bluuebunny/crossref_metadata_2025_split huggingface dataset:
2344. Clinical Profile and Immunologic Response from COVID-19 Vaccine Among People Living with HIV Enrolled in a Treatment Hub in the Philippines
Authors: Festin Mark John , Berba Regina , Ramos Christine P , Lim Jodor 
Published: November 2023

Abstract

Background
SARS-CoV-2 has caused more than 1 million deaths worldwide. Several studies showed that People with HIV had higher rates of hospitalization and mortality with COVID-19 compared with people without HIV but data on serologic response to COVID-19 vaccine among People Living with HIV (PLHIV) is still limited.

Methods
A prospective cohort study on determination of serologic response to COVID-19 vaccine among completely vaccinated PLHIV enrolled in a treatment hub in the Philippines until December 31, 2021 was done. Baseline demographics were collected via chart review. History of COVID-19 infection was also asked during enrollment, on follow-up and at the end of 6 months after the 2nd dose of vaccination.
Blood Extraction were done on enrollment and on follow-up visit to the treatment hub. All the specimen were processed using the SARS-CoV2 ( RocheElecsys Anti-SARS-CoV2 spike (S) protein assays.

Results
A total of 261 PLHIV who received vaccination from February 11, 2021 to December 29, 2021 were enrolled in the study. The participants received any of the following vaccine brands: CoronoVac/Sinovac (41%), Oxford-AstraZeneca (20.7%), Pfizer-BioNTech (21.5%), Moderna (14.2% and Janseen (2.7%). Univariate analysis showed that presence of opportunistic infection, HIV Viral load , Antiretroviral(ARV) Status, COVID-19 Vaccine brand were all significant predictors of antibody response. On multiple regression analysis, only the Vaccine Brand and Viral load remained significant. Sinovac gave a lower median antibody level and seroconversion rate as compared to other vaccine brands. HIV Viral load &gt; 1000 copies/ml was predictive of lower antibody response.

Conclusion
In this study among PLHIV, the type of vaccine and HIV viral load were significant predictors of antibody response to COVID-19 Vaccine. Specifically, Sinovac COVID-19 Vaccine gave a lower Median SARS-CoV-2 IgG(S) Antibody and Seroconversion rate as compared to other Vaccine brands. HIV Viral load &gt; 1000 copies/ml was predictive of lower antibody response to COVID-19 Vaccine . Overall, the antibody response peaked at 2-4 weeks after vaccination and decreases thereafter.

Disclosures
All Authors: No reported disclosures
2345. Factors associated with COVID-19 vaccination refusal among U.S. Immigration and Customs Enforcement detainees
Authors: Palacios Carlo Foppiano , Travassos Mark 
Published: November 2023

Abstract

Background
COVID-19 has disproportionately affected migrant detainees, leading to SARS-CoV-2 test positivity rates exceeding 50% among migrants in U.S. Immigration and Customs Enforcement (ICE) detainment facilities. The federal government started vaccinating migrants in detention centers in January 2021 for SARS-CoV-2, but little data on vaccine uptake is available. We sought to identify ICE facility characteristics and particular vaccines associated with vaccination refusal in migrant detention centers.

Methods
As result of Freedom of Information Act request, we acquired a comprehensive dataset of SARS-CoV-2 immunization efforts across ICE facilities from January, 2021 to July, 2022. Data included number of vaccines offered and refused, brand of vaccine (Janssen, Moderna, or Pfizer), vaccination date, detention facility name, and whether ICE Health Service Corps (IHSC) staffed the vaccine delivery. We incorporated data from ICE website on each detention center’s ownership, management of operations, detainee capacity, and COVID-19 burden (as of January 11th, 2021). Descriptive statistics, chi-square, Welch’s ANOVA, and multivariate logistic regression were performed.

Results
Of 129,046 vaccines offered, 65,015 (50.4%) were refused across 103 detention centers across 29 states on 506 vaccination dates. Factors associated with higher refusal included facilities not operated by IHSC (p&lt; 0.001), local government operation (p=0.03), private operations (p=0.02), and vaccinations during the 2nd (p&lt; 0.001) and 3rd quarters (p&lt; 0.001) of 2022. Factors associated with lower refusal included ownership by local or state government, other public association, or private company; combination private/public operations; any COVID-19 death within ICE facility; and vaccination with Moderna and Pfizer (all p&lt; 0.005).
Figure 1. Numbers of SARS-CoV-2 vaccinations administered (blue) and vaccine refusals (orange) in United States Immigration and Customs Enforcement facilities.

Conclusion
Half of ICE detainees refused vaccination against SARS-CoV-2. Refusal rates were lower among vaccination campaigns utilizing mRNA vaccines and among facilities with documented COVID-19 death. Addressing refusal rates may involve detainee education on the efficacy and safety of different SARS-CoV-2 vaccines.

Disclosures
All Authors: No reported disclosures
2347. Factors Associated with COVID-19 and Influenza Vaccine Coadministration in Rhode Island
Authors: Gargano Lisa M , Dumont Dora M 
Published: November 2023

Abstract

Background
Co-administration of COVID-19 and influenza vaccines has several advantages, has been advocated by various public health authorities, and should be seen as an opportunity to increase the uptake of both vaccines. Co-administration of vaccines has a substantial role to play in decreasing the number of consultations or provider visits and hence missed opportunities and can increase timeliness of vaccination. The objective of this analysis was to examine factors associated with COVID-19 and influenza vaccine co-administration in Rhode Island (RI).

Methods
Data were from the RI Child and Adult Immunization Registry (RICAIR), which maintains records of all vaccinations administered in the state. Dates of vaccination were from September 1, 2022-March 30, 2023, corresponding with the availability of influenza vaccine in RI. Co-administration was defined as receipt of COVID-19 and influenza vaccine on the same day. Logistic regression was used to examine the association between selected factors and location of co-administration.

Results
There were 473,872 individuals who received either a COVID-19 and/or influenza vaccine during the study period. Of those, 205,486 received both vaccines, of whom 95,599 received both vaccines on the same day. Adults 19-64 years were less likely to receive both vaccines compared to adults 65+ years (42.8% vs. 59.0%), but of those who did, a greater proportion (52.1% vs. 39.8%; p-value &lt; 0.0001) received them on the same day. Compared to other race/ethnicity groups, Hispanic/Latinos were the least likely to get both vaccines (24.9%), but they were the most likely to get them co-administered (53.4%). Of those who received both COVID-19 and influenza vaccines in the same day, 70.0% were vaccinated at a pharmacy, compared to 22.2% at a primary care provider (PCP). Non-Hispanic Blacks and Hispanic/Latinos had higher odds of receiving same day vaccines from their PCP versus a pharmacy than non-Hispanic Whites (AOR 2.7 [95% CI 2.5-2.9] and 5.0 [95% CI: 4.7-5.3], respectively).

Conclusion
These data demonstrate a willingness to co-administer vaccines among adults. Identifying groups that are less likely to co-administer vaccines and understanding behaviors around where people are getting co-administered will aid in outreach and education efforts.

Disclosures
All Authors: No reported disclosures
2361. Prevalence of Zoster Infection Post mRNA COVID-19 Vaccination Compared to Influenza Vaccination
Authors: Lazbin Mark S , Kaelber David C 
Published: November 2023

Abstract

Background
Introduction: Varicella-zoster virus (VZV) reactivation was not listed as a side effect of any vaccine until introduction of COVID-19 vaccines. Since COVID-19 vaccines were introduced, several case reports described the link between COVID-19 vaccination and VZV reactivation. In our study we aimed to investigate how often patients developed VZV reactivation after mRNA COVID-19 vaccine compared to influenza vaccine.

Methods
We used the TriNetX platform and its global health research network containing aggregated de-identified information of electronic health records on over 100 million patients from scores of healthcare organizations. Three patient groups were identified:
Patients receiving their 1st mRNA COVID-19 vaccine 12/20/2020-12/20/2022
Patients receiving their 2nd mRNA COVID-19 vaccine 12/20/2020-12/20/2022
Patients receiving influenza vaccine 12/20/2018-12/20/2022
Propensity Score Matching was used for age, gender, and Zoster vaccine status.
We examined the prevalence of VZV reactivation in each group during the first 21 days following vaccination.

Results
Out of 444,016 patients in each matched group receiving either their 1st mRNA COVID-19 vaccine or the Influenza vaccine, 0.04% in the COVID-19 vaccine group and 0.15% in the influenza group, odds ratio (OR) 0.24 (95% CI 0.20-0.29), were diagnosed with VZV reactivation within 21 days. Among 445,382 patients in each matched group receiving either their 2nd mRNA COVID-19 vaccine or their influenza vaccine, 0.04% in the COVID-19 vaccine group and 0.13% in the Influenza group, OR 0.27 (95% CI 0.22-0.32), were diagnosed with VZV reactivation within 21 days. There was a lower risk of VZV reactivation after 1st or 2nd dose of mRNA COVID-19 vaccine than influenza vaccine.

Conclusion
The risk of VZV reactivation after the 1st or 2nd dose of mRNA COVID-19 vaccination is smaller than VZX reactivation after influenza vaccine. The risk of VZV reactivation after mRNA COVID-19 vaccine is very low and hesitance to receive COVID-19 vaccine due to concern of VZV reactivation is not substantiated.

Disclosures
David C. Kaelber, MD, PhD, MPH, FAAP, FACP, FACMI, FAMIA, Becton, Dickinson and Company: Advisor/Consultant|Dynavax Technologies Corporation: Advisor/Consultant|Merck Sharp & Dohme Corporation: Advisor/Consultant
2368. SARS-CoV-2 mRNA vaccination induces B cell immunity in the tonsils and adenoids of children
Authors: Xu Qin , Mudd Pamela , Behzadpour Hengameh , Bellusci Lorenza , Grubbs Gabrielle , Pourhashemi Sara , Tang Juanjie , Liu Can , Newman Daniel , Shi Lihong , Milanez-Almeida Pedro , Kardava Lela , Tsang John , Moir Susan , Khurana Surender , Schwartzberg Pamela , Manthiram Kalpana 
Published: November 2023

Abstract

Background
We recently reported that SARS-CoV-2 infection triggered robust adaptive immune responses in the tonsils and adenoids of children. However, whether intramuscular mRNA vaccination induces immunity in these tissues is unknown.

Methods
We collected peripheral blood, tonsils, and adenoids from 21 children undergoing tonsillectomy/adenoidectomy in 2022 who had previously received a COVID-19 mRNA vaccination. From questionnaires and serology, we identified 10 vaccinated subjects who had not been infected; the remaining 11 were both infected and vaccinated. We characterized SARS-CoV-2-specific B cells that bound fluorescently-labelled spike proteins (S1 and RBD) in the blood and tissues of these participants using high dimensional flow cytometry, and compared them to SARS-CoV-2-specific B cells from 24 COVID-19 convalescent children recruited in 2020-2021.

Results
We identified SARS-CoV-2-specific B cells (S1+RBD+) in the blood, tonsils, and adenoids of nearly all infected and vaccinated subjects. Tonsils and adenoids post-infection had a higher percentage of S1+RBD+ memory B cells than post-vaccination, but differences in the percentage of S1+RBD+ cells were not noted in the peripheral blood. Furthermore, we found that only 20% of vaccinated only subjects had SARS-CoV-2-specific germinal center B cells in their tissues compared to over 70% of infected subjects and subjects with hybrid immunity. Unsupervised analyses of the high dimensional flow cytometry data revealed differences in the characteristics of SARS-CoV-2-specific B cells post-vaccination and post-infection; S1+RBD+ B cells from infected subjects had a higher portion of CXCR3+ and IgA+ memory B cells, while those from vaccinated subjects had a greater proportion of CD21lo memory B cells in the blood and tissues, implying a greater extrafollicular response post-vaccination but stronger mucosal IgA and IFN-γ-induced B cell responses post-infection.

Conclusion
We found tissue-specific immunity to SARS-CoV-2 in the upper respiratory tract lymphoid tissue after mRNA vaccination, but vaccination induced B cell phenotypes distinct from that of natural infection which may affect the quality and duration of immunity in the blood and at the mucosal surface.

Disclosures
Pedro Milanez-Almeida, PhD, Novartis: Salary
2960. A Gut Pathobiont Triggers Neuroinflammation and Neurocognitive Impairment via Breaching the Gut-Brain Axis in a Preclinical Model of Alzheimer’s Disease: From Microbial Pathogenesis to Neuropathogenesis
Authors: Park Gwoncheol , Kadyan Saurabh , Nagpal Ravinder 
Published: November 2023

Abstract

Background
Klebsiella pneumoniae (Kpn) is notorious for causing nosocomial infections and is commonly found in elderly patients in hospitals with Alzheimer's disease (AD). This bacterium can cause bloodstream infection, which may worsen AD pathophysiology, but there are no studies demonstrating the mechanistic role of this pathogen in AD.

Methods
We infected APP/PS mice intestinally with Kpn with (Kpn+Ab) and without antibiotics (Kpn) for a week and then fecal and serum samples were collected 1 and 3 weeks afterwards. Neurocognitive function and motor coordination were tested followed by collection of intestinal and brain tissues at 5 weeks. Microbiome profiles were measured using 16S rRNA amplicon sequencing.
Study design

Results
Kpn was found to have explosively increased in the gut of all mice that received antibiotics and negatively correlated with microbial diversity. Conversely, Kpn was barely detected in the mice that did not receive antibiotics. This underscores the role of antibiotic-induced gut dysbiosis in instigating a ‘pathobiome’ signature. Notably, after five weeks post-infection, Kpn was found to be more abundantly colonized in the small intestine than large colon. Importantly, in the Kpn+Ab group, Kpn was detected not only in the blood but also in the brain, indicating the translocation of Kpn from the intestine to the brain via circulation. In mice in which Kpn was found in the brain, a substantial amount of neuroinflammation caused by bacterial infection was observed. Subsequent neurocognitive and behavioral tests revealed that mice infected with Kpn, especially those in the Kpn+Ab group, had impaired memory function and motor coordination.
Effects of Klebsiella pneumoniae colonization.
A. Changes in microbial composition before and after K. pn colonization, B. Correlation between microbial diversity (Shannon entropy) and abundance of Kpn of Kpn+Ab group C. Assessment of motor coordination (incline screen and hanging wire test) and memory function (T-maze) test. D. Neuroinflammation after K.pn translocation from gut to brain, E. Abundance of K.pn in the three parts of small intestine, colon, blood, and brain.

Conclusion
These results corroborate the emerging notion of the implicating role of the gut dysbiosis and consequent gut-brain axis impairment in Alzheimer’s neuropathology. Our findings suggest that Alzheimer's patients who are hospitalized and treated with antibiotics are at a higher risk of contracting multi-drug resistant Kpn. Further, these data also hint that gut pathobiome may increase the host’s predisposition to AD by breaching the gut-brain axis thereby triggering neuroinflammation and impairing neurocognitive function. Our ongoing studies are anticipated to reveal underlying mechanisms and will be presented at the conference.

Disclosures
All Authors: No reported disclosures
2370. Characterizing Predictors of COVID-19 Vaccine Refusal in an Urban Southern California Jail
Authors: Qureshi Nazia , Miller Loren G , Judge Stephen , Tran Ngoc Dung , Henderson Sean O 
Published: November 2023

Abstract

Background
Correctional populations have been disproportionately affected by COVID-19, with majority of the largest single-site outbreaks being linked to jails and prisons. Vaccination is a key strategy to reduce the transmission of SARS-CoV-2 in carceral settings but can be challenging to implement due to vaccine hesitancy and medical mistrust. We sought to identify factors associated with COVID-19 vaccine refusal in the largest urban jail system in the Unites States.

Methods
We retrospectively analyzed electronic health record data for individuals who were offered COVID-19 vaccination at the Los Angeles County Jail between January 19, 2021 and January 31, 2023 and used multivariable logistic regression to determine predictors of COVID-19 vaccine refusal.

Results
Of the 21,424 individuals offered, 2,060 (9.6%) refused vaccination. Refusal was associated with being male ([aOR] = 2.3, 95% CI (1.9, 2.8)), age 18-34 ([aOR] = 1.2, 95% CI (1.1, 1.4), referent group: age 45-54), Black/African American race ([aOR] = 1.2, 95% CI (1.1, 1.4)), reporting ever being houseless ([aOR] = 1.2, 95% CI (1.1, 1.3)), and having a history of not receiving influenza vaccination while incarcerated ([aOR] = 2.4, 95% CI (2.0, 2.8)). When analyzing the male and female populations separately, the male-specific trends reflected those seen in the overall population, whereas the only significant predictor of vaccine refusal in the female population was not receiving influenza vaccination while in custody ([aOR] = 6.5, 95% CI (2.4, 17.6)).

Conclusion
Identifying predictors of vaccine refusal in correctional populations is an essential first step in the development and implementation of targeted interventions to mitigate vaccine hesitancy.

Disclosures
Loren G. Miller, MD MPH, ContraFect: Grant/Research Support|GSK: Grant/Research Support|Medline: Grant/Research Support|Merck: Grant/Research Support|Paratek: Grant/Research Support
2375. Contemporary Patterns and Predictors of Influenza and COVID-19 Vaccination Among US Adults During the COVID-19 Pandemic
Authors: Bush Christopher , Mues Katherine E , Desai Shaina , Arakaki Brent , Dharia Priyadarshani , Ghaswalla Parinaz , Park Yoonyoung 
Published: November 2023

Abstract

Background
With the development of combined influenza and COVID-19 vaccines, there is a need to understand contemporary patterns of both COVID-19 and influenza vaccine administration in the real world. This study aimed to describe patterns and assess predictors of COVID-19 and influenza vaccine administration among insured, influenza-vaccinated adults in the US from 2020 to 2022.Figure 1.Study SchemaFigure 2.Multivariable Odds Ratios for Factors Associated With Observed Vaccine Pattern in Follow-up

Methods
A cohort of adults ≥18 years with evidence of an influenza vaccination administered between August 1, 2020, and July 31, 2021 (index date) was generated using open and closed administrative claims sourced from HealthVerity. Fig 1 includes additional inclusion and exclusion criteria, subject characteristics, and follow-up windows. Baseline characteristics and time-to-subsequent vaccine administration after index date were assessed via descriptive statistics. Multinomial logistic regression was used to assess the association between subject characteristics and receipt of subsequent influenza and COVID-19 vaccines.

Results
Of 3,043,095 influenza vaccinated adults, 13.7% had a subsequent influenza vaccination, 21.1% had a subsequent COVID-19 vaccination, and 50.7% had both through July 31, 2022. Following the index date, the median (IQR) time to a subsequent influenza vaccine was 373 (353, 396) days and 185 (144, 383) days for a subsequent COVID-19 vaccine. Among those who received both vaccines, most (64.1%) received a COVID-19 vaccine followed by influenza. Prior influenza vaccine was associated with subsequent receipt of both vaccines vs influenza only (OR, 95% CI: 1.18, 1.18-1.19). Adults ≥65 years and those considered high-risk for serious complications were slightly less likely to receive both vaccines compared to influenza only (Fig 2; OR, 95% CI, ≥65 years: 0.93, 0.92-0.94; high-risk: 0.91, 0.90-0.92). Outcome misclassification could be driving these results.

Conclusion
During influenza seasons impacted by the COVID-19 pandemic, evidence of prior preventive services and immunizations were associated with subsequent influenza and COVID-19 vaccine administration. As the pandemic subsides, there will be a continued need to assess COVID-19 and influenza vaccination patterns to inform future vaccination campaigns, including combination influenza and COVID-19 vaccines.

Disclosures
Christopher Bush, MPH, Aetion, Inc.: Employee|Aetion, Inc.: Stocks/Bonds Katherine E. Mues, PhD, Aetion, Inc.: Employee Shaina Desai, MPH, Aetion, Inc.: Employee Brent Arakaki, BS, Aetion, Inc.: Employee Priyadarshani Dharia, PhD, MD, MPH, Moderna, Inc.: Salary|Moderna, Inc.: Stocks/Bonds Parinaz Ghaswalla, PhD, Moderna, Inc: Employee|Moderna, Inc: Stocks/Bonds Yoonyoung Park, ScD, Moderna, Inc.: Employee|Moderna, Inc.: Stocks/Bonds
2379. An Urban Detroit Clinic’s Experience in Bivalent COVID-19 Booster Uptake in People Living with HIV
Authors: Ramakrishna Jahanavi M , Yesilyaprak Abdullah , Monday Lea M , Newman Gretchen Snoeyenbos 
Published: November 2023

Abstract

Background
Both HIV and COVID-19 disproportionately affect vulnerable communities. People living with HIV (PLWH) are a priority population for COVID-19 vaccination. Bivalent COVID-19 boosters (BCB) were granted emergency use authorization on August 31, 2022. We assessed onsite BCB uptake amongst PLWH enrolled at our HIV clinic in Detroit, Michigan.

Methods
HIV care data was obtained from CareWare collected as part of Ryan White program quality initiatives. BCB (Pfizer/BioNTech and Moderna) administration data from September 1, 2022 to March 20, 2023 was pulled using Current Procedural Terminology codes from our Athena electronic medical record. We excluded patients &lt; 18 years old. A deterministic match was done using name and date of birth. Of 2268 PLWH, 1,921 (84.7%) had complete care data. The outcome of interest was the percentage of patients who received the BCB. Covariates examined were gender, age (years), race, CDC transmission risk factor, year of HIV diagnosis, insurance type, HIV viral load measurement after Sep. 1, 2022, and most recent HIV viral load value (&lt; or &gt; 200 copies/mL). Bivariate analysis was done using Wilcoxon rank sum test and Pearson's Chi-squared test. Statistical significance was defined as P &lt; 0.05. We used R 4.3.0 for all analyses.

Results
Of 1,921 PLHW, 519 (27%) received the BCB. Compared to PLWH 18-29, those 50 years and older were more likely to receive the BCB (P &lt; 0.001). Although not statistically significant, Black PLWH (26%) were less likely to have been vaccinated with the BCB compared to white PLWH (32%, P &lt; 0.30). BCB uptake was higher in PLWH diagnosed with HIV prior to 2010 (P &lt; 0.001). PLWH enrolled in Medicare were more likely to receive the BCB than those with other or no insurance (P &lt; 0.001). No statistically significant trends were found based on CDC HIV transmission risk factor. Only 5% of PLWH who underwent HIV viral load testing before Sep. 1, 2022 received the BCB compared to 33% with testing after Sep. 1, 2022 (P &lt; 0.001). Patients with viral load &lt; 200 copies/mL (28%) had a higher BCB vaccination rate compared to those with viral load &gt; 200 copies/mL (16%, P &lt; 0.001).

Conclusion
Vaccine surveillance studies such as this one are critical to equitable vaccine distribution to PLWH by identifying subpopulations that may benefit from more intensive outreach.

Disclosures
All Authors: No reported disclosures