (30 mg). CONCLUSIONS The present case suggests a possible link between the BNT162b2 COVID-19 vaccine and NMS with adrenal insufficiency based on the temporal relationship between vaccine administration and disease onset, although the patient was taking valproate, a potential cause of NMS. Having a high level of suspicion is important because the diagnosis of NMS with adrenal insufficiency is often challenging due to non-specific clinical manifestations. However, this case does not negate the utility of vaccination because these complications are extremely rare and can be treated with early diagnosis and proper management.


Subject(s)
Adrenal Insufficiency , COVID-19 , Neuroleptic Malignant Syndrome , Adrenal Insufficiency/chemically induced , Adrenal Insufficiency/complications , Adrenocorticotropic Hormone , Bromocriptine/therapeutic use , COVID-19/prevention & control , Dantrolene/therapeutic use , Humans , Hydrocortisone/therapeutic use , Male , Middle Aged , Neuroleptic Malignant Syndrome/diagnosis , Neuroleptic Malignant Syndrome/etiology , Neuroleptic Malignant Syndrome/therapy , Vaccination/adverse effects , Valproic Acid/adverse effects
7.
Lima; Perú. Ministerio de Salud; May. 2022. 12 p.
Monography in Spanish | MINSAPERÚ, MINSAPERÚ | ID: biblio-1369420

ABSTRACT

El documento contiene las disposiciones para la implementación del retorno al centro de trabajo del personal de la salud y personal administrativo que cuenten con las tres (3) dosis de vacunación contra la COVID-19 establecido por el Ministerio de Salud, indistintamente de su régimen laboral o modalidad de contratación, salvaguardando su salud y bioseguridad en el trabajo, en el marco de la Única Disposición Complementaria Final del Decreto de Urgencia N° 051-2021 y las normas emitidas por el Ministerio de Salud para la vigilancia, prevención y control de la COVID-19.


Subject(s)
Administrative Personnel , Vaccination , Containment of Biohazards , Surveillance , COVID-19 , Occupational Groups
8.
Pediatrics ; 149(Suppl 5)2022 May 01.
Article in English | MEDLINE | ID: mdl-35503337

ABSTRACT

BACKGROUND AND OBJECTIVES: Vaccinations are recognized as a feasible, cost-effective public health intervention for reducing the burden and associated mortality of many infectious diseases. The purpose of this study was to evaluate the effectiveness of potential interventions to improve the uptake of vaccines among children and adolescents. METHODS: We performed a literature search until December 2020. Eligible studies were identified using Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, and other sources. We included studies conducted on children and adolescents aged 5 to 19 years. Studies comprised of hospitalized children and those with comorbid conditions were excluded. Two authors independently performed the meta-analysis. RESULTS: Findings from 120 studies (123 articles), of which 95 were meta-analyzed, reveal that vaccination education may increase overall vaccination coverage by 19% (risk ratio [RR], 1.19; 95% confidence interval [CI], 1.12-1.26), reminders by 15% (RR, 1.15; 95% CI, 1.11-1.18), interventions for providers by 13% (RR, 1.13; 95% CI, 1.07-1.19), financial incentives by 67% (RR, 1.67; 95% CI, 1.40-1.99), and multilevel interventions by 25% (RR, 1.25; 95% CI, 1.10-1.41). The impact of school-based clinics and policy and legislation on overall vaccination coverage is still uncertain, and no impact of a multicomponent intervention on overall vaccination coverage was found. CONCLUSIONS: Educational interventions, reminders, provider-directed interventions, financial incentives, and multilevel interventions may improve vaccination coverage among school-aged children and adolescents.


Subject(s)
Vaccination Coverage , Vaccination , Adolescent , Child , Health Education , Humans , Motivation
9.
N C Med J ; 83(3): 197-202, 2022.
Article in English | MEDLINE | ID: mdl-35504705

ABSTRACT

North Carolina implemented a rapid statewide COVID-19 vaccine strategy that focused on vaccinating people quickly and equitably. We describe the sociodemographic factors associated with COVID-19 vaccine uptake in North Carolina and how these factors were considered in communication as well as community and health care provider engagement in the COVID-19 response.


Subject(s)
COVID-19 Vaccines , COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Health Personnel , Humans , North Carolina/epidemiology , Vaccination
10.
Methods Mol Biol ; 2451: 597-604, 2022.
Article in English | MEDLINE | ID: mdl-35505036

ABSTRACT

Tumor ablation by photodynamic therapy (PDT) results in a strong reduction in tumor mass and can lead to improved recognition of tumor cells by the immune system. This supports combinations of PDT and immunotherapy for the treatment of advanced tumors. Therapeutic vaccination is a tumor-specific type of cancer immunotherapy that aims to directly strengthen the immune response against tumor antigens. In this chapter, we describe the combination of PDT and therapeutic vaccination using a peptide tumor antigen vaccine.


Subject(s)
Cancer Vaccines , Neoplasms , Photochemotherapy , Cancer Vaccines/therapeutic use , Humans , Immunotherapy/methods , Neoplasms/drug therapy , Photochemotherapy/methods , Vaccination
11.
J R Soc Interface ; 19(190): 20210781, 2022 May.
Article in English | MEDLINE | ID: mdl-35506215

ABSTRACT

Face masks do not completely prevent transmission of respiratory infections, but masked individuals are likely to inhale fewer infectious particles. If smaller infectious doses tend to yield milder infections, yet ultimately induce similar levels of immunity, then masking could reduce the prevalence of severe disease even if the total number of infections is unaffected. It has been suggested that this effect of masking is analogous to the pre-vaccination practice of variolation for smallpox, whereby susceptible individuals were intentionally infected with small doses of live virus (and often acquired immunity without severe disease). We present a simple epidemiological model in which mask-induced variolation causes milder infections, potentially with lower transmission rate and/or different duration. We derive relationships between the effectiveness of mask-induced variolation and important epidemiological metrics (the basic reproduction number and initial epidemic growth rate, and the peak prevalence, attack rate and equilibrium prevalence of severe infections). We illustrate our results using parameter estimates for the original SARS-CoV-2 wild-type virus, as well as the Alpha, Delta and Omicron variants. Our results suggest that if variolation is a genuine side-effect of masking, then the importance of face masks as a tool for reducing healthcare burdens from COVID-19 may be under-appreciated.


Subject(s)
COVID-19 , Masks , COVID-19/epidemiology , COVID-19/prevention & control , Humans , SARS-CoV-2 , Vaccination
14.
Indian J Ophthalmol ; 70(5): 1817-1818, 2022 05.
Article in English | MEDLINE | ID: mdl-35502082

ABSTRACT

A 28-year-old female who underwent an uneventful femtosecond laser enabled keratoplasty (FLEK) in her left eye presented with pain, redness, and blurring of vision in the operated eye two weeks after getting immunized with COVID-19 vector vaccine (ChAdOx1 nCoV19 Vaccine Recombinant COVISHIELD, AstraZeneca). Slit-lamp examination showed donor stromal edema with Descemet's membrane folds and Khodadoust line (KP's on endothelium) with anterior chamber cells and flare. The patient was diagnosed with acute corneal graft rejection and advised hourly topical steroids with cycloplegics and oral steroids. The patient responded to treatment and there was progressive reversal of graft rejection with the patient achieving best spectacle-corrected visual acuity (BSCVA) of 20/30 after five weeks of treatment. Our case highlights possible immune corneal graft rejection after COVID19 vaccination and the need to step up topical steroids before vaccination.


Subject(s)
COVID-19 , Corneal Diseases , Corneal Transplantation , Adult , COVID-19 Vaccines/adverse effects , Corneal Diseases/surgery , Corneal Transplantation/adverse effects , Endothelium , Female , Graft Rejection/diagnosis , Humans , Immunization , Postoperative Complications , Steroids , Vaccination , Visual Acuity
15.
Indian J Ophthalmol ; 70(5): 1837-1840, 2022 05.
Article in English | MEDLINE | ID: mdl-35502089

ABSTRACT

A 49-year-old Indian male presented with rapidly progressive vision loss 1 day after receiving the second dose of BNT162b2 mRNA coronavirus disease 2019 (COVID-19) vaccine (Pfizer-BioNTech, NY, USA). The eye had secondary angle closure glaucoma, bullous retinal detachment, and massive intraocular hemorrhage. Ultrasound showed an ill-defined subretinal mass with moderate internal reflectivity. Magnetic resonance imaging (MRI) confirmed an enhancing heterogeneous subretinal mass. Histopathology showed a necrotic melanocytic lesion arising from the posterior edge of the ciliary body and choroid. Necrotic uveal melanoma was confirmed after expert histopathology opinion. Uveal melanomas can rarely present with tumor necrosis following mRNA COVID-19 vaccination.


Subject(s)
COVID-19 , Melanoma , COVID-19 Vaccines/adverse effects , Humans , Male , Melanoma/diagnosis , Melanoma/pathology , Middle Aged , Necrosis , RNA, Messenger , Uveal Neoplasms , Vaccination
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