November 2024
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7 Reads
Vaccine
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November 2024
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7 Reads
Vaccine
August 2024
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15 Reads
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22 Citations
MMWR. Morbidity and mortality weekly report
Since 1994, the U.S. Vaccines for Children (VFC) program has covered the cost of vaccines for children whose families might not otherwise be able to afford vaccines. This report assessed and quantified the health benefits and economic impact of routine U.S. childhood immunizations among both VFC-eligible and non-VFC-eligible children born during 1994-2023. Diphtheria and tetanus toxoids and acellular pertussis vaccine; Haemophilus influenzae type b conjugate vaccine; oral and inactivated poliovirus vaccines; measles, mumps, and rubella vaccine; hepatitis B vaccine; varicella vaccine; pneumococcal conjugate vaccine; hepatitis A vaccine; and rotavirus vaccine were included. Averted illnesses and deaths and associated costs over the lifetimes of 30 annual cohorts of children born during 1994-2023 were estimated using established economic models. Net savings were calculated from the payer and societal perspectives. Among approximately 117 million children born during 1994-2023, routine childhood vaccinations will have prevented approximately 508 million lifetime cases of illness, 32 million hospitalizations, and 1,129,000 deaths, at a net savings of 2.7 trillion in societal costs. From both payer and societal perspectives, routine childhood vaccinations among children born during 1994-2023 resulted in substantial cost savings. Childhood immunizations continue to provide substantial health and economic benefits, while promoting health equity.
March 2023
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8 Reads
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2 Citations
Journal of Women's Health
Pregnant women* and their infants are at increased risk for serious influenza, pertussis, and COVID-19-related complications, including preterm birth, low-birth weight, and maternal and fetal death. The advisory committee on immunization practices recommends pregnant women receive tetanus-toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine during pregnancy, and influenza and COVID-19 vaccines before or during pregnancy. Vaccination coverage estimates and factors associated with maternal vaccination are measured by various surveillance systems. The objective of this report is to provide a detailed overview of the following surveillance systems that can be used to assess coverage of vaccines recommended for pregnant women: Internet panel survey, National Health Interview Survey, National Immunization Survey-Adult COVID Module, Behavioral Risk Factor Surveillance System, Pregnancy Risk Assessment Monitoring System, Vaccine Safety Datalink, and MarketScan. Influenza, Tdap, and COVID-19 vaccination coverage estimates vary by data source, and select estimates are presented. Each surveillance system differs in the population of pregnant women, time period, geographic area for which estimates can be obtained, how vaccination status is determined, and data collected regarding vaccine-related knowledge, attitudes, behaviors, and barriers. Thus, multiple systems are useful for a more complete understanding of maternal vaccination. Ongoing surveillance from the various systems to obtain vaccination coverage and information regarding disparities and barriers related to vaccination are needed to guide program and policy improvements.
January 2023
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50 Reads
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3 Citations
Obstetrics and Gynecology
Objective: To examine the association between influenza vaccination during pregnancy and infant influenza vaccination. Methods: We conducted a retrospective analysis of individuals aged 15-49 years who were continually privately insured from August 2017 to May 2019 and had singleton live births between September 2017 and February 2018 and their infants. Influenza vaccination coverage was assessed for pregnant people during the 2017-2018 influenza season and for their infants during the 2018-2019 season using the 2017-2019 MarketScan data. Multivariate log-binomial regressions were conducted to examine the association between influenza vaccination during pregnancy and infant influenza vaccination. Results: Of the 34,919 pregnant people in this analysis, 14,168 (40.6%) received influenza vaccination during pregnancy. Of the infants born to people vaccinated during pregnancy, 90.0% received at least one dose of influenza vaccine during the 2018-2019 season and 75.5% received at least two doses. Of the infants born to those not vaccinated during pregnancy, 66.3% received at least one dose of influenza vaccine and 51.8% received at least two doses. At-least-one-dose coverage was 35.7% higher (adjusted risk ratio [aRR] 1.34, 95% CI 1.33-1.36) and at-least-two-dose coverage was 45.8% higher (aRR 1.43, 95% CI 1.41-1.46) for infants born to people who received influenza vaccination during pregnancy compared with infants born to people who did not. Conclusion: Our results show a positive and statistically significant relationship between influenza vaccination during pregnancy and infant influenza vaccination status in their first season eligible for vaccination. Interventions to increase influenza vaccination coverage among pregnant people may also increase infant influenza vaccination coverage, offering greater protection against serious complications of influenza in both vulnerable populations.
December 2022
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9 Reads
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2 Citations
AJPM Focus
Introduction Vaccination with tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) during pregnancy is highly effective against Bordetella pertussis in young infants. We aimed to evaluate uptake of maternal Tdap vaccination during the recommended gestation period of 27 through 36 weeks among women enrolled in a public medical insurance plan in the United States. Methods In this analysis using Centers for Medicare and Medicaid Services insurance claims data, we identified women aged 15 through 49 years who delivered a liveborn infant from 2016 through 2019. We identified claims for Tdap vaccination to calculate the proportion of women who were vaccinated during weeks 27 through 36 of gestation in each calendar year. We also assessed average annual maternal Tdap coverage by age group, race and ethnicity, U.S. Census region of residence, and plan type. Data were analyzed in 2021. Results Among 4,318,823 deliveries, the four-year national average for Tdap vaccination was 26%, improving from 22% in 2016 to 31% in 2019 (p<0.001). Within subgroups, the lowest four-year average coverage was among women aged 15 through 18 years (22%), black, non-Hispanic (23%) and Hispanic women (24%), those residing in the South (18%), enrolled in a Children's Health Insurance Program plan (22%), and covered by a fee-for-service plan (19%). Coverage increased across all subgroups from 2016 through 2019. Conclusion Although maternal Tdap coverage among publicly insured women in the United States increased from 2016 through 2019, it remained considerably lower than estimated national coverage, with notable differences by race and ethnicity.
October 2022
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20 Reads
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9 Citations
The Journal of Infectious Diseases
Background: The aim of this study was to evaluate the health and economic impact of the varicella vaccination program on varicella disease in the United States (US), 1996-2020. Methods: Analysis was conducted using the Centers for Disease Control and Prevention or published annual population-based varicella incidence, and varicella-associated hospitalization, outpatient visit, and mortality rates in the US population aged 0-49 years during 1996-2020 (range, 199.5-214.2 million persons) compared to before vaccination (1990-1994). Disease costs were estimated using the societal perspective. Vaccination program costs included costs of vaccine, administration, postvaccination adverse events, and travel and work time lost to obtain vaccination. All costs were adjusted to 2020 US dollars using a 3% annual discount rate. The main outcome measures were the number of varicella-associated cases, hospitalizations, hospitalization days, and premature deaths prevented; life-years saved; and net societal savings from the US varicella vaccination program. Results: Among US persons aged 0-49 years, during 1996-2020, it is estimated that more than 91 million varicella cases, 238 000 hospitalizations, 1.1 million hospitalization days, and almost 2000 deaths were prevented and 118 000 life-years were saved by the varicella vaccination program, at net societal savings of $23.4 billion. Conclusions: Varicella vaccination has resulted in substantial disease prevention and societal savings for the US over 25 years of program implementation.
March 2022
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21 Reads
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6 Citations
American Journal of Public Health
New York City (NYC) introduced a universal prekindergarten program in 2014 that mandated influenza vaccination for enrollment. We conducted a difference-in-difference-in-differences study to evaluate the program using 2012 to 2019 MarketScan claims data. After the introduction of the program, influenza vaccine uptake among four-year-old children in NYC during the subsequent seasons increased by 6.3 to 9.8 percentage points compared with the rest of New York State. (Am J Public Health. Published online ahead of print March 24, 2022: e1–e5. https://doi.org/10.2105/AJPH.2022.306765 )
March 2022
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11 Reads
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1 Citation
American Journal of Preventive Medicine
Introduction National Immunization Survey-Child data are used widely to assess childhood vaccination coverage in the U.S. This study compares National Immunization Survey-Child coverage estimates with estimates using other supplementary data sources. Methods Retrospective analyses in 2021 assessed vaccination coverage of privately insured children for vaccines recommended by the Advisory Committee on Immunization Practices by age 2 years, using the 2015–2018 MarketScan Commercial Claims and Encounters databases and the 2018–2019 Healthcare Effectiveness Data and Information Set. The coverage estimates were compared statistically with those using the 2016–2018 National Immunization Survey-Child. Results Estimated coverage ranged from 69.9% (≥2 doses of influenza vaccine) to 95.0% (≥3 doses of diphtheria, tetanus toxoids, and acellular pertussis vaccine) using the MarketScan Commercial Claims and Encounters data and from 68.0% (≥2 doses of influenza vaccine) to 92.2% (≥1 dose of measles, mumps, and rubella vaccine) using the Healthcare Effectiveness Data and Information Set. The difference between the MarketScan Commercial Claims and Encounters and National Immunization Survey-Child estimates ranged from 0.1 to 4.3 percentage points and was statistically significant for 6 of the 13 assessed vaccines/doses and percentage of children receiving no vaccinations. The difference between the Healthcare Effectiveness Data and Information Set and National Immunization Survey-Child estimates ranged from 0.4 to 7.2 percentage points and was statistically significant for 6 of the 10 assessed vaccines/doses. Conclusions For certain vaccines and populations of interest, the National Immunization Survey-Child, MarketScan Commercial Claims and Encounters, and Healthcare Effectiveness Data and Information Set data might give comparable coverage of privately insured children.
June 2021
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7 Reads
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2 Citations
Public Health Reports
Objective Pregnant women are at increased risk of serious complications from influenza and are recommended to receive an influenza vaccination during pregnancy. The objective of this study was to assess trends, timing patterns, and associated factors of influenza vaccination among pregnant women. Methods We used 2010-2018 MarketScan data on 1 286 749 pregnant women aged 15-49 who were privately insured to examine trends and timing patterns of influenza vaccination coverage. We examined descriptive statistics and identified factors associated with vaccination uptake by using multivariate log-binomial and Cox proportional hazard models. Results In-plan influenza vaccination coverage before delivery increased from 22.0% during the 2010-2011 influenza season to 33.2% during the 2017-2018 influenza season. About two-thirds of vaccinated women received the vaccine in September or October during each influenza season. For women who delivered in September through May, influenza vaccination coverage increased rapidly at the beginning of influenza season and flattened after October. For women who delivered in June through August, influenza vaccination coverage increased gradually until February and flattened thereafter. Most vaccinated women who delivered before January received the vaccine in the third trimester. Increased likelihood of being vaccinated was associated with age 31-40, living in a metropolitan statistical area, living outside the South, enrollment in a consumer-driven or high-deductible health plan, being spouses or dependents of policy holders, and delivery in November through January. Conclusions Despite increases during the past several years, vaccination uptake is still suboptimal, particularly after October. Health care provider education on timing of vaccination and recommendations throughout influenza seasons are needed to improve influenza vaccination coverage among pregnant women.
May 2021
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52 Reads
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65 Citations
Annals of Internal Medicine
Background: New cases of COVID-19 continue to occur daily in the United States, and the need for medical treatments continues to grow. Knowledge of the direct medical costs of COVID-19 treatments is limited. Objective: To examine the characteristics of older adults with COVID-19 and their costs for COVID-19-related medical care. Design: Retrospective observational study. Setting: Medical claims for Medicare fee-for-service (FFS) beneficiaries. Patients: Medicare FFS beneficiaries aged 65 years or older who had a COVID-19-related medical encounter during April through December 2020. Measurements: Patient characteristics and direct medical costs of COVID-19-related hospitalizations and outpatient visits. Results: Among 28.1 million Medicare FFS beneficiaries, 1 181 127 (4.2%) sought COVID-19-related medical care. Among these patients, 23.0% had an inpatient stay and 4.2% died during hospitalization. The majority of the patients were female (57.0%), non-Hispanic White (79.6%), and residents of an urban county (77.2%). Medicare FFS costs for COVID-19-related medical care were 21 752, and the mean length of stay was 9.2 days; hospitalization cost and length of stay were higher if the patient needed a ventilator (32 015 and 11.3 days). The mean cost per outpatient visit was $164. Patients aged 75 years or older were more likely to be hospitalized, but their hospitalizations were associated with lower costs than for younger patients. Male sex and non-White race/ethnicity were associated with higher probability of being hospitalized and higher medical costs. Limitation: Results are based on Medicare FFS patients. Conclusion: The COVID-19 pandemic has resulted in substantial disease and economic burden among older Americans, particularly those of non-White race/ethnicity. Primary funding source: None.
... Beyond its health implications, vaccine hesitancy carries significant economic costs. From 1994 to 2014, routine childhood immunizations in the United States prevented 508 million illnesses, 32 million hospitalizations, and 1,129,000 deaths, generating $540 billion in direct savings and $2.7 trillion in societal savings [31]. However, even modest declines in vaccination rates can erode these gains. ...
August 2024
MMWR. Morbidity and mortality weekly report
... It is vital to assess the efficacy of COVID-19 vaccination in pregnant women who have conditions that elevate the risk of preterm birth, such as gestational hypertension and diabetes. These pre-existing conditions markedly increase the likelihood of obstetric complications, and vaccination may offer additional protection for these women [40][41][42]. The current literature provides limited insights into COVID-19 vaccination in pregnant women with such conditions, hindering the development of tailored guidelines for this subgroup. ...
March 2023
Journal of Women's Health
... Additionally, factors affecting maternal tetanus vaccination in Egypt have been explored, shedding light on the challenges and barriers to vaccination in developing country settings (Ahmed & El-Berrawy, 2019). Furthermore, a systematic review and metaanalysis in Ethiopia emphasized the importance of TT vaccination coverage among childbearing women, providing insights into associated factors and the need for improved vaccination strategies (Nigussie et al., 2021;Zhou et al., 2023). These studies collectively underscore the significance of TT vaccination in developing countries and the necessity for targeted interventions to enhance vaccination uptake among pregnant women. ...
January 2023
Obstetrics and Gynecology
... In the USA, six years after the Advisory Committee on Immunization Practices [47]. These levels remained unchanged before the COVID-19 pandemic [48] and when the pandemic was nearing its end. During the 2022-2023 influenza season, coverage was only 55.4% [49]. ...
December 2022
AJPM Focus
... It is particularly emphasized that college students, healthcare workers, and school staff, who are at higher risk of VZV exposure or transmission, should be vaccinated if they lack evidence of immunity to chickenpox [37]. Moreover, global application experience has demonstrated that VarV vaccination markedly diminishes the incidence and severity of chickenpox [38][39][40], making it the most cost-effective strategy for preventing and controlling the disease [41][42][43]. For instance, following the implementation of the VarV vaccination strategy across the United States, the two-dose vaccine coverage rate among adolescents aged 13-17 exceeded 90%, while hospitalization and mortality rates for chickenpox in the 20-49 age group declined by 85% and 94%, respectively [44]. ...
October 2022
The Journal of Infectious Diseases
... Decades of preschool evaluation research have focused on estimating associations between preschool attendance and children's school readiness; this research has largely shown that public preschool improves children's academic outcomes in kindergarten (Phillips et al., 2017). Although less attention has been paid to the potential of public preschool to enhance health outcomes, a growing body of research suggests that attending public preschool may be associated with better health across the lifespan, especially for low-income children (Campbell et al., 2014;Conti et al., 2016;DHHS, 2010;D'Onise et al., 2010;Friedman-Krauss et al., 2019;Frisvold & Lumeng, 2011;Hong et al., 2019Hong et al., , 2022Lumeng et al., 2010;Masuda et al., 2021;Mondi et al., 2017;Morrissey, 2019;Reynolds et al., 2007Reynolds et al., , 2011Reynolds et al., , 2021. What is not known, however, is whether public preschool improves children's health-related outcomes as they approach kindergarten and whether attending preschool earlier than just the year before kindergarten entry is a promising way to boost early childhood health for low-income children. ...
March 2022
American Journal of Public Health
... DOI: 10.61634/2782-3024-2024-14- [20][21][22][23][24][25][26][27] Массовая иммунизация населения -самая эффективная мера борьбы с инфекционными заболеваниями. Несмотря на то, что введение вакцины не гарантирует, что ребенок не заболеет, вакцинопрофилактика позволяет снизить риск осложнений и смертельного исхода. ...
March 2022
American Journal of Preventive Medicine
... CAD for the non-hospitalized group. Internationally, the median costs for hospitalization range from $11,260 USD in Brazil to $21,752 USD in the U.S. 30,31 The mean cost for hospitalizations with ICU admit was fivetimes higher than those without ICU admit ($75,674.91 CAD with a median of $54,260.57 ...
May 2021
Annals of Internal Medicine
... 7,8 As a result, routine childhood vaccination programmes were disrupted [9][10][11][12][13][14][15] and adult vaccination rates decreased. 16,17 The World Health Organization (WHO) estimated that 25 million children missed vaccinations in 2021, 5.9 million more than in 2019; 18 modeling suggested 27-30 million children missed certain vaccinations in 2020. 15 It is unclear whether changes in vaccination rates as people adjusted to life in the COVID-19 pandemic primarily resulted from missed opportunities for vaccination and/or if they reflected a substantial shift in attitudes toward vaccination. ...
February 2021
MMWR. Morbidity and mortality weekly report
... This highlights the urgency of addressing underimmunization in the urban cities [7,8]. Even though urban areas have been shown to have higher vaccination coverage compared to rural ones, mainly due to better access to healthcare facilities and more staff and greater access to vaccines, there are still specific barriers that can reduce immunization coverage compared to rural areas, including population diversity and urban poverty [9]. ...
October 2020
Journal of Adolescent Health