bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-1954. Wastewater-Based Surveillance More Accurately Describes Disease Burden Of COVID-19 In Communities with Less Than 60,000 Inhabitants – An Ontario-Wide Study
Authors: Hegazy Nada , Ken Peng K , Hu Joan , Dean Charmaine , Renouf Elizabeth , Delatolla Robert 
Published: January 2025

Abstract

Background
The emergence of COVID-19 in Canada prompted extensive efforts in population-wide surveillance, including wastewater-based surveillance (WBS). WBS offers insights into the prevalence of infectious disease burden, however, reasons for poor correlation between hospital admissions and wastewater viral signal in some locations across Ontario remain unclear, while others demonstrate remarkable correlations. This study aims to elucidate the parameters influencing hospitalization-WBS correlation quality to guide infectious disease research and surveillance.Figure 1:Geographic overview of sampling locations in Ontario, Canada

Methods
Wastewater viral signals and daily hospital admissions geospatially linked with the surveyed sewersheds, were obtained from the Ontario Wastewater Surveillance Initiative. The study included 94 sampling sites (Figure 1), excluding those with inadequate sampling frequency. Spearman’s rank correlation coefficient (ρ) was calculated between hospital admissions and wastewater signals for all included sites during the Omicron BA.1 and BA.2 waves from Nov. 1st,2021 to Jun. 30th, 2022. Regression trees were constructed using the R packages “rpart” and “rpart.plot” to identify factors influencing hospitalization-WBS ρ, including population size, hospital admissions range, proportion of zero admissions, and site isolation status.Figure 2:Regression trees representing a classification model for evaluating the correlation quality between hospitalizations and wastewater signal during the Omicron BA.1 wave – coinciding with a period of waned vaccination immunity (A) and the Omicron BA.2 wave – coinciding with a period of significant vaccination immunity (B).

Results
Regression tree analysis identified critical population size thresholds influencing hospitalization-WBS ρ: populations under 66,000 exhibited weaker ρ (ρ &gt; 0.650) during Omicron BA.1, and under 187,000 during the BA.2 wave (Figure 3). Larger population areas exhibited stronger hospitalization-WBS ρ, suggesting both are reliable infectious disease burden indicators, influenced by differences in community immunity dynamics between the two waves.

Conclusion
Populations under 66,000 during a period of waned vaccine immunity and under 187,000 during a period of significant vaccine immunity exhibit distinct relationship between hospital admissions and wastewater signals. These thresholds mark key sizes of communities where the efficacy of wastewater surveillance becomes more pronounced, emphasizing its utility in smaller populations where clinical surveillance of infectious diseases may be limited.

Disclosures
All Authors: No reported disclosures
P-1963. Changes in COVID-19 Sentiment and Behavior among Healthcare Professionals Over Time in a Rural State
Authors: Wright Brianna S , Kang Daniel , Scherer Aaron , Ward Melissa , Diekema Daniel , Herwaldt Loreen 
Published: January 2025

Abstract

Background
We assessed attitudes towards COVID-19 and use of COVID-19 infection prevention practices during the pandemic among employees at an academic health center in a rural state.Figure 1:Reported Level of Worry about Spreading SARS- CoV-2

Methods
We invited all employees aged &gt;18 years reporting prior COVID-19 on a screening survey to participate and randomly selected other participants (Ps) from among those not reporting prior COVID-19 to create a study cohort of 302 participants. Ps completed surveys at 3-month intervals (T0, T3, T6, T9). We used the Chi-squared test to assess changes in Ps’ responses between individual time points.Figure 2:Reported Willingness to Go into Public Places

Results
At T0 most Ps thought their risk of acquiring COVID-19 either in the hospital or the community was low (&lt; 3%) and &lt; 20% worried that they or their household members would “catch COVID-19.” However, 45% of Ps were worried about spreading SARS-CoV-2 asymptomatically.
Ps’ perceived likelihood of getting COVID-19 at the hospital and in the community did not change. The percent of Ps who were very worried about getting COVID-19 was significantly lower at T1 (1.7%), T2 (2.6%), and T3 (5.7%) than at T0 (11.3%; P &lt; .05 for all). The percent of Ps who were very worried that household members would get COVID-19 decreased from T0 (16.6%) to T1 (8.0%; P = .03).
After vaccines were introduced, Ps tended to report being less worried about spreading COVID-19, more willing to go to public places and less likely to wear face masks in the public. Shortly after the Delta variant emerged, these sentiments changed direction but did not return to their baseline cautiousness level. Shortly before the Omicron variant emerged, the sentiments of those who were seropositive at any time and those who remained seronegative during the study period diverged, with the latter being more worried about asymptomatic spread, less willing to go to public places and more willing to mask in the community than those who seroconverted. Consistent with these changes, 21 of 26 (80.8%) seroconversions occurred during the Omicron surge.Figure 3:Changes in Reported Use of Face Coverings in Public

Conclusion
Some attitudes and behaviors changed over time possibly related to vaccine availability and the predominant SARS-Co-V2 variant. Ps who remained seronegative tended to be more concerned about getting COVID-19 and were more likely to continue using COVID-19 infection prevention practices.

Disclosures
Daniel Diekema, MD, MS, D(ABMM), Affinity Biosensors: Grant/Research Support|bioMerieux, Inc: Grant/Research Support Loreen Herwaldt, MD, 3M: Grant/Research Support|PDI: Grant/Research Support
P-2004. Risk Factors for Death in Children with Multisystem Inflammatory Syndrome in Children — United States, 2020-2022
Authors: Yousaf Anna R , Simeone Regina , Lindsey Katherine N , Shah Ami B , Wu Michael J , Free Rebecca J , Zambrano Laura D , Campbell Angela P 
Published: January 2025

Abstract

Background
Although multisystem inflammatory syndrome in children (MIS-C) incidence has decreased, cases continue to occur and can have notable morbidity and mortality. This investigation evaluates clinical and demographic risk factors for death from MIS-C.Table 1.Demographic and clinical risk factors for death in children with Multisystem Inflammatory Syndrome in Children, United States, 2020-2022

Methods
We evaluated children reported to CDC national MIS-C surveillance with illness onset February 2020–December 2022 and known illness outcome. We performed multivariable logistic regression to estimate odds of death compared with survival for patient characteristics and MIS-C organ involvement. Model covariates were selected a priori including age at MIS-C onset, date of MIS-C onset, race and ethnicity, and presence of any underlying medical condition. To compare risk of death across the pandemic we evaluated patients with date of MIS-C onset in five pandemic waves corresponding to peaks of MIS-C activity.Table 2.Organ system involvement risk factors for death in children with Multisystem Inflammatory Syndrome in Children, United States, 2020-2022

Results
Of 8,767 MIS-C cases reported, there were 76 (9%) deaths (Table 1). Compared with children aged 5–11 years, children &lt; 1 year and 16–20 years had increased odds of death (aOR 4.8 [1.7–13.6], p&lt; 0.01, and 8.2 [4.6–14.8], p&lt; 0.001, respectively). American Indian/alaska Native (AIAN) and Native Hawaiian/Pacific Islander (NHPI) children had increased odds of death compared with White non-Hispanic children (aOR 5.4 [1.4–20.9, p=0.01 and 5.9 [1.5–23.1, p=0.01, respectively). Children with MIS-C illness onset after wave 1 had decreased odds of death compared with those during wave 1. Presence of &gt;1 underlying medical condition was associated with higher odds of death (aOR 2.3 [1.5–3.7, p&lt; 0.001); diabetes, congenital heart disease, neurologic, immunosuppressive/autoimmune, and noncardiac congenital disorders were all independently associated with death. Cardiovascular, respiratory, neurologic, and renal MIS-C organ involvement increased odds of death while children with mucocutaneous involvement had decreased odds (Table 2).

Conclusion
Younger (&lt; 1 year) and older (16-20 years) age, AIAN and NHPI race and ethnicity, MIS-C early in the pandemic, and underlying medical conditions are risk factors for death from MIS-C. Cardiovascular, respiratory, neurologic, and renal involvement increased risk of death. Identifying risk factors associated with death may help clinicians with management and prognosis.

Disclosures
Regina Simeone, PhD, Pfizer: Stocks/Bonds (Private Company)
P-6. Effect of a school-based tutorial about the HPV vaccine for female middle school students on the HPV vaccination rate in Japan
Authors: Murata Yo , Saito Yuya , Obonai Toshimasa 
Published: January 2025

Abstract

Background
Vaccine hesitancy related to the HPV vaccine poses a global challenge. In Japan, the Ministry of Health, Labour and Welfare (MHLW) rescinded recommendations for the inclusion of the HPV vaccine in the national immunization program following reports of adverse events in 2013, which led to a drop in the vaccination rate to less than 1%. Despite the MHLW's decision to reinstate the recommendations in 2022, the vaccination rate has remained low partly because the information targeting children and their guardians is insufficient. This study aimed to assess the effect of a school-based vaccine tutorial on the HPV vaccination rate in female middle school students in Japan.Figure 1:Difference in the pre- and the post-intervention vaccination rate.

Methods
This prospective study, conducted in Higashimurayama, Tokyo from September 2023 to March 2024, enrolled female students aged 13 to 14 years in seven middle schools. Four and three schools formed the tutorial group and control group, respectively and information about HPV vaccination was provided to the tutorial group at school. The difference in the pre-intervention vaccination rate (September 2023) and the post-intervention vaccination rate (March 2024) was assessed using a questionnaire. Additionally, HPV vaccine knowledge and the rate of students’ discussing the vaccine with their family were compared.Table 1:Knowledge about cervical cancer, HPV infection and HPV vaccination among tutorial group and control group.

Results
In total 123 and 175 students from the tutorial and control group, respectively, were analyzed. The pre-intervention vaccination rate was 9.8% and 7.4% (p=0.476), and the post-intervention vaccination rate was 16.3% and 9.7% for the respective group, indicating an increase of 6.5% and 2.3%, respectively (p=0.068). (Figure 1) Knowledge about the HPV vaccine increased to a significantly greater degree in the tutorial group (Table 1), and the rate of students’ discussing the vaccine with their family was significantly higher in the tutorial group after the intervention (46% vs 28%; p=0.0018).

Conclusion
Although the HPV vaccine tutorial did not cause a statistically significant increase in the vaccination rate, it demonstrated an upward trend in the tutorial group. Furthermore, the tutorial increased knowledge and interest in the vaccine among both the students and their family, suggesting that HPV vaccine tutorials can improve the HPV vaccination rate.

Disclosures
All Authors: No reported disclosures
P-2019. Retrospective Cohort Study on use of Monoclonal Antibodies against COVID19 during Pregnancy
Authors: Vikraman Praveen Kumar , Shamayl Ahmed , Gandhi Shivanthidevi , Sohail Rubab , Akerman Meredith , Sison Cristina , Donaghy Henry 
Published: January 2025

Abstract

Background
The safety and efficacy of monoclonal antibodies (MAB) against SARS-CoV-2 virus was studied in pregnant individuals with COVID19 infection. We examined adverse outcomes associated with MAB infusion in pregnant patients with COVID19 and compared mortality outcomes between the cohorts; pregnant patients with COVID19 who received MAB and pregnant patients with COVID19 who did not receive MAB.

Methods
A cross-sectional retrospective chart review of pregnant patients with COVID19 treated in the Northwell Health System from January 2021 to January 2022 was conducted. Outcomes studied included comparing demographic and clinical characteristics amongst pregnant women who received MAB infusion vs. pregnant women who did not receive MAB infusion, the association between MAB infusion and adverse pregnancy outcomes within one month of MAB infusion, and the association between MAB infusion and 30-day all-cause mortality.

Results
A total of 269 patients were studied. 49% were White, mean ± SD age was 31.8 (5.5) years, 26% were vaccinated for COVID19, 45% received MAB infusion, 3% reported adverse infusion related events, and 4% reported adverse pregnancy outcomes.
Subjects that received MAB infusion were more likely to be older (33 vs. 30.8 years, p=0.0008) and vaccinated (85% vs. 14%; p&lt; 0.0001). Monoclonal antibody utilization was higher in Caucasian women compared to other racial and ethnic groups (p&lt; 0.0001). In subjects that received MAB infusion, 9% (n = 11) reported an adverse pregnancy outcome. Only 1 subject passed away at 30 days (did not receive MAB infusion). All subjects receiving MAB survived at 30 days.

Conclusion
The number of patients who received MAB and reported adverse infusion related events and adverse pregnancy outcomes within 1 month of MAB infusion were low. Patients who had been vaccinated and Caucasian patients were more likely to receive monoclonal antibody. Further study is needed to elucidate factors influencing the differential uptake of novel therapeutic options for the management of SARS-CoV-2, including access to care and factors influencing patient preferences in using new therapies.

Disclosures
All Authors: No reported disclosures
P-2032. The Time to Return to Work in Healthcare Workers With COVID-19 Infection Treated With Ensitrelvir, a Novel Oral Inhibitor of 3C-Like Protease of SARS-COV-2
Authors: Katsuta Makoto , Kitazono Masatoshi , Nagai Naohito , Karibe Hiroto , Takahashi Yusaku , Ariwa Yasuko , Sonoyama Takuhiro , Yamaguchi Tomoyoshi 
Published: January 2025

Abstract

Background
Early diagnosis and treatment with antivirals are important in COVID-19 management. This study aimed to investigate the time to return to work and COVID-19 symptom improvement in healthcare workers treated with ensitrelvir.

Methods
A retrospective single-center, observational study was conducted to assess the effect of ensitrelvir on the time to return to work and the resolution of symptoms at the time of return in healthcare workers diagnosed with COVID-19 between June and September 2023 during the Omicron dominant period. The differences in patient background between the ensitrelvir treated group and no antiviral treatment group was not adjusted, and we conducted descriptive analysis. The criteria for returning to work were defined as improvement of symptoms and an antigen quantification test result of ≤ 100 pg/mL after the 6th day of onset.

Results
A total of 102 healthcare workers were registered, and ensitrelvir was administered in 60 cases. The average number of days from onset of symptoms to ensitrelvir administration was 0.8 days. The female proportion was 76.7% and 78.6% in the ensitrelvir-treated and non-treated groups, respectively, with average ages of 38.2 and 30.6 years in each group, respectively. The severity of COVID-19 was mild in all cases. No side effects were observed in the ensitrelvir-treated group. The average time to meet the criteria for returning to work was 6.9 days in the ensitrelvir treated group and 7.7 days in the non-treated group. 35 patients (58.3%) in the ensitrelvir-treated group and 15 patients (35.7%) in the non-treated group experienced recovery (fever resolution and disappearance of COVID-19 symptoms) on the day of returning to work. Additionally, 25 patients (41.7%) in the ensitrelvir-treated group and 27 patients (64.3%) in the non-treated group experienced improvement (fever resolved but some symptoms remained) on the day of returning to work.

Conclusion
This study showed that early treatment of COVID-19 with ensitrelvir may improve symptoms and reduce the number of days to return to work. The results suggest that early antiviral drug administration to healthcare workers may contribute to the maintenance and continuity of routine healthcare, thereby avoiding Healthcare workers shortage.

Disclosures
Makoto Katsuta, Shionogi & Co., Ltd.: Lecture fees Takuhiro Sonoyama, MD, Shionogi & Co., Ltd.: Stocks/Bonds (Private Company) Tomoyoshi Yamaguchi, MD, Shionogi & Co., Ltd.: Lecture fees
P-9. Standardized Model for SARS-CoV-2 and Influenza Vaccination of Hospitalized Patients: A Before-After Quality Improvement Study
Authors: Linkenheld-Struk Amber L , Williams Victoria R , Chan Karen , Carating Helene , Marchesano Romina , Do Jennifer , Sullivan Sherri , Beechinor Danette , Silverstein William K , Leis Jerome A 
Published: January 2025

Abstract

Background
Hospitalized patients are at increased risk of complications from viral respiratory infection. Seasonal vaccination can reduce this risk and may be missed in the community for patients with prolonged hospital admissions. The optimal approach to ensuring timely vaccination of eligible inpatients against both seasonal influenza and SARS-CoV-2 has yet to be established.

Methods
We implemented a before-after quasi-experimental study of a standardized model for vaccinating patients admitted to an acute care hospital. The target population was inpatients designated as alternate level of care (ALC), defined as those recovered from their acute medical illness and awaiting transfer to post-acute care facility. The model involved an automated daily report of ALC patients without documented receipt of seasonal influenza or SARS-CoV-2 vaccine. This report was communicated daily by Infection Preventionists to unit-level pharmacist, physician, and unit leads to assess, consent and administer vaccination as appropriate. Vaccination rates of baseline (2022-23) and intervention (2023-24) seasons were measured and compared between identical time periods (10 Oct to 19 Jan). The primary outcome was the proportion of ALC patients vaccinated upon discharge, broken down by hospital versus community-initiated administration.

Results
At baseline, hospital-initiated vaccine accounted for 3.4% and 2% of vaccines in eligible patients against influenza and SARS-CoV-2, respectively. Post intervention, rates of hospital-initiated vaccination increase significantly for influenza (12%, OR 3.88, 95% CI 2.48-6.09; p&lt; 0.001) and SARS-CoV-2 (10.7%, OR 5.76, 95% CI 3.30-10.04; p&lt; 0.001). For influenza and SARS-CoV-2 vaccination during the intervention season, hospital-initiated vaccination contributed 76.3% and 78.4% of vaccination rate in Oct-Nov, as compared to 33.7% and 29.4% in Dec-Jan.

Conclusion
A standardized model resulted in significant uptake in vaccination against both influenza and SARS-CoV-2 during the 2023-24 respiratory viral season in ALC patients. The greatest impact occurred early in the season, likely due to slower uptake in the community. Further study is needed to assess the impact of this intervention on inpatient outcomes.

Disclosures
All Authors: No reported disclosures
P-12. Evaluating the Epidemiological Impact of Lowering the Recommended Age for Adult Pneumococcal Vaccination in the United States
Authors: Bakker Kevin , Meleleo Giulio , Sharomi Oluwaseun , Nachbar Robert , Oidtman Rachel 
Published: January 2025

Abstract

Background
In the United States, there are two age-based pneumococcal vaccine recommendations – children aged 0-2 years and adults aged 65+ years. Adults aged 50-64 are recommended to receive a pneumococcal vaccine if at increased risk of pneumococcal disease; disease burden in this age groups represents the third highest level of pneumococcal disease. PCV20, a 20-valent PCV, and PCV15 are higher valent vaccines currently approved for adults. V116, an investigational adult specific PCV is being developed to specifically broaden protection in the adult population, by including key serotypes in currently licensed vaccines and 8 unique serotypes responsible for ∼30% of pneumococcal disease in adults in the US.

Cumulative IPD cases in a 10-year projection period for V116 and PCV20.

Methods
We evaluated the impact of lowering the pneumococcal adult age-based vaccine recommendations in the United States to individuals aged 50+ years using a model that tracked age- and serotype-specific Streptococcus pneumoniae (SP) transmission. The model was calibrated to historical age- and serotype-specific invasive pneumococcal disease (IPD) data in the United States spanning 2000-2019. We evaluated the impact of lowering the recommended vaccination age in adults to 50+ years-old with V116. For projections we maintained an 80/20 coverage of PCV20/PCV15 in 82% of children and assumed a VCR of 57% for adults aged 65+. In the 50+ years old scenario, we reduced VCR to 46%, which was the age-specific tetanus rates for individuals aged 50-64 years-old multiplied by the reduction in uptake from the Shingrix vaccine when the recommended age was lowered. These adult VCR values assume a PCV was received in the last 10 years.

Results
Reducing the adult recommended vaccination age to 50+ years with the reduced VCR, led to similar overall reductions in IPD incidence when compared to maintaining the vaccination age at 65+ years (Table 1). The additional reductions in IPD in 50-64 year-olds was negated by the increase in cases in individuals aged 65+ years, due to vaccine waning.

Conclusion
If the recommended pneumococcal vaccination age for adults is reduced, additional efforts must be made to minimize the reduction of VCR, otherwise total IPD incidence will be similar to the current 65+ year-old age recommendation due to vaccine waning.

Disclosures
Kevin Bakker, PhD, Merck & Co., Inc.: Grant/Research Support|Merck & Co., Inc.: Stocks/Bonds (Public Company) Giulio Meleleo, PhD, Merck & Co., Inc.: Vendor Oluwaseun Sharomi, MSc, PhD, Merck & Co., Inc.: Full time employee|Merck & Co., Inc.: Stocks/Bonds (Public Company) Robert Nachbar, PhD, Merck & Co., Inc.: US 7,219,020, US 5,292,741|Merck & Co., Inc.: Vendor|Merck & Co., Inc.: Stocks/Bonds (Public Company) Rachel Oidtman, PhD, Merck & Co., Inc.: Full time employee|Merck & Co., Inc.: Stocks/Bonds (Public Company)