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1.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America ; 06, 2023.
Article in English | EMBASE | ID: covidwho-2188616

ABSTRACT

BACKGROUND: COVID-19 vaccination coverage remains lower in communities with higher social vulnerability. Factors such as SARS-CoV-2 exposure risk and access to health care are often correlated with social vulnerability and may therefore contribute to a relationship between vulnerability and observed vaccine effectiveness (VE). Understanding whether these factors impact VE could contribute to our understanding of real-world VE. METHOD(S): We used electronic health record data from seven health systems to assess vaccination coverage among patients with medically attended COVID-19-like illness. We then used a test-negative design to assess VE for 2- and 3-dose mRNA adult (>=18 years) vaccine recipients across Social Vulnerability Index (SVI) quartiles. SVI rankings were determined by geocoding patient addresses to census tracts;rankings were grouped into quartiles for analysis. RESULT(S): In July 2021, primary series vaccination coverage was higher in the least vulnerable quartile than in the most vulnerable quartile (56% vs. 36%, respectively). In February 2022, booster dose coverage among persons who had completed a primary series was higher in the least vulnerable quartile than in the most vulnerable quartile (43% vs. 30%). VE among 2-dose and 3-dose recipients during the Delta and Omicron BA.1 periods of predominance was similar across SVI quartiles. CONCLUSION(S): COVID-19 vaccination coverage varied substantially by SVI. Differences in VE estimates by SVI were minimal across groups after adjusting for baseline patient factors. However, lower vaccination coverage among more socially vulnerable groups means that the burden of illness is still disproportionately borne by the most socially vulnerable populations. Copyright Published by Oxford University Press on behalf of Infectious Diseases Society of America 2023.

2.
MMWR - Morbidity & Mortality Weekly Report ; 71(5152):1616-1624, 2022.
Article in English | MEDLINE | ID: covidwho-2204207

ABSTRACT

During June-October 2022, the SARS-CoV-2 Omicron BA.5 sublineage accounted for most of the sequenced viral genomes in the United States, with further Omicron sublineage diversification through November 2022.* Bivalent mRNA vaccines contain an ancestral SARS-CoV-2 strain component plus an updated component of the Omicron BA.4/BA.5 sublineages. On September 1, 2022, a single bivalent booster dose was recommended for adults who had completed a primary vaccination series (with or without subsequent booster doses), with the last dose administered >=2 months earlier (1). During September 13-November 18, the VISION Network evaluated vaccine effectiveness (VE) of a bivalent mRNA booster dose (after 2, 3, or 4 monovalent doses) compared with 1) no previous vaccination and 2) previous receipt of 2, 3, or 4 monovalent-only mRNA vaccine doses, among immunocompetent adults aged >=18 years with an emergency department/urgent care (ED/UC) encounter or hospitalization for a COVID-19-like illness. VE of a bivalent booster dose (after 2, 3, or 4 monovalent doses) against COVID-19-associated ED/UC encounters was 56% compared with no vaccination, 31% compared with monovalent vaccination only with last dose 2-4 months earlier, and 50% compared with monovalent vaccination only with last dose >=11 months earlier. VE of a bivalent booster dose (after 2, 3, or 4 monovalent doses) against COVID-19-associated hospitalizations was 57% compared with no vaccination, 38% compared with monovalent vaccination only with last dose 5-7 months earlier, and 45% compared with monovalent vaccination only with last dose >=11 months earlier. Bivalent vaccines administered after 2, 3, or 4 monovalent doses were effective in preventing medically attended COVID-19 compared with no vaccination and provided additional protection compared with past monovalent vaccination only, with relative protection increasing with time since receipt of the last monovalent dose. All eligible persons should stay up to date with recommended COVID-19 vaccinations, including receiving a bivalent booster dose. Persons should also consider taking additional precautions to avoid respiratory illness this winter season, such as masking in public indoor spaces, especially in areas where COVID-19 community levels are high.

5.
Workshop on Visual Analytics in Healthcare (VAHC) ; : 1-3, 2020.
Article in English | Web of Science | ID: covidwho-1868555

ABSTRACT

To manage a localized outbreak or global pandemic like COVID-19, Public Health agencies (PH) and health systems utilize a variety of information systems. Although existing PH information systems enable capture of data on laboratory-confirmed cases of COVID-19, the current pandemic has illuminated several deficits in the existing U.S. information infrastructure, including gaps in access to and visualization of near-real-time (daily) impacts to the healthcare system. To address these gaps, we leveraged our state-wide health information exchange-derived dataset that represents nearly all healthcare facilities in Indiana. The resultant dashboard has evolved to present data on hospitalization, emergency department utilization, and other metrics of interest to PH and a broader constituency across the state.

6.
Morbidity and Mortality Weekly Report ; 71(7):255-263, 2022.
Article in English | GIM | ID: covidwho-1812722

ABSTRACT

What is already known about this topic? Protection against COVID-19 after 2 doses of mRNA vaccine wanes, but little is known about durability of protection after 3 doses. What is added by this report? Vaccine effectiveness (VE) against COVID-19-associated emergency department/urgent care (ED/UC) visits and hospitalizations was higher after the third dose than after the second dose but waned with time since vaccination. During the Omicron-predominant period, VE against COVID-19-associated ED/UC visits and hospitalizations was 87% and 91%, respectively, during the 2 months after a third dose and decreased to 66% and 78% by the fourth month after a third dose. Protection against hospitalizations exceeded that against ED/UC visits. What are the implications for public health practice? All eligible persons should remain up to date with recommended COVID-19 vaccinations to best protect against COVID-19-associated hospitalizations and ED/UC visits.

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