COVID-19-associated hospitalizations among vaccinated, unvaccinated adults
JAMA Internal Medicine
Peer-Reviewed PublicationAbout The Study: When Omicron was the dominant variant during the early months of 2022 from January to April, COVID-19-associated hospitalization rates were 10.5 times higher in unvaccinated adults and 2.5 times higher in vaccinated adults with no booster dose compared with those who had received a booster dose. Results of the study suggest that clinicians and public health practitioners should continue to promote vaccination with all recommended doses for eligible persons.
Authors: Fiona Havers, M.D., M.H.S., of the Centers for Disease Control and Prevention in Atlanta, is the corresponding author.
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(doi:10.1001/jamainternmed.2022.4299)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
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JOURNAL
JAMA Internal Medicine
New study provides insights into each US state’s COVID-19 vaccination rate
Many people unvaccinated for COVID-19 remain unconvinced of its necessity, and the social and demographic factors underlying this decision vary substantially from region to region, investigators report in the American Journal of Preventive Medicine
Peer-Reviewed PublicationIMAGE: GEOFACET MAP SHOWING WEIGHTED PROPORTION OF RESPONDENTS REPORTING THEY ARE VACCINATED, DEFINITELY WILL GET VACCINATED, PROBABLY WILL GET VACCINATED OR ARE UNSURE, OR PROBABLY/DEFINITELY WILL NOT GET VACCINATED FROM MAY–DECEMBER 2021. view more
CREDIT: AMERICAN JOURNAL OF PREVENTIVE MEDICINE
Ann Arbor, September 8, 2022 – In the first year of its availability, 84.2% of US adults received at least one dose of COVID-19 vaccine. Progress in COVID-19 vaccination slowed after April 2021, and millions of Americans remain unvaccinated. New research in the American Journal of Preventive Medicine, published by Elsevier, finds wide geographic variance in vaccine uptake and identifies the underlying behavioral and social drivers that factor into the decision to remain unvaccinated. The findings suggest that improving COVID-19 vaccine confidence may not be solved by a “one-size-fits-all solution.”
“Many studies have explored vaccine coverage and vaccine confidence at a national level, but these are likely to vary widely by geography and sociodemographics,” said lead investigator Nina B. Masters, PhD, Epidemic Intelligence Service, and Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA. “We decided to explore state and regional trends in COVID-19 vaccine confidence and the underlying reasons for non-vaccination.”
The study used data from the National Immunization Survey-Adult COVID Module. This is a nationally representative household cellphone survey of US adults aged 18 or older. Of the 531,798 participants surveyed (April 22 to December 31, 2021), respondents who had not received a COVID-19 vaccine were then asked how likely they were (definitely, probably, probably not, definitely will not, not sure) to get vaccinated. Additional questions were asked about the individual’s concerns about COVID-19 and confidence in vaccine safety and importance.
To understand social norms, the participants were asked how many friends and family members had received a COVID-19 vaccination, and if a healthcare provider had recommended that they receive the vaccine. For practical factors, the survey asked whether one’s work or school required COVID-19 vaccination and whether they experienced any actual or perceived difficulty in accessing a vaccination. Demographic data were also collected. The analysis examined these variables nationally and for each state for each month in the survey period, to support trends over time.
In general, rural residents were less likely to be vaccinated than urban residents, but in the Southeast and Midwest, differences in vaccination coverage by urbanicity were smaller. In most states, Black and Hispanic adults were less likely to be vaccinated than White and non-Hispanic adults. However, in the South and the Southeast, where vaccination rates were low compared to the rest of the US, vaccination coverage was similar across race and ethnicity. The Southeast and Midwest had the largest proportion of unvaccinated people who indicated that they would probably get a COVID-19 vaccine or were unsure. These regions saw similar trends in concern about COVID-19 and confidence in the importance of getting vaccinated.
Overall, individuals with low confidence in the importance of the vaccine were five times more likely to remain unvaccinated. This suggests that focused messaging about the benefits of vaccination, compared to the risk of the disease, remains a priority. Adults in rural areas – as well as those with less than a college degree, without insurance, making less than $75,000/year and under 65 – had higher prevalence of non-vaccination across all regions, while associations between vaccination and race/ethnicity varied by region.
“Our analysis supports the idea that reasons for non-vaccination are personal and individual, and there are nuances and differences in this reasoning, for example, between an unvaccinated, young individual living in a rural community in the Southeast and an unvaccinated, older individual living in the Northeast who has mostly vaccinated friends and family. It’s important to meet people where they are to build confidence in vaccines,” said Dr. Masters. “The CDC has made national, regional, and state data available on the Behavioral and Social Drivers of COVID-19 vaccination through national surveys of adults and parents. State and local health departments may be able to strengthen their ongoing efforts locally by accessing these data at the CDC COVID Data Tracker: Vaccine Confidence.”
JOURNAL
American Journal of Preventive Medicine
METHOD OF RESEARCH
Data/statistical analysis
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Geographic Heterogeneity in Behavioral and Social Drivers of COVID-19 Vaccination
Patients may have and transmit COVID-19 viruses with diverse genetic sequences simultaneously, with possible implications for evolution of new variants
IMAGE: RESEARCHERS FIND PATIENTS MAY HAVE AND TRANSMIT COVID-19 VIRUSES WITH DIVERSE GENETIC SEQUENCES SIMULTANEOUSLY. view more
CREDIT: MONSTERA, PEXELS (CC0, HTTPS://CREATIVECOMMONS.ORG/PUBLICDOMAIN/ZERO/1.0/)
Patients may have and transmit COVID-19 viruses with diverse genetic sequences simultaneously, with possible implications for evolution of new variants
Article URL: http://journals.plos.org/plosgenetics/article?id=10.1371/journal.pgen.1010200
Article Title: COVID-19 infection and transmission includes complex sequence diversity
Author Countries: United States
Funding: This work was supported by a Merit Review grant (CX001848) from the US Department of Veterans Affairs to CJD and by a grant from the US Department of Veterans Affairs Office of Research and Development as part of funding for VASeqCURE (grant number N/A) which in turn received funding from the American Rescue Plan Act funds. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
JOURNAL
PLoS Genetics
COI STATEMENT
Competing interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: CJD has received research grants from Clorox, Pfizer, and PDI. All other authors report no conflicts of interest relevant to this article.
Researchers at Case Western Reserve University show that all COVID-19 infections include a wide mix of SARS-CoV-2 virus variants
More detailed tracking of virus genetic variations can provide early warning to public health efforts
Peer-Reviewed PublicationIMAGE: WHOLE GENOME SEQUENCING OF 140 COVID SAMPLES FROM INFECTED INDIVIDUALS BETWEEN APRIL 2020 AND AUGUST 2021 SHOW INFECTION SIGNATURES CONSISTENT WITH THE MAJOR STRAIN AT THE TIME REPRESENTED IN DIFFERENT COLOR PARTITIONS. EACH HORIZONTAL LINE ILLUSTRATES A SEQUENCED SAMPLE, AND LINEAGE SPECIFIC POSITIONS ARE SHOWN VERTICALLY. GRAY SHADED BOXES REPRESENT MIXED ALLELE FREQUENCIES OBSERVED IN OUR SAMPLES. INTERESTINGLY, WE OBSERVE SAMPLES THAT REPRESENT MIXED ALLELE FREQUENCIES DURING THE TRANSITION BETWEEN B.1.1.7 AND B.1.617.2 (PURPLE PARTITION). FROM THE PAPER: COVID-19 INFECTION AND TRANSMISSION INCLUDES COMPLEX SEQUENCE DIVERSITY, PLOS GENETICS, SEPTEMBER 8, 2022 view more
CREDIT: ERNEST (RICKY) CHAN
CLEVELAND—Researchers at Case Western Reserve University found wide genetic variation in SARS-CoV-2 viruses among 360 patients whose viral infections were genetically sequenced, showing that all individual infections include multiple variants of the virus.
The researchers noted that reporting about the virus usually highlights a single dominant strain, which leads to under-reporting virus genetic variation and can have serious consequences in public-health planning and response.
“Our work brings attention to the complexity of infectious diseases that is often over-simplified when considering only the most abundant virus in an infection, and we demonstrate the importance of examining the variations that are historically considered noise,” said Ernest (Ricky) Chan, director of the bioinformatics core with the Cleveland Institute for Computational Biology at the Case Western Reserve School of Medicine. “We see that genetic variants observed in low frequency in SARS-CoV-2 infections can be early indicators of new strains responsible for later transmission surges.”
The paper, “COVID-19 Infection and Transmission Includes Complex Sequence Diversity,” will be published on September 8, 2022 in PLOS Genetics. {Embargoed for 9.8 at 2pm ET.)
The CWRU team performed full genome sequencing of SARS-CoV-2 viruses from 250 patients in Northeast Ohio and used similar data from another 110 patients with full genetic sequences of infecting viruses provided through international research collaborators.
These data were developed in the early days of the COVID-19 pandemic when the Alpha variant and then the Delta variant were of major concern. This work showed that mutations found in Omicron BA.1 and BA.2 were already present as relatively minor variations at least a year before Omicron and its many iterations became “variants of concern.” Omicron and its own variants were central to a major COVID-19 resurgence last winter.
“Concentration on a majority consensus of virus variants within the global research community diverts attention from genetic variation that may contribute significantly to the continuing evolution of the COVID-19 pandemic,” said Peter Zimmerman, a professor in the Department of Pathology at the School of Medicine. {EMBED LINK TO BIO} “Focus on majority variants is a critical first step in development of diagnostics, therapeutics and vaccines, however the research community needs to quantify and report out variation, so that the public health community and the general public are better prepared and nimble in response to the ever-evolving virus.”
Much continues to be made to define and track the emergence of virus lineages across the ongoing evolution of SARS-CoV-2 around the world. In the interest of time, global researchers have been relying on tracking and reporting on relatively dominant variations. But the CWRU researchers noted that, given the multiple variations within single infections, it is important to report a more complete representation of the viral genetic sequences to understand how these genetic changes can spread and potentially interact with different categories of patient conditions, including evasion from eradication efforts.
Contact: Paula Darte: paula.darte@case.edu or 216-870-6323
About Case Western Reserve University
Case Western Reserve University is one of the country's leading private research institutions. Located in Cleveland, we offer a unique combination of forward-thinking educational opportunities in an inspiring cultural setting. Our leading-edge faculty engage in teaching and research in a collaborative, hands-on environment. Our nationally recognized programs include arts and sciences, dental medicine, engineering, law, management, medicine, nursing, and social work. About 5,100 undergraduate and 6,700 graduate students comprise our student body. Visit case.edu to see how Case Western Reserve thinks beyond the possible.
About the Cleveland Institute for Computational Biology
The Institute, housed at Case Western Reserve University, convenes a wide range of researchers and professionals for intellectual exchange, to support one another’s work, and to serve as consultants on a variety of inquiries.
The institute leads and/or supports regional, national, and international collaborations that seek to improve individual, public, and population health drawing on related disciplines: genetic and population epidemiology, genomic variation, translational clinical research. Visit http://www.icompbio.net/overview/ to learn more.
JOURNAL
PLoS Genetics
SUBJECT OF RESEARCH
Cells
ARTICLE TITLE
COVID-19 infection and transmission includes complex sequence diversity
ARTICLE PUBLICATION DATE
8-Sep-2022
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