Wildfire smoke may have amplified arctic phytoplankton bloom

Peer-Reviewed Publication

NORTH CAROLINA STATE UNIVERSITY

Smoke from a Siberian wildfire may have transported enough nitrogen to parts of the Arctic Ocean to amplify a phytoplankton bloom, according to new research from North Carolina State University and the International Research Laboratory Takuvik (CNRS/Laval University) in Canada. The work sheds light on some potential ecological effects from Northern Hemisphere wildfires, particularly as these fires become larger, longer and more intense.

In the summer of 2014, satellite imagery detected a larger than normal algal bloom in the Laptev Sea, located in the Arctic Ocean approximately 850 kilometers (528 miles) south of the North Pole.

“For a bloom that large to occur, the area would need a substantial influx of new nitrogen supply, as the Arctic Ocean is nitrogen-depleted,” says Douglas Hamilton, assistant professor of marine, earth and atmospheric sciences at NC State and co-first author of a paper describing the work. Hamilton was formerly a research associate at Cornell University, where the research was conducted. “So we needed to figure out where that nitrogen was coming from.”

First, the researchers looked at the “usual suspects” for nitrogen input, such as sea ice melt, river discharge and ocean upwelling, but didn’t find anything that would account for the amount of nitrogen necessary for the bloom to occur.

But during that same time period, exceptionally large wildfires in Siberia, Russia, located directly upwind of the bloom, had burned approximately 1.5 million hectares (or about 3.5 million acres) of land.

So the researchers turned their attention to atmospheric composition. They used the Community Earth System Model (CESM), a computer model that can simulate what happens to emissions from natural and human sources as they enter and leave the atmosphere. The model was fed information about wind, temperature and atmospheric composition – including the composition of wildfire smoke – from the time period in question.

The model simulations showed that during late July and August of 2014 – when the bloom was detected and the Siberian wildfire was burning – nitrogen deposition from the atmosphere was almost double that of the preceding and following years.

“The wildfires were located in rapidly warming boreal regions, which have a lot of peat in the thawing permafrost,” Hamilton says. “Peat is very nitrogen rich and the smoke from the burning peat was hypothesized as the most likely source of much of the additional nitrogen.”

“We’ve known that fires can impact phytoplankton blooms, though it is unexpected to see something like this in the Arctic Ocean,” says Mathieu Ardyna, co-first author and CNRS researcher at the International Research Laboratory Takuvik (CNRS/Laval University). “Most likely, since fires are locality-specific and difficult to predict, blooms like this won’t be the norm – but when these wildfires do occur the nutrients they bring in could lead to sustained or multiple blooms.”

The researchers’ next steps could include reviewing the historical satellite record and further characterizing the chemical composition of the particles within the smoke to get a clearer picture of how wildfires like these might impact different ecosystems.

“A one-off bloom like this won’t change ecosystem structure, but both Siberia and high arctic Canada are getting more wildfires,” Hamilton says. “So it may be interesting to explore potential downstream effects if fire activity and nutrient supply remain high.”

The work appears in Communications Earth & Environment and was supported by the Department of Energy under grant number DE-SC0021302, the Alg-O-Nord research project of the CNES (Centre National d’Etudes Spatiales), High Impact Publications Program of ArcticNet and a European Union’s Horizon 2020 Marie Sklodowska-Curie grant (no. 746748).

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Note to editors: An abstract follows.

“Wildfire aerosol deposition likely amplified a summertime Arctic phytoplankton bloom”

DOI: 10.1038/s43247-022-00511-9

Authors: Mathieu Ardyna, Laval University, Stanford University and CNRS; Douglas S. Hamilton, North Carolina State University and Cornell University; Tristan Harmel, University of Toulouse; Léo Lacour, Julien Laliberté, Laval University; Diana N. Bernstein, University of Southern Mississippi; Chris Horvat, Brown University; Rémi Laxenaire, Florida State University and CNRS; Matthew Mills, Gert van Dijken, Kevin Robert Arrigo, Stanford University; Igor Polyakov, University of Alaska and Finnish Meterological Institute; Hervé Claustre, CNRS; Natalie Mahowald, Cornell University
Published: Sept. 19, 2022 in Communications Earth & Environment

Abstract:
In recent years, an increase in the frequency of wildfires has been observed in July and August in boreal forest and tundra ecosystems at a pan-Arctic scale. Although Northern Hemisphere wildfires are common, they are becoming particularly unusual by their increased latitude, duration, and intensity. Such extreme wildfire activity is correlated to the increased temperatures, dry conditions, and atmospheric disturbances (i.e., thunderstorms) associated with climate change. We report here a newly observed and unexpected consequence of high latitude wildfires; large phytoplankton blooms near the North Pole (up to 82°N in the eastern Eurasian Basin), induced by the northward transport and deposition of nutrients carried within wildfire aerosol smoke plumes. These Arctic surface waters, which are highly stratified and nitrogen-depleted with respect to phytoplankton requirements, received large amounts of wildfire-derived nitrogen in the summer of 2014 that relieved nutrient limitation and triggered an unusually large phytoplankton bloom. Such intensified climate-driven changes to natural biogeochemical cycles will need to be quantified and integrated into Arctic studies to account for their impacts on both nutrient and carbon cycles.

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JOURNAL

Communications Earth & Environment

DOI

10.1038/s43247-022-00511-9 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Wildfire aerosol deposition likely amplified a summertime Arctic phytoplankton bloom

ARTICLE PUBLICATION DATE

19-Sep-2022

COI STATEMENT

Social touch and its newly discovered neural pathway

Peer-Reviewed Publication

EÖTVÖS LORÁND UNIVERSITY (ELTE), FACULTY OF SCIENCE

Touch plays an important role in social behavior. A kind gesture, a hug, a pat on the back strengthens our social relations. But what happens in our brain as a result of touch? In their latest study, published in the scientific journal Current Biology, the researchers of the Institute of Biology at the Faculty of Science at Eötvös Loránd University described the role of a novel neural pathway in the brain. Nature has also highlighted these results.

Social behavior requires complex sensory inputs involving several senses, e.g. touch, sight, hearing, smell. Psychologists, but also instinctively the everyday person, know the importance of touch, for example, the calming effect of the hugs and caresses of our loved ones and friends.

The physical contact of touch is also important in social relations, just think of the grooming behavior of monkeys, or an appreciative pat on the back.

Neurobiologists have already identified that the information acquired through touch is relayed in the thalamus of ​​the brain and becomes conscious in the cerebral cortex, but at the same time, it has been suggested that

the brain learns about the stimuli coming from our peers in another way, since the pleasant feeling appears even without awareness.

 

In order to learn about the mechanism of touch without consciousness, a study led by Árpád Dobolyi, a professor at Eötvös Loránd University, was completed, in which Semmelweis University, the Institute for Experimental Medicine, and the University of Heidelberg also participated. The first author was David Keller, PhD student of Árpád Dobolyi.

During their research, they pointed out that the neural pathway leading directly from the thalamus to the hypothalamus plays an important role in the processing of touch information, and this pathway uses the parathyroid hormone 2 neuropeptide (PTH2) as a neurotransmitter.

In the future, their results may contribute to the development of therapeutic agents that can help the development of social behaviors.

"The research showed that tactile stimuli coming from conspecifics are processed in the brain in a different way than stimuli created by inanimate objects. The two pathways separate in the area of the thalamus. The brain mechanisms activated by conspecifics also directly reach the hypothalamic regions responsible for the triggering of behavioural, hormonal and vegetative responses, as well as the feeling of reward" - said Árpád Dobolyi, head of the research at the Department of Physiology and Neurobiology, ELTE Institute of Biology.

WHAT HAPPENS IN OUR BRAINS WHEN WE ARE TOUCHED?

The researchers modeled social contact of female rats who were littermates. The hypothalamus, located in the lower part of the brain, under the thalamus, is the main regulatory center for the social behavior in rodents, because in this species the role of the cerebral cortex is not dominant. At the same time,

the hypothalamus probably also plays a role in regulating instinctive behaviors in humans. However, it is not known how information necessary for social behavior arrives in the hypothalamus.

According to the hypothesis of the research, the ascending sensory pathway carrying information about social touch reaches the hypothalamus from the thalamus without relay in the cerebral cortex. This thalamo-hypothalamic neural pathway was previously unknown. At the same time, such an input can directly trigger hypothalamic-controlled hormonal and autonomic changes.

As a first step, the researchers showed that neurons in a hitherto little-known area of the thalamus are selectively activated in response to social contact. Then, the activity of these neurons was experimentally increased or decreased using chemogenetic methods based on viral gene transfer.

It was found that these thalamic neurons facilitate friendly social interactions between experimental rats of the same sex, which involve direct, i.e., physical contact. They then described the outputs of the studied thalamic nucleus and found that the neurons of the nucleus project most to the anterior part of the hypothalamus, the so-called preoptic area.

AFTER DISCOVERING THE NEURAL PATHWAYS, THEY TURNED TO THE MOLECULAR MECHANISMS

The researchers further proved that the experimental manipulation of the activity of the thalamo-hypothalamic neural pathway also determines how much the animals interact with each other. So this neural pathway plays an important role in the processing of information associated with contact. After that, the information-carrying molecules in the neural pathway, the so-called neurotransmitters, were examined. Neuropeptide transmitters play multiple roles in the neuronal networks responsible for social relationships.

Oxytocin is a prosocial neuropeptide known to promote social interactions, including social contact in rodents.

Other neuropeptides have been shown to play a crucial role in the behavioral response to chronic social isolation.

The parathormone-like neuropeptide (PTH2) has recently been shown to sense the presence of conspecifics in zebrafish through the mechanoreceptors of the lateral line organ. Surprisingly, the PTH2 neuropeptide was only present in those neurons of the thalamus that were activated during social interaction.

Moreover, the level of PTH2 in these neurons decreased when the animals were separated from each other. In further experiments, the researchers showed that PTH2 stimulates neurons located in the preoptic area of the hypothalamus. However, when PTH2 was experimentally prevented from binding to its receptors in the preoptic area, physical contact between the animals ceased.

This proved that the PTH2 peptide neurotransmitter transmits important social behavior-determining inputs to the preoptic area from the thalamus. Finally, the researchers showed a similarity in the anatomical structure of the thalamo-hypothalamic neural pathway and the distribution of the PTH2 receptor between the rat and human brains.

„This discovery may also be important in the future for treatment of psychological diseases, as the avoidance of physical contact is an inherent part of many diseases. If we know these neural pathways and mechanisms, in the long term

we can better understand why the avoidance of physical contact develops, and possibly prevent these processes and influence them favorably for the individual.

Of course, this is still a distant future, but with the research we have come closer to understanding how our brain and thus our body reacts to touch, which brain areas are activated when we are touched," Árpád Dobolyi, head of the research at the Department of Physiology and Neurobiology, ELTE Institute of Biology, summarized the results.

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JOURNAL

Current Biology

DOI

10.1016/j.cub.2022.08.062 

ARTICLE TITLE

A thalamo-preoptic pathway promotes social grooming in rodents

ARTICLE PUBLICATION DATE

15-Sep-2022

Globally, diets are not much healthier today than they were thirty years ago

Researchers detail eating habits of adults and children in 185 countries over 3 decades

Peer-Reviewed Publication

TUFTS UNIVERSITY, HEALTH SCIENCES CAMPUS

On a scale from 0 to 100 of how well people stick to recommended diets, with 0 being a poor diet (think heavy consumption of sugar and processed meats), and 100 representing the recommended balance of fruits, vegetables, legumes/nuts and whole grains, most countries would earn a score around 40.3. Globally, this represents a small, but meaningful, 1.5-point gain between 1990 and 2018, researchers from the Friedman School of Nutrition Science and Policy at Tufts University report today in the journal Nature Food.

The study, one of the most comprehensive estimates yet of global dietary quality—and the first to include findings among children as well as adults—highlights the challenges worldwide to encourage healthy eating. Although global gains were modest, there was notable variation by country, with nutritious options becoming more popular in the United States, Vietnam, China, and Iran, and less so in Tanzania, Nigeria, and Japan.

“Intake of legumes/nuts and non-starchy vegetables increased over time, but overall improvements in dietary quality were offset by increased intake of unhealthy components such as red/processed meat, sugar-sweetened beverages, and sodium,” says lead author Victoria Miller, a visiting scientist from McMaster University in Canada who started this study as a postdoctoral scholar with Dariush Mozaffarian, Dean for Policy and Jean Mayer Professor of Nutrition at the Friedman School, and senior author on the paper.

Dietary Quality in Detail

Poor diet is a leading cause of illness, responsible for 26% of preventable death worldwide. While interventions and policies to support healthy eating are urgently needed, little has been known about differences in dietary quality by demographics such as age, sex, education, or proximity to urban areas—helpful information to target public health campaigns.

Miller and colleagues addressed this gap by measuring global, regional, and national eating patterns among adults and children across 185 countries based on data from over 1,100 surveys from the Global Dietary Database, a large, collaborative compilation of data on food and nutrient consumption levels worldwide. The researchers’ primary outcome was the 0 to 100 scale known as the Alternative Healthy Eating Index, a validated measure of diet quality.

Regionally, averages ranged from as low as 30.3 in Latin America and the Caribbean to as high as 45.7 in South Asia. The average score of all 185 countries included in the study was 40.3. Only 10 countries, representing less than 1 percent of the world’s population, had scores over 50. The world’s highest scoring countries were Vietnam, Iran, Indonesia and India, and the lowest scoring were Brazil, Mexico, the United States and Egypt.

Globally, among adults, women were more likely to eat recommended diets than men, and older adults more so than younger adults.

“Healthy eating was also influenced by socioeconomic factors, including education level and urbanicity,” says Miller. “Globally and in most regions, more educated adults and children with more educated parents generally had higher overall dietary quality.”

“On average across the world, dietary quality was also greater among younger children but then worsened as children aged,” she adds. “This suggests that early childhood is an important time for intervention strategies to encourage the development of healthy food preferences.”

The researchers note some study imitations to consider include measurement errors in the dietary data, incomplete survey availability in some countries, and a lack of information on some important dietary considerations, such as trans-fats intake. But the findings offer key benchmarks for comparison as new information is added to the Global Dietary Database.

Turning Data into Policy

The researchers say that the scale and detail of the Nature Food study enables nutrition researchers, health agencies, and policymakers to better understand trends in dietary intake that can be used to set targets and invest in actions that encourage healthy eating, such as promoting meals made up of produce, seafood, and plant oils.

“We found that both too few healthy foods and too many unhealthy foods were contributing to global challenges in achieving recommended dietary quality,” says Mozaffarian. “This suggests that policies that incentivize and reward more healthy foods, such as in healthcare, employer wellness programs, government nutrition programs, and agricultural policies, may have a substantial impact on improving nutrition in the United States and around the world.”

The research team next plans to look at estimating how different aspects of poor diets directly contribute to major disease conditions around the world, as well as modeling the effects of various policies and programs to improve diets globally, regionally, and nationally.

This research was supported by grants from the Bill and Melinda Gates Foundation and from the American Heart Association. Complete information on authors, funders, and conflicts of interest is available in the published paper.

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JOURNAL

Nature Food

DOI

10.1038/s43016-022-00594-9 

METHOD OF RESEARCH

Data/statistical analysis

ARTICLE TITLE

Global dietary quality in 185 countries from 1990 to 2018 show wide differences by nation, age, education, and urbanicity

ARTICLE PUBLICATION DATE

19-Sep-2022

Changes to animal feed could supply food for one billion people

Livestock and fish could be fed more agricultural by-products, freeing up food for people

Peer-Reviewed Publication

AALTO UNIVERSITY

 

IMAGE: MATERIALS CURRENTLY FED TO LIVESTOCK AND FISH COULD BE REDIRECTED TO INCREASE THE AMOUNT OF FOOD AVAILABLE FOR PEOPLE. view more 

CREDIT: PIXABAY

While millions around the world face the threat of famine or malnutrition, the production of feed for livestock and fish is tying up limited natural resources that could be used to produce food for people. New research from Aalto University, published in Nature Food, shows how adjustment to the feeding of livestock and fish could maintain production while making more food available for people. These relatively simple changes would increase the global food supply significantly, providing calories for up to 13% more people without requiring any increase in natural resource use or major dietary changes. 

Currently, roughly a third of cereal crop production is used as animal feed, and about a quarter of captured fish aren’t used to feed people. Matti Kummu, an associate professor of global water and food issues at Aalto, led a team that investigated the potential of using crop residues and food by-products in livestock and aquaculture production, freeing up the human-usable material to feed people.

‘This was the first time anyone has collected the food and feed flows in this detail globally, from both terrestrial and aquatic systems, and combined them together. That let us understand how much of the food by-products and residues is already in use, which was the first step to determining the untapped potential,’ explains Kummu.

The team analysed the flow of food and feed, as well as their by-products and residues, through the global food production system. They then identified ways to shift these flows to produce a better outcome. For example, livestock and farmed fish could be fed food system by-products, such as sugar beet or citrus pulp, fish and livestock by-products or even crop residues, instead of materials that are fit for human use. 

With these changes, up to 10-26% of total cereal production and 17 million tons of fish (~11% of the current seafood supply) could be redirected from animal feed to human use. Depending on the precise scenario, the gains in food supply would be 6-13% in terms of caloric content and 9-15% in terms of protein content. ‘That may not sound like a lot, but that’s food for up to about one billion people,’ says Aalto’s Vilma Sandström, the first author of the study.

These findings dovetail nicely with earlier work from Kummu’s group on reducing food loss throughout the supply chain, from production, transport and storage through to consumer waste. ‘In that study, we showed that reducing food loss and waste by half would increase the food supply by about 12%. Combined with using by-products as feed, that would be about one-quarter more food,’ he says.

Some of the changes, such as feeding crop residues to livestock, would lead to a drop in livestock productivity, but the researchers accounted for that in their analysis. Another challenge is that the human-edible food currently used in livestock production and aquaculture is different from the food people are used to. For example, a different variety of corn is used in feed industries and some of the grains are lower quality, while the fish used in fishmeal production tend to be small, bony fish that currently aren’t popular with consumers.

However, overcoming these hurdles could result in substantial gains. Realising these benefits would require some adjustments in supply chains. ‘For example, we’d need to reorganise the food system so that the industries and producers with by-products can find the livestock and aquaculture producers who would need them. And some of the by-products would need processing prior to using them as feed,’ says Sandström.

‘I don't think there’s any serious problem with doing this. What we’re suggesting is already being done on a certain scale and in some areas, so it’s not something that would have to be developed from scratch. We just need to adjust the current system and increase the scale of those practices,’ Kummu concludes.

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JOURNAL

Nature Food

DOI

10.1038/s43016-022-00589-6 

ARTICLE TITLE

Food system by-products upcycled in livestock and aquaculture feeds can increase global food supply

Facemask can detect viral exposure from a 10-minute conversation with an infected person

Peer-Reviewed Publication

CELL PRESS

 

VIDEO: A VIDEO DEMONSTRATION OF THE WIRELESS BIOELECTRONIC MASK FOR A REAL-TIME TEST view more 

CREDIT: MATTER/WANG ET AL.

Scientists have created a face mask that can detect common respiratory viruses, including influenza and the coronavirus, in the air in droplets or aerosols. The highly sensitive mask, presented September 19 in the journal Matter, can alert the wearers via their mobile devices within 10 minutes if targeted pathogens are present in the surrounding air.

“Previous research has shown face mask wearing can reduce the risk of spreading and contracting the disease. So, we wanted to create a mask that can detect the presence of virus in the air and alert the wearer,” says Yin Fang, the study’s corresponding author and a material scientist at Shanghai Tongji University.

Respiratory pathogens that cause COVID-19 and H1N1 influenza spread through small droplets and aerosols released by infected people when they talk, cough, and sneeze. These virus-containing molecules, especially tiny aerosols, can remain suspended in the air for a long time.

Fang and his colleagues tested the mask in an enclosed chamber by spraying the viral surface protein containing trace-level liquid and aerosols on the mask. The sensor responded to as little as 0.3 microliters of liquid containing viral proteins, about 70 to 560 times less than the volume of liquid produced in one sneeze and much less than the volume produced by coughing or talking, Fang says.

The team designed a small sensor with aptamers, which are a type of synthetic molecule that can identify unique proteins of pathogens like antibodies. In their proof-of-concept design, the team modified the multi-channel sensor with three types of aptamers, which can simultaneously recognize surface proteins on SARS-CoV-2, H5N1, and H1N1.

Once the aptamers bind to the target proteins in the air, the ion-gated transistor connected will amplify the signal and alert the wearers via their phones. An ion-gated transistor is a novel type of device that is highly sensitive, and thus the mask can detect even trace levels of pathogens in the air within 10 minutes. 

“Our mask would work really well in spaces with poor ventilation, such as elevators or enclosed rooms, where the risk of getting infected is high,” Fang says. In the future, if a new respiratory virus emerges, they can easily update the sensor’s design for detecting the novel pathogens, he adds.

Next, the team hopes to shorten the detection time and further increase the sensitivity of the sensor by optimizing the design of the polymers and transistors. They are also working on wearable devices for a variety of health conditions including cancers and cardiovascular diseases.

“Currently, doctors have been relying heavily on their experiences in diagnosing and treating diseases. But with richer data collected by wearable devices, disease diagnosis and treatment can become more precise,” Fang says.

A wearable bioelectronic mask for the detection of airborne respiratory infectious disease viruses

CREDIT

Matter/Wang et al.

The work is supported by National Key Research and Development Program, National Natural Science Foundation of China, Science and Technology Commission of Shanghai Municipality, Shanghai Municipal Science and Technology Major Project and the Fundamental Research Funds for the Central Universities.

Matter, Wang et al. “Wearable bioelectronic masks for wireless detection of respiratory infectious diseases by gaseous media” https://www.cell.com/matter/fulltext/S2590-2385(22)00477-5

Matter (@Matter_CP), published by Cell Press, is a new journal for multi-disciplinary, transformative materials sciences research. Papers explore scientific advancements across the spectrum of materials development—from fundamentals to application, from nano to macro. Visit https://www.cell.com/matter. To receive Cell Press media alerts, please contact press@cell.com.

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JOURNAL

Matter

DOI

10.1016/j.matt.2022.08.020 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Wearable Bioelectronic Masks for Wireless Detection of Respiratory Infectious Diseases by Gaseous Media

ARTICLE PUBLICATION DATE

19-Sep-2022

Disclaimer: AAAS and

Human Papillomavirus Vaccination Before and During the COVID-19 Pandemic

Jenny K. R. Francis, MD, MPH^1,2; Sitara M. Weerakoon, PhD, MPH^3,4; Serena L. Lucas, RN, BSN, MBA²; et alMatthew S. Mathew, MS^3,4; Julia C. Durante, MD^1,2; Nancy Kelly, MD^1,2; Jasmin A. Tiro, PhD⁵

Author Affiliations Article Information

JAMA Netw Open. 2022;5(9):e2234000. doi:10.1001/jamanetworkopen.2022.34000

Introduction

Every clinical encounter is an opportunity to vaccinate. The COVID-19 pandemic disrupted in-person encounters, leading to delays in childhood vaccinations across different seasonal patterns.^1,2 Historically, human papillomavirus (HPV) vaccination has lagged behind other adolescent vaccinations.³ Strategies to catch up by offering vaccines at every encounter starting at age 9 years^4,5 and prioritizing population subgroups are needed. We characterized HPV vaccination by age and season from 2019 to 2021 and compared vaccination by encounter before and during the COVID-19 pandemic to identify catch-up priority groups.

Methods

This cross-sectional study assessed encounters from January 2019 to December 2021 of patients aged 9 to 22 years at Children’s Health Medical Group, Dallas, Texas, who were seen for well or follow-up visits, with no change in HPV vaccine supply or availability during the study period. The study was approved by the University of Texas Southwestern Medical Center institutional review board, with a waiver of informed consent because this was a nonregulated quality improvement project. The STROBE reporting guideline was followed.

Structured queries of electronic health records were used to identify patients due for an HPV dose and whether it was received at an encounter. Demographic characteristics and encounter features (eg, order during study period) associated with HPV vaccination were assessed using Mann-Whitney tests adjusted for nonindependence of observations. To understand pandemic effects and seasonal variation, difference-in-difference testing compared total vaccines administered each season in each year.² A priori significance was set at 2-sided P ≤ .05. Analyses were performed used Stata, version 15.

Results

Among 4548 patients with 10 469 encounters (Table 1), the percentage receiving HPV vaccination was higher in 2021 (1118 of 3522 [35.0%]) and 2020 (1182 of 3320 [35.6%]) compared with 2019 (1222 of 3957 [30.9%]) (P < .001) despite a 19.3% decrease in the number of encounters in 2021 (n = 3192) compared with 2019 (n = 3957). The youngest eligible age group (9-10 years) had the lowest percentage of vaccinations compared with other age groups, representing 3629 of 10 469 encounters (34.7%) but only 10 of 3522 vaccinations (0.3%).

Table 2 compares the adjusted percentage change in vaccinations per season. In 2020 compared with 2019, there was an 17.99% increase in vaccinations during the winter. At the beginning of the COVID-19 pandemic in spring and summer 2020, vaccinations changed by −37.31% and −22.30%, respectively, and by 37.37 % in fall. In 2021 compared with 2020, vaccinations changed by −11.66 % in winter, 44.64% in spring, −3.85% in summer, and −28.33% in fall. In 2021 compared with 2019 (before the pandemic), vaccinations changed by 4.23% in winter, −9.33% in spring, −25.29% in summer, and 6.97% in fall.

Discussion

We found a steady increase in HPV vaccinations per encounter between 2019 and 2021 despite an 19.3% decrease in overall encounters. The pandemic may have been associated with providers feeling pressured to not miss vaccination at in-person encounters. The number of unique patients was unchanged during the pandemic, which was likely true for other settings. A study limitation is that encounter-level data are useful for clinicians to understand day-to-day vaccine performance but cannot be compared with patient-level state or national data.

Patients aged 9 to 10 years were the least vaccinated even though the practice recommended vaccinations at all encounters. Future studies with larger samples should evaluate age and sex together to assess disparities. Also, vaccination levels in summer of 2020 and 2021 did not catch up to prepandemic vaccination levels in 2019 despite summer typically having more well visits and sports-related examinations. Of note, HPV vaccinations in winter 2020 vs 2019 were largely unchanged, a control for this unadjusted analysis. Efforts to catch up and surpass prepandemic vaccination levels should consider age and seasonality to forecast patient need and adjust vaccine stock and storage to ensure HPV vaccination does not decrease further.

Back to top

Article Information

Accepted for Publication: August 12, 2022.

Published: September 19, 2022. doi:10.1001/jamanetworkopen.2022.34000

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 Francis JKR et al. JAMA Network Open.

Corresponding Author: Jenny K. R. Francis, MD, MPH, Department of Pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390 (jenny.francis@utsouthwestern.edu).

Author Contributions: Dr Francis had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Francis.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Francis, Weerakoon, Mathew.

Critical revision of the manuscript for important intellectual content: Francis, Weerakoon, Lucas, Durante, Kelly, Tiro.

Statistical analysis: Francis, Weerakoon.

Obtained funding: Francis.

Administrative, technical, or material support: Francis, Lucas, Mathew.

Supervision: Francis, Durante.

Conflict of Interest Disclosures: Dr Lucas reported receiving grants from the American Cancer Society during the conduct of the study. Dr Tiro reported receiving grants from the National Institutes of Health and Cancer Prevention and Research Institute of Texas outside the submitted work. No other disclosures were reported.

Funding/Support: This work was supported by the American Cancer Society HPV Cancer Free Texas and grant K23 HD097291 from the National Institutes of Health (Dr Francis).

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We thank the research team, specifically the clinical staff at Children’s Health System of Texas. Stephanie E. Trenkner, MD, and Sonia Allouch, MD (Department of Pediatrics, University of Texas Southwestern Medical Center and Children’s Health System of Texas), attended meetings and reviewed vaccine data as part of a scholarly project. They were not compensated for their role.

References

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Nelson  R.  COVID-19 disrupts vaccine delivery.   Lancet Infect Dis. 2020;20(5):546. doi:10.1016/S1473-3099(20)30304-2PubMedGoogle ScholarCrossref

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Ackerson  BK, Sy  LS, Glenn  SC,  et al.  Pediatric vaccination during the COVID-19 pandemic.   Pediatrics. 2021;148(1):e2020047092. doi:10.1542/peds.2020-047092PubMedGoogle ScholarCrossref

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Pingali  C, Yankey  D, Elam-Evans  LD,  et al.  National, regional, state, and selected local area vaccination coverage among adolescents aged 13-17 years—United States, 2020.   MMWR Morb Mortal Wkly Rep. 2021;70(35):1183-1190. doi:10.15585/mmwr.mm7035a1PubMedGoogle ScholarCrossref

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O’Leary  ST, Nyquist  AC. Why AAP recommends initiating HPV vaccination as early as age 9. AAP News. Accessed May 18, 2022. https://publications-aap-org.foyer.swmed.edu/aapnews/news/14942

5.

American Cancer Society. HPV vaccination at 9-12 years of age. Accessed May 18, 2022. https://hpvroundtable.org/wp-content/uploads/2022/04/Evidence-Summary-HPV-Vaccination-Age-9-12-Final.pdf