bluuebunny/crossref_metadata_2025_split huggingface dataset:
574. High Acceptance and Rapid Implementation of COVID-19 Vaccine in a Public HIV Clinic in Northern California: An Initial Analysis of Social Determinants
Authors: Lin Jennifer , Wong Frank Oi-Shan , Thibodeaux Christopher , Choi-McInturff Moon , Tamayo Aracely , Levy Vivian 
Published: December 2021

Abstract

Background
Safety net HIV providers face operational challenges during the COVID pandemic with services often transformed to telehealth. HIV infected persons are a priority population for SARS CoV-2 vaccination. Medical mistrust of COVID vaccines has been cited as a contributor to vaccine hesitancy. Data on efficient and successful vaccination efforts of HIV infected persons in safety net health systems is needed. In San Mateo County, Latino persons comprised 42% of all COVID cases, Whites 16%, and African Americans 2%.

Methods
SARS CoV2 vaccination with BNT162b2 (Pfizer–BioNTech), mRNA-1273 (Moderna) or Ad26.COV2.S (Janssen) vaccine were offered beginning February 2, 2021 through May 28, 2021 in a northern California public County HIV clinic. Clinic patients were contacted by bilingual English/Spanish speaking HIV clinic staff and appointments scheduled at County affiliated vaccination sites. Clinic staff followed up by phone with patients who did not initially accept vaccine. We calculate the percentage of patients who completed vaccine series and use multivariable logistic regression analysis to estimate the odds of series completion by patient race/ethnicity, gender and age.

Results
Virtually all, 95% (349/365) of HIV patients in our County HIV clinic were offered vaccine during a 17 week period. Among those, 86% (313/365) accepted and received at least one dose and 80% completed the series (292/365) at time of this analysis. Janssen vaccine was given to only 2% (7/313) patients. Series completion was highest among Latinos and Asians. Latinos had the highest odds of vaccine series completion (OR = 4.12; 95% CI 1.71 - 9.93).
COVID-19 Vaccine Series Completion in a California Public HIV Clinic by Race/Ethnicity, Age and Sexual Orientation, n=364

Conclusion
HIV patients offered SARS CoV2 vaccine by County HIV clinic staff with established patient care relationships had high vaccine acceptance (80%), comparable to 68% series completion in the county overall and 56% in the health equity quartile county census tracts. Latino HIV infected persons were most likely to complete the COVID vaccine series. Ryan White funded HIV clinics are ideal hubs to coordinate HIV patient COVID vaccination efforts. Adding COVID vaccine completion to HIV clinic performance measures would likely be beneficial.

Disclosures
All Authors: No reported disclosures
575. Local Experience of Breakthrough SARS-CoV-2 Infections After Full Vaccination
Authors: Khan Ahmed A , Havener Gayla , Graham Donald , Miller Brian , O'Neill Gail , Sundareshan Vidya 
Published: December 2021

Abstract

Background
SARS-CoV-2 the etiology of COVID-19 has caused more than 33 million cases and almost 600,000 deaths in the United States alone. Vaccination is a vital tool in controlling the pandemic. With accelerated infection rates in various parts of the world, the incidence of variants has risen and threatens to set back the long sought after immunity, provided by available vaccines. The objective of this study was to evaluate the breakthrough infection rate after complete vaccination, in Sangamon County, with a rural and urban population of 195,000 in Central Illinois.

Methods
Data regarding breakthrough infections collected from the Sangamon County Department of Public Health, included the total number of infections, time after vaccination, age range of those infected and the type of vaccine used. Complete vaccination was defined as 14 days after the single dose of Johnson & Johnson/Janssen or the second dose of Pfizer-BioNTech or Moderna Inc. vaccine.

Results
The number of fully vaccinated individuals at the time of writing of this study was 87,086 which corresponded to 44.58 % of the total population. The breakthrough infection percentage was calculated as 0.036%. The mean time after vaccination to infection was 49.13 days with a standard deviation of 23.28.

Conclusion
Breakthrough infections among fully vaccinated individuals in our county, have been quite rare, which points to the high efficacy of the vaccines. A complex number of factors likely contribute to this including virus-related factors i.e. variant forms and specific patient-related factors which are not a part of this study. The afore-mentioned high efficacy rate of the vaccines provides further justification, to continue to pursue a persistent vaccination strategy to mitigate the effects of the SARS-CoV-2 virus.

Disclosures
All Authors: No reported disclosures
576. Determinants of COVID-19 Vaccine Hesitancy: A Cross-Sectional Study in 3 Communities in the United States and Lebanon
Authors: Yasmin Mohamad , Tfaily Mohamad Ali , Emery Rebecca P , Hassouna Habiba , Obeid Rita , Bhugra Mudita , Bonomo Robert A , Kanafani Zeina 
Published: December 2021

Abstract

Background
The ongoing COVID-19 pandemic has thus far resulted in substantial worldwide mortality. As of November 2020, COVID-19 vaccines became available following Emergency Use Authorization (EUA) issued by the FDA. Recent longitudinal studies published as of March 2021 demonstrated that vaccine hesitancy remains high despite improvements compared to 2020. This study sought to explore the perceptions, beliefs, attitudes, and knowledge surrounding COVID-19 and identify determinants uniquely associated with vaccine hesitancy.

Methods
A cross-sectional electronic survey was created based on CDC & IDSA recommendations. The survey was distributed from March 2021 until June 2021 randomly to faculty members, healthcare workers, and students (≥18 years old) across 3 major academic centers (Case Western Reserve University, Spectrum Health, and the American University of Beirut Medical Center [AUBMC]). Data collected included socio-economic characteristics, demographics, knowledge, and attitudes pertaining to COVID-19 and vaccination. A multivariable regression model was utilized to evaluate for independent associations between variables and vaccination willingness/hesitancy as the primary outcome.

Results
In total, 7,197 participants completed the survey with an overall response rate of 94%. Females constituted 75.7% of the study population. Overall, 87.8% of the study cohort indicated willingness to get vaccinated. Factors associated independently with vaccination hesitancy included: younger age, lower attained education, lower knowledge score, physician recommendation against vaccination, not receiving the influenza vaccine annually, and other beliefs and attitudes as reported in table 1.
Table 1. Independent predictors of COVID-19 vaccine hesitancy among study respondents

Conclusion
Most survey respondents indicated willingness to receive COVID-19 vaccination. The perception or belief that vaccination is more harmful than COVID-19 disease represented an especially robust barrier against vaccination. Since recommendations made by healthcare providers were strongly associated with either vaccination hesitancy or willingness to get vaccinated, developing educational strategies at this level could enhance vaccine acceptance in an effort to curb the pandemic.

Disclosures
Robert A. Bonomo, MD, entasis (Research Grant or Support)Merck (Grant/Research Support)NIH (Grant/Research Support)VA Merit Award (Grant/Research Support)VenatoRx (Grant/Research Support)
582. Risk Factors for Progression to Hospitalization in Adolescents Presenting with Mild or Moderate COVID-19
Authors: Dubois Melanie , Campbell Jeffrey , Lamb Gabriella S , Lamb Gabriella S , Nakamura Mari M 
Published: December 2021

Abstract

Background
Most adolescents (age 12-17 years) with COVID-19 have mild disease. However, certain comorbidities may be risk factors for disease progression, and hospitalization rates for this age group have increased. Adolescents and adults with mild to moderate COVID-19 are eligible for monoclonal antibody therapy. To identify subgroups likely to benefit from this intervention, we evaluated the relationship between comorbidities and need for hospitalization in US adolescents presenting with mild to moderate COVID-19.

Methods
We analyzed presence of comorbidities and need for hospitalization within 28 days of diagnosis for adolescents in the PIDTRAN registry, a multicenter retrospective cohort of US pediatric patients with COVID-19. Comorbidities assessed included obesity, chronic kidney disease (CKD), diabetes (DM), immunosuppressive disease or treatment (IS), sickle cell disease (SCD), congenital/acquired heart disease (CHD), neurologic disease/neurodevelopmental disorders (ND), medical-related technology dependence (MTD), and pulmonary disease requiring daily inhaled corticosteroids (PD). We used multivariable logistic regression to determine race/ethnicity-adjusted associations between comorbidities and hospitalization.

Results
1574 patients met inclusion criteria, of whom 180 (11.4%) were hospitalized within 28 days of COVID-19 diagnosis. In a race/ethnicity-adjusted model, the following comorbidities were independently associated with increased odds of hospitalization: IS (OR 10.8 [95%CI 5.4 – 21.7]); CKD (OR 5.1 [95%CI 1.0 – 25.6]); DM (OR 4.2 [95%CI 1.7 – 10.6]); SCD (OR 3.4 [95%CI 1.1 – 10.6]). ND (OR 3.0 [95%CI 1.7 – 5.4]); and obesity (OR 2.0 [95%CI 1.1 – 3.9]). Notably, CHD, MTD, and PD were not independently associated with hospitalization. There was no effect modification of race/ethnicity on the association between obesity or DM and hospitalization.
Table 1: Characteristics of adolescents in our cohort

Figure 1. Association between comorbidities and hospitalization. Model 1: comorbidities only. Model 2: comorbidities, adjusted for race/ethnicity. Abbreviations: CKD – chronic kidney disease; SCD – sickle cell disease; ICS – inhaled corticosteroids.

Conclusion
IS, CKD, DM, SCD, ND, and obesity were associated with increased odds of hospitalization in adolescents presenting with mild to moderate COVID-19. Adolescents with these comorbidities should be prioritized for consideration of treatment with monoclonal antibodies.

Disclosures
Gabriella S. Lamb, MD, MPH, Nothing to disclose
583. SARS-CoV-2 Spike Protein S1/S2 Antibodies after Vaccination with Sinopharm in Peruvian Physicians
Authors: Lopera Maria , Vera Romina , Tapia Carlos , Cabrera Carlos , Gonzales-Zamora Jose , Alave jorge 
Published: December 2021

Abstract

Background
Peru started its national vaccination campaign in February 2021 using Sinopharm vaccine, targeting healthcare personnel on its initial phase. Although the immunogenicity of this vaccine was tested in clinical trials, there are no studies that evaluated the humoral response post vaccination in Peru.

Methods
We conducted a cross sectional study, which objective was to evaluate the humoral immunogenicity triggered by the Sinopharm vaccine in Peruvian physicians. We collected demographic and epidemiologic data via an electronic. The SARS-CoV-2 spike protein S1/S2 antibodies were measured by chemiluminescense (Liaison®). A positive test was defined as &gt;15 U/ml, which has correlation of 95% with neutralizing antibodies measured by plaque reduction neutralizing test.

Results
92 participants were enrolled in the study. The epidemiologic characteristics are described in table 1. The mean level of antibodies measured at least 2 weeks from the second vaccine dose was 67.5 ± 70.5 U/ml. 85.7% of the study cohort had positive S1/S2 antibodies. In the univariate analysis, an imperfect negative correlation was found between the level of antibodies and participants’ age (r= -0.24; regression F test 5.25; p = 0.0242). A weak negative correlation was observed between the antibody titer and the time elapsed from the second vaccine dose and the day of antibody measurement (r= -0.17). A higher antibody level post vaccine was found in individuals who worked in COVID units (105.5 U / mL vs 58.2 U / mL; p = 0.0125), and in participants with history of COVID (216.5 U / mL vs 81.2 U / mL; p = &lt; 0.0000). Hypertension was associated with lower antibody titers (36.9 U / mL vs. 74.6; p = 0.0464). In the multivariate analysis, working in COVID units, having previous COVID infection and shorter time from second vaccine dose and day of antibody measurement were associated with higher antibody levels post vaccine (table 2).

Conclusion
Our study showed that the time elapsed from the second vaccine dose and the day of antibody measurement, having previous COVID-19 infection and working in COVID -19 units may help to predict higher antibody titers post vaccine. Larger studies to evaluate the humoral response post Sinopharm vaccine and its clinical implications are still needed in Peru.

Disclosures
All Authors: No reported disclosures
584. Phase 1 Placebo-Controlled Trial of COVI-VAC™, an Intranasal, Live Attenuated COVID-19 Vaccine
Authors: Tasker Sybil , Bendel Daryl , Bevan Melissa , Mueller Steffen , Kushnir Anna , Londt Brandon , Robert Coleman J 
Published: December 2021

Abstract

Background
COVI-VACTM is an intra-nasal live-attenuated SARS-COV-2 synthetic viral vaccine being developed for the prevention of COVID-19. COVI-VAC is attenuated through deletion of the furin cleavage site and introduction of 283 silent deoptimizing mutations that maintain viral amino acid sequence but result in significant attenuation due to slow translation in the human host cell. Notably, COVI-VAC includes all viral antigens and is not limited to spike. COVI-VAC has demonstrated attenuation, immunogenicity and single dose protection in both Syrian golden hamster and non-human primate models.

Methods
48 healthy young adults were enrolled in an inpatient quarantine setting to one of 3 dose escalating cohorts and randomized to COVI-VAC or saline placebo given as nose drops, as a single 0.5mL dose or 2 doses 28 days apart. Endpoints included solicited and unsolicited adverse events, serum cytokines, viral shedding and sequence stability, mucosal and serum antibody responses and IFN ELISpot. Subjects will be followed for 1 year for late safety events and durability of immune response.

Results
Dosing is complete. There has been no trend in solicited reactogenicity events, and all unsolicited adverse events reported to date have been mild. There have been no SAEs or Grade 3 or 4 events. Vaccine virus from anonymized subjects was shed at levels lower than that likely to result in onward transmission, and the deoptimized sequence of the shed virus remained unchanged compared to the original vaccine sequence. Unblinded data including immunogenicity will be available prior to the IDWeek meeting.

Conclusion
COVI-VAC appears safe and well tolerated in healthy young adults. Vaccination resulted in minimal viral shedding without sequence instability. Safety and shedding data supports continued development in a wider Phase 2/3 population.

Disclosures
Sybil Tasker, MD, MPH, FIDSA, Codagenix Inc (Employee, Shareholder) Daryl Bendel, MD, Codagenix Inc (Scientific Research Study Investigator) Melissa Bevan, MD, Codagenix Inc (Scientific Research Study Investigator) Steffen Mueller, PhD, Codagenix Inc (Board Member, Employee, Shareholder) Anna Kushnir, PHD, Codagenix Inc (Employee) Brandon Londt, PhD, Codagenix Inc (Other Financial or Material Support, contracted lab services) J. Robert Coleman, PhD, Codagenix Inc. (Board Member, Employee, Shareholder)
585. Safety of Pfizer-BioNtech COVID-19 Vaccine in Healthcare Workers, Singapore
Authors: Kam Kai-Qian , Yung Chee Fu , Chong Chia Yin , Li Jia hui , Nadua Karen Donceras , Tan Natalie W , Thoon Koh Cheng 
Published: December 2021

Abstract

Background
On 14 December 2020, the Pfizer-BioNTech coronavirus disease 2019 (COVID-19) vaccine was granted emergency use authorization in Singapore. Healthcare workers (HCW) were prioritized to receive the vaccine. We aim to investigate the side effects and risk factors for allergic reactions in our institution.

Methods
All HCW vaccinations were recorded in an electronic centralized database. All reactions occurring within a 30-minute observation period post vaccination were recorded. Staff were required to report any vaccine-related medical consult including hospitalization occurring within 14 days after vaccination. Moderate/severe reactions were assessed by a medical team and determined if the reactions were probable allergic reactions with consultation with an Allergist. We extracted data from 8 Jan 2021 to 30 April 2021.

Results
5030 and 159 HCW completed 2 doses and 1 dose of the vaccine respectively. There were 1056 HCWs (20.3%) with self-reported pre-existing allergy. There were 114 (1.1%) reactions occurring without the 30-minute observation period, and 64 (56.1%) were related to first dose of vaccine. The most common side effect experienced was aches or pain on any part of the body (n=46, 40.4%) followed by fatigue and/or giddiness (n=45, 39.5%), palpitations and/or shortness of breath (n=22, 19.3%), systemic rash and/or angioedema (n=12, 10.5%) and nausea and/or vomiting (n=12, 10.5%). A total of 23 HCWs complained of systemic rash and/or angioedema that occurred anytime post vaccination. Fifteen HCWs (0.29% of the cohort) were considered to have probable allergic reaction to the vaccine. None of the reactions were classified as anaphylaxis or severe reactions, but 4 HCWs required short hospitalization stay for observation. HCWs with pre-existing allergy had 2.6 times the risk of having probable vaccine-related allergic reaction than HCWs without pre-existing allergy (RR 2.6, 95% CI 0.9 to 7.3, p=0.068) but this was not statistically significant.

Conclusion
No anaphylaxis or severe reactions were observed in our institution. Acute side effects in our cohort were in line with published trial reports. We noted a raised relative risk of 2.6 of pre-existing allergy with probable vaccine-related allergic reaction but this was not statistically significant.

Disclosures
All Authors: No reported disclosures
587. An Intervention to Improve COVID-19 Vaccination Rates Among Inpatients at a Veterans Affairs Hospital
Authors: Fujita Ayako , Goolsby Tiffany , Powell Krista , Cartwright Emily J 
Published: December 2021

Abstract

Background
Hospitalizations are an opportunity to increase vaccine uptake and hospital-based strategies have been effective at increasing influenza and pneumococcal vaccination. Offering COVID-19 vaccination at discharge can reduce barriers to vaccination and target patients at high risk for severe illness and death. We evaluated a COVID-19 vaccine intervention implemented as part of routine discharge planning.

Methods
We trained healthcare personnel during April 2021 to review and document vaccine eligibility and interest for adult inpatients on medical, surgical, or psychiatric wards at the Atlanta VA Medical Center during discharge planning using a templated note in the electronic medical record (EMR). Outpatient vaccination center personnel were deployed to the participating wards daily (except Sundays) to facilitate vaccine administration at discharge. We measured the percentage of discharged patients with vaccine eligibility documented using the template and compared the number of patients vaccinated at discharge in the 4 weeks pre- and post-training. All Georgia adults became eligible for COVID-19 vaccines on March 25, 2021, prior to our intervention.

Results
Of the 769 patients discharged from one of the participating wards during the 4-week post-training, 474 (62%) had vaccine eligibility documented (Table 1). Of the 474 patients with documentation, 88 (19%) were eligible. Reasons for ineligibility included prior vaccination (n=266, 69%), patient refusal (n=103, 27%), and acute COVID infection (n=12, 3%). Of the 88 eligible patients, 61 (69%) received vaccination before discharge. In total, 16 of 793 inpatients in the pre-training period and 61 of 769 in the post-training period (2% vs 8%; p&lt; 0.05) were vaccinated prior to discharge.
Table 1. COVID-19 vaccine eligibility and vaccination before discharge during the post-training period, reported by week

Conclusion
We found relatively high and sustained uptake of an intervention to screen hospitalized patients for COVID-19 vaccination eligibility. Creating a templated note in the EMR resulted in vaccination of nearly 70% of eligible patients prior to hospital discharge.

Disclosures
All Authors: No reported disclosures
588. Seroconversion Among Adults After Receiving At Least One Dose of a COVID-19 Vaccine: COVID-19 Community Research Partnership, Mid-Atlantic, Southeast and Southern United States, December 2020-May 2021
Authors: Friedman-Klabanoff DeAnna J , Tjaden Ashley , Santacatterina Michele , Munawar Iqra , Sanders John W , Herrington David M , Wierzba Thomas F , Berry Andrea 
Published: December 2021

Abstract

Background
Well-regulated clinical trials have shown authorized COVID-19 vaccines to be immunogenic and highly efficacious. Information about antibody responses after vaccination in real-world settings is needed.

Methods
We evaluated seroconversion rates in adults reporting ≥ 1 dose of an authorized COVID-19 vaccine in a U.S. multistate longitudinal cohort study, the COVID-19 Community Research Partnership. Participants were recruited through 12 participating healthcare systems and community outreach. Participants had periodic home-based serologic testing using either a SARS-CoV-2 nucleocapsid and spike IgM/IgG lateral flow assay (63% of participants) or a SARS-CoV-2 spike IgG enzyme-linked immunosorbent assay (37% of participants). The timing and number of tests before and after vaccination varied based on participant time in study. Participants were included if they were seronegative on the last test before and had &gt;1 test result after vaccination (some had previously been seropositive, but seroreverted). A weighted Cox regression model with right censoring was used to obtain adjusted hazard ratios for sex, age, race/ethnicity, and prior seropositivity. Time-to-event (seroconversion) was defined as time to first positive test &gt; 4 days after vaccination; participants were censored at the date of their last available test result.

Results
13,459 participants were included and 11,722 seroconverted (Table). Median time in study was 272 days (range 31–395). Median follow-up time from vaccine to last available test was 56 days (range 1–147). Participants had a median of 3 tests (range 1–12) before and 2 tests (range 1–8) after vaccination. Based on the Kaplan-Meier method, median time to seroconversion after first COVID-19 vaccination was 35 days (interquartile range: 25–45). Likelihood of seroconversion decreased with older age (Table). Female participants, non-Hispanic Black participants, and participants who were previously seropositive were more likely to seroconvert (Table).

Conclusion
All subgroups had high rates of seroconversion, with some small differences in likelihood of seroconversion between subgroups. These data demonstrate the excellent immunogenicity of COVID-19 vaccines in real-world settings in the US.

Disclosures
All Authors: No reported disclosures