bluuebunny/crossref_metadata_2025_split huggingface dataset:
2360. Factors Affecting COVID-19 Vaccine Uptake in People Living with HIV
Authors: Kunkel Victoria N , Summers Nathan A , Singh Nupur 
Published: November 2023

Abstract

Background
There is a lack of available data regarding COVID-19 vaccination rates in people living with HIV (PLWH). We examined a group of PLWH to evaluate the association between specific demographics and COVID-19 vaccine uptake.

Methods
This is a retrospective observational study which included PLWH who were seen in an HIV clinic at an academic medical center in Memphis, TN. 300 randomly selected PLWH who had been seen at least once in the clinic within an 18-month study period during the COVID-19 pandemic were included. Univariate analysis using Chi Square and T tests followed by multivariable regression including significant results from univariate analysis identified factors associated with COVID-19 vaccine uptake.

Results
300 PLWH between January 2021 to June 2022 were included in the study. 248 (82.67%) were Black, 27 (9%) were White, 2 (0.67%) were Asian, and 23 (7.67%) were of multiracial/other races. The average age was 47 years old. 243 (81%) were retained in care, defined as 3 visits within the 18-month period with 2 of them being at least 6 months apart. 239 (81.29%) of the participants had a suppressed HIV viral load, defined as HIV RNA &lt; 200 copies/mL. The mean number of total vaccinations in the previous 3 years was 4.61, and the mean number of influenza vaccinations in the past 3 years was 1.64. 207 (69%) of the participants received at least 1 COVID-19 vaccine, with 187 (62.33%) being fully vaccinated, defined as 2 doses of mRNA or 1 adenovirus vector vaccine. Age, number of attended clinic visits, retention in care, viral suppression, and number of previous vaccinations were associated with receiving at least one COVID-19 vaccine in univariate analysis, while only age (odds ratio (OR) 1.07, p&lt; 0.0001), number of influenza vaccinations in the past 3 years (OR 0.58, p=0.03), and total number of vaccinations in the prior 3 years (OR 2.29, p&lt; 0.0001) were significant in multivariable analysis.Table 1.Demographics and COVID-19 vaccine uptake, N=300.Table 2.Multivariable analysis, N=294.

Conclusion
Age and total number of vaccinations in the past 3 years were positively correlated with having at least one COVID vaccine. Number of influenza vaccinations in the past 3 years was negatively correlated with having at least one COVID vaccine. Further study is needed to identify targeted interventions to improve vaccine uptake in this population.

Disclosures
All Authors: No reported disclosures
2376. Trends in COVID-19 vaccination among reproductive-aged in Jamaica: a comparison of two time periods
Authors: Pinkney Jodian , Bogart Laura , Carroll Kamali , Bryan Lenroy , Witter Givana , Ashour Dina , Hurtado Rocio M , Goldfarb Ilona T , Hyle Emily P , Psaros Christina , Ojikutu Bisola 
Published: November 2023

Abstract

Background
In Jamaica, COVID-19 vaccines have been recommended for pregnant women since August 2021, yet data detailing COVID-19 vaccination behaviors among pregnant Jamaican women have been limited. Specifically, it is unknown if COVID-19 vaccination among pregnant Jamaican women has increased over time, similar to trends observed in the United States.

Methods
A convenience sample of reproductive-aged Jamaican women were recruited from a teaching hospital during two distinct time periods (TP): (1) February 2022 and (2) May-July 2022. Participants self-identified as pregnant (versus nonpregnant) and completed a web-based survey that assessed self-reported COVID-19 vaccination and medical mistrust beliefs. We analyzed the relationship between TP and a predetermined set of variables using chi-square or Fisher’s exact tests. We used logistic regression to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for self-reported COVID-19 vaccination by TP, adjusting for age, education, and comorbidities.

Results
Of the 429 participants, 178 (41%) completed the survey in TP1 and 251 (59%) in TP2 (Table 1). Self-reported data, including trusted sources of COVID-19 vaccination and type of COVID-19 vaccine received, did not differ significantly between TP1 and TP2 (Table 1). Self-reported COVID-19 vaccination among pregnant women was 35% in TP1 vs. 60% in TP2 (aOR (95% CI): 2.78 (1.40 - 5.50). Pregnant women were less likely to agree with the medical mistrust belief, “I don’t trust the COVID-19 vaccine,” in TP2 compared with TP1 (aOR (95% CI): 0.43 (0.18 - 0.99). Self-reported vaccination and medical mistrust beliefs among nonpregnant women did not differ between TP1 and TP2.

Conclusion
Self-reported COVID-19 vaccination among pregnant Jamaican women was significantly higher in TP2 compared with TP1, while medical mistrust related to COVID-19 vaccination was lower. To improve the efficacy of vaccination campaigns and enhance the communication of vaccine safety between pregnant women and their healthcare providers in the future, it is crucial to identify trends in COVID-19 vaccination and medical mistrust beliefs among pregnant women over time.

Disclosures
Emily P. Hyle, MD MSc, UpToDate.com: Royalties
2377. The Influence of the COVID-19 Infodemic on Vaccine Hesitancy: A Prospective Survey-Based Study
Authors: Quon Cameron , Walker Macey , Graves Lisa 
Published: November 2023

Abstract

Background
The COVID-19 pandemic was an "infodemic" of accurate and inaccurate information as termed by the World Health Organization. Media engagement has been correlated with greater belief in misinformation and lower vaccination rates.
The aim of this study was to investigate how individuals make decisions regarding the COVID-19 vaccine with a particular focus on specific media outlet consumption.

Methods
We conducted an online survey via the Western Michigan Homer Stryker M.D. School of Medicine Facebook account from August 1, 2021 to August 30, 2021. The primary outcome was the choice to take the COVID-19 vaccine. Respondents were assigned a media score based on the companies they used to receive COVID-19 information. The score was calculated based on a Pew Research Center study on the political leaning of various news outlets.
A Sampling of the Political Spectrum of Media Outlets
Some of the major media outlets assessed in our survey with the left being more liberal and right being more conservative.

Results
There were 1,757 responses with a prevalence of 89.6% vaccine acceptors. Respondents were predominantly White, female, and liberal with an average age of 44. There was a 1.06 (95% CI 1.04, 1.07) multiplicative increase in odds of choosing the vaccine for every point towards more liberal media consumption. Both media score (c=0.77) and political leaning scale (c=0.81) had a strongly positive correlation with vaccination choice. Attitudes of vaccine acceptors and non-acceptors aligned with the viewpoints of their friends and family. While both groups had good relationships with their doctors, there were no significant differences in vaccine choice.
Respondent Demographics and Political Spectrum
The demographics and political spectrum of the survey's respondents.
Likelihood of choosing the vaccine
The prevalence of vaccine acceptors, the odds ratio for media use, and the correlation between media and vaccination and political affiliation and vaccination.

Conclusion
This study demonstrates that individuals who prefer more liberal leaning media outlets are more likely to choose to receive the vaccine. They also suggest the physician's voice must compete with the media in terms of vaccine messaging.
While this study is limited by a respondent demographic that did not necessarily reflect that of the country, it is at least reflective of those who engage with the medical school's outreach. Performing a study of this nature within local communities can provide population insights enabling customized communication strategies.
Future studies should explore ways physicians can use media to enhance their voice and counter misinformation. Access to reliable information about the COVID-19 vaccine is critical in helping individuals make informed decisions about vaccination.

Disclosures
All Authors: No reported disclosures
2378. Use of Natural Language Processing to Extract Published Real World Data on a COVID Vaccine and Antiviral Treatment
Authors: Raghuram Anupama , Ssentongo Anna , Pereira Lenon Mendes , Kuang Yuting , Uyei Jennifer , Park Peter 
Published: November 2023

Abstract

Background
The COVID-19 global pandemic generated an exponential increase in scientific publications over the last 3 years. LitCovid includes ∼350,000 articles related to COVID-19, vaccine and antiviral medicine development, and real-world data (RWD). The need to identify and extract medical data from relevant articles presents an opportunity to use natural language processing (NLP) and machine learning to analyze large volumes of text related to COVID-19. We evaluated the use of NLP to rapidly identify and extract RWD from vaccine and antiviral effectiveness studies to summarize the data for healthcare professionals.

Methods
We used a two-step approach comprised of (1) an automated NLP system with machine learning and rule-based methods to extract medical data from articles and (2) a manual evidence synthesis approach to confirm accuracy by expert review to create a RWD dataset for effectiveness related to BNT162b2 (Pfizer-BioNTech COVID-19 Vaccine) and nirmatrelvir/ritonavir (Paxlovid). NLP linguistic models for automatic data extraction were developed for topics related to vaccine effectiveness, boosters, fourth dose, variant-adapted vaccines, antiviral treatment effectiveness, and long COVID. RWD were captured into a novel data excel template.

Results
NLP model training and development was conducted on CORD-19 Open Research Dataset, and NLP-based extraction has been applied on 100 studies. Elapsed NLP-based extraction time was compared to manual extraction by 6 scientific experts over a 10 day test, and speed gains of 2.5-3.0x were achieved. NLP-based and manual extraction of data from &gt;130 publications was then used to present individual study results and summarize effectiveness results into two publicly available websites (www.vaccinemedicaldata.com; www.antiviralmedicaldata.com) with high data accuracy. NLP also allowed for automated labeling and output normalization of data into a scalable model using ontologies.

Conclusion
NLP is an efficient technology for automated extraction of medical data from published literature for vaccine and antiviral effectiveness topics. Automated medical data mining using NLP may support end-to-end extraction of study results to quickly educate prescribers and improve vaccine and antiviral healthcare decision making.

Disclosures
Anupama Raghuram, MD, Merck: Employee|Merck: Stocks/Bonds|Pfizer: Employee|Pfizer: Stocks/Bonds Anna Ssentongo, PhD, IQVIA: Employee Lenon Mendes Pereira, PhD, IQVIA: Employee Yuting Kuang, PhD, IQVIA: Employee Jennifer Uyei, PhD, MPH, IQVIA: Employee|IQVIA: Stocks/Bonds Peter Park, PhD, Pfizer: Employee|Pfizer: Stocks/Bonds
2384. Exploring COVID-19 Vaccine Hesitancy in Unvaccinated Adults within a Semi-Urban Population of South India: A Qualitative Investigation
Authors: Sathyapalan Dipu T , Nair Sivapriya , Nampoothiri Vrinda , Moni Merlin 
Published: November 2023

Abstract

Background
This qualitative study examines COVID-19 vaccine hesitancy among unvaccinated adults in a semi-urban region of South India. Despite broad vaccination coverage in India, vaccine hesitancy persists, contributing to the ongoing transmission. By conducting region-specific in-depth qualitative research, we aim to identify barriers to vaccination, to address this public health menace.

Methods
This grounded theory-based qualitative study explores COVID-19 vaccine hesitancy among unvaccinated adults in semi-urban regions of Ernakulam, Kerala, India. Conducted from April to May 2022, the study used purposive sampling to enrol participants with the help of ASHA workers. Semi-structured face-to-face interviews were carried out, utilizing an open-ended questionnaire-based interview guide. Audio files of the interviews were transcribed verbatim, and the data underwent a multistage thematic analysis using the constant comparative method.

Results
In our study with 35 unvaccinated individuals, vaccine hesitancy factors were categorized into three themes: vaccine-related (33.33%), social/environmental (31.67%), and individual factors (35%). Individual factors included medical conditions (26.67%) and attitudes towards vaccines (8.33%). Vaccine-related factors involved safety concerns (15%), efficacy (6.67%), and administration mode (5%). Social/environmental factors covered accessibility/availability (16.67%) and influencers like healthcare workers, friends, and family (15%). Table 1, Figure 1, and Figure 2 provide further details on themes, subthemes, and their overlap.
Figure 1
Representation of identified themes and subthemes among the vaccine hesitant individuals
Figure 2
Schematic representation of identified themes and its overlap among the vaccine hesitant individuals.
Table 1
Excerpts of 35 study participants outlining the factors for Covid-19 vaccine hesitancy exploring themes and sub-themes of quotes

Conclusion
Our study finds three main factors contributing to COVID-19 vaccine hesitancy: vaccine-related concerns, social/environmental influences, and individual factors. To tackle hesitancy, it's crucial to address safety concerns, engage with various medical systems, and leverage community influencers. Focusing on vaccine equity and addressing the needs of vulnerable populations is essential for the success of vaccination programs. Targeted communication strategies and behaviour change interventions should be employed to promote vaccine acceptance, and public health authorities must provide accurate, transparent information on vaccine safety and efficacy.

Disclosures
All Authors: No reported disclosures
2390. Factors Affecting Parental COVID-19 Vaccine Hesitancy in Cancer Parents with Minor Children
Authors: Umetsu Kazue , Kosugi Kazuhiro , Takahashi Tomoko , Fujisawa Daisuke , Kawaguchi Takashi , Kubo Emi , Inoue Yujiro , Ishizuka Keisuke , Harada Mariko , Inoue Tomonori , Ohtake Kento , Yamaya Shiori , Takehana Jun , Matsuo Takahiro , Okinaka Keiji , Yamaguchi Takuhiro , Miura Tomofumi 
Published: November 2023

Abstract

Background
Cancer patients are vulnerable to COVID-19 infection. Parents living with their minor children in general are at an elevated risk of infection. Thus, cancer patients with minor children (“cancer parents”) are at high risk of contracting COVID-19 and experiencing a severe course. Vaccination is the best clinical approach for preventing COVID-19 infection. However, still, they may hesitate to get their children vaccinated, as parents without cancer does. This study aims to explore the factors associated with parental COVID-19 vaccine hesitancy in cancer parents.

Methods
This study was a secondary analysis of an online cross-sectional survey conducted from December 2022 to January 2023. The eligible participants were cancer patients whose children were aged between 5 and 17. They were recruited through an online peer-support group. The participants were asked to self-report sociodemographic characteristics, medical history, previous COVID-19 infection, vaccination status, fear of COVID-19 scale, and the reasons for COVID-19 vaccine hesitancy. We conducted a multivariate logistic regression analysis to explore the factors associated with COVID-19 vaccine hesitancy. The factors were selected based on a literature review, and variables with a p-value &lt; 0.1 in univariate analysis were retained in the final regression model.

Results
Overall, 199 participants were included [84.9% female; mean age 45.8 years]. The participant’s COVID-19 vaccination rate was 90.5 % (n = 180), but 95 participants (47.7%) were hesitant to vaccinate their child. The factors positively associated with vaccine hesitancy were a younger age of child (adjusted odds ratio (aOR) = 0.66 (95% confidence interval (CI): 0.56–0.77); p&lt; 0.001), lower family income (aOR = 0.22 (95% CI: 0.08–0.62); p=0.004), and fewer participant’s vaccination doses (aOR = 0.34 (95% CI: 0.23–0.50); p&lt; 0.001). The main reasons for vaccine hesitancy were concerns about safety and adverse reactions of the vaccines (Figure 1).

Conclusion
Although most cancer parents had been vaccinated themselves, approximately half of them were hesitant to get their children vaccinated. It is essential to provide cancer parents with detailed information regarding the safety of COVID-19 vaccines to minimize vaccine hesitancy toward their children.

Disclosures
All Authors: No reported disclosures
2392. Impact of Vaccination Against SARS-CoV-2 on Severity and Mortality in Hospitalized Patients with COVID-19 in a Referral Hospital in Nicaragua
Authors: VEGA-JARQUIN N O R V I N G , Porras-Cortés Guillermo D 
Published: November 2023

Abstract

Background
On October 2021, the World Health Organization exhorted countries to evaluate the effectiveness of vaccination against SARS-CoV-2 and its impact on severity and mortality caused by COVID-19. A previous study in Nicaragua had demonstrated that 78.5% of a sample of the Nicaraguan population had antibody titers against SARS-CoV-2. The present study was conducted with the aim of estimating the impact that vaccination had on severity and mortality in hospitalized patients with a diagnosis of COVID-19 in the Hospital Dr. Fernando Vélez Paiz, a referral hospital in Nicaragua.

Methods
This is a retrospective cohort study. A total of 510 patients diagnosed with COVID-19 were hospitalized in the respiratory ward of the Hospital Dr. Fernando Vélez Paiz between January 2022 and October 2022. After applying the inclusion criteria, 220 patients were analyzed in the study. For the purpose of the study, the population that received at least one dose of vaccine against SARS-CoV-2 was denominated vaccinated. The national database of immunization was checked. The primary outcomes to evaluate were severity of illness (scores qCOVID, NEWS, and CXR), and mortality in vaccinated and unvaccinated populations. An analysis of risk relative (RR) in the exposed population (vaccinated) was done.

Results
The mean age of the population was 67.2 ± 15.6 years old. Of the 220 patients, 157 (71.4%) had received at least one dose of the vaccine, and 63 (38.6%) had not been vaccinated. The most frequent vaccine recorded was ChAdOx1 (Astra Zeneca or CoviShield), in 102 patients (65%) (Table 1). There was no difference in severity of illness at admission in the qCOVID score, NEWS score, and CXR score. There were 47 patients (21.4%) who died. The mortality rates in the unvaccinated and vaccinated patients were 30.2% and 17.8%, respectively (Table 2). The RR (CI95%) for mortality in the vaccinated patients was 0.59 (0.35-0.97), showing that vaccination is a significant factor for protection against the probability of dying. The Kaplan-Meier analysis shows higher chance of survival in vaccinated patients (Figure 1).Table 1.Types of Vaccines Recorded in Patients Hospitalized with COVID-19Table 2.Mortality in Vaccinated and Unvaccinated Patients and Risk Relative for MortalityFigure 1.Survival Curve of Vaccinated and Unvaccinated Patients with COVID-19

Conclusion
This study demonstrated that the mortality rate was lower in vaccinated versus non-vaccinated patients that were hospitalized in a respiratory ward due to COVID-19 in a hospital in Nicaragua.

Disclosures
All Authors: No reported disclosures
2399. Changing Demographics of Infective Endocarditis in South Carolina: An Ecological Study
Authors: Garrison Phillip G , Royer Julie , Habicht Max , Battle Sarah , Antosz Kayla , Burch Anna-Kathryn , Al-Hasan Majdi N , Justo Julie Ann , Bailey Pamela 
Published: November 2023

Abstract

Background
The opioid epidemic in America is likely changing the demographics of patients with infective endocarditis (IE). Traditionally, IE is attributed to older patients and those with prosthetic heart valves or cardiac devices. Rising rates of opioid use (OU), usually via injection, has resulted in younger patients being diagnosed with IE, which raises treatment challenges.

Methods
This retrospective ecological study analyzed hospitalization records from the South Carolina Revenues and Fiscal Affairs Office (SC RFA) from 2016-2021. ICD-10 codes for the diagnosis of IE yielded 7,175 hospitalizations with 5,066 unique patients. Cases of IE with concurrent OU were identified. Rurality of hospital county, hospital teaching status, hospital bed size, length of stay, total costs, discharge status, and distance to hospital zip were reviewed. Data was analyzed by year and age group (18-34, 35-49, 50-64,65-79, and 80+). Poisson regression was used to examine change in trends.

Results
From 2016-2021, inpatient stays related to IE showed no significant trend for age groups 35 years and older (p &gt; 0.19), while showing a significant positive trend in the 18-to-34 age group (p = 0.04). Of the 7,175 IE hospitalizations, 977 (13.6%) had a concurrent diagnosis of OU. The percentage of patients with concurrent IE and OU diagnosis increased from 7% to 17% of patients/year. The rate of inpatient stays related to concurrent IE and OU increased from 3.8 to 11.1 (p = 0.01) and 2.5 to 8.7 per 100,000 of SC population (p = 0.01), for the 18–34 year-old and 35-49 year old groups, respectively, while not significantly changing in patients 50 years and older over the study period (p = 0.57).
Rate Per 100,000 SC Population of Inpatient Stays Related to IE and OU by Age Group

Conclusion
There are few epidemiologic studies of IE since the 2015 Infectious Diseases Society of America treatment guidelines, though significant concern about the juxtaposition of the opioid epidemic with diseases like IE. There are major changes in the demographics of IE patients. This study supports the need for updated guidelines to specifically address IE in the setting of OU, particularly in younger patients. This includes possible disparities in treatment due to lack of access to ID physicians in rural communities and challenges in providing prolonged intravenous antibiotic therapy.

Disclosures
Julie Ann Justo, PharmD, MS, FIDSA, BCPS, Gilead Sciences: Advisor/Consultant|Shionogi: Advisor/Consultant|Vaxart: Stocks/Bonds