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Introduction: Vaccination rates may be improved through culturally tailored messages, but little is known about them among disaggregated Asian American subgroups. We assessed the vaccination rates for key vaccines among these subgroups. Methods: Using the National Health Interview Survey, we analyzed recent vaccination rates (2015–2018, n=188,250) and trends (2006–2018) among Asians (Chinese [n=3,165], Asian Indian [n=3,525], Filipino [n=3,656], other Asian [n=5,819]) and non-Hispanic White adults (n=172,085) for 6 vaccines (the human papillomavirus, hepatitis B, pneumococcal, influenza, tetanus-diphtheria [tetanus], and shingles vaccines). We controlled demographic, socioeconomic, and health-related variables in multivariable logistic regression and predicted marginal modeling analyses. We also computed vaccination rates among Asian American subgroups on the 2015–2018 National Health Interview Survey data stratified by foreign-born and U.S.-born status. We used Joinpoint regression to analyze trends in vaccination rates. All analyses were conducted in 2021 and 2022. Results: Among Asians, shingles (29.2%; 95% CI=26.6, 32.0), tetanus (53.7%; 95% CI=51.8, 55.6), and pneumococcal (53.8%; 95% CI=50.1, 57.4) vaccination rates were lower than among non-Hispanic Whites. Influenza (47.9%; 95% CI=46.2, 49.6) and hepatitis B (40.5%; 95% CI=39.0, 42.7) vaccination rates were similar or higher than among non-Hispanic Whites (48.4%; 95% CI=47.9, 48.9 and 30.7%; 95% CI=30.1, 31.3, respectively). Among Asians, we found substantial variations in vaccination rates and trends. For example, Asian Indian women had lower human papillomavirus vaccination rates (12.9%; 95% CI=9.1, 18.0) than all other Asian subgroups (Chinese: 37.9%; 95% CI=31.1, 45.2; Filipinos: 38.7%; 95% CI=29.9, 48.3; other Asians: 30.4%; 95% CI=24.8, 36.7) and non-Hispanic Whites (36.1%; 95% CI=34.8, 37.5). Being male, having lower educational attainment and income, having no health insurance or covered by public health insurance only, and lower frequency of doctor visits were generally associated with lower vaccine uptakes. Foreign-born Asian aggregate had lower vaccination rates than U.S.-born Asian aggregate for all vaccines except for influenza. We also found subgroup-level differences in vaccination rates between foreign-born and U.S.-born Asians. We found that (1) foreign-born Chinese, Asian Indians, and other Asians had lower human papillomavirus and hepatitis B vaccination rates; (2) foreign-born Chinese and Filipinos had lower pneumococcal vaccination rates; (3) foreign-born Chinese and Asian Indians had lower influenza vaccination rates; and (4) all foreign-born Asian subgroups had lower tetanus vaccination rates. Conclusions: Vaccination rates and trends differed among Asian American subgroups. Culturally tailored messaging and interventions may improve vaccine uptakes.

Background: Patients with advanced knee arthritis who develop a septic joint are not adequately treated with irrigation and debridement and intravenous antibiotics because of antecedent cartilage damage. The gold standard treatment has been a 2-stage approach. The periprosthetic joint infection literature has demonstrated the superiority of articulating spacers, and metal-on-poly (MOP) spacers are being used with increasing frequency. The purpose of this study was to compare the postoperative outcomes of patients with infected, arthritic knees treated by a 2-stage approach to those of patients who received single-stage treatment with a MOP spacer. Methods: Sixteen patients with native knee septic arthritis treated with an antibiotic spacer between 1998 and 2019 were reviewed. Demographic data, clinical data, knee motion, Knee Society score, Timed-Up-and-Go, and pain scores were collected. Survivorship of final implants was compared. Results: Six of 16 knees (38%) received single-stage treatment, and 10 received 2-stage treatment (62%). Five of 6 MOP spacers (83%) were retained at a mean follow-up of 3 ± 1.2 years. Nine of 10 (90%) receiving static spacers had subsequent reconstruction, with 9 (100%) surviving at mean follow-up of 7 ± 3.2 years. The patients who received MOP spacers trended toward greater terminal flexion, higher Knee Society score, and faster Timed-Up-and-Go at final follow-up. Conclusion: Infection in a native, arthritic knee may be effectively treated using single-stage MOP spacer. Postoperative outcomes of single-stage MOP spacers compare favorably to staged static spacers and with those undergoing revision surgery for other indications. Longer follow-up is needed to evaluate durability of MOP spacers.

Background: Although Asian-American individuals have higher rates of some vaccine-preventable diseases such as hepatitis B, vaccination rates among them are low compared with those of non-Hispanic White individuals. Most vaccine research looks at Asian-American people as a single category despite large within-group heterogeneity in health-seeking behaviours. Little is known about vaccination coverage among disaggregated Asian-American ethnic subgroups, although such information could inform policies focused on increasing vaccine uptake. Therefore, we aimed to assess vaccination coverage for several vaccines among disaggregated Asian-American subgroups. Methods: We examined National Health Interview Survey (NHIS) data from 2015–18 to analyse the vaccination status of Chinese, Asian Indian, Filipino, other Asian, and non-Hispanic White adults (n=253 626) for seven vaccines recommended by the US Centers for Disease Control and Prevention: human papillomavirus (HPV), hepatitis B (HBV), influenza, tetanus, tetanus-diphtheria-pertussis (Tdap), shingles, and the pneumococcal vaccine. We used NHIS data from 2006–18 (n=880 210) to analyse changes in vaccination rates for each ethnic group over time. We used logistic regression to estimate differences in vaccination rates while controlling for demographic, socioeconomic and health-related variables. Findings: Among the seven vaccines, HPV and shingles vaccines had the lowest uptake, whereas Tdap had the highest uptake among all groups. Compared with the non-Hispanic White group, Asian Indians were almost half as likely to receive the HPV vaccine (odds ratio 0·61, 95% CI 0·41–0·92), whereas Filipinos (1·51, 1·02–2·25) and other Asians (1·42, 1·02–1·97) were more likely to receive it. The Filipino (1·50, 1·21–1·88) and other Asian groups (1·42, 1·19–1·71) were more likely to receive the HBV vaccine than the non-Hispanic White group. For the influenza vaccine, the Asian Indian (1·28, 1·05–1·56), Filipino (1·44, 1·17–1·79) and other Asian (1·38, 1·16–1·65) groups were more likely to receive the vaccine than the non-Hispanic White group. For the pneumococcal vaccine, the Chinese (0·57, 0·34–0·94) and other Asian (0·66, 0·47–0·92) groups were less likely to receive the vaccine than the non-Hispanic White group. Interpretation: Among US adults, we found significant disparities in vaccine uptake among different Asian and Asian-American ethnic groups. US policy makers trying to improve vaccine uptake among Asian and Asian-American people could learn from successful international immunisation programmes to develop culturally appropriate interventions to improve vaccine uptake in Asian and Asian-American individuals. Funding: None.