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1. Comparison of bivalent and monovalent SARS-CoV-2 variant vaccines: the phase 2 randomized open-label COVAIL trial

Author

Branche, Angela R., Rouphael, Nadine G., Diemert, David J., Falsey, Ann R., Losada, Cecilia, Baden, Lindsey R., Frey, Sharon E., Whitaker, Jennifer A., Little, Susan J., Anderson, Evan J., Walter, Emmanuel B., Novak, Richard M., Rupp, Richard, Jackson, Lisa A., Babu, Tara M., Kottkamp, Angelica C., Luetkemeyer, Anne F., Immergluck, Lilly C., Presti, Rachel M., Bäcker, Martín, Winokur, Patricia L., Mahgoub, Siham M., Goepfert, Paul A., Fusco, Dahlene N., Malkin, Elissa, Bethony, Jeffrey M., Walsh, Edward E., Graciaa, Daniel S., Samaha, Hady, Sherman, Amy C., Walsh, Stephen R., Abate, Getahun, Oikonomopoulou, Zacharoula, El Sahly, Hana M., Martin, Thomas C. S., Kamidani, Satoshi, Smith, Michael J., Ladner, Benjamin G., Porterfield, Laura, Dunstan, Maya, Wald, Anna, Davis, Tamia, Atmar, Robert L., Mulligan, Mark J., Lyke, Kirsten E., Posavad, Christine M., Meagher, Megan A., Stephens, David S., Neuzil, Kathleen M., Abebe, Kuleni, Hill, Heather, Albert, Jim, Telu, Kalyani, Mu, Jinjian, Lewis, Teri C., Giebeig, Lisa A., Eaton, Amanda, Netzl, Antonia, Wilks, Samuel H., Türeli, Sina, Makhene, Mamodikoe, Crandon, Sonja, Montefiori, David C., Makowski, Mat, Smith, Derek J., Nayak, Seema U., Roberts, Paul C., and Beigel, John H.

Abstract

Vaccine protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection wanes over time, requiring updated boosters. In a phase 2, open-label, randomized clinical trial with sequentially enrolled stages at 22 US sites, we assessed safety and immunogenicity of a second boost with monovalent or bivalent variant vaccines from mRNA and protein-based platforms targeting wild-type, Beta, Delta and Omicron BA.1 spike antigens. The primary outcome was pseudovirus neutralization titers at 50% inhibitory dilution (ID50titers) with 95% confidence intervals against different SARS-CoV-2 strains. The secondary outcome assessed safety by solicited local and systemic adverse events (AEs), unsolicited AEs, serious AEs and AEs of special interest. Boosting with prototype/wild-type vaccines produced numerically lower ID50titers than any variant-containing vaccine against all variants. Conversely, boosting with a variant vaccine excluding prototype was not associated with decreased neutralization against D614G. Omicron BA.1 or Beta monovalent vaccines were nearly equivalent to Omicron BA.1 + prototype or Beta + prototype bivalent vaccines for neutralization of Beta, Omicron BA.1 and Omicron BA.4/5, although they were lower for contemporaneous Omicron subvariants. Safety was similar across arms and stages and comparable to previous reports. Our study shows that updated vaccines targeting Beta or Omicron BA.1 provide broadly crossprotective neutralizing antibody responses against diverse SARS-CoV-2 variants without sacrificing immunity to the ancestral strain. ClinicalTrials.gov registration: NCT05289037.

Published
2023
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2. Baricitinib versus dexamethasone for adults hospitalised with COVID-19 (ACTT-4): a randomised, double-blind, double placebo-controlled trial

Author

Wolfe, Cameron R, Tomashek, Kay M, Patterson, Thomas F, Gomez, Carlos A, Marconi, Vincent C, Jain, Mamta K, Yang, Otto O, Paules, Catharine I, Palacios, Guillermo M Ruiz, Grossberg, Robert, Harkins, Michelle S, Mularski, Richard A, Erdmann, Nathaniel, Sandkovsky, Uriel, Almasri, Eyad, Pineda, Justino Regalado, Dretler, Alexandra W, de Castilla, Diego Lopez, Branche, Angela R, Park, Pauline K, Mehta, Aneesh K, Short, William R, McLellan, Susan L F, Kline, Susan, Iovine, Nicole M, El Sahly, Hana M, Doernberg, Sarah B, Oh, Myoung-don, Huprikar, Nikhil, Hohmann, Elizabeth, Kelley, Colleen F, Holodniy, Mark, Kim, Eu Suk, Sweeney, Daniel A, Finberg, Robert W, Grimes, Kevin A, Maves, Ryan C, Ko, Emily R, Engemann, John J, Taylor, Barbara S, Ponce, Philip O, Larson, LuAnn, Melendez, Dante Paolo, Seibert, Allan M, Rouphael, Nadine G, Strebe, Joslyn, Clark, Jesse L, Julian, Kathleen G, de Leon, Alfredo Ponce, Cardoso, Anabela, de Bono, Stephanie, Atmar, Robert L, Ganesan, Anuradha, Ferreira, Jennifer L, Green, Michelle, Makowski, Mat, Bonnett, Tyler, Beresnev, Tatiana, Ghazaryan, Varduhi, Dempsey, Walla, Nayak, Seema U, Dodd, Lori E, Beigel, John H, Kalil, Andre C, Wahid, Lana, Walter, Emmanuel B., Belur, Akhila G., Dreyer, Grace, Patterson, Jan E., Bowling, Jason E., Dixon, Danielle O., Hewlett, Angela, Odrobina, Robert, Pupaibool, Jakrapun, Mocherla, Satish, Lazarte, Suzana, Cayabyab, Meilani, Hussein, Rezhan H., Golamari, Reshma R., Krill, Kaleigh L., Rajme, Sandra, Riska, Paul F., Zingman, Barry S., Mertz, Gregory, Sosa, Nestor, Goepfert, Paul A., Berhe, Mezgebe, Dishner, Emma, Fayed, Mohamed, Hubel, Kinsley, Martinez-Orozco, José Arturo, Bautista Felix, Nora, Elmor, Sammy T., Bechnak, Amer Ryan, Saklawi, Youssef, Van Winkle, Jason W., Zea, Diego F., Laguio-Vila, Maryrose, Walsh, Edward E., Falsey, Ann R., Carvajal, Karen, Hyzy, Robert C., Hanna, Sinan, Olbrich, Norman, Traenkner, Jessica J., Kraft, Colleen S., Tebas, Pablo, Baron, Jillian T, Levine, Corri, Nock, Joy, Billings, Joanne, Kim, Hyun, Elie-Turenne, Marie-Carmelle, Whitaker, Jennifer A., Luetkemeyer, Anne F., Dwyer, Jay, Bainbridge, Emma, Gyun Choe, Pyoeng, Kyung Kang, Chang, Jilg, Nikolaus, Cantos, Valeria D, Bhamidipati, Divya R., Nithin Gopalsamy, Srinivasa, Chary, Aarthi, Jung, Jongtak, Song, Kyoung-Ho, Kim, Hong Bin, Benson, Constance A., McConnell, Kimberly, Wang, Jennifer P., Wessolossky, Mireya, Perez, Katherine, Eubank, Taryn A, Berjohn, Catherine, Utz, Gregory C., Jackson, Patrick E.H., Bell, Taison D., Haughey, Heather M., Moanna, Abeer, Cribbs, Sushma, Harrison, Telisha, Colombo, Christopher J., Schofield, Christina, Colombo, Rhonda E., Tapson, Victor F., Grein, Jonathan, Sutterwala, Fayyaz, Ince, Dilek, Winokur, Patricia L., Fung, Monica, Jang, Hannah, Wyles, David, Frank, Maria G., Sarcone, Ellen, Neumann, Henry, Viswanathan, Anand, Hochman, Sarah, Mulligan, Mark, Eckhardt, Benjamin, Carmody, Ellie, Ahuja, Neera, Nadeau, Kari, Svec, David, Macaraeg, Jeffrey C., Morrow, Lee, Quimby, Dave, Bessesen, Mary, Nicholson, Lindsay, Adams, Jill, Kumar, Princy, Lambert, Allison A., Arguinchona, Henry, Alicic, Radica Z., Saito, Sho, Ohmagari, Norio, Mikami, Ayako, Chien Lye, David, Hong Lee, Tau, Ying Chia, Po, Hsieh, Lanny, Amin, Alpesh N., Watanabe, Miki, Candiotti, Keith A., Castro, Jose G., Antor, Maria A., Lee, Tida, Lalani, Tahaniyat, Novak, Richard M., Wendrow, Andrea, Borgetti, Scott A., George, Sarah L., Hoft, Daniel F., Brien, James D., Cohen, Stuart H., Thompson, George R., Chakrabarty, Melony, Guirgis, Faheem, Davey, Richard T., Voell, Jocelyn, Strich, Jeffrey R., Lindholm, David A., Mende, Katrin, Wellington, Trevor R., Rapaka, Rekha R., Husson, Jennifer S., Levine, Andrea R., Yen Tan, Seow, Shafi, Humaira, Chien, Jaime M F, Hostler, David C., Hostler, Jordanna M., Shahan, Brian T., Adams, David H., Osinusi, Anu, Cao, Huyen, Burgess, Timothy H., Rozman, Julia, Chung, Kevin K., Nieuwoudt, Christina, El-Khorazaty, Jill A., Hill, Heather, Pettibone, Stephanie, Gettinger, Nikki, Engel, Theresa, Lewis, Teri, Wang, Jing, Deye, Gregory A., Nomicos, Effie, Pikaart-Tautges, Rhonda, Elsafy, Mohamed, Jurao, Robert, Koo, Hyung, Proschan, Michael, Yokum, Tammy, Arega, Janice, and Florese, Ruth

Abstract

Baricitinib and dexamethasone have randomised trials supporting their use for the treatment of patients with COVID-19. We assessed the combination of baricitinib plus remdesivir versus dexamethasone plus remdesivir in preventing progression to mechanical ventilation or death in hospitalised patients with COVID-19.

Published
2022
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3. Efficacy of interferon beta-1a plus remdesivir compared with remdesivir alone in hospitalised adults with COVID-19: a double-bind, randomised, placebo-controlled, phase 3 trial.

Author

Kalil, Andre C, Mehta, Aneesh K, Patterson, Thomas F, Erdmann, Nathaniel, Gomez, Carlos A, Jain, Mamta K, Wolfe, Cameron R, Ruiz-Palacios, Guillermo M, Kline, Susan, Regalado Pineda, Justino, Luetkemeyer, Anne F, Harkins, Michelle S, Jackson, Patrick E H, Iovine, Nicole M, Tapson, Victor F, Oh, Myoung-don, Whitaker, Jennifer A, Mularski, Richard A, Paules, Catharine I, and Ince, Dilek

Subjects
INTERFERON beta-1a, REMDESIVIR, ADULTS, COVID-19, OXYGEN saturation, INFECTION
Abstract

Functional impairment of interferon, a natural antiviral component of the immune system, is associated with the pathogenesis and severity of COVID-19. We aimed to compare the efficacy of interferon beta-1a in combination with remdesivir compared with remdesivir alone in hospitalised patients with COVID-19. We did a double-blind, randomised, placebo-controlled trial at 63 hospitals across five countries (Japan, Mexico, Singapore, South Korea, and the USA). Eligible patients were hospitalised adults (aged ≥18 years) with SARS-CoV-2 infection, as confirmed by a positive RT-PCR test, and who met one of the following criteria suggestive of lower respiratory tract infection: the presence of radiographic infiltrates on imaging, a peripheral oxygen saturation on room air of 94% or less, or requiring supplemental oxygen. Patients were excluded if they had either an alanine aminotransferase or an aspartate aminotransferase concentration more than five times the upper limit of normal; had impaired renal function; were allergic to the study product; were pregnant or breast feeding; were already on mechanical ventilation; or were anticipating discharge from the hospital or transfer to another hospital within 72 h of enrolment. Patients were randomly assigned (1:1) to receive intravenous remdesivir as a 200 mg loading dose on day 1 followed by a 100 mg maintenance dose administered daily for up to 9 days and up to four doses of either 44 μg interferon beta-1a (interferon beta-1a group plus remdesivir group) or placebo (placebo plus remdesivir group) administered subcutaneously every other day. Randomisation was stratified by study site and disease severity at enrolment. Patients, investigators, and site staff were masked to interferon beta-1a and placebo treatment; remdesivir treatment was given to all patients without masking. The primary outcome was time to recovery, defined as the first day that a patient attained a category 1, 2, or 3 score on the eight-category ordinal scale within 28 days, assessed in the modified intention-to-treat population, defined as all randomised patients who were classified according to actual clinical severity. Safety was assessed in the as-treated population, defined as all patients who received at least one dose of the assigned treatment. This trial is registered with ClinicalTrials.gov , NCT04492475. Between Aug 5, 2020, and Nov 11, 2020, 969 patients were enrolled and randomly assigned to the interferon beta-1a plus remdesivir group (n=487) or to the placebo plus remdesivir group (n=482). The mean duration of symptoms before enrolment was 8·7 days (SD 4·4) in the interferon beta-1a plus remdesivir group and 8·5 days (SD 4·3) days in the placebo plus remdesivir group. Patients in both groups had a time to recovery of 5 days (95% CI not estimable) (rate ratio of interferon beta-1a plus remdesivir group vs placebo plus remdesivir 0·99 [95% CI 0·87–1·13]; p=0·88). The Kaplan-Meier estimate of mortality at 28 days was 5% (95% CI 3–7%) in the interferon beta-1a plus remdesivir group and 3% (2–6%) in the placebo plus remdesivir group (hazard ratio 1·33 [95% CI 0·69–2·55]; p=0·39). Patients who did not require high-flow oxygen at baseline were more likely to have at least one related adverse event in the interferon beta-1a plus remdesivir group (33 [7%] of 442 patients) than in the placebo plus remdesivir group (15 [3%] of 435). In patients who required high-flow oxygen at baseline, 24 (69%) of 35 had an adverse event and 21 (60%) had a serious adverse event in the interferon beta-1a plus remdesivir group compared with 13 (39%) of 33 who had an adverse event and eight (24%) who had a serious adverse event in the placebo plus remdesivir group. Interferon beta-1a plus remdesivir was not superior to remdesivir alone in hospitalised patients with COVID-19 pneumonia. Patients who required high-flow oxygen at baseline had worse outcomes after treatment with interferon beta-1a compared with those given placebo. The National Institute of Allergy and Infectious Diseases (USA). [ABSTRACT FROM AUTHOR]

Published
2021
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4. Immunization Strategies to Span the Spectrum of Immunocompromised Adults

Author

Whitaker, Jennifer A.

Abstract

The Advisory Committee on Immunization Practices to the US Centers for Disease Control and Prevention provides annual recommendations for routine adult immunizations. Many recommendations consider patient factors such as age, medical conditions, and medications that increase an individual’s risk for infection with a vaccine-preventable disease. These factors, particularly those that lead to immunocompromise, may also alter the risk-benefit ratio for live vaccines, and/or lead to decreased vaccine immunogenicity and effectiveness. The provider may need to consider alternative vaccination strategies, including higher antigen dose vaccines, adjuvanted vaccines, avoidance of live vaccines, and careful timing of vaccination to optimize safety and effectiveness in immunocompromised populations. This thematic review discusses general principles regarding immunization of adults across the spectrum of immunocompromise, examines current guidelines and studies that support them, and outlines future research needs.

Published
2020
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5. Anti-influenza hyperimmune intravenous immunoglobulin for adults with influenza A or B infection (FLU-IVIG): a double-blind, randomised, placebo-controlled trial

Author

Davey, Richard T, Fernández-Cruz, Eduardo, Markowitz, Norman, Pett, Sarah, Babiker, Abdel G, Wentworth, Deborah, Khurana, Surender, Engen, Nicole, Gordin, Fred, Jain, Mamta K, Kan, Virginia, Polizzotto, Mark N, Riska, Paul, Ruxrungtham, Kiat, Temesgen, Zelalem, Lundgren, Jens, Beigel, John H, Lane, H Clifford, Neaton, James D, Davey, Richard T, Fernández-Cruz, Eduardo, Markowitz, Norman, Pett, Sarah, Babiker, Abdel G, Wentworth, Deborah, Khurana, Surender, Engen, Nicole, Gordin, Fred, Jain, Mamta K, Kan, Virginia, Polizzotto, Mark N, Riska, Paul, Ruxrungtham, Kiat, Temesgen, Zelalem, Lundgren, Jens, Beigel, John H, Lane, H Clifford, Neaton, James D, Butts, Jessica, Denning, Eileen, DuChene, Alain, Krum, Eric, Harrison, Merrie, Meger, Sue, Peterson, Ross, Quan, Kien, Shaughnessy, Megan, Thompson, Greg, Vock, David, Metcalf, Julia, Dewar, Robin, Rehman, Tauseef, Natarajan, Ven, McConnell, Rose, Flowers, Emily, Smith, Kenny, Hoover, Marie, Coyle, Elizabeth M, Munroe, David, Aagaard, Bitten, Pearson, Mary, Cursley, Adam, Webb, Helen, Hudson, Fleur, Russell, Charlotte, Sy, Aminata, Purvis, Cara, Jackson, Brooke, Collaco-Moraes, Yolanda, Carey, Dianne, Robson, Rosemary, Sánchez, Adriana, Finley, Elizabeth, Conwell, Donna, Losso, Marcelo H, Gambardella, Luciana, Abela, Cecilia, Lopez, Paco, Alonso, Helena, Touloumi, Giota, Gioukari, Vicky, Anagnostou, Olga, Avihingsanon, Anchalee, Pussadee, Kanitta, Ubolyam, Sasiwimol, Omotosho, Bola, Solórzano, Clemencia, Petersen, Tianna, Vysyaraju, Kranthi, Rizza, Stacey A, Whitaker, Jennifer A, Nahra, Raquel, Baxter, John, Coburn, Patricia, Gardner, Edward M, Scott, James A, Faber, Leslie, Pastor, Erica, Makohon, Linda, MacArthur, Rodger A, Hillman, L Monique, Farrough, Marti J, Polenakovik, Hari M, Clark, Linda A, Colon, Roberto J, Kunisaki, Ken M, DeConcini, Miranda, Johnson, Susan A, Wolfe, Cameron R, Mkumba, Laura, Carbonneau, June Y, Morris, Alison, Fitzpatrick, Meghan E, Kessinger, Cathy J, Salata, Robert A, Arters, Karen A, Tasi, Catherine M, Panos, Ralph J, Lach, Laura A, Glesby, Marshall J, Ham, Kirsis A, Hughes, Valery G, Schooley, Robert T, Crouch, Daniel, Muttera, Leticia, Novak, Richard M, Bleasdale, Susan C, Zuckerman, Ariel E, Manosuthi, Weerawat, Thaonyen, Supeda, Chiewcharn, Thaniya, Suwanpimolkul, Gompol, Gatechumpol, Sivaporn, Bunpasang, Sirikunya, Angus, Brian J, Anderson, Monique, Morgan, Marcus, Minton, Jane, Gkamaletsou, Maria N, Hambleton, Joe, Price, David A, Llewelyn, Martin J, Sweetman, Jonathan, Carbone, Javier, Arribas, Jose R, Montejano, Rocio, Lobo Beristain, Jose L, Martinez, Iñaki Z, Barberan, Jose, Hernandez, Paola, Dwyer, Dominic E, Kok, Jen, Borges, Alvaro, Brandt, Christian T, Knudsen, Lene S, Sypsas, Nikolaos, Constantinou, Costas, Markogiannakis, Antonios, Zakynthinos, Spyros, Katsaounou, Paraskevi, Kalomenidis, Ioannis, Mykietiuk, Analia, Alzogaray, Maria F, Obed, Mora, Macias, Laura M, Ebensrtejin, Juan, Burgoa, Patricia, Nannini, Esteban, Lahitte, Matias, Perez-Patrigeon, Santiago, Martínez-Orozco, José Arturo, and Ramírez-Hinojosa, Juan Pablo

Abstract

Since the 1918 influenza pandemic, non-randomised studies and small clinical trials have suggested that convalescent plasma or anti-influenza hyperimmune intravenous immunoglobulin (hIVIG) might have clinical benefit for patients with influenza infection, but definitive data do not exist. We aimed to evaluate the safety and efficacy of hIVIG in a randomised controlled trial.

Published
2019
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6. Receipt and duration of buprenorphine treatment during pregnancy and postpartum periods in a national privately-insured cohort

Author

Wang, Xi, Meisel, Zachary, Kellom, Katherine, Whitaker, Jennifer, Strane, Douglas, Chatterjee, Anyun, Rosenquist, Rebecka, and Matone, Meredith

Abstract

•About one in three privately-insured opioid-dependent birthing people were treated with buprenorphine.•About half of buprenorphine users received treatment for at least six months.•Hispanic and Black birthing people had lower buprenorphine use rates than white birthing people.•Lowest buprenorphine use rate in states with punitive policies related to substance use in pregnancy.

Published
2023
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8. Vaccinology in the third millennium: scientific and social challenges.

Author

Poland, Gregory A, Whitaker, Jennifer A, Poland, Caroline M, Ovsyannikova, Inna G, and Kennedy, Richard B

Abstract

The epidemiology of deaths due to vaccine-preventable diseases has been significantly and positively altered through the use of vaccines. Despite this, significant challenges remain in vaccine development and use in the third millennium. Both new (Ebola, Chikungunya, Zika, and West Nile) and re-emerging diseases (measles, mumps, and influenza) require the development of new or next-generation vaccines. The global aging of the population, and accumulating numbers of immunocompromised persons, will require new vaccine and adjuvant development to protect large segments of the population. After vaccine development, significant challenges remain globally in the cost and efficient use and acceptance of vaccines by the public. This article raises issues in these two areas and suggests a way forward that will benefit current and future generations. [ABSTRACT FROM AUTHOR]

Published
2016
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9. Rapid decline in vaccine-boosted neutralizing antibodies against SARS-CoV-2 Omicron variant

Author

Lyke, Kirsten E., Atmar, Robert L., Islas, Clara Dominguez, Posavad, Christine M., Szydlo, Daniel, Paul Chourdhury, Rahul, Deming, Meagan E., Eaton, Amanda, Jackson, Lisa A., Branche, Angela R., El Sahly, Hana M., Rostad, Christina A., Martin, Judith M., Johnston, Christine, Rupp, Richard E., Mulligan, Mark J., Brady, Rebecca C., Frenck, Robert W., Bäcker, Martín, Kottkamp, Angelica C., Babu, Tara M., Rajakumar, Kumaravel, Edupuganti, Srilatha, Dobrzynski, David, Coler, Rhea N., Archer, Janet I., Crandon, Sonja, Zemanek, Jillian A., Brown, Elizabeth R., Neuzil, Kathleen M., Stephens, David S., Post, Diane J., Nayak, Seema U., Suthar, Mehul S., Roberts, Paul C., Beigel, John H., Montefiori, David C., Husson, Jennifer S., Price, Angie, Whitaker, Jennifer A., Keitel, Wendy A., Falsey, Ann R., Shannon, Ian, Graciaa, Daniel, Rouphael, Nadine, Anderson, Evan J., Kamidani, Satoshi, Muniz, Gysella B., Bhatnagar, Sonika, Wald, Anna, Berman, Megan, Porterfield, Laura, Stanford, Amber, Dong, Jennifer Lee, Carsons, Steven E., Badillo, Diana, Parker, Susan, Dickey, Michelle, Larsen, Sasha E., Hural, John, Ingersoll, Brian, Lee, Marina, Lai, Lilin, Floyd, Katharine, Ellis, Madison, Moore, Kathryn M., Manning, Kelly, Foster, Stephanie L., and Patel, Mit

Abstract

The Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exhibits reduced susceptibility to vaccine-induced neutralizing antibodies, requiring a boost to generate protective immunity. We assess the magnitude and short-term durability of neutralizing antibodies after homologous and heterologous boosting with mRNA and Ad26.COV2.S vaccines. All prime-boost combinations substantially increase the neutralization titers to Omicron, although the boosted titers decline rapidly within 2 months from the peak response compared with boosted titers against the prototypic D614G variant. Boosted Omicron neutralization titers are substantially higher for homologous mRNA vaccine boosting, and for heterologous mRNA and Ad26.COV2.S vaccine boosting, compared with homologous Ad26.COV2.S boosting. Homologous mRNA vaccine boosting generates nearly equivalent neutralizing activity against Omicron sublineages BA.1, BA.2, and BA.3 but modestly reduced neutralizing activity against BA.2.12.1 and BA.4/BA.5 compared with BA.1. These results have implications for boosting requirements to protect against Omicron and future variants of SARS-CoV-2. This trial was conducted under ClincalTrials.gov: NCT04889209.

Published
2022
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10. Determinants of Tuberculosis Infection Control–Related Behaviors Among Healthcare Workers in the Country of Georgia

Author

Mirtskhulava, Veriko, Whitaker, Jennifer A., Kipiani, Maia, Harris, Drew A., Tabagari, Nino, Owen-Smith, Ashli A., Kempker, Russell R., and Blumberg, Henry M.

Abstract

OBJECTIVETo better understand tuberculosis (TB) infection control (IC) in healthcare facilities (HCFs) in Georgia.DESIGNA cross-sectional evaluation of healthcare worker (HCW) knowledge, beliefs and behaviors toward TB IC measures including latent TB infection (LTBI) screening and treatment of HCWs.SETTINGGeorgia, a high-burden multidrug-resistant TB (MDR-TB) country.PARTICIPANTSHCWs from the National TB Program and affiliated HCFs.METHODSAn anonymous self-administered 55-question survey developed based on the Health Belief Model (HBM) conceptual framework.RESULTSIn total, 240 HCWs (48% physicians; 39% nurses) completed the survey. The overall average TB knowledge score was 61%. Only 60% of HCWs reported frequent use of respirators when in contact with TB patients. Only 52% of HCWs were willing to undergo annual LTBI screening; 48% were willing to undergo LTBI treatment. In multivariate analysis, HCWs who worried about acquiring MDR-TB infection (adjusted odds ratio [aOR], 1.7; 95% confidence interval [CI], 1.28–2.25), who thought screening contacts of TB cases is important (aOR, 3.4; 95% CI, 1.35–8.65), and who were physicians (aOR, 1.7; 95% CI, 1.08–2.60) were more likely to accept annual LTBI screening. With regard to LTBI treatment, HCWs who worked in an outpatient TB facility (aOR, 0.3; 95% CI, 0.11–0.58) or perceived a high personal risk of TB reinfection (aOR, 0.5; 95% CI, 0.37–0.64) were less likely to accept LTBI treatment.CONCLUSIONThe concern about TB reinfection is a major barrier to HCW acceptance of LTBI treatment. TB IC measures must be strengthened in parallel with or prior to the introduction of LTBI screening and treatment of HCWs.Infect Control Hosp Epidemiol2015;00(0): 1–7

Published
2015
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11. Immunogenicity of a Recombinant Herpes Zoster Vaccine in Patients with Chronic Lymphocytic Leukemia

Author

Muchtar, Eli, Koehler, Amber, Johnson, Michael J, Rabe, Kari G, Ding, Wei, Call, Timothy G., Leis, Jose F., Kenderian, Saad S., Hayman, Suzanne R., Wang, Yucai, Hampel, Paul J., Holets, Mathew, Darby, Heather C, Slager, Susan L., Kay, Neil E., Whitaker, Jennifer A, Levin, Myron, Kennedy, Richard, Weinberg, Adriana, and Parikh, Sameer A.

Abstract

Johnson: GSK: Research Funding. Ding:Abbvie: Research Funding; Astra Zeneca: Research Funding; DTRM: Research Funding; alexion: Membership on an entity's Board of Directors or advisory committees; MEI Pharma: Membership on an entity's Board of Directors or advisory committees; Octapharma: Membership on an entity's Board of Directors or advisory committees; Merck: Membership on an entity's Board of Directors or advisory committees, Research Funding; Beigene: Membership on an entity's Board of Directors or advisory committees. Kenderian:Humanigen: Consultancy, Patents & Royalties, Research Funding; Torque: Consultancy; Novartis: Patents & Royalties, Research Funding; Kite: Research Funding; Gilead: Research Funding; Juno: Research Funding; BMS: Research Funding; Tolero: Research Funding; Mettaforge: Patents & Royalties; Lentigen: Research Funding; MorphoSys: Research Funding; Sunesis: Research Funding. Wang:Novartis: Research Funding; Incyte: Research Funding; Innocare: Research Funding. Kay:Juno Theraputics: Membership on an entity's Board of Directors or advisory committees; Oncotracker: Membership on an entity's Board of Directors or advisory committees; Dava Oncology: Membership on an entity's Board of Directors or advisory committees; Rigel: Membership on an entity's Board of Directors or advisory committees; Morpho-sys: Membership on an entity's Board of Directors or advisory committees; Cytomx: Membership on an entity's Board of Directors or advisory committees; Agios Pharma: Membership on an entity's Board of Directors or advisory committees; Astra Zeneca: Membership on an entity's Board of Directors or advisory committees; Sunesis: Research Funding; Abbvie: Research Funding; MEI Pharma: Research Funding; Pharmacyclics: Membership on an entity's Board of Directors or advisory committees, Research Funding; Acerta Pharma: Research Funding; Tolero Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees, Research Funding; Bristol Meyer Squib: Membership on an entity's Board of Directors or advisory committees, Research Funding. Levin:GSK: Research Funding. Kennedy:ICW Ventures: Research Funding. Weinberg:GSK: Research Funding. Parikh:GlaxoSmithKline: Honoraria; AstraZeneca: Honoraria, Research Funding; Janssen: Honoraria, Research Funding; TG Therapeutics: Research Funding; Merck: Research Funding; AbbVie: Honoraria, Research Funding; MorphoSys: Research Funding; Verastem Oncology: Honoraria; Pharmacyclics: Honoraria, Research Funding; Genentech: Honoraria; Ascentage Pharma: Research Funding.

Published
2020
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12. Immunogenicity of a Recombinant Herpes Zoster Vaccine in Patients with Chronic Lymphocytic Leukemia

Author

Muchtar, Eli, Koehler, Amber, Johnson, Michael J, Rabe, Kari G, Ding, Wei, Call, Timothy G., Leis, Jose F., Kenderian, Saad S., Hayman, Suzanne R., Wang, Yucai, Hampel, Paul J., Holets, Mathew, Darby, Heather C, Slager, Susan L., Kay, Neil E., Whitaker, Jennifer A, Levin, Myron, Kennedy, Richard, Weinberg, Adriana, and Parikh, Sameer A.

Abstract

Introduction:In 2017, a two-dose recombinant zoster vaccine (RZV) containing glycoprotein E (gE) and a novel adjuvant was approved to prevent herpes zoster and its complications in adults ≥50 years of age in the US. There are limited data on the immunogenicity and safety of RZV in patients with chronic lymphocytic leukemia (CLL).

Published
2020
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14. Book briefs

Author

Kaynak, Erdener, O'Neill, Onora, Cheema, G Shabbir, Rondinelli, Dennis, Cassen, Robert, Hyden, Goran, Berg, Robert, Whitaker, Jennifer Seymour, Collier, Paul, and Lal, Deepak

Abstract

World food marketing systems, Butterworth & Co, London, 1986.Faces of hunger. An essay on poverty, justice and development, Studies in applied philosophy, Allen & Unwin, London, 1986. xiii + 178, distributed in South Africa by MacMillan South Africa, Braamfontein.Decentralization and development - Policy implementation in developing countries, Sage Publications, London, 1983, 319 ppSoviet interests in the Third World, Sage Publications, London, 1985, xi + 329 ppNo shortcuts to progress - African development management in perspective, Heinemann Educational Books Ltd, London, 1983, xv + 223 pp.Strategies for African Development, University of California Press, London, 1986, xii + 603 pp.Labour and poverty In Kenya 1900-1980, Clarendon Press, Oxford, 1986, xii + 296, £20,00

Published
1987
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15. Efficacy of interferon beta-1a plus remdesivir compared with remdesivir alone in hospitalised adults with COVID-19: a double-bind, randomised, placebo-controlled, phase 3 trial

Author

Kalil, Andre C, Mehta, Aneesh K, Patterson, Thomas F, Erdmann, Nathaniel, Gomez, Carlos A, Jain, Mamta K, Wolfe, Cameron R, Ruiz-Palacios, Guillermo M, Kline, Susan, Regalado Pineda, Justino, Luetkemeyer, Anne F, Harkins, Michelle S, Jackson, Patrick E H, Iovine, Nicole M, Tapson, Victor F, Oh, Myoung-don, Whitaker, Jennifer A, Mularski, Richard A, Paules, Catharine I, Ince, Dilek, Takasaki, Jin, Sweeney, Daniel A, Sandkovsky, Uriel, Wyles, David L, Hohmann, Elizabeth, Grimes, Kevin A, Grossberg, Robert, Laguio-Vila, Maryrose, Lambert, Allison A, Lopez de Castilla, Diego, Kim, EuSuk, Larson, LuAnn, Wan, Claire R, Traenkner, Jessica J, Ponce, Philip O, Patterson, Jan E, Goepfert, Paul A, Sofarelli, Theresa A, Mocherla, Satish, Ko, Emily R, Ponce de Leon, Alfredo, Doernberg, Sarah B, Atmar, Robert L, Maves, Ryan C, Dangond, Fernando, Ferreira, Jennifer, Green, Michelle, Makowski, Mat, Bonnett, Tyler, Beresnev, Tatiana, Ghazaryan, Varduhi, Dempsey, Walla, Nayak, Seema U, Dodd, Lori, Tomashek, Kay M, Beigel, John H, Hewlett, Angela, Taylor, Barbara S, Bowling, Jason E, Serrano, Ruth C, Rouphael, Nadine G, Wiley, Zanthia, Phadke, Varun K, Certain, Laura, Imlay, Hannah N, Engemann, John J, Walter, Emmanuel B, Meisner, Jessica, Rajme, Sandra, Billings, Joanne, Kim, Hyun, Martinez-Orozco, Jose A, Bautista Felix, Nora, Elmor, Sammy T, Bristow, Laurel R, Mertz, Gregory, Sosa, Nestor, Bell, Taison D, West, Miranda J, Elie-Turenne, Marie-Carmelle, Grein, Jonathan, Sutterwala, Fayyaz, Gyun Choe, Pyoeng, Kyung Kang, Chang, El Sahly, Hana M, Rhie, Kevin S, Hussein, Rezhan H, Winokur, Patricia L, Mikami, Ayako, Saito, Sho, Benson, Constance A, McConnell, Kimberly, Berhe, Mezgebe, Dishner, Emma, Frank, Maria G, Sarcone, Ellen, Crouch, Pierre-Cedric B, Jang, Hannah, Jilg, Nikolaus, Perez, Katherine, Janak, Charles, Cantos, Valeria D, Rebolledo, Paulina A, Gharbin, John, Zingman, Barry S, Riska, Paul F, Falsey, Ann R, Walsh, Edward E, Branche, Angela R, Arguinchona, Henry, Arguinchona, Christa, Van Winkle, Jason W, Zea, Diego F, Jung, Jongtak, Song, Kyoung-Ho, Kim, Hong Bin, Dwyer, Jay, Bainbridge, Emma, Hostler, David C, Hostler, Jordanna M, Shahan, Brian T, Hsieh, Lanny, Amin, Alpesh N, Watanabe, Miki, Short, William R, Tebas, Pablo, Baron, Jillian T, Ahuja, Neera, Ling, Evelyn, Go, Minjoung, Yang, Otto O, Ahn, Jenny, Arias, Rubi, Rapaka, Rekha R, Hubbard, Fleesie A, Campbell, James D, Cohen, Stuart H, Thompson, George R, Chakrabarty, Melony, Taylor, Stephanie N, Masri, Najy, Lacour, Alisha, Lee, Tida, Lalani, Tahaniyat, Lindholm, David A, Markelz, Ana Elizabeth, Mende, Katrin, Colombo, Christopher J, Schofield, Christina, Colombo, Rhonda E, Guirgis, Faheem, Holodniy, Mark, Chary, Aarthi, Bessesen, Mary, Hynes, Noreen A, Sauer, Lauren M, Marconi, Vincent C, Moanna, Abeer, Harrison, Telisha, Lye, David C, Ong, Sean W X, Ying Chia, Po, Huprikar, Nikhil, Ganesan, Anuradha, Madar, Christian, Novak, Richard M, Wendrow, Andrea, Borgetti, Scott A, George, Sarah L, Hoft, Daniel F, Brien, James D, McLellan, Susan L F, Levine, Corri, Nock, Joy, Yen Tan, Seow, Shafi, Humaira, Chien, Jaime M F, Candiotti, Keith, Finberg, Robert W, Wang, Jennifer P, Wessolossky, Mireya, Utz, Gregory C, Chambers, Susan E, Stephens, David S, Burgess, Timothy H, Rozman, Julia, Hyvert, Yann, Seitzinger, Andrea, Osinusi, Anu, Cao, Huyen, Chung, Kevin K, Conrad, Tom M, Cross, Kaitlyn, El-Khorazaty, Jill A, Hill, Heather, Pettibone, Stephanie, Wierzbicki, Michael R, Gettinger, Nikki, Engel, Theresa, Lewis, Teri, Wang, Jing, Deye, Gregory A, Nomicos, Effie, Pikaart-Tautges, Rhonda, Elsafy, Mohamed, Jurao, Robert, Koo, Hyung, Proschan, Michael, Davey, Richard, Yokum, Tammy, Arega, Janice, and Florese, Ruth

Abstract

Functional impairment of interferon, a natural antiviral component of the immune system, is associated with the pathogenesis and severity of COVID-19. We aimed to compare the efficacy of interferon beta-1a in combination with remdesivir compared with remdesivir alone in hospitalised patients with COVID-19.

Published
2021
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16. Bigger savings from biogas.

Author

Rohrbacher, Joe, Lisk, Bryan, Szoch, Christopher, Bullard, C. Michael, Whitaker, Jennifer, Wichser, Robert, and Frederick, Thomas

Subjects
WATER utilities, SEWAGE disposal plants, ENERGY conservation
Abstract

The article discusses improvements made by the Rivanna Water and Sewer Authority (RWSA) to the Moores Creek Wastewater Treatment Plant (WWTP) in Charlottesville, Virginia to achieve significant energy savings and improve treatment performance. It outlines alternative options for biogas use considered by RWSA including the installation of a combined heat and power system. The way the enhancements benefited the nutrient removal performance of the facility is described.

Published
2012

17. Comparison of the QuantiFERON-TB Gold Plus and QuantiFERON-TB Gold In-Tube Interferon Gamma Release Assays in Patients at Risk for Tuberculosis and in Health Care Workers

Author

Theel, Elitza S., Hilgart, Heather, Breen-Lyles, Margaret, McCoy, Kevin, Flury, Rhiannon, Breeher, Laura E., Wilson, John, Sia, Irene G., Whitaker, Jennifer A., Clain, Jeremy, Aksamit, Timothy R., and Escalante, Patricio

Abstract

ABSTRACTThe QuantiFERON-TB Gold Plus (QFT-Plus; Qiagen, Germantown, MD) interferon gamma release assay (IGRA) received FDA clearance in 2017 and will replace the prior version of the assay, the QFT-Gold In-Tube (QFT-GIT). Here, we compared performances of the QFT-Plus assay and the QFT-GIT version in a diverse patient population, including patients undergoing evaluation for or follow-up of latent tuberculosis infection (LTBI; n= 39) or active TB infection (n= 3), and in health care workers (HCWs; n= 119) at Mayo Clinic (Rochester, MN). Compared to the QFT-GIT, the QFT-Plus assay showed 91.2% (31/34) positive, 98.4% (124/126) negative, and 96.6% (156/161) overall qualitative agreement among the 161 enrolled subjects, with a Cohen's kappa value of 0.91 (excellent interrater agreement). Among the 28 patients diagnosed with LTBI at the time of enrollment, the QFT-GIT and QFT-Plus assays agreed in 24 (85.7%) patients; in all four discordant patients, the positivity of the QFT-GIT or QFT-Plus IGRA was associated with low-level interferon gamma (IFN-?) reactivity, ranging from 0.36 IU/ml to 0.66 IU/ml. Additionally, we document a high degree of correlation between IFN-? levels in the QFT-GIT TB antigen tube and each of the two QFT-Plus TB antigen tubes, as well as between the QFT-Plus TB1 and TB2 tubes (Pearson's correlation coefficients [R] > 0.95). Overall, we show comparable results between the QFT-GIT and QFT-Plus assays in our study population composed of subjects presenting with a diverse spectrum of TB infections. Our findings suggest that the necessary transition to the QFT-Plus assay will be associated with a minimal difference in assay performance characteristics.

Published
2018
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18. STORY THAT BEGINS AND ENDS WITH BURNING.

Author

Whitaker, Jennifer

Subjects
STORY That Begins & Ends With Burning (Poem), WHITAKER, Jennifer
Abstract

The poem "STORY THAT BEGINS AND ENDS WITH BURNING" by Jennifer Whitaker is presented. First Line: Help, as usual, arrived too late. In jugs slung across; Last Line: smoldering but whole, was still there to be opened.

Published
2015

19. Aminoglycoside-Resistant Aeromonas hydrophilaas Part of a Polymicrobial Infection following a Traumatic Fall into Freshwater

Author

Shak, Joshua R., Whitaker, Jennifer A., Ribner, Bruce S., and Burd, Eileen M.

Abstract

ABSTRACTAmikacin is a first-line treatment for Aeromonasinfection due to high efficacy. There are few reports of aminoglycoside-resistant Aeromonasspp. We report a soft tissue infection containing multiple pathogens, including a strain of Aeromonas hydrophilaresistant to amikacin, tobramycin, and multiple cephalosporins.

Published
2011
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20. Father as Distant Boat.

Author

Whitaker, Jennifer

Subjects
FATHER As Distant Boat (Poem), WHITAKER, Jennifer
Abstract

Presents the poem "Father as Distant Boat," by Jennifer Whitaker. First Line: Far across the lake, on the other shore, the family; Last Line: they'll leap from your edges like flames.

Published
2009

21. IN THE DICTIONARY OF BALLET TERMS.

Author

Whitaker, Jennifer

Subjects
IN the Dictionary of Ballet Terms (Poem), WHITAKER, Jennifer
Abstract

The poem "In the Dictionary of Ballet Terms" by Jennifer Whitaker is presented. First Line: there is a violence you can't imagine. Last Line: all my strange new words that spoke of home.

Published
2013

22. What to Wear to Father's Funeral.

Author

Whitaker, Jennifer

Subjects
WHAT to Wear to a Father's Funeral (Poem), WHITAKER, Jennifer
Abstract

Presents the poem "What to Wear to a Father's Funeral," by Jennifer Whitaker. First Line: A chain around your neck of fingernail moons; Last Line: tucked in deep, so that only the smallest corner shows.

Published
2010

23. Child as Pallid Bat in the Attic.

Author

Whitaker, Jennifer

Subjects
CHILD As Pallid Bat in the Attic (Poem), WHITAKER, Jennifer
Abstract

Presents the poem "Child as Pallid Bat in the Attic," by Jennifer Whitaker. First Line: One twilight it happened: Crawling into the house; Last Line: of the trap, you find a thing to feed on in the dark.

Published
2010

24. Understanding Harvest.

Author

Whitaker, Jennifer

Subjects
UNDERSTANDING Harvest (Poem), WHITAKER, Jennifer
Abstract

Presents the poem "Understanding Harvest," by Jennifer Whitaker. First Line: First, make it September. Last Line: the veil from the loom.

Published
2005

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