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1.
Vaccine ; 42(7): 1617-1629, 2024 Mar 07.
Article in English | MEDLINE | ID: mdl-38341291

ABSTRACT

INTRODUCTION: Being up-to-date with all recommended vaccines is needed to protect children from vaccine preventable diseases. Understanding vaccination patterns is needed to develop messaging and strategies to increase vaccination uptake and confidence. METHODS: Data from the 2011 to 2021 National Immunization Surveys was used to assess trends and disparities in vaccination patterns, zero vaccination status, and up-to-date status of U.S. children by 19-35 months. RESULTS: From 2011 to 2021, adherence to the recommended schedule using the stringent definition increased from 35.7 % to 52.2 % (p < 0.01), adherence to the alternate schedule decreased from 28.2 % to 15.1 % (p < 0.01), and proportion of children who were not up-to-date decreased from 49.0 % to 33.3 % (p < 0.01). However, the proportion of children who had zero vaccinations did not change from 2011 (0.9 %) to 2021 (0.9 %; p = 0.08). In 2021, children 19-23 months were less likely to follow the recommended schedule than children 24-29 months (49.2 % compared to 56.4 %, p < 0.01). Adherence to the recommended schedule among children 19-23 months decreased in 2021 compared to 2020 overall and for some subpopulations (e.g. those with non-Hispanic (NH) Black parents (33.2 % compared to 44.9 %, p < 0.01). Furthermore, it was lowest among children of NH Black parents living at or below the federal poverty level (31.2 %) compared to their respective NH White counterparts (43.6 %, p < 0.01). CONCLUSIONS: While there were overall increases in adherence to the recommended schedule from 2011 to 2021, a sustained catch-up program is needed to prevent missed vaccinations and achieve equitable vaccination coverage for all children.


Subject(s)
Vaccination , Vaccines , Child , Humans , Infant , Immunization Schedule , Poverty , Vaccination Coverage , Black or African American , United States
2.
Am J Epidemiol ; 193(1): 121-133, 2024 Jan 08.
Article in English | MEDLINE | ID: mdl-37552958

ABSTRACT

Understanding the extent of coronavirus disease 2019 (COVID-19) nonvaccination attributable to vaccine hesitancy versus other barriers can help prioritize approaches for increasing vaccination uptake. Using data from the Centers for Disease Control and Prevention's Research and Development Survey, a nationally representative survey fielded from May 1 to June 30, 2021 (n = 5,458), we examined the adjusted population attribution fraction (PAF) of COVID-19 vaccine hesitancy attributed to nonvaccination according to sociodemographic characteristics and health-related variables. Overall, the adjusted PAF of nonvaccination attributed to vaccine hesitancy was 76.1%. The PAF was highest among adults who were ≥50 years of age (87.9%), were non-Hispanic White (83.7%), had a bachelor's degree or higher (82.7%), had an annual household income of at least $75,000 (85.5%), were insured (82.4%), and had a usual place for health care (80.7%). The PAF was lower for those who were current smokers (65.3%) compared with never smokers (77.9%), those who had anxiety or depression (65.2%) compared with those who did not (80.1%), and those who had a disability (64.5%) compared with those who did not (79.2%). Disparities in PAF suggest areas for prioritization of efforts for intervention and development of messaging campaigns that address all barriers to uptake, including hesitancy and access, to advance health equity and protect individuals from COVID-19.


Subject(s)
COVID-19 , Adult , United States/epidemiology , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Vaccination Hesitancy , COVID-19 Vaccines , Anxiety , Anxiety Disorders , Vaccination
3.
Ann Med ; 55(1): 2196436, 2023 12.
Article in English | MEDLINE | ID: mdl-37052255

ABSTRACT

INTRODUCTION: Despite recommendations for influenza and COVID-19 vaccines, studies have documented gaps and disparities in vaccination coverage for adults and adolescents. Understanding the proportion and demographics of those unvaccinated against influenza and/or COVID-19 is important for tailoring appropriate messaging and strategies to increase confidence and uptake. METHODS: Using the 2021 National Health Interview Survey (NHIS), we assessed the prevalence of four vaccination patterns (exclusive influenza vaccination, exclusive COVID-19 vaccination, dual influenza and COVID-19 vaccination, and neither vaccination) by sociodemographic and other characteristics among adults and adolescents 12-17 years. Adjusted multivariable regression analyses were conducted to examine factors associated with each of the four vaccination categories among adults and adolescents. RESULTS: In 2021, 42.5% of adults and 28.3% of adolescents received both influenza and COVID-19 vaccines, while approximately a quarter (22.4%) of adults and a third (34.0%) of adolescents did not receive either vaccine. Among adults and adolescents, 6.0% and 11.4% were exclusively vaccinated against influenza and 29.1% and 26.4% were exclusively vaccinated against COVID-19, respectively. Among adults, exclusive COVID-19 or dual vaccination was more likely to be associated with older age, non-Hispanic multi/other race, and having a college degree compared to their respective counterparts. Exclusive influenza or neither vaccination was more likely to be associated with younger age, having a high school diploma or less, living below the poverty level, and having a previous COVID-19 diagnosis. CONCLUSION: During the COVID-19 pandemic, approximately two-thirds of adolescents and three-fourths of adults received exclusive influenza or COVID-19 vaccines or both vaccines in 2021. Vaccination patterns differed by sociodemographic and other characteristics. Promoting confidence in vaccines and reducing barriers to access is needed to protect individuals and families from severe health consequences of vaccine-preventable diseases. Being up-to-date with all recommended vaccinations can prevent a future resurgence of hospitalizations and cases.Key messages42.5% of adults and 28.3% of adolescents received both influenza and COVID-19 vaccines in 2021, while approximately a quarter (22.4%) of adults and a third (34.0%) of adolescents did not receive either vaccine; 6.0% of adults and 11.4% of adolescents were exclusively vaccinated against influenza and 29.1% of adults and 26.4% of adolescents were exclusively vaccinated against COVID-19.Among adults, exclusive COVID-19 vaccination or dual vaccination was more likely to be associated with older age, non-Hispanic multi/other race, and having a college degree or higher compared to their respective counterparts; exclusive influenza vaccination or neither vaccination was more likely to be associated with younger age, having a high school diploma or less, living below poverty level, and having a previous COVID-19 diagnosis compared to their respective counterparts.Promoting confidence in vaccines and reducing barriers to access is needed to protect individuals and families from severe health consequences of vaccine-preventable diseases. Being up-to-date with all recommended vaccinations can prevent a future resurgence of hospitalizations and cases, especially as new variants emerge.


Subject(s)
COVID-19 , Influenza Vaccines , Influenza, Human , Vaccine-Preventable Diseases , Adult , Humans , Adolescent , Influenza, Human/epidemiology , Influenza, Human/prevention & control , COVID-19 Vaccines , COVID-19 Testing , Pandemics/prevention & control , COVID-19/epidemiology , COVID-19/prevention & control , Vaccination
4.
Vaccine ; 41(2): 467-475, 2023 01 09.
Article in English | MEDLINE | ID: mdl-36481107

ABSTRACT

OBJECTIVES: To estimate trends in, and factors associated with, vaccination patterns and up-to-date immunization status of U.S. children by 19 to 35 months of age. METHODS: Data from the 2015 to 2020 National Immunization Surveys were used to assess trends in vaccination patterns, up-to-date status, and zero vaccination status of U.S. children by 19-35 months. Vaccination patterns were categorized as: 1) recommended, 2) alternate, or 3) unknown or unclassifiable. Multivariable analyses were conducted to examine factors associated with each vaccination pattern and up-to-date status for all recommended vaccines. RESULTS: From 2015 to 2020, the proportion of U.S. children completing the recommended schedule increased from 62.5% to 69.4%, alternative schedule decreased from 21.6% to 16.2%, and unknown or unclassifiable schedules decreased from 15.9% to 14.3%. In addition, being not up-to-date decreased from 39.7% to 35.6%. There was no change in the percentage of children receiving zero vaccinations from 2015 to 2020 (0.9% to 0.9%). Respondents with lower household income or who were uninsured were more likely to follow an alternate or unknown/unclassifiable schedule, or not be up-to-date with vaccines. CONCLUSION: Following any schedule other than the recommended schedule was associated with not being up-to-date on immunizations. Increased efforts to catch up on recommended vaccines is important for protecting children's health. Further efforts should be made to improve timely adherence to recommended vaccination schedules, particularly among populations with the largest disparities in coverage through a tailored approach to increase confidence in and access to vaccines.


Subject(s)
Vaccination , Vaccines , Humans , Child , United States , Infant , Immunization Schedule , Immunization , Child Health
5.
Opt Express ; 23(5): 6554-61, 2015 Mar 09.
Article in English | MEDLINE | ID: mdl-25836873

ABSTRACT

An analog of plasmonic system for electromagnetically induced transparency (EIT), in which a small nanodisk with a big side-coupled-nanodisk is directly coupled to the metal-insulator -metal (MIM) waveguide, has been proposed and investigated theoretically and numerically. When the resonant frequencies of the two nanodisks differ not too much, a powerful EIT-like effect can be obtained, and the transparency window can be easily tuned by adjusting the radii of the two nanodisks. The plasmonic device can be used as a high-performance EIT-like filter with transmission over 80% and full width at half-maximum (FWHM) less than 30nm, besides, the novel structure shows a high group index over 355. The system paves a new way toward highly integrated optical circuits and networks, especially for wavelength-selective, ultrafast switching, light storage and nonlinear devices.

6.
Opt Express ; 22(8): 9912-9, 2014 Apr 21.
Article in English | MEDLINE | ID: mdl-24787873

ABSTRACT

A compact wavelength band-pass filter based on metal-insulator-metal (MIM) nanodisk cavity is proposed and numerically investigated by using Finite-Difference Time-Domain (FDTD) simulations. It is found that the transmission characteristics of the filter can be easily adjusted by changing the geometrical parameters of the radius of the nanodisk and coupling distance between the nanodisk and waveguide. By extending the length of input/output waveguides, the filter shows the resonant mode inhibition function. Basing on this characteristic, a two-port wavelength demultiplexer is designed, which can separate resonant modes inside the nanodisk with high transmission up to 70%. The waveguide filter may become a potential application for the design of devices in highly integrated optical circuits.

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