bluuebunny/crossref_metadata_2025_split huggingface dataset:
2322. Challenges Faced by Perinatally-Infected Young People Living with HIV in Kenya During the COVID-19 Pandemic
Authors: Singh Manjot , Nyandiko Winstone , DeLong Allison , Ashimosi Celestine , Munyoro Dennis , Lidweye Janet , Nyagaya Jack , Biegon Whitney , Aluoch Josephine , Chory Ashley , Sang Edwin , Jepkemboi Eslyne , Orido Millicent , Novitsky Vladimir , Vreeman Rachel , Kantor Rami 
Published: November 2023

Abstract

Background
Understanding challenges experienced by young people living with HIV (YPLWH) during the COVID-19 pandemic could guide care during public health crises, particularly in resource-limited settings.

Methods
Surveys utilizing validated and self-reported measures were administered to perinatally-infected YPLWH receiving care at four clinics at the Academic Model Providing Access to Healthcare (AMPATH) in western Kenya between February 2021 and July 2022. Reported psychological, physical, and socioeconomic challenges were summarized overall and across viral load (VL) thresholds (virologic failure VL &gt;40 copies/mL; treatment failure VL &gt;1000 copies/mL). COVID-19-related events, restrictions, and interventions in Kenya from the beginning of the pandemic through the entirety of the study period were compiled into a pandemic timeline and temporal patterns of the evaluated challenges within this timeline were assessed using generalized additive models.

Results
Among 442 participants (median age 17 years, IQR 14-19; 49% female), 89% reported any challenge (mean 2.92 of the 23 challenges estimated; SD=2.14); 48% psychological, 66% physical, and 62% socioeconomic. Major psychological challenges included moderate to severe depression (36%) and anxiety (29%) symptoms. Major physical challenges included recent illness (31%), and recent symptoms of cough (34%), congestion (25%), and fatigue (23%). Major socioeconomic challenges included food insecurity (31%), household income loss (27%), and departure from usual residence (20%). Participants with virologic or treatment failure experienced more challenges compared to those suppressed. Trends of challenges over time were stable for all but physical challenges, which decreased in parallel with the reduced incidence of respiratory infections as masking and social distancing measures were implemented.

Conclusion
The vast majority of Kenyan YPLWH experienced significant wellness challenges during the COVID-19 pandemic, conceivably due to pandemic-imposed travel restrictions and mitigation measures, and possibly impacting HIV care. This knowledge could guide intervention opportunities in this vulnerable population for current and future pandemics.

Disclosures
All Authors: No reported disclosures
2325. Five-day quarantine of patients exposed to SARS-CoV-2 within hospitals in the Omicron variant era
Authors: Choo Eun Ju 
Published: November 2023

Abstract

Background
Since severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be transmitted even in the absence of symptoms, it can be difficult to prevent its transmission within healthcare facilities. This study aimed to investigate whether initial screening tests and quarantine are still necessary for in-hospital close contact patients in the Omicron-dominant era.

Methods
This retrospective, observational study was performed at a tertiary hospital in South Korea, comprising mostly multi-bed rooms, with four or five beds each. Real-time reverse transcriptase polymerase chain reaction (RT-PCR) for SARS-CoV-2 was performed on the first and fourth day of quarantine, using a PowerChekTM 2019-nCoV Real-time PCR Kit (Kogenebiotech, Seoul, Korea) or an Allplex 2019-nCoV Assay (Seegene, Seoul, Korea). If relevant symptoms developed during quarantine, testing was promptly performed, regardless of the established schedule.

Results
Between June 15, 2022 and December 29, 2022, there were 179 events of COVID-19 within the hospital. Eighteen exposed patients were excluded because they were discharged during quarantine, and 705 patients were included in the final analysis. The median number of exposed inpatients was 4 (interquartile range, 2 – 5) for each event. Fifty-six (7.9%; 95% confidence interval [95%CI], 6.0 – 10.3%) exposed patients had positive initial screening tests. Among those with an initially negative test, positive conversion was identified in 31 patients (4.8%; 95%CI, 3.2 – 6.8%) during quarantine. In correlation with the number of confirmed COVID-19 cases in South Korea at that time, the number of in-hospital events and exposed patients peaked in August 2022. However, positive test rates at initial testing or during quarantine did not differ significantly according to the month (P = 0.095 and P = 0.104, respectively). This study showed that 12.3% of exposed patients had a positive PCR test, either at initial screening or during quarantine.

Conclusion
This study suggests that screening and quarantine are still necessary for close contact inpatients in the Omicron variant era. Testing intervals and the duration of quarantine may need adjustment considering the current shortage of isolation rooms, testing capacity, and healthcare personnel.

Disclosures
All Authors: No reported disclosures
2327. Masking without Mandates: Patient Preferences
Authors: Harris Matthew , Narvaez Joseph , Salvador Annabella , Farber Bruce 
Published: November 2023

Abstract

Background
Masking has been a foundational component of COVID-19 transmission reduction strategies; however, mask mandates have begun to sunset. The United States Center for Disease Control and Prevention has recommended curtailing mask use in healthcare settings and guiding decisions based on community transmission rates. There is little data describing patient perspectives on the continued use of masks in clinical settings.

Methods
Patient surveys were disseminated via email and SMS using census-sampling methodology to all patients with a clinical encounter within the past 3 months to gauge perceptions of the need for continued masking for patients, visitors, and medical staff in the clinical setting. Data analysis was performed using descriptive and inferential statistics. Thematic analysis was used to analyze qualitative data.

Results
10,964 (5.6%) of 196,424 surveys were completed. 5,418 (49%) of respondents were age 65 and older and 7,728 (70%) were female. Respondents prefer masking at all times in the inpatient setting (Med-surg, ICU, Oncology, Pediatrics, Mother/Baby, Emergency Dept) for clinical staff mean(m) 61.2% (range (r) 56.5%-71.3%), patients m = 56.9 (r 51.5-65.4), and visitors m = 58.5 (r 52.8-67.0). When local transmission rates are moderate to high, preference for masking increases by 36%, 45% and 42% for staff, patients, and visitors respectively. Patients hospitalized for COVID-19 in the past 365 days demonstrated a preference towards masking at all times, m = 63.5, (r 59.1-73.2) and when transmission rates are elevated, m= 86.6 (r 84.5-89.5), compared to those who were not hospitalized, m = 61.7 (r 57.1-71.6) and m = 76.0 (r 72.1 – 82.7). Respondents were less likely to prefer masking in non-clinical environments (∼25%). Approximately 40% preferred mask use in the ambulatory environment for all groups.

Conclusion
While mask utilization is becoming less ubiquitous in the current phase of the COVID-19 pandemic, the majority of patients prefer masks to be worn by staff, patients, and visitors in the inpatient setting. This is especially true for patients hospitalized for COVID-19 in the past year and during periods of moderate to high community transmission rates.

Disclosures
All Authors: No reported disclosures
2332. COVID-19 Primary Series and Booster Vaccination and Potential for Immune Imprinting
Authors: Chemaitelly Hiam , Ayoub Houssein H , Abu-Raddad Laith J 
Published: November 2023

Abstract

Background
Epidemiological evidence for immune imprinting was investigated in immune histories related to vaccination in Qatar from onset of the omicron wave, on December 19, 2021, through September 15, 2022.

Methods
Matched, retrospective, cohort studies were conducted to investigate differences in incidence of SARS-CoV-2 reinfection in the national cohort of persons who had a primary omicron infection, but different vaccination histories. History of primary-series (two-dose) vaccination was compared to that of no vaccination, history of booster (three-dose) vaccination was compared to that of two-dose vaccination, and history of booster vaccination was compared to that of no vaccination. Associations were estimated using Cox proportional-hazards regression models.

Results
The adjusted hazard ratio for incidence of reinfection, including also adjustment for differences in testing rate, in the two-dose cohort relative to that in the unvaccinated cohort was 0.43 (95% CI: 0.39-0.49). The adjusted hazard ratio comparing incidence of reinfection in the three-dose cohort to that in the two-dose cohort was 1.47 (95% CI: 1.23-1.76). The adjusted hazard ratio comparing incidence of reinfection in the three-dose cohort to that in the unvaccinated cohort was 0.57 (95% CI: 0.48-0.68). All adjusted hazard ratios appeared stable over 6 months of follow-up. Divergence in cumulative incidence curves in all comparisons increased markedly when incidence was dominated by BA.4/BA.5 and BA.2.75*. No reinfection in any cohort progressed to severe, critical, or fatal COVID-19.

Conclusion
History of primary-series vaccination enhanced immune protection against omicron reinfection, but history of booster vaccination compromised protection against omicron reinfection. These findings do not undermine the short-term public health utility of booster vaccination.

Disclosures
All Authors: No reported disclosures
2334. The effectiveness of bivalent COVID-19 booster among patients with hematologic malignancies
Authors: Aleissa Muneerah M , Davey Sonya , Rooks Rebecca , Izaguirre Natalie E , Yates Bridget , Kanwal Urwah , Baden Lindsey R , Issa Nicolas C , Sherman Amy C 
Published: November 2023

Abstract

Background
Patients with hematologic malignancies remain at higher risk for developing severe SARS-CoV-2 infections and have reduced immune responses to vaccines.

Methods
A prospective observational study was conducted at Brigham and Women’s Hospital and Dana-Farber Cancer Institute from January 2021 to May 2023. Adult participants were included if they had a history of lymphoid malignancy (LM) or had received hematopoietic stem cell transplantation (HSCT). SARS-CoV-2 antibodies were measured before vaccination and every 2-3 months thereafter. COVID-19 vaccination history and SARS-CoV-2 infections (by report or positive PCR) were recorded longitudinally. Our primary outcome for this study was to evaluate the incidence of breakthrough SARS-CoV-2 infections after receiving a bivalent COVID-19 vaccine booster (Omicron/wildtype).

Results
A total of 144 participants were included in the analysis. Of those, 98 (68%) received a bivalent COVID-19 booster. The median age was 68 (IQR 61 – 73) and 51 (52%) were male. The majority of participants 61 (62%) had LM and 37 (38%) underwent HSCT with a median time from transplant to first vaccine of 317 days (IQR 171 – 742). Overall, the incidence of breakthrough SARS-CoV-2 infections was 13 (13%) (Figure) with a median time from vaccination to breakthrough infection of 72 days (IQR 54 – 112). There were no SARS-CoV-2 related mortality or severe disease leading to hospitalization in our cohort.
Figure

Conclusion
Our analysis demonstrates a low incidence of breakthrough SARS-CoV-2 infections and no severe disease among those who received a bivalent mRNA vaccine, highlighting the potential protection of the bivalent booster against SARS-CoV-2 in patients with hematologic malignancies who had previously been vaccinated or boosted. Further studies are warranted to determine the optimal number and type of booster vaccinations needed to protect this vulnerable population.

Disclosures
Nicolas C. Issa, MD, AiCuris: Grant/Research Support|Astellas: Grant/Research Support|Boehringer Ingelheim: Advisor/Consultant|Fujifilm: Grant/Research Support|GSK: Grant/Research Support|Merck: Grant/Research Support|Moderna: Grant/Research Support
2336. General Safety Profile of mRNA-1273 (Moderna COVID-19 Vaccine) in the Elderly Population
Authors: Anteyi Kate , Urdaneta Veronica , Dharia Priyadarshani , Emile-Backer Magalie , Khamamkar Vaishali , Esposito Daina , Straus Walter 
Published: November 2023

Abstract

Background
Early in the pandemic, the elderly was recognized to be at high risk for COVID-19 related morbidity and mortality and then prioritized for vaccination. To provide further insight supporting the safety of mRNA-1273 in the elderly, we analyzed and characterized adverse events (AE) reported in the Moderna global safety database (GSDB) after mRNA-1273 administration in the elderly population.

Methods
We conducted a descriptive analysis of cumulative data (18 Dec 2020 -17 Dec 2022) from recipients of the mRNA-1273 vaccine, aged &gt;65 years, in the GSDB. Data were aggregated and assessed to search for patterns and variations. Findings were summarized using frequency distributions.

Results
As of 17 Dec 2022, an estimated 773 million doses of mRNA-1273 had been administered, with 658,519 case reports collected in the GSDB. Of these 133,303 cases (20.2%) were in the elderly, 25% were “serious cases”; most reports involved females (65.6%).
Most AE (49.0%) were associated with reactogenicity (including pain, redness, swelling or induration at the injection site, headache, fever, myalgia) similar to results from clinical trials. The most frequently reported events in the elderly were pyrexia, headache, fatigue, chills, and myalgia (Table). Fatal outcomes were reported in 3.3% of the cases. Review of these cases showed they were frequently confounded by common comorbidities of the elderly, including hypertension (42.6%), diabetes mellitus (28.2%), atrial fibrillation (12.6%) and chronic obstructive pulmonary disease (12.2%). These comorbidities provided alternate etiologies for the fatal outcomes.

Conclusion
The pattern of adverse events identified in the elderly population was generally consistent with the known safety profile of mRNA-1273 vaccine. This review provides supporting evidence for the favorable safety profile of mRNA-1273 in the elderly population.

Disclosures
Kate Anteyi, MD, MPH, MBA, Moderna, Inc.: Salary|Moderna, Inc.: Stocks/Bonds Veronica Urdaneta, MD, MPH, Moderna, Inc.: Salary|Moderna, Inc.: Stocks/Bonds Priyadarshani Dharia, PhD, MD, MPH, Moderna, Inc.: Salary|Moderna, Inc.: Stocks/Bonds Magalie Emile-Backer, PharmD, CCRP, Moderna, Inc.: Salary|Moderna, Inc.: Stocks/Bonds Vaishali Khamamkar, MS, Moderna, Inc.: Salary|Moderna, Inc.: Stocks/Bonds Daina Esposito, PhD, MPH, Moderna, Inc.: Salary|Moderna, Inc.: Stocks/Bonds Walter Straus, MD, MPH, Moderna, Inc.: Salary|Moderna, Inc.: Stocks/Bonds
2339. COVID-19 Vaccination in Adults and Children. Cross-Sectional Study of Adults', Pediatricians' and Parents' perceptions and Acceptance of COVID-19 Vaccine in Colombia
Authors: Cortés Margarita , Puentes Andrea , Arenas Mónica , Arango Carlos , Brea José , Beltran Claudia , Debbag Roberto 
Published: November 2023

Abstract

Background
COVID-19 (C-19) immunization started in Colombia in February 2021 for adults; in October 2021 for children over 3 years old (yo), and since January 2023 the recommendation was extended to children 6 m - 3 yo.
At the time of this study, C-19 vaccine (C-19V) coverage rates were still low in Colombia: adults, first booster: 43.7%; children over 3 yo 67.8% first dose, 47.9% second dose.
The objective of this study was to assess C-19V acceptance in Colombia, among pediatricians, parents of children up to 18 yo and adults.

Methods
In January 2023 we carried out 3 online surveys on C-19V among adults, parents and pediatricians in Colombia.

Results
Adults
655 adults over 18 yo participated in the study: 80% lived in an urban area, 80% had completed high school, 93% had received C-19V (50% complete primary schedule, 35% first booster); 83% had been contacted by their social security to be reminded about the importance of vaccination. Among the non-vaccinated, 71% did not want to receive C-19V; over 41% said they did not want or did not need it. In the vaccinated group, 66% reported confidence in the vaccines and 55% said they willed would complete their C-19V schedule.
Pediatricians
767 pediatricians answered the survey, 52.1% work in private practice. Perception of C-19V risks among pediatricians was low for both adults and children; vaccine acceptance was lower for healthy children than for adults (69.4 vs 96.4%). The main causes for vaccine hesitancy were the lack of scientific information, fear of immediate and long-term side effects, and non-severity of the disease in children (57.3%, 20.8% and 33.3%, and 21.8%, respectively).
Parents
Of the 646 parents, 86.2% were mothers, 57.7% had postgraduate degrees, 89.4% had vaccinated their children against C-19. The main cause for vaccine hesitancy was vaccine safety (36.6%); 71.2% were informed about how vaccines work, and 64.8% regarding the risks of C-19 in children.

Conclusion
These results show a high acceptance of C-19V in Colombia. However, coverage rates for were low at the time of the study. This might suggest that besides vaccine confidence, other factors impacting coverage rates should be evaluated, as vaccine access.

Disclosures
All Authors: No reported disclosures
2341. Response to Vaccination Against COVID-19 in a Community Oncology Practice: a Rational for Antibody Testing
Authors: Egoryan Goar , Rodriguez-Nava Guillermo 
Published: November 2023

Abstract

Background
Patients with cancer are at increased risk of morbidity and mortality from COVID-19. Vaccination is crucial to prevent this potentially fatal infection. The aim of this study was to evaluate the seroconversion rate in response to 3 different COVID-19 vaccines in patients with cancer in a community setting.

Methods
In this retrospective cohort study, we included 136 patients of a community oncology clinic with solid and hematological malignancies, fully vaccinated against SARS-CoV-2 and without a history of COVID-19. We evaluated qualitative seroconversion rates against the SARS-CoV-2 spike protein after 2 doses and after a booster dose, and the factors associated with increased risk for lack of seroconversion.
Cancer types in studied population

Results
The median age was 71.5 years (IQR, 64 – 79.75 years), 67 (49.3%) were receiving active treatment; 94 (69.1%) patients had a hematological malignancy, 38 (27.9%) had a solid malignancy, and 4 (2.9%) had both. Only 90 (66.2%) patients developed antibodies against the SARS-CoV-2 spike protein after initial vaccination. 53.8% of those who did not initially develop antibodies, converted after a booster dose. In a multivariable binary logistic regression, patients with hematologic malignancies were nine times more likely to not develop antibodies compared to patients with a solid malignancy or both, when controlling for age, type of COVID-19 vaccine, and cancer therapy (odds ratio [OR] 9.57; 95% confidence interval [CI] 2.65 – 34.60, p=.001). Older age was also associated with an increased risk for not developing antibodies (OR 1.07; 95% CI 1.03 – 1.11, p &lt; .001).
Antibody response after initial vaccination in each therapy group
The rate of antibody production per each vaccine group (initial vaccination)
The rate of antibody production in response to booster per each hematologic malignancy type

Conclusion
In this population of patients from a community oncology clinic, older patients and patients with a hematological malignancy had an increased risk for not developing antibodies against the SARS-CoV-2 spike protein. A booster dose induced a response in a significant number of patients.

Disclosures
All Authors: No reported disclosures
2342. Evaluation of mRNA-LNP and adjuvanted protein SARS-CoV-2 vaccines in a maternal antibody mouse model
Authors: England Ross N , Drapeau Elizabeth , Hosseinzadeh Reihaneh , Weissman Drew , Hensley Scott 
Published: November 2023

Abstract

Background
Maternal antibodies (matAbs) protect against a myriad of pathogens early in life; however, these antibodies can also inhibit de novo immune responses against some vaccine platforms. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) matAbs are efficiently transferred during pregnancy and protect infants against subsequent SARS-CoV-2 infections. It is unknown if matAbs inhibit immune responses elicited by different types of SARS-CoV-2 vaccines.

Methods
We established a mouse model to determine if SARS-CoV-2 spike (S)-specific matAbs inhibit immune responses elicited by recombinant protein and nucleoside-modified mRNA-lipid nanoparticle (mRNA-LNP) vaccines. Mouse dams were vaccinated with SARS-CoV-2 S protein-encoding mRNA-LNP vaccine (or vehicle) in early pregnancy and pups were born and matAbs quantitated in pup serum by ELISA. Pups with and without matAbs were vaccinated at weaning with recombinant S protein (adjuvanted with Addavax or empty LNP) or mRNA-LNP and serum S-specific IgG quantitated over time.

Results
S-specific matAbs were transferred to pups and decayed over time as expected. We found that SARS-CoV-2 mRNA-LNP vaccines elicited robust de novo antibody responses in mouse pups in the presence of matAbs. Recombinant protein vaccines were also able to circumvent the inhibitory effects of matAbs when co-administered with Addavax or empty LNP as adjuvants.

Conclusion
While additional studies need to be completed in humans, our results raise the possibility that mRNA-LNP-based and adjuvanted protein-based SARS-CoV-2 vaccines have the potential to be effective when delivered in the presence of matAbs.

Disclosures
Reihaneh Hosseinzadeh, MASc, Acuitas Therapeutics: Employee Drew Weissman, MD, PhD, Intellectual Property/Patents: D.W. is named on the first patent describing nucleoside-modified mRNA and on patents describing its use as a treatment and vaccine platform. Scott Hensley, PhD, Intellectual Property/Patents: SEH is named on patents that describe the use of nucleoside-modified mRNA as a platform to deliver therapeutic proteins and as a vaccine platform