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1. A qualitative evaluation of frontline clinician perspectives toward antibiotic stewardship programs.

Author

Tjilos, Maria, Drainoni, Mari-Lynn, Burrowes, Shana AB, Butler, Jorie M, Damschroder, Laura J, Bidwell Goetz, Matthew, Madaras-Kelly, Karl, Reardon, Caitlin M, Samore, Matthew H, Shen, Jincheng, Stenehjem, Edward A, Zhang, Yue, and Barlam, Tamar F

Subjects
Health Services and Systems, Nursing, Health Sciences, Clinical Research, Clinical Trials and Supportive Activities, Medical and Health Sciences, Epidemiology, Biomedical and clinical sciences, Health sciences
Abstract

ObjectiveTo examine the perspectives of caregivers that are not part of the antibiotic stewardship program (ASP) leadership team (eg, physicians, nurses, and clinical pharmacists), but who interact with ASPs in their role as frontline healthcare workers.DesignQualitative semistructured interviews.SettingThe study was conducted in 2 large national healthcare systems including 7 hospitals in the Veterans' Health Administration and 4 hospitals in Intermountain Healthcare.ParticipantsWe interviewed 157 participants. The current analysis includes 123 nonsteward clinicians: 47 physicians, 26 pharmacists, 29 nurses, and 21 hospital leaders.MethodsInterviewers utilized a semistructured interview guide based on the Consolidated Framework for Implementation Research (CFIR), which was tailored to the participant's role in the hospital as it related to ASPs. Qualitative analysis was conducted using a codebook based on the CFIR.ResultsWe identified 4 primary perspectives regarding ASPs. (1) Non-ASP pharmacists considered antibiotic stewardship activities to be a high priority despite the added burden to work duties: (2) Nurses acknowledged limited understanding of ASP activities or involvement with these programs; (3) Physicians criticized ASPs for their restrictions on clinical autonomy and questioned the ability of antibiotic stewards to make recommendations without the full clinical picture; And (4) hospital leaders expressed support for ASPs and recognized the unique challenges faced by non-ASP clinical staff.ConclusionFurther understanding these differing perspectives of ASP implementation will inform possible ways to improve ASP implementation across clinical roles.

Published
2023

2. Survey of physician and pharmacist steward perceptions of their antibiotic stewardship programs

Author

Burrowes, Shana AB, Drainoni, Mari-Lynn, Tjilos, Maria, Butler, Jorie M, Damschroder, Laura J, Goetz, Matthew Bidwell, Madaras-Kelly, Karl, Reardon, Caitlin M, Samore, Matthew H, Shen, Jincheng, Stenehjem, Edward, Zhang, Yue, and Barlam, Tamar F

Subjects
Health Services and Systems, Health Sciences, Clinical Research, Good Health and Well Being, antbiotic stewardship, pharmacist stewards, volunteer stewards
Abstract

ObjectiveTo examine how individual steward characteristics (eg, steward role, sex, and specialized training) are associated with their views of antimicrobial stewardship program (ASP) implementation at their institution.DesignDescriptive survey from a mixed-methods study.SettingTwo large national healthcare systems; the Veterans' Health Administration (VA) (n = 134 hospitals) and Intermountain Healthcare (IHC; n = 20 hospitals).ParticipantsWe sent the survey to 329 antibiotic stewards serving in 154 hospitals; 152 were physicians and 177 were pharmacists. In total, 118 pharmacists and 64 physicians from 126 hospitals responded.MethodsThe survey was grounded in constructs of the Consolidated Framework for Implementation Research, and it assessed stewards' views on the development and implementation of antibiotic stewardship programs (ASPs) at their institutions We then examined differences in stewards' views by demographic factors.ResultsRegardless of individual factors, stewards agreed that the ASP added value to their institution and was advantageous to patient care. Stewards also reported high levels of collegiality and self-efficacy. Stewards who had specialized training or those volunteered for the role were less likely to think that the ASP was implemented due to a mandate. Similarly volunteers and those with specialized training felt that they had authority in the antibiotic decisions made in their facility.ConclusionsGiven the importance of ASPs, it may be beneficial for healthcare institutions to recruit and train individuals with a true interest in stewardship.

Published
2021

3. Number needed to vaccinate with a COVID-19 booster to prevent a COVID-19-associated hospitalization during SARS-CoV-2 Omicron BA.1 variant predominance, December 2021–February 2022, VISION Network: a retrospective cohort study

Author

Adams, Katherine, Riddles, John J., Rowley, Elizabeth A.K., Grannis, Shaun J., Gaglani, Manjusha, Fireman, Bruce, Hartmann, Emily, Naleway, Allison L., Stenehjem, Edward, Hughes, Alexandria, Dalton, Alexandra F., Natarajan, Karthik, Dascomb, Kristin, Raiyani, Chandni, Irving, Stephanie A., Sloan-Aagard, Chantel, Kharbanda, Anupam B., DeSilva, Malini B., Dixon, Brian E., Ong, Toan C., Keller, Jean, Dickerson, Monica, Grisel, Nancy, Murthy, Kempapura, Nanez, Juan, Fadel, William F., Ball, Sarah W., Patel, Palak, Arndorfer, Julie, Mamawala, Mufaddal, Valvi, Nimish R., Dunne, Margaret M., Griggs, Eric P., Embi, Peter J., Thompson, Mark G., Link-Gelles, Ruth, and Tenforde, Mark W.

Published
2023
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4. Perspectives of Physician and Pharmacist Stewards on Successful Antibiotic Stewardship Program Implementation: A Qualitative Study

Author

Barlam, Tamar F, Childs, Ellen, Zieminski, Sarah A, Meshesha, Tsega M, Jones, Kathryn E, Butler, Jorie M, Damschroder, Laura J, Goetz, Matthew Bidwell, Madaras-Kelly, Karl, Reardon, Caitlin M, Samore, Matthew H, Shen, Jincheng, Stenehjem, Edward, Zhang, Yue, and Drainoni, Mari-Lynn

Subjects
Medical Microbiology, Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, antibiotic resistance, antibiotic stewardship, infectious diseases, infection prevention, Clinical sciences, Medical microbiology
Abstract

BackgroundAntibiotic stewardship programs (ASPs) are required at every hospital regardless of size. We conducted a qualitative study across different hospital settings to examine perspectives of physician and pharmacist stewards about the dynamics within their team and contextual factors that facilitate the success of their programs.MethodsSemistructured interviews were conducted in March-November 2018 with 46 ASP stewards, 30 pharmacists, and 16 physicians, from 39 hospitals within 2 large hospital systems.ResultsWe identified 5 major themes: antibiotic stewards were enthusiastic about their role, committed to the goals of stewardship for their patients and as a public-health imperative, and energized by successful interventions; responsibilities of pharmacist and physician stewards are markedly different, and pharmacy stewards performed the majority of the day-to-day stewardship work; collaborative teamwork is important to improving care, the pharmacists and physicians supported each other, and pharmacists believed that having a strong physician leader was essential; provider engagement strategies are a critical component of stewardship, and recommendations must be communicated in a collegial manner that did not judge the provider competence, preferably through face-to-face interactions; and hospital leadership support for ASP goals and for protected time for ASP activities is critical for success.ConclusionsThe physician-pharmacist team is essential for ASPs; most have pharmacists leading and performing day-to-day activities with physician support. Collaborative, persuasive approaches for ASP interventions were the norm. Stewards were careful not to criticize or judge inappropriate antibiotic prescribing. Further research should examine whether this persuasive approach undercuts provider appreciation of stewardship as a public health mandate.

Published
2020

5. Effectiveness of COVID-19 vaccines at preventing emergency department or urgent care encounters and hospitalizations among immunocompromised adults: An observational study of real-world data across 10 US states from August-December 2021

Author

Embi, Peter J., Levy, Matthew E., Patel, Palak, DeSilva, Malini B., Gaglani, Manjusha, Dascomb, Kristin, Dunne, Margaret M., Klein, Nicola P., Ong, Toan C., Grannis, Shaun J., Natarajan, Karthik, Yang, Duck-Hye, Stenehjem, Edward, Zerbo, Ousseny, McEvoy, Charlene, Rao, Suchitra, Thompson, Mark G., Konatham, Deepika, Irving, Stephanie A., Dixon, Brian E., Han, Jungmi, Schrader, Kristin E., Grisel, Nancy, Lewis, Ned, Kharbanda, Anupam B., Barron, Michelle A., Reynolds, Sue, Liao, I-Chia, Fadel, William F., Rowley, Elizabeth A., Arndorfer, Julie, Goddard, Kristin, Murthy, Kempapura, Valvi, Nimish R., Weber, Zachary A., Fireman, Bruce, Reese, Sarah E., Ball, Sarah W., and Naleway, Allison L.

Published
2023
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6. Effectiveness and Safety of an Emergency Department Code Sepsis Protocol: A Pragmatic Clinical Trial.

Author

Peltan, Ithan D., Bledsoe, Joseph R., Jacobs, Jason R., Groat, Danielle, Klippel, Carolyn, Adamson, Michelle, Hooper, Gabriel A., Tinker, Nick J., Foster, Rachel A., Stenehjem, Edward A., Moores Todd, Tamara D., Balls, Adam, Avery, Jennifer, Brunson, Gary, Jones, Jon, Bair, Jeremy, Dorais, Andrew, Samore, Matthew H., Hough, Catherine L., and Brown, Samuel M.

Subjects
CORONAVIRUS disease treatment, SEPSIS, HOSPITAL emergency services
Abstract

Rationale: Sepsis care delivery—including the initiation of prompt, appropriate antimicrobials—remains suboptimal. Objectives: This study was conducted to determine direct and off-target effects of emergency department (ED) sepsis care reorganization. Methods: This pragmatic pilot trial enrolled adult patients who presented from November 2019 to February 2021 to an ED in Utah before and after implementation of a multimodal, team-based "Code Sepsis" protocol. Patients who presented to two other EDs where usual care was continued served as contemporaneous control subjects. The primary outcome was door-to-antimicrobial time among patients meeting Sepsis-3 criteria before ED departure. Secondary and safety outcomes included all-cause 30-day mortality, antimicrobial utilization and overtreatment, and antimicrobial-associated adverse events. Multivariable regression analyses used difference-in-differences methods to account for trends in outcomes unrelated to the studied intervention. Results: Code Sepsis protocol activation (N = 307) exhibited 8.5% sensitivity and 66% positive predictive value for patients meeting sepsis criteria before ED departure. Among 10,151 patients who met sepsis criteria during the study, adjusted difference-in-differences analysis demonstrated a 13-minute (95% confidence interval = 7–19) decrease in door-to-antimicrobial time associated with Code Sepsis implementation (P < 0.001). Mortality and clinical safety outcomes were unchanged, but Code Sepsis implementation was associated with increased false-positive presumptive infection diagnoses among patients who met sepsis criteria in the ED and increased antimicrobial utilization. Conclusions: Implementation of a team-based protocol for rapid sepsis evaluation and treatment during the coronavirus disease (COVID-19) pandemic's first year was associated with decreased ED door-to-antimicrobial time but also increased antimicrobial utilization. Measurement of both patient-centered and off-target effects of sepsis care improvement interventions is essential to comprehensive assessment of their value. Clinical trial registered with (NCT 04148989). [ABSTRACT FROM AUTHOR]

Published
2024
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7. Effectiveness of two-dose vaccination with mRNA COVID-19 vaccines against COVID-19–associated hospitalizations among immunocompromised adults—Nine States, January–September 2021

Author

Embi, Peter J., Levy, Matthew E., Naleway, Allison L., Patel, Palak, Gaglani, Manjusha, Natarajan, Karthik, Dascomb, Kristin, Ong, Toan C., Klein, Nicola P., Liao, I-Chia, Grannis, Shaun J., Han, Jungmi, Stenehjem, Edward, Dunne, Margaret M., Lewis, Ned, Irving, Stephanie A., Rao, Suchitra, McEvoy, Charlene, Bozio, Catherine H., Murthy, Kempapura, Dixon, Brian E., Grisel, Nancy, Yang, Duck-Hye, Goddard, Kristin, Kharbanda, Anupam B., Reynolds, Sue, Raiyani, Chandni, Fadel, William F., Arndorfer, Julie, Rowley, Elizabeth A., Fireman, Bruce, Ferdinands, Jill, Valvi, Nimish R., Ball, Sarah W., Zerbo, Ousseny, Griggs, Eric P., Mitchell, Patrick K., Porter, Rachael M., Kiduko, Salome A., Blanton, Lenee, Zhuang, Yan, Steffens, Andrea, Reese, Sarah E., Olson, Natalie, Williams, Jeremiah, Dickerson, Monica, McMorrow, Meredith, Schrag, Stephanie J., Verani, Jennifer R., Fry, Alicia M., Azziz-Baumgartner, Eduardo, Barron, Michelle A., Thompson, Mark G., and DeSilva, Malini B.

Published
2022
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12. Risk of COVID‐19 Hospitalization and Protection Associated With mRNA Vaccination Among US Adults With Psychiatric Disorders.

Author

Levy, Matthew E., Yang, Duck‐Hye, Dunne, Margaret M., Miley, Kathleen, Irving, Stephanie A., Grannis, Shaun J., Weber, Zachary A., Griggs, Eric P., Spark, Talia L., Bassett, Elizabeth, Embi, Peter J., Gaglani, Manjusha, Natarajan, Karthik, Valvi, Nimish R., Ong, Toan C., Naleway, Allison L., Stenehjem, Edward, Klein, Nicola P., Link‐Gelles, Ruth, and DeSilva, Malini B.

Abstract

Background: Although psychiatric disorders have been associated with reduced immune responses to other vaccines, it remains unknown whether they influence COVID‐19 vaccine effectiveness (VE). This study evaluated risk of COVID‐19 hospitalization and estimated mRNA VE stratified by psychiatric disorder status. Methods: In a retrospective cohort analysis of the VISION Network in four US states, the rate of laboratory‐confirmed COVID‐19‐associated hospitalization between December 2021 and August 2022 was compared across psychiatric diagnoses and by monovalent mRNA COVID‐19 vaccination status using Cox proportional hazards regression. Results: Among 2,436,999 adults, 22.1% had ≥1 psychiatric disorder. The incidence of COVID‐19‐associated hospitalization was higher among patients with any versus no psychiatric disorder (394 vs. 156 per 100,000 person‐years, p < 0.001). Any psychiatric disorder (adjusted hazard ratio [aHR], 1.27; 95% CI, 1.18–1.37) and mood (aHR, 1.25; 95% CI, 1.15–1.36), anxiety (aHR, 1.33, 95% CI, 1.22–1.45), and psychotic (aHR, 1.41; 95% CI, 1.14–1.74) disorders were each significant independent predictors of hospitalization. Among patients with any psychiatric disorder, aHRs for the association between vaccination and hospitalization were 0.35 (95% CI, 0.25–0.49) after a recent second dose, 0.08 (95% CI, 0.06–0.11) after a recent third dose, and 0.33 (95% CI, 0.17–0.66) after a recent fourth dose, compared to unvaccinated patients. Corresponding VE estimates were 65%, 92%, and 67%, respectively, and were similar among patients with no psychiatric disorder (68%, 92%, and 79%). Conclusion: Psychiatric disorders were associated with increased risk of COVID‐19‐associated hospitalization. However, mRNA vaccination provided similar protection regardless of psychiatric disorder status, highlighting its benefit for individuals with psychiatric disorders. [ABSTRACT FROM AUTHOR]

Published
2024
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13. Vaccine Effectiveness of the Original Monovalent COVID-19 Vaccines in preventing Emergency Department or Urgent Care Encounters and Hospitalizations among Adults with Disabilities: VISION Network, June 2021-September 2022

Author

Patel, Palak, primary, Schrader, Kristin E, additional, Rice, Catherine E, additional, Rowley, Elizabeth, additional, Cree, Robyn A, additional, DeSilva, Malini B, additional, Embi, Peter J, additional, Gaglani, Manjusha, additional, Grannis, Shaun J, additional, Ong, Toan C, additional, Stenehjem, Edward, additional, Naleway, Allison L, additional, Ball, Sarah, additional, Natarajan, Karthik, additional, Klein, Nicola P, additional, Adams, Katherine, additional, Kharbanda, Anupam, additional, Ray, Caitlin, additional, Link-Gelles, Ruth, additional, and Tenforde, Mark W, additional

Published
2023
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17. Reply to Buetti et al

Author

Stenehjem, Edward, Hersh, Adam L., and Pavia, Andrew T.

Published
2017

19. Clinical Epidemiology and Risk Factors for Critical Outcomes Among Vaccinated and Unvaccinated Adults Hospitalized With Coronavirus Disease 2019—VISION Network, 10 States, June 2021–March 2023

Author

Griggs, Eric P, primary, Mitchell, Patrick K, additional, Lazariu, Victoria, additional, Gaglani, Manjusha, additional, McEvoy, Charlene, additional, Klein, Nicola P, additional, Valvi, Nimish R, additional, Irving, Stephanie A, additional, Kojima, Noah, additional, Stenehjem, Edward, additional, Crane, Bradley, additional, Rao, Suchitra, additional, Grannis, Shaun J, additional, Embi, Peter J, additional, Kharbanda, Anupam B, additional, Ong, Toan C, additional, Natarajan, Karthik, additional, Dascomb, Kristin, additional, Naleway, Allison L, additional, Bassett, Elizabeth, additional, DeSilva, Malini B, additional, Dickerson, Monica, additional, Konatham, Deepika, additional, Fireman, Bruce, additional, Allen, Katie S, additional, Barron, Michelle A, additional, Beaton, Maura, additional, Arndorfer, Julie, additional, Vazquez-Benitez, Gabriela, additional, Garg, Shikha, additional, Murthy, Kempapura, additional, Goddard, Kristin, additional, Dixon, Brian E, additional, Han, Jungmi, additional, Grisel, Nancy, additional, Raiyani, Chandni, additional, Lewis, Ned, additional, Fadel, William F, additional, Stockwell, Melissa S, additional, Mamawala, Mufaddal, additional, Hansen, John, additional, Zerbo, Ousseny, additional, Patel, Palak, additional, Link-Gelles, Ruth, additional, Adams, Katherine, additional, and Tenforde, Mark W, additional

Published
2023
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20. Impact of an antibiotic stewardship initiative on urgent-care respiratory prescribing across patient race, ethnicity, and language

Author

Seibert, Allan M., Hersh, Adam L., Patel, Payal K., Hicks, Lauri A., Fino, Nora, Stanfield, Valoree, and Stenehjem, Edward A.

Abstract

AbstractWe conducted a post hoc analysis of an antibiotic stewardship intervention implemented across our health system’s urgent-care network to determine whether there was a differential impact among patient groups. Respiratory urgent-care antibiotic prescribing decreased for all racial, ethnic, and preferred language groups, but disparities in antibiotic prescribing persisted.

Published
2024
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21. Effectiveness of COVID-19 mRNA Vaccines Against COVID-19-Associated Hospitalizations Among Immunocompromised Adults During SARS-CoV-2 Omicron Predominance--VISION Network, 10 States, December 2021-August 2022

Author

Britton, Amadea, Embi, Peter J., Levy, Matthew E., Gaglani, Manjusha, DeSilva, Malini B., Dixon, Brian E., Dascomb, Kristin, Patel, Palak, Schrader, Kristin E., Klein, Nicola P., Ong, Toan C., Natarajan, Karthik, Hartmann, Emily, Kharbanda, Anupam B., Irving, Stephanie A., Dickerson, Monica, Dunne, Margaret M., Raiyani, Chandni, Grannis, Shaun J., Stenehjem, Edward, Zerbo, Ousseny, Rao, Suchitra, Han, Jungmi, Sloan-Aagard, Chantel, Griggs, Eric P., Weber, Zachary A., Murthy, Kempapura, Fadel, William F., Grisel, Nancy, McEvoy, Charlene, Lewis, Ned, Barron, Michelle A., Nanez, Juan, Reese, Sarah E., Mamawala, Mufaddal, Valvi, Nimish R., Arndorfer, Julie, Goddard, Kristin, Yang, Duck- Hye, Fireman, Bruce, Ball, Sarah W., Link-Gelles, Ruth, Naleway, Allison L., and Tenforde, Mark W.

Subjects
Vaccination, Messenger RNA, Adults, Vaccines, Health
Abstract

Persons with moderate-to-severe immunocompromising conditions might have reduced protection after COVID-19 vaccination, compared with persons without immunocompromising conditions (1-3). On August 13, 2021, the Advisory Committee on Immunization Practices (ACIP) [...]

Published
2022

22. Clinical Epidemiology and Risk Factors for Critical Outcomes Among Vaccinated and Unvaccinated Adults Hospitalized With COVID-19—VISION Network, 10 States, June 2021–March 2023.

Author

Griggs, Eric P, Mitchell, Patrick K, Lazariu, Victoria, Gaglani, Manjusha, McEvoy, Charlene, Klein, Nicola P, Valvi, Nimish R, Irving, Stephanie A, Kojima, Noah, Stenehjem, Edward, Crane, Bradley, Rao, Suchitra, Grannis, Shaun J, Embi, Peter J, Kharbanda, Anupam B, Ong, Toan C, Natarajan, Karthik, Dascomb, Kristin, Naleway, Allison L, and Bassett, Elizabeth

Subjects
MORTALITY risk factors, EVALUATION of medical care, INTENSIVE care units, RELATIVE medical risk, COVID-19, IMMUNIZATION, CONFIDENCE intervals, AGE distribution, PATIENTS, CATASTROPHIC illness, RISK assessment, HOSPITAL admission & discharge, HOSPITAL mortality, HOSPITAL care, VACCINATION status, COMORBIDITY, DISEASE complications, EVALUATION
Abstract

Background The epidemiology of coronavirus disease 2019 (COVID-19) continues to develop with emerging variants, expanding population-level immunity, and advances in clinical care. We describe changes in the clinical epidemiology of COVID-19 hospitalizations and risk factors for critical outcomes over time. Methods We included adults aged ≥18 years from 10 states hospitalized with COVID-19 June 2021–March 2023. We evaluated changes in demographics, clinical characteristics, and critical outcomes (intensive care unit admission and/or death) and evaluated critical outcomes risk factors (risk ratios [RRs]), stratified by COVID-19 vaccination status. Results A total of 60 488 COVID-19–associated hospitalizations were included in the analysis. Among those hospitalized, median age increased from 60 to 75 years, proportion vaccinated increased from 18.2% to 70.1%, and critical outcomes declined from 24.8% to 19.4% (all P <.001) between the Delta (June–December, 2021) and post-BA.4/BA.5 (September 2022–March 2023) periods. Hospitalization events with critical outcomes had a higher proportion of ≥4 categories of medical condition categories assessed (32.8%) compared to all hospitalizations (23.0%). Critical outcome risk factors were similar for unvaccinated and vaccinated populations; presence of ≥4 medical condition categories was most strongly associated with risk of critical outcomes regardless of vaccine status (unvaccinated: adjusted RR, 2.27 [95% confidence interval {CI}, 2.14–2.41]; vaccinated: adjusted RR, 1.73 [95% CI, 1.56–1.92]) across periods. Conclusions The proportion of adults hospitalized with COVID-19 who experienced critical outcomes decreased with time, and median patient age increased with time. Multimorbidity was most strongly associated with critical outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Antibiotics on Demand: Advances in Asynchronous Telemedicine Call for Increased Antibiotic Surveillance.

Author

O'Toole, Rebecca, Martinez, Kathryn A, Rothberg, Michael B, Diiorio, Gillian, Stenehjem, Edward A, Ward, Kristina E, and LaPlante, Kerry L

Subjects
ANTIBIOTICS, ANTIMICROBIAL stewardship, WELL-being, DRUG efficacy, HEALTH services accessibility, RESPIRATORY infections, ANTI-infective agents, DRUGS, TELEMEDICINE, PATIENT safety
Abstract

The rapid growth of telehealth services has brought about direct-to-consumer telemedicine platforms, enabling patients to request antibiotics online without a virtual or face-to-face consultation. While telemedicine aims to enhance accessibility, this trend raises significant concerns regarding appropriate antimicrobial use and patient safety. In this viewpoint, we share our first-hand experience with 2 direct-to-consumer platforms, where we intentionally sought inappropriate antibiotic prescriptions for nonspecific symptoms strongly indicative of a viral upper respiratory infection. Despite the lack of clear necessity, requested antibiotic prescriptions were readily transmitted to our local pharmacy following a simple monetary transaction. The effortless acquisition of patient-selected antibiotics online, devoid of personal interactions or consultations, underscores the urgent imperative for intensified antimicrobial stewardship initiatives led by state and national public health organizations in telehealth settings. By augmenting oversight and regulation, we can ensure the responsible and judicious use of antibiotics, safeguard patient well-being, and preserve the efficacy of these vital medications. [ABSTRACT FROM AUTHOR]

Published
2024
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25. Effectiveness of 2, 3, and 4 COVID-19 mRNA Vaccine Doses Among Immunocompetent Adults During Periods when SARS-CoV-2 Omicron BA.1 and BA.2/BA.2.12.1 Sublineages Predominated--VISION Network, 10 States, December 2021-June 2022

Author

Link-Gelles, Ruth, Levy, Matthew E., Gaglani, Manjusha, Irving, Stephanie A., Stockwell, Melissa, Dascomb, Kristin, DeSilva, Malini B., Reese, Sarah E., Liao, I-Chia, Ong, Toan C., Grannis, Shaun J., McEvoy, Charlene, Patel, Palak, Klein, Nicola P., Hartmann, Emily, Stenehjem, Edward, Natarajan, Karthik, Naleway, Allison L., Murthy, Kempapura, Rao, Suchitra, Dixon, Brian E., Kharbanda, Anupam B., Akinseye, Akintunde, Dickerson, Monica, Lewis, Ned, Grisel, Nancy, Han, Jungmi, Barron, Michelle A., Fadel, William F., Dunne, Margaret M., Goddard, Kristin, Arndorfer, Julie, Konatham, Deepika, Valvi, Nimish R., Currey, J.C., Fireman, Bruce, Raiyani, Chandni, Zerbo, Ousseny, Sloan-Aagard, Chantel, Ball, Sarah W., Thompson, Mark G., and Tenforde, Mark W.

Subjects
Medical research, Medicine, Experimental, Messenger RNA, Infection, Adults, Vaccines, Health, University of Colorado
Abstract

On July 15, 2022, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). The Omicron variant (B.1.1.529) of SARS-CoV-2, the virus that causes COVID-19, was [...]

Published
2022

26. Implementation of an Antibiotic Stewardship Initiative in a Large Urgent Care Network

Author

Stenehjem, Edward, primary, Wallin, Anthony, additional, Willis, Park, additional, Kumar, Naresh, additional, Seibert, Allan M., additional, Buckel, Whitney R., additional, Stanfield, Valoree, additional, Brunisholz, Kimberly D., additional, Fino, Nora, additional, Samore, Matthew H., additional, Srivastava, Rajendu, additional, Hicks, Lauri A., additional, and Hersh, Adam L., additional

Published
2023
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27. Effect of tele‐COVID rounds and a tele‐stewardship intervention on antibiotic use in COVID‐19 patients admitted to 17 small community hospitals

Author

May, Stephanie Shealy, primary, Veillette, John J., additional, Webb, Brandon J., additional, Stenehjem, Edward A., additional, Throneberry, Steven K., additional, Gelman, Stephanie, additional, Pirozzi, Michael, additional, Stanfield, Valoree, additional, Dustin Waters, C., additional, Grisel, Nancy A., additional, and Vento, Todd J., additional

Published
2023
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28. Reply to Adelman et al

Author

Hooper, Gabriel A, primary, Stenehjem, Edward A, additional, Bledsoe, Joseph R, additional, Brown, Samuel M, additional, and Peltan, Ithan D, additional

Published
2023
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29. Effectiveness of BNT162b2 COVID-19 Vaccination in Children and Adolescents

Author

Klein, Nicola P., primary, Demarco, Maria, additional, Fleming-Dutra, Katherine E., additional, Stockwell, Melissa S., additional, Kharbanda, Anupam B., additional, Gaglani, Manjusha, additional, Rao, Suchitra, additional, Lewis, Ned, additional, Irving, Stephanie A., additional, Hartmann, Emily, additional, Natarajan, Karthik, additional, Dalton, Alexandra F., additional, Zerbo, Ousseny, additional, DeSilva, Malini B., additional, Konatham, Deepika, additional, Stenehjem, Edward, additional, Rowley, Elizabeth A. K., additional, Ong, Toan C., additional, Grannis, Shaun J., additional, Sloan-Aagard, Chantel, additional, Han, Jungmi, additional, Verani, Jennifer R, additional, Raiyani, Chandni, additional, Dascomb, Kristin, additional, Reese, Sarah E., additional, Barron, Michelle A., additional, Fadel, William F., additional, Naleway, Allison L., additional, Nanez, Juan, additional, Dickerson, Monica, additional, Goddard, Kristin, additional, Murthy, Kempapura, additional, Grisel, Nancy, additional, Weber, Zacharay A., additional, Dixon, Brian E., additional, Patel, Palak, additional, Fireman, Bruce, additional, Arndorfer, Julie, additional, Valvi, Nimish R., additional, Griggs, Eric P., additional, Hallowell, Carly, additional, Embi, Peter J., additional, Ball, Sarah W., additional, Thompson, Mark G., additional, Tenforde, Mark W., additional, and Link-Gelles, Ruth, additional

Published
2023
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30. Early Estimates of Bivalent mRNA Vaccine Effectiveness in Preventing COVID-19–Associated Emergency Department or Urgent Care Encounters and Hospitalizations Among Immunocompetent Adults — VISION Network, Nine States, September–November 2022

Author

Tenforde, Mark W., primary, Weber, Zachary A., additional, Natarajan, Karthik, additional, Klein, Nicola P., additional, Kharbanda, Anupam B., additional, Stenehjem, Edward, additional, Embi, Peter J., additional, Reese, Sarah E., additional, Naleway, Allison L., additional, Grannis, Shaun J., additional, DeSilva, Malini B., additional, Ong, Toan C., additional, Gaglani, Manjusha, additional, Han, Jungmi, additional, Dickerson, Monica, additional, Fireman, Bruce, additional, Dascomb, Kristin, additional, Irving, Stephanie A., additional, Vazquez-Benitez, Gabriela, additional, Rao, Suchitra, additional, Konatham, Deepika, additional, Patel, Palak, additional, Schrader, Kristin E., additional, Lewis, Ned, additional, Grisel, Nancy, additional, McEvoy, Charlene, additional, Murthy, Kempapura, additional, Griggs, Eric P., additional, Rowley, Elizabeth A. K., additional, Zerbo, Ousseny, additional, Arndorfer, Julie, additional, Dunne, Margaret M., additional, Goddard, Kristin, additional, Ray, Caitlin, additional, Zhuang, Yan, additional, Timbol, Julius, additional, Najdowski, Morgan, additional, Yang, Duck-Hye, additional, Hansen, John, additional, Ball, Sarah W., additional, and Link-Gelles, Ruth, additional

Published
2023
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31. Estimation of COVID-19 mRNA Vaccine Effectiveness and COVID-19 Illness and Severity by Vaccination Status During Omicron BA.4 and BA.5 Sublineage Periods

Author

Link-Gelles, Ruth, primary, Levy, Matthew E., additional, Natarajan, Karthik, additional, Reese, Sarah E., additional, Naleway, Allison L., additional, Grannis, Shaun J., additional, Klein, Nicola P., additional, DeSilva, Malini B., additional, Ong, Toan C., additional, Gaglani, Manjusha, additional, Hartmann, Emily, additional, Dickerson, Monica, additional, Stenehjem, Edward, additional, Kharbanda, Anupam B., additional, Han, Jungmi, additional, Spark, Talia L., additional, Irving, Stephanie A., additional, Dixon, Brian E., additional, Zerbo, Ousseny, additional, McEvoy, Charlene E., additional, Rao, Suchitra, additional, Raiyani, Chandni, additional, Sloan-Aagard, Chantel, additional, Patel, Palak, additional, Dascomb, Kristin, additional, Uhlemann, Anne-Catrin, additional, Dunne, Margaret M., additional, Fadel, William F., additional, Lewis, Ned, additional, Barron, Michelle A., additional, Murthy, Kempapura, additional, Nanez, Juan, additional, Griggs, Eric P., additional, Grisel, Nancy, additional, Annavajhala, Medini K., additional, Akinseye, Akintunde, additional, Valvi, Nimish R., additional, Goddard, Kristin, additional, Mamawala, Mufaddal, additional, Arndorfer, Julie, additional, Yang, Duck-Hye, additional, Embí, Peter J., additional, Fireman, Bruce, additional, Ball, Sarah W., additional, and Tenforde, Mark W., additional

Published
2023
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33. Effectiveness of the Original Monovalent Coronavirus Disease 2019 Vaccines in Preventing Emergency Department or Urgent Care Encounters and Hospitalizations Among Adults With Disabilities: VISION Network, June 2021-September 2022.

Author

Patel, Palak, Schrader, Kristin E, Rice, Catherine E, Rowley, Elizabeth, Cree, Robyn A, DeSilva, Malini B, Embi, Peter J, Gaglani, Manjusha, Grannis, Shaun J, Ong, Toan C, Stenehjem, Edward, Naleway, Allison L, Ball, Sarah, Natarajan, Karthik, Klein, Nicola P, Adams, Katherine, Kharbanda, Anupam, Ray, Caitlin, Link-Gelles, Ruth, and Tenforde, Mark W

Subjects
COVID-19, OUTPATIENT medical care, HOSPITAL emergency services, DISABILITIES, VACCINE effectiveness, PEOPLE with disabilities
Abstract

Adults with disabilities are at increased risk for severe coronavirus disease 2019 (COVID-19). Using data across 9 states during Delta- and Omicron-predominant periods (June 2021–September 2022), we evaluated the effectiveness of the original monovalent COVID-19 messenger RNA vaccines among 521 206 emergency department/urgent care encounters (11 471 [2%] in patients with a documented disability) and 139 548 hospitalizations (16 569 [12%] in patients with a disability) for laboratory-confirmed COVID-19 illness in adults (aged ≥18 years). Across variant periods and for the primary series or booster doses, vaccine effectiveness was similar in those with and those without a disability. These findings highlight the importance of adults with disabilities staying up to date with COVID-19 vaccinations. [ABSTRACT FROM AUTHOR]

Published
2023
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34. Concordance Between Initial Presumptive Versus Final Adjudicated Diagnoses of Infection Among Patients Meeting Sepsis-3 Criteria in the Emergency Department

Author

Hooper, Gabriel A, primary, Klippel, Carolyn J, additional, McLean, Sierra R, additional, Stenehjem, Edward A, additional, Webb, Brandon J, additional, Murnin, Emily R, additional, Hough, Catherine L, additional, Bledsoe, Joseph R, additional, Brown, Samuel M, additional, and Peltan, Ithan D, additional

Published
2023
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35. Protection From COVID-19 mRNA Vaccination and Prior SARS-CoV-2 Infection Against COVID-19–Associated Encounters in Adults During Delta and Omicron Predominance

Author

Bozio, Catherine H, primary, Butterfield, Kristen A, additional, Briggs Hagen, Melissa, additional, Grannis, Shaun, additional, Drawz, Paul, additional, Hartmann, Emily, additional, Ong, Toan C, additional, Fireman, Bruce, additional, Natarajan, Karthik, additional, Dascomb, Kristin, additional, Gaglani, Manjusha, additional, DeSilva, Malini B, additional, Yang, Duck-Hye, additional, Midgley, Claire M, additional, Dixon, Brian E, additional, Naleway, Allison L, additional, Grisel, Nancy, additional, Liao, I Chia, additional, Reese, Sarah E, additional, Fadel, William F, additional, Irving, Stephanie A, additional, Lewis, Ned, additional, Arndorfer, Julie, additional, Murthy, Kempapura, additional, Riddles, John, additional, Valvi, Nimish R, additional, Mamawala, Mufaddal, additional, Embi, Peter J, additional, Thompson, Mark G, additional, and Stenehjem, Edward, additional

Published
2023
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36. Vaccine effectiveness against influenza-associated urgent care, emergency department, and hospital encounters during the 2021-2022 season, VISION Network

Author

Tenforde, Mark W, primary, Weber, Zachary A, additional, DeSilva, Malini B, additional, Stenehjem, Edward, additional, Yang, Duck-Hye, additional, Fireman, Bruce, additional, Gaglani, Manjusha, additional, Kojima, Noah, additional, Irving, Stephanie A, additional, Rao, Suchitra, additional, Grannis, Shaun J, additional, Naleway, Allison L, additional, Kirshner, Lindsey, additional, Kharbanda, Anupam B, additional, Dascomb, Kristin, additional, Lewis, Ned, additional, Dalton, Alexandra F, additional, Ball, Sarah W, additional, Natarajan, Karthik, additional, Ong, Toan C, additional, Hartmann, Emily, additional, Embi, Peter J, additional, McEvoy, Charlene E, additional, Grisel, Nancy, additional, Zerbo, Ousseny, additional, Dunne, Margaret M, additional, Arndorfer, Julie, additional, Goddard, Kristin, additional, Dickerson, Monica, additional, Patel, Palak, additional, Timbol, Julius, additional, Griggs, Eric P, additional, Hansen, John, additional, Thompson, Mark G, additional, Flannery, Brendan, additional, and Klein, Nicola P, additional

Published
2023
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38. Relationships Between Social Vulnerability and Coronavirus Disease 2019 Vaccination Coverage and Vaccine Effectiveness

Author

Dalton, Alexandra F, primary, Weber, Zachary A, additional, Allen, Katie S, additional, Stenehjem, Edward, additional, Irving, Stephanie A, additional, Spark, Talia L, additional, Adams, Katherine, additional, Zerbo, Ousseny, additional, Lazariu, Victoria, additional, Dixon, Brian E, additional, Dascomb, Kristin, additional, Hartmann, Emily, additional, Kharbanda, Anupam B, additional, Ong, Toan C, additional, DeSilva, Malini B, additional, Beaton, Maura, additional, Gaglani, Manjusha, additional, Patel, Palak, additional, Naleway, Allison L, additional, Kish, Magdalene N S, additional, Grannis, Shaun J, additional, Grisel, Nancy, additional, Sloan-Aagard, Chantel, additional, Rao, Suchitra, additional, Raiyani, Chandni, additional, Dickerson, Monica, additional, Bassett, Elizabeth, additional, Fadel, William F, additional, Arndorfer, Julie, additional, Nanez, Juan, additional, Barron, Michelle A, additional, Vazquez-Benitez, Gabriela, additional, Liao, I Chia, additional, Griggs, Eric P, additional, Reese, Sarah E, additional, Valvi, Nimish R, additional, Murthy, Kempapura, additional, Rowley, Elizabeth A K, additional, Embi, Peter J, additional, Ball, Sarah, additional, Link-Gelles, Ruth, additional, and Tenforde, Mark W, additional

Published
2023
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40. Early Estimates of Bivalent mRNA Vaccine Effectiveness in Preventing COVID-19–Associated Emergency Department or Urgent Care Encounters and Hospitalizations Among Immunocompetent Adults — VISION Network, Nine States, September–November 2022

Author

Tenforde, Mark W., primary, Weber, Zachary A., additional, Natarajan, Karthik, additional, Klein, Nicola P., additional, Kharbanda, Anupam B., additional, Stenehjem, Edward, additional, Embi, Peter J., additional, Reese, Sarah E., additional, Naleway, Allison L., additional, Grannis, Shaun J., additional, DeSilva, Malini B., additional, Ong, Toan C., additional, Gaglani, Manjusha, additional, Han, Jungmi, additional, Dickerson, Monica, additional, Fireman, Bruce, additional, Dascomb, Kristin, additional, Irving, Stephanie A., additional, Vazquez-Benitez, Gabriela, additional, Rao, Suchitra, additional, Konatham, Deepika, additional, Patel, Palak, additional, Schrader, Kristin E., additional, Lewis, Ned, additional, Grisel, Nancy, additional, McEvoy, Charlene, additional, Murthy, Kempapura, additional, Griggs, Eric P., additional, Rowley, Elizabeth A. K., additional, Zerbo, Ousseny, additional, Arndorfer, Julie, additional, Dunne, Margaret M., additional, Goddard, Kristin, additional, Ray, Caitlin, additional, Zhuang, Yan, additional, Timbol, Julius, additional, Najdowski, Morgan, additional, Yang, Duck-Hye, additional, Hansen, John, additional, Ball, Sarah W., additional, and Link-Gelles, Ruth, additional

Published
2022
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46. Waning 2-Dose and 3-Dose Effectiveness of mRNA Vaccines Against COVID-19-Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults During Periods of Delta and Omicron Variant Predominance--VISION Network, 10 States, August 2021-January 2022

Author

Ferdinands, Jill M., Rao, Suchitra, Dixon, Brian E., Mitchell, Patrick K., DeSilva, Malini B., Irving, Stephanie A., Lewis, Ned, Natarajan, Karthik, Stenehjem, Edward, Grannis, Shaun J., Han, Jungmi, McEvoy, Charlene, Ong, Toan C., Naleway, Allison L., Reese, Sarah E., Embi, Peter J., Dascomb, Kristin, Klein, Nicola P., Griggs, Eric P., Konatham, Deepika, Kharbanda, Anupam B., Yang, Duck-Hye, Fadel, William F., Grisel, Nancy, Goddard, Kristin, Patel, Palak, Liao, I-Chia, Birch, Rebecca, Valvi, Nimish R., Reynolds, Sue, Arndorfer, Julie, Zerbo, Ousseny, Murthy, Monica Dickerson Kempapura, Williams, Jeremiah, Bozio, Catherine H., Blanton, Lenee, Verani, Jennifer R., Schrag, Stephanie J., Dalton, Alexandra F., Wondimu, Mehiret H., Link-Gelles, Ruth, Azziz-Baumgartner, Eduardo, Barron, Michelle A., Gaglani, Manjusha, Thompson, Mark G., and Fireman, Bruce

Subjects
Pfizer Inc., Vaccination, Hospitals -- Emergency service, Messenger RNA, Emergency medicine, Adults, Vaccines, Pharmaceutical industry, Health
Abstract

On February 11, 2022, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). CDC recommends that all persons aged [greater than or equal to] 12 [...]

Published
2022

47. Effectiveness of a Third Dose of mRNA Vaccines Against COVID-19--Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults During Periods of Delta and Omicron Variant Predominance--VISION Network, 10 States, August 2021-January 2022

Author

Thompson, Mark G., Natarajan, Karthik, Irving, Stephanie A., Rowley, Elizabeth A., Griggs, Eric P., Gaglani, Manjusha, Klein, Nicola P., Grannis, Shaun J., DeSilva, Malini B., Stenehjem, Edward, Reese, Sarah E., Dickerson, Monica, Naleway, Allison L., Han, Jungmi, Konatham, Deepika, McEvoy, Charlene, Rao, Suchitra, Dixon, Brian E., Dascomb, Kristin, Lewis, Ned, Levy, Matthew E., Patel, Palak, Liao, I-Chia, Kharbanda, Anupam B., Barron, Michelle A., Fadel, William F., Grisel, Nancy, Goddard, Kristin, Yang, Duck-Hye, Wondimu, Mehiret H., Murthy, Kempapura, Valvi, Nimish R., Arndorfer, Julie, Fireman, Bruce, Dunne, Margaret M., Embi, Peter, Azziz-Baumgartner, Eduardo, Zerbo, Ousseny, Bozio, Catherine H., Reynolds, Sue, Ferdinands, Jill, Williams, Jeremiah, Link-Gelles, Ruth, Schrag, Stephanie J., Verani, Jennifer R., Ball, Sarah, and Ong, Toan C.

Subjects
Pfizer Inc., Medical research, Medicine, Experimental, Hospitals -- Emergency service, Messenger RNA, Emergency medicine, Adults, Vaccines, Pharmaceutical industry, Health, University of Colorado, Comirnaty (Vaccine)
Abstract

On January 21, 2022, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). Estimates of COVID-19 mRNA vaccine effectiveness (VE) have declined in recent months [...]

Published
2022

48. Protection of Two and Three mRNA Vaccine Doses Against Severe Outcomes Among Adults Hospitalized With COVID-19—VISION Network, August 2021 to March 2022

Author

DeSilva, Malini B, primary, Mitchell, Patrick K, additional, Klein, Nicola P, additional, Dixon, Brian E, additional, Tenforde, Mark W, additional, Thompson, Mark G, additional, Naleway, Allison L, additional, Grannis, Shaun J, additional, Ong, Toan C, additional, Natarajan, Karthik, additional, Reese, Sarah E, additional, Zerbo, Ousseny, additional, Kharbanda, Anupam B, additional, Patel, Palak, additional, Stenehjem, Edward, additional, Raiyani, Chandni, additional, Irving, Stephanie A, additional, Fadel, William F, additional, Rao, Suchitra, additional, Han, Jungmi, additional, Reynolds, Sue, additional, Davis, Jonathan M, additional, Lewis, Ned, additional, McEvoy, Charlene, additional, Dickerson, Monica, additional, Dascomb, Kristin, additional, Valvi, Nimish R, additional, Barron, Michelle A, additional, Goddard, Kristin, additional, Vazquez-Benitez, Gabriela, additional, Grisel, Nancy, additional, Mamawala, Mufaddal, additional, Embi, Peter J, additional, Fireman, Bruce, additional, Essien, Inih J, additional, Griggs, Eric P, additional, Arndorfer, Julie, additional, and Gaglani, Manjusha, additional

Published
2022
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49. Effectiveness of COVID-19 Vaccines at Preventing Emergency Department or Urgent Care Encounters and Hospitalizations Among Immunocompromised Adults: An Observational Study of Real-World Data Across 10 US States from August-December 2021

Author

Embi, Peter J., primary, Levy, Matthew E., additional, Patel, Palak, additional, DeSilva, Malini B., additional, Gaglani, Manjusha, additional, Dascomb, Kristin, additional, Dunne, Margaret M., additional, Klein, Nicola P., additional, Ong, Toan C., additional, Grannis, Shaun J., additional, Natarajan, Karthik, additional, Yang, Duck-Hye, additional, Stenehjem, Edward, additional, Zerbo, Ousseny, additional, McEvoy, Charlene, additional, Rao, Suchitra, additional, Thompson, Mark G., additional, Konatham, Deepika, additional, Irving, Stephanie A., additional, Dixon, Brian E., additional, Han, Jungmi, additional, Schrader, Kristin E., additional, Grisel, Nancy, additional, Lewis, Ned, additional, Kharbanda, Anupam B., additional, Barron, Michelle A., additional, Reynolds, Sue, additional, Liao, I-Chia, additional, Fadel, William F., additional, Rowley, Elizabeth A., additional, Arndorfer, Julie, additional, Goddard, Kristin, additional, Murthy, Kempapura, additional, Valvi, Nimish R., additional, Weber, Zachary A., additional, Fireman, Bruce, additional, Reese, Sarah E., additional, Ball, Sarah W., additional, and Naleway, Allison L., additional

Published
2022
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50. A Fully Integrated Infectious Diseases and Antimicrobial Stewardship Telehealth Service Improves Staphylococcus aureus Bacteremia Bundle Adherence and Outcomes in 16 Small Community Hospitals

Author

Veillette, John J, primary, May, Stephanie S, additional, Gabrellas, Alithea D, additional, Gelman, Stephanie S, additional, Albritton, Jordan, additional, Lyons, Michael D, additional, Stenehjem, Edward A, additional, Webb, Brandon J, additional, Dalto, Joseph D, additional, Throneberry, S Kyle, additional, Stanfield, Valoree, additional, Grisel, Nancy A, additional, and Vento, Todd J, additional

Published
2022
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