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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Children/Adolescents (6)
- Community-Based Practice (1)
- COVID-19 (5)
- Disparities (2)
- Education: Patient and Caregiver (2)
- Healthcare Costs (1)
- Healthcare Utilization (2)
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- Infectious Diseases (2)
- Kidney Disease and Health (1)
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- Provider: Clinician (1)
- Provider: Physician (1)
- Public Reporting (1)
- Racial and Ethnic Minorities (3)
- Registries (1)
- Rural/Inner-City Residents (1)
- Rural Health (1)
- Sexual Health (2)
- Shared Decision Making (1)
- Social Determinants of Health (1)
- Transplantation (2)
- Urban Health (1)
- (-) Vaccination (14)
- Vulnerable Populations (1)
- Women (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 14 of 14 Research Studies DisplayedHeintzman J, Springer R, Marino M
Latino adolescent-mother language concordance, neighborhood deprivation, and vaccinations in community health centers.
Researchers examined the association between adolescent-mother language concordance and neighborhood social deprivation with adolescent vaccination completion in order to understand social/family factors related to Latino adolescent vaccination. They used a multistate, EHR-based dataset of community health center patients to compare three Latino groups; their sample included over 56,000 adolescent-mother dyads. Their findings indicated that English-preferring adolescents with Spanish-preferring mothers had the highest completion rates. The researchers concluded that future studies could attempt to understand what advantage this language dyad may have in adolescent vaccination completion.
AHRQ-funded; HS025962.
Citation: Heintzman J, Springer R, Marino M .
Latino adolescent-mother language concordance, neighborhood deprivation, and vaccinations in community health centers.
Matern Child Health J 2023 Nov; 27(11):2026-37. doi: 10.1007/s10995-023-03742-0..
Keywords: Racial and Ethnic Minorities, Community-Based Practice, Vaccination, Children/Adolescents, Vulnerable Populations, Social Determinants of Health
Fernandez JR, Strassle PD, Richmond J
County-level barriers in the COVID-19 vaccine coverage index and their associations with willingness to receive the COVID-19 vaccine across racial/ethnic groups in the U.S.
This study examined whether county-level vaccination barriers varied across racial/ethnic groups in the U.S., if they were associated with willingness to receive the COVID-19 vaccine, and if they differed across racial/ethnic groups. Data was taken from the REACH-US study. County-level vaccination barriers were measured using the COVID-19 Vaccine Coverage Index. Results showed that American Indian/Alaska Native, African American, Hispanic/Latino, and Multiracial adults were more likely than White adults to live in counties with higher overall county-level vaccination barriers. Higher sociodemographic barriers were associated with less willingness to receive the COVID-19 vaccine. History of low vaccination was associated with less willingness to receive the COVID-19 vaccine among African American adults. The researchers concluded that future vaccination programs should include efforts accounting for structural barriers to preventive healthcare and their intersection with sociodemographic factors.
AHRQ-funded; HS026122.
Citation: Fernandez JR, Strassle PD, Richmond J .
County-level barriers in the COVID-19 vaccine coverage index and their associations with willingness to receive the COVID-19 vaccine across racial/ethnic groups in the U.S.
Front Public Health 2023 Oct 12; 11:1192748. doi: 10.3389/fpubh.2023.1192748..
Keywords: COVID-19, Vaccination, Patient Adherence/Compliance, Racial and Ethnic Minorities
Feldman AG, Beaty BL, Ferrolino Ja
Safety and immunogenicity of live viral vaccines in a multicenter cohort of pediatric transplant recipients.
This study’s objective was to determine the safety and immunogenicity of live vaccines in pediatric liver and kidney transplant recipients. This cohort study included 281 children, of which 270 had received a liver transplant, 9 a kidney transplant, and 2 were liver-kidney transplant recipients. None of the children included had completed their primary measles-mumps-rubella (MMR) and varicella-zoster virus (VZV) vaccine series and/or had displayed nonprotective serum antibody levels at enrollment between January 1, 2002, and February 28, 2023. Safety data was collected after these transplant recipients had received 1 to 3 doses or MMR vaccine and/or 1 to 3 doses of VZV vaccine. The median time from transplant to enrollment was 6.3 years, with the median age at first posttransplant vaccine 8.9 years. The majority of children developed protective antibodies following vaccination (107 of 149 varicella, 130 of 152 measles, 100 of 120 mumps, and 124 of 125 rubella). One year post vaccination, the majority of children who initially mounted protective antibodies maintained this protection (34 of 44 varicella, 45 of 49 measles, 35 of 42 mumps, 51 of 54 rubella). Five children developed varicella, all of which resolved within 1 week, and there were no cases of measles or rubella and no episodes or graft rejection within 1 month of vaccination. There was also no association between antibody response and immunosuppression level at the time of vaccination.
AHRQ-funded; HS026510.
Citation: Feldman AG, Beaty BL, Ferrolino Ja .
Safety and immunogenicity of live viral vaccines in a multicenter cohort of pediatric transplant recipients.
JAMA Netw Open 2023 Oct; 6(10):e2337602. doi: 10.1001/jamanetworkopen.2023.37602..
Keywords: Children/Adolescents, Vaccination, Transplantation
Ferranna M, Robinson LA, Cadarette D
The benefits and costs of U.S. employer COVID-19 vaccine mandates.
This study examined the benefits and costs of U.S. employer COVID-19 mandates for federal employees and contractors and for some healthcare and private sector workers if there had not been major challenges in court that halted or delayed the mandates. The authors estimated the direct costs and health-related benefits that would have accrued if these vaccination requirements had been implemented as intended. Compared with the January 2022 vaccination rates, they found that the mandates could have led to 15 million additional vaccinated individuals, increasing the overall proportion of the fully vaccinated U.S. population from 64% to 68%. They examined scenarios involving the emergence of a novel, more transmissible variant, against which vaccination and previous infection offer moderate protection, and found that the estimated net benefits are potentially large. They estimated that they reach almost $20,000 per additional vaccinated individual, with more than 20,000 total deaths averted over the 6-month period assessed. For other scenarios involving a fading pandemic, existing vaccination-acquired or infection-acquired immunity provides sufficient protection, and the mandates' benefits are unlikely to exceed their costs. They believe that mandates may be most useful when the consequences of inaction are catastrophic. However, they did not compare the effects of mandates with alternative policies for increasing vaccination rates or for promoting other protective measures, which may receive stronger public support and be less likely to be overturned by litigation.
AHRQ-funded; HS000055.
Citation: Ferranna M, Robinson LA, Cadarette D .
The benefits and costs of U.S. employer COVID-19 vaccine mandates.
Risk Anal 2023 Oct; 43(10):2053-68. doi: 10.1111/risa.14090..
Keywords: COVID-19, Vaccination, Healthcare Costs
Bahakel H, Feldman AG, Danziger-Isakov L
Immunization of solid organ transplant candidates and recipients: a 2022 update.
The authors discussed the dissemination and implementation of up-to-date vaccine recommendations to aid primary care providers and multi-disciplinary transplant team members taking care of solid organ transplant patients. Key recommendations included: All age-appropriate vaccines should be administered pretransplant; nonimmune liver and kidney transplant recipients on low-dose immunosuppression can be given live vaccines posttransplant under careful medical observation; immunizations should be a prioritized part of pre- and posttransplant care.
AHRQ-funded; HS026510.
Citation: Bahakel H, Feldman AG, Danziger-Isakov L .
Immunization of solid organ transplant candidates and recipients: a 2022 update.
Infect Dis Clin North Am 2023 Sep; 37(3):427-41. doi: 10.1016/j.idc.2023.03.004..
Keywords: Vaccination, Transplantation
Kim D, Swaminathan S, Lee Y
Racial and ethnic disparities in excess deaths after COVID-19 vaccine deployment among persons with kidney failure.
COVID-19 resulted in clear racial/ethnic disparities in excess deaths among persons with kidney failure. It is not clear whether or how these disparities changed throughout the pandemic, especially after the deployment of COVID-19 vaccines. The purpose of this study was to examine disparities in excess mortality for the Medicare population with kidney failure from March 2020, through December 2021. The study found that there were 686,719 patients with kidney failure in January 2020. Researchers reported an increase in excess deaths beginning March 1, 2020, with a peak in January 2021. From March 1, 2020, through January 30, 2021, and there were substantial disparities in excess deaths across racial/ethnic groups. The number of excess deaths was 5582, 4303, and 2679 for non-Hispanic White, non-Hispanic Black, and Hispanic patients, respectively. The percent excess deaths was 31.9% for Hispanic patients, 27.5% for non-Hispanic Black patients, and 16.4% for non-Hispanic White patients. After the wide distribution of COVID-19 vaccines since the end of January 2021, the lowest percent excess deaths was observed among Hispanic patients, followed by Black patients, and White patients.
AHRQ-funded; HS028285.
Citation: Kim D, Swaminathan S, Lee Y .
Racial and ethnic disparities in excess deaths after COVID-19 vaccine deployment among persons with kidney failure.
Clin J Am Soc Nephrol 2023 Sep; 18(9):1207-09. doi: 10.2215/cjn.0000000000000226..
Keywords: COVID-19, Racial and Ethnic Minorities, Disparities, Vaccination, Kidney Disease and Health, Mortality
Miller ME, Rahim MQ, Coven SL
Pediatric hematology and oncology physician and nurse practitioner views of the HPV vaccine and barriers to administration.
This study’s goal was to examine provider views regarding HPV vaccination for pediatric survivors of cancer and pediatric patients with sickle cell disease. The authors conducted qualitative interviews with 20 pediatric hematology/oncology physicians and nurse practitioners. They found that 90% of interviewees support HPV vaccination in their population. The number of providers who reported that they counsel about HPV or provide HPV vaccination was 45%, even in stem cell and sickle cell clinics, where other childhood vaccines are commonly provided. Clinicians identified provider-level, clinic-level, and system-level barriers to giving the HPV vaccination, that included but was not limited to time/flow constraints, lack of resources, and continued education regarding the HPV vaccine.
AHRQ-funded; HS026390.
Citation: Miller ME, Rahim MQ, Coven SL .
Pediatric hematology and oncology physician and nurse practitioner views of the HPV vaccine and barriers to administration.
Hum Vaccin Immunother 2023 Aug 1; 19(2):2224089. doi: 10.1080/21645515.2023.2224089..
Keywords: Vaccination, Sexual Health, Infectious Diseases, Prevention, Provider: Clinician, Provider: Physician
Hatch BA, Kenzie E, Ramalingam N
Impact of the COVID-19 vaccination mandate on the primary care workforce and differences between rural and urban settings to inform future policy decision-making.
The purpose of this cross-sectional study was to determine how vaccine mandates affect the healthcare workforce. Between October 28, 2021- November 18, 2021, following implementation of a COVID-19 vaccination mandate for healthcare personnel, the researchers conducted a survey of Oregon primary care clinic staff. The survey included 19 questions that assessed the clinic-level effects of the vaccination mandate. Study outcomes included job loss among staff, receipt of an approved vaccination waiver, new vaccination among staff, and the perceived significance of the policy on clinic staffing. Staff from 80 clinics across 28 counties completed surveys, representing 38 rural and 42 urban clinics. The study found that clinics reported job loss (46%), use of vaccination waivers (51%), and newly vaccinated staff (60%). Significantly more rural clinics (compared to urban) used medical and/or religious vaccination waivers (71% vs 33%) and reported significant impact on clinic staffing (45% vs 21%). There was also a non-significant trend toward more job loss for rural compared to urban clinics (53% vs. 41%). Qualitative analysis revealed a decrease in clinic morale and mixed opinions of the vaccination mandate.
AHRQ-funded; HS027080.
Citation: Hatch BA, Kenzie E, Ramalingam N .
Impact of the COVID-19 vaccination mandate on the primary care workforce and differences between rural and urban settings to inform future policy decision-making.
PLoS One 2023 Jun 27; 18(6):e0287553. doi: 10.1371/journal.pone.0287553..
Keywords: COVID-19, Vaccination, Primary Care, Policy, Rural Health, Urban Health, Rural/Inner-City Residents
Glenn BA, Crespi CM, Herrmann AK
Effectiveness and feasibility of three types of parent reminders to increase adolescent human papillomavirus (HPV) vaccination.
Efforts to boost human papillomavirus (HPV) vaccination rates among adolescents have seen moderate success with the use of parent notifications. Nonetheless, there is limited research on the comparative efficacy and practicality of various HPV reminder methods in settings with restricted resources. The purpose of this quasi-experimental study (2016-2017) assessed the impact of three types of parent reminders (written correspondence, automated phone calls, and SMS messages) on HPV vaccine uptake for the subsequent dose among 12-year-olds at a prominent Federally Qualified Health Center in Los Angeles County. The researchers matched six clinics into three groups, randomly allocating one clinic from each group to either intervention or control. The intervention clinics were randomly assigned one of the three reminder methods. The researchers determined the rates of vaccine uptake for the next dose and analyzed intervention outcomes using logistic regression models. The proportion of successfully delivered reminders for each method was used as a measure of feasibility. The study included 877 12-year-olds due for an HPV vaccine dose (47% female, more than 85% Latino). The study found that after a 4-month follow-up, 23% of those in the intervention group received an HPV vaccine dose, compared to just 12% in the control group. Overall, receiving any reminder led to higher rates of the next-required HPV vaccine compared to standard care (p = 0.046). Notable improvements were seen with SMS reminders (p = 0.036) and among boys (p = 0.006). Automated phone calls proved to be the least feasible method. Text message reminders are both effective and practical in encouraging HPV vaccination.
AHRQ-funded; HS000044
Citation: Glenn BA, Crespi CM, Herrmann AK .
Effectiveness and feasibility of three types of parent reminders to increase adolescent human papillomavirus (HPV) vaccination.
Prev Med 2023 Apr;169:107448. doi: 10.1016/j.ypmed.2023.107448.
Keywords: Children/Adolescents, Vaccination, Sexual Health
Stone CA, Jr., Robinson LB, Li L
Clinical phenotypes of immediate first-dose reactions to mRNA COVID-19: a multicenter latent class analysis.
The objectives of this retrospective study were to define distinct clinical phenotypes of immediate reactions after dose 1 of mRNA COVID-19 vaccination, and to assess the relation of clinical phenotype to mRNA COVID-19 vaccine second dose tolerance. Researchers identified 265 patients who experienced dose-1 immediate reactions with 3 phenotype clusters: limited or predominantly cutaneous, sensory, or systemic. Of these, 223 patients received a second dose and 200 tolerated the second dose; sensory cluster (numbness or tingling) was associated with a higher likelihood of second dose intolerance, but this finding did not persist when accounting for objective signs.
AHRQ-funded; HS026395.
Citation: Stone CA, Jr., Robinson LB, Li L .
Clinical phenotypes of immediate first-dose reactions to mRNA COVID-19: a multicenter latent class analysis.
J Allergy Clin Immunol Pract 2023 Feb;11(2):458-65.e1. doi: 10.1016/j.jaip.2022.08.048.
Keywords: COVID-19, Medication, Adverse Drug Events (ADE), Adverse Events, Infectious Diseases, Vaccination
Glanz JM, Wagner NM, Narwaney KJ
A mixed methods study of parental vaccine decision making and parent-provider trust.
Given the growing public health problem of parental vaccine hesitancy, researchers investigated parental vaccine decisionmaking through the use of focus groups and a mailed survey. They found that parents had overall trust in their pediatricians but not in the information they provided about vaccines. Parents refusing or delaying vaccines were twice as likely to begin thinking about vaccines before their child was born.
AHRQ-funded; HS019760
Citation: Glanz JM, Wagner NM, Narwaney KJ .
A mixed methods study of parental vaccine decision making and parent-provider trust.
Acad Pediatr. 2013 Sep-Oct;13(5):481-8. doi: 10.1016/j.acap.2013.05.030..
Keywords: Children/Adolescents, Vaccination, Education: Patient and Caregiver, Healthcare Utilization, Shared Decision Making
Williams SE, Rothman RL, Offit PA
A randomized trial to increase acceptance of childhood vaccines by vaccine-hesitant parents: a pilot study.
This pilot study evaluated an educational intervention (a video and written information) to improve parental attitudes and vaccine-uptake in vaccine-hesitant parents. It found a modest increase in parental attitudes toward vaccines but no difference in receipt of vaccines between the intervention and control groups at 12 weeks.
AHRQ-funded; HS019675
Citation: Williams SE, Rothman RL, Offit PA .
A randomized trial to increase acceptance of childhood vaccines by vaccine-hesitant parents: a pilot study.
Acad Pediatr. 2013 Sep-Oct;13(5):475-80. doi: 10.1016/j.acap.2013.03.011..
Keywords: Children/Adolescents, Vaccination, Education: Patient and Caregiver, Healthcare Utilization
Tsui J, Gee GC, Rodriguez HP
Exploring the role of neighborhood socio-demographic factors on HPV vaccine initiation among low-income, ethnic minority girls.
This study of neighborhood factors associated with human papillomavirus (HPV) vaccine uptake, especially among disadvantaged groups, found that initiation rates were highest among girls from the most disadvantaged neighborhoods. However, mother’s awareness of HPV, age, and insurance status were also strong predictors for initiation.
AHRQ-funded; HS020172
Citation: Tsui J, Gee GC, Rodriguez HP .
Exploring the role of neighborhood socio-demographic factors on HPV vaccine initiation among low-income, ethnic minority girls.
J Immigr Minor Health. 2013 Aug;15(4):732-40. doi: 10.1007/s10903-012-9736-x..
Keywords: Vaccination, Children/Adolescents, Women, Health Insurance, Disparities
Vawdrey DK, Natarajan K, Kanter AS
Informatics lessons from using a novel immunization information system.
This paper describes the informatics challenges and lessons learned during nearly 15 years of collecting, using, and exchanging electronic immunization information. The authors report on their experience with developing and using the EzVac system for 1) clinical care, both in local and global settings, 2) public health reporting, 3) consumer engagement, and 4) clinical and informatics research.
AHRQ-funded; HS018158.
Citation: Vawdrey DK, Natarajan K, Kanter AS .
Informatics lessons from using a novel immunization information system.
Stud Health Technol Inform 2013;192:589-93..
Keywords: Health Information Technology (HIT), Registries, Public Reporting, Vaccination