ABSTRACT
BackgroundDespite lower circulation of influenza virus throughout 2020-2022 during the COVID-19 pandemic, seasonal influenza vaccination has remained a primary tool to reduce influenza-associated illness and death. The relationship between the decision to receive a COVID-19 vaccine and/or an influenza vaccine is not well understood. MethodsWe assessed predictors of receipt of 2021-2022 influenza vaccine in a secondary analysis of data from a case-control study enrolling individuals who received SARS-CoV-2 testing. We used mixed effects logistic regression to estimate factors associated with receipt of seasonal influenza vaccine. We also constructed multinomial adjusted marginal probability models of being vaccinated for COVID-19 only, seasonal influenza only, or both as compared with receipt of neither vaccination. ResultsAmong 1261 eligible participants recruited between 22 October 2021 - 22 June 2022, 43% (545) were vaccinated with both seasonal influenza vaccine and [≥]1 dose of a COVID-19 vaccine, 34% (426) received [≥]1 dose of a COVID-19 vaccine only, 4% (49) received seasonal influenza vaccine only, and 19% (241) received neither vaccine. Receipt of [≥]1 COVID-19 vaccine dose was associated with seasonal influenza vaccination (adjusted odds ratio [aOR]: 3.72; 95% confidence interval [CI]: 2.15-6.43); this association was stronger among participants receiving [≥]1 COVID-19 booster dose (aOR=16.50 [10.10- 26.97]). Compared with participants testing negative for SARS-CoV-2 infection, participants testing positive had lower odds of receipt of 2021-2022 seasonal influenza vaccine (aOR=0.64 [0.50-0.82]). ConclusionsRecipients of a COVID-19 vaccine were more likely to receive seasonal influenza vaccine during the 2021-2022 season. Factors associated with individuals likelihood of receiving COVID-19 and seasonal influenza vaccines will be important to account for in future studies of vaccine effectiveness against both conditions. Participants who tested positive for SARS-CoV-2 in our sample were less likely to have received seasonal influenza vaccine, suggesting an opportunity to offer influenza vaccination before or after a COVID-19 diagnosis.
ABSTRACT
COVID-19 is extraordinary both as once-in-a-lifetime pandemic and having abundant real-time case data, thus providing an extraordinary opportunity for timely independent analysis and novel perspectives. We investigate the weekly periodicity in the daily reported new cases and new deaths with the implied relationships to the societal and institutional responses using autocorrelation and Fourier transformation. The results show significant linear correlations between the weekly periodicity and the total cases and deaths, ranging from 50% to 84% for sizable groups of countries with population normalized deaths spanning nearly three orders of magnitude, from a few to approaching a thousand per million. In particular, the Strength Indicator of the periodicity in the new cases, defined by the autocorrelation with a 7-day lag, is positively correlated strongly to the total deaths per million in respective countries. The Persistence Indicator of the periodicity, defined as the average of three autocorrelations with 7-, 14- and 21-day lags, is an overall better indicator of the progression of the pandemic. For longer time series, Fourier transformation gives similar results. This analysis begins to fill the gap in modeling and simulation of epidemics with the inclusion of high frequency modulations, in this case most likely from human behaviors and institutional practices, and reveals that they can be highly correlated to the magnitude and duration of the pandemic. The results show that there is significant need to understand the causes and effects of the periodicity and its relationship to the progression and outcome of the pandemic, and how we could adapt our strategies and implementations to reduce the extent of the impact of COVID-19.
ABSTRACT
OBJECTIVE: The provision of 'adequate analgesia' (which reduces the pain score by ≥2 and to <4 [0-10 scale]) is significantly associated with high levels of satisfaction with pain management among adult patients. We aimed to determine the variables (including 'adequate analgesia') associated with parent satisfaction with their child's pain management. METHODS: We undertook an observational, pilot study in a mixed, metropolitan ED. Patients aged 4-16 years with a triage pain score of ≥4 were enrolled. Data included demographics, presenting complaint, pain scores every 30 min, analgesia administered, time to first analgesia, provision of nurse-initiated analgesia (NIA), and 'adequate analgesia', and parent satisfaction 48-h post-discharge (6 point scale: very unsatisfied - very satisfied). RESULTS: Complete data were collected on 185 patients: mean (SD) age 10.4 (3.6) years, weight 41.9 (17.8) kg; 93 (50.3%) were male. One hundred and ten (59.4%) parents were very satisfied with their child's pain management. Children of very satisfied parents had shorter times to analgesia than those who did not (median [interquartile range] 14 (33) vs 33 (46) min, respectively, P = 0.003). Parents whose children received NIA or 'adequate analgesia' were more often very satisfied than those whose children did not. However, the differences were not significant (difference in proportions: 13.2% [95% CI -1.9, 28.3], P = 0.07 and 10.2% [95% CI -5.02, 25.34], P = 0.16, respectively). CONCLUSION: Short times to analgesia are associated with parent satisfaction. There were non-significant trends towards high levels of satisfaction following the provision of NIA and 'adequate analgesia'. These findings will inform a well-powered study to confirm this association.
