Publications by authors named "Ackerson B"

This retrospective cohort study evaluated the comparative vaccine effectiveness (cVE) of licensed standard-dose cell-based versus egg-based influenza vaccines in preventing influenza hospitalization among adults 18-64 years during the 2022-2023 season. The cohort included eligible Kaiser Permanente Southern California members who received ≥ 1 dose of influenza vaccine (n = 848,334). The adjusted cVE against influenza hospitalization was -10.

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Importance: Clinical trials have demonstrated high vaccine efficacy (VE) against lower respiratory tract disease (LRTD) but enrolled a smaller proportion of persons aged 75 years or older and those with comorbidities than seen in highest-risk populations in clinical practice settings. Additionally, VE against respiratory syncytial virus (RSV)-related hospitalizations and emergency department (ED) visits is not yet fully described.

Objective: To estimate Respiratory Syncytial Virus Prefusion F (RSVpreF) effectiveness in older adults.

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  • A study developed and validated a natural language processing (NLP) algorithm to identify postherpetic neuralgia (PHN) from unstructured electronic health records (EHRs), aiming to improve accuracy compared to traditional diagnosis codes and prescription data.
  • The research involved reviewing EHRs from a large health care system and comparing the NLP's performance with code-based methods by analyzing sensitivity, specificity, and other statistical measures.
  • Results showed the NLP algorithm had high sensitivity (90.9%) and specificity (98.5%), with notable advantages in identifying PHN cases compared to code-based methods, which exhibited much lower sensitivity (52.7%-61.8%).
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  • The study examined the pregnancy outcomes of adults who received the HepB-CpG vaccine or the traditional HepB-alum vaccine shortly before or during pregnancy at Kaiser Permanente Southern California.* -
  • Among the individuals studied, those who received HepB-CpG had a higher live birth rate (84%) compared to HepB-alum recipients (74%), with lower spontaneous abortion rates for the HepB-CpG group (7% vs. 17%).* -
  • No major birth defects were reported in either group, suggesting that HepB-CpG does not pose additional risks for pregnancy outcomes compared to HepB-alum.*
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  • Influenza significantly impacts older adults, necessitating updated data on vaccine effectiveness within this group.
  • A study at Kaiser Permanente Southern California assessed the comparative vaccine effectiveness of high-dose, adjuvanted, and standard-dose cell-based influenza vaccines against the standard-dose egg-based vaccine among individuals aged 65 and older.
  • Results indicated that both high-dose and adjuvanted vaccines offered better protection against influenza-related medical encounters and hospitalization compared to the standard-dose egg-based vaccine during the 2022-2023 flu season.
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Background: Pneumococcal carriage is associated with increased acquisition and duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among adults. While pneumococcal conjugate vaccines (PCVs) prevent carriage of vaccine-serotype pneumococci, their potential impact on coronavirus disease 2019 (COVID-19)-related outcomes remains poorly understood in populations with prevalent immunity against SARS-CoV-2.

Methods: We undertook a retrospective cohort study of adults aged ≥65 years in the Kaiser Permanente Southern California healthcare system who had received ≥2 COVID-19 vaccine doses, comparing risk of SARS-CoV-2 infection between 1 January 2021 and 31 December 2022 among recipients and nonrecipients of 13-valent PCV (PCV13) employing multiple strategies to mitigate bias from differential test-seeking behavior.

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  • This study evaluates the effectiveness of ChatGPT, an AI program, in providing accurate information related to radiation oncology, including answering patient questions and summarizing significant clinical research.
  • The assessment revealed that ChatGPT often produced inaccurate or incomplete information, with only 39.7% of patient question responses deemed correct and comprehensive.
  • Despite the shortcomings, the study suggests that while ChatGPT is currently unreliable as a resource for patients and healthcare providers in radiation oncology, there may be potential for improvement in the future.
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We provide updated results (11 October 2023 through 29 February 2024) from our previously conducted test-negative case-control study in Kaiser Permanente Southern California to evaluate sublineage-specific effectiveness of the BNT162b2 XBB1.5-adapted vaccine. Results suggest that XBB1.

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Background: Urinary tract infections (UTIs) occur commonly and often recur. However, recent data on the epidemiology of recurrent UTI (rUTI) are scarce.

Methods: Between 1 January 2016 and 31 December 2020, index uncomplicated UTIs (uUTIs) from office, emergency department, hospital, and virtual care settings were identified from the electronic health records of women at Kaiser Permanente Southern California.

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Importance: Data describing the early additional protection afforded by the recently recommended BNT162b2 XBB vaccine (Pfizer-BioNTech; 2023-2024 formulation) are limited.

Objective: To estimate the association between receipt of the BNT162b2 XBB vaccine and medically attended COVID-19 outcomes among US adults 18 years and older.

Design, Setting, And Participants: This test-negative case-control study was performed to estimate the effectiveness of the BNT162b2 XBB vaccine against COVID-19-associated hospitalization and emergency department (ED) or urgent care (UC) encounters among adults in the Kaiser Permanente Southern California health system between October 10, 2023, and December 10, 2023.

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  • A study of 148,994 adults with uncomplicated urinary tract infections (UTIs) found that 19% had a recurrence after a median of 300 days.
  • The initial UTI was primarily caused by Escherichia coli (79%), but this decreased over time while Klebsiella spp. increased.
  • Antibiotic resistance was common, with 57% of initial infections showing nonsusceptibility, rising to 65% in subsequent infections, indicating a need for ongoing monitoring of resistance patterns for better treatment strategies.
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With recent advances in topical therapies for atopic dermatitis (AD), steroid-sparing options like calcineurin inhibitors, Janus kinase (JAK) inhibitors, and phosphodiesterase-4 (PDE-4) inhibitors are becoming mainstays in therapy, underscoring the importance of careful selection and usage of topical corticosteroids (TCSs) to minimize side effects. Alongside the necessity of emollient use, these steroid-sparing alternatives offer rapid itch relief and efficacy in improving disease severity. While TCSs still hold a prominent role in AD management, promising novel topical treatments like tapinarof and live biotherapeutics to modulate the skin microbiome are also discussed.

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  • Emerging SARS-CoV-2 sublineages continue to pose a risk for serious COVID-19 disease, particularly as many individuals haven’t been vaccinated in over a year.
  • A study evaluated the effectiveness of the mRNA-1273 bivalent vaccine against these circulating sublineages by analyzing confirmed cases and matching them to controls, revealing a decline in vaccine effectiveness over time.
  • The findings suggest that periodic revaccination with updated vaccines could be necessary to lower COVID-19-related health issues as the effectiveness of existing vaccines decreases against new variants.
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A clear understanding of real-world uptake of nirmatrelvir-ritonavir for treatment of SARS-CoV-2 can inform treatment allocation strategies and improve interpretation of effectiveness studies. We used data from a large US healthcare system to describe nirmatrelvir-ritonavir dispenses among all SARS-CoV-2 positive patients aged ≥ 12 years meeting recommended National Institutes of Health treatment eligibility criteria for the study period between 1 January and 31 December, 2022. Overall, 10.

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We evaluated the vaccine effectiveness (VE) of two doses of recombinant zoster vaccine (RZV) against herpes zoster (HZ) and postherpetic neuralgia (PHN) in Chinese adults at Kaiser Permanente Southern California (KPSC). Chinese KPSC members were identified based on self-reported ethnicity or self-reported preferred spoken/written language. Those aged ≥50 years who received two doses of RZV 4 weeks to ≤ 6 months apart were matched 1:4 to RZV unvaccinated Chinese members and followed through June 2022; second doses were accrued 6/1/2018-12/31/2020.

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  • - The study aimed to determine if earlier brain MRIs from patients receiving multiple courses of stereotactic radiosurgery (SRS) showed signs of undetected brain metastases that later needed treatment.
  • - Researchers reviewed MRIs from 683 patients, finding that 128 of the 345 treated metastases in follow-up courses corresponded to retrospectively identified lesions, or "retrospectively identified metastases" (RIMs), which were classified based on imaging criteria.
  • - Results indicated that many RIMs could indicate future treatment needs; specifically, a significant percentage of RIMs met diagnostic criteria, suggesting improved detection methods could lead to earlier intervention and fewer SRS sessions.
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Background: XBB-related omicron sublineages have recently replaced BA.4/5 as the predominant omicron sublineages in the USA and other regions globally. Despite preliminary signs of immune evasion of XBB sublineages, few data exist describing the real-world effectiveness of bivalent COVID-19 vaccines, especially against XBB-related illness.

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Objective: To develop a Multi-Feature-Combined (MFC) model for proof-of-concept in predicting local failure (LR) in NSCLC patients after surgery or SBRT using pre-treatment CT images. This MFC model combines handcrafted radiomic features, deep radiomic features, and patient demographic information in an integrated machine learning workflow.

Methods: The MFC model comprised three key steps.

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  • The bivalent mRNA-1273 COVID-19 vaccine, which targets both the original virus and the Omicron BA.4/BA.5 variants, has been authorized to enhance protection against COVID-19.
  • A matched cohort study showed that compared to those who only received monovalent vaccines, the bivalent vaccine had a 70.3% effectiveness rate in preventing hospitalizations due to COVID-19.
  • The bivalent booster not only sustained strong protection for over three months but also demonstrated effectiveness against medically attended SARS-CoV-2 infections (55.0%) and COVID-19 hospital deaths (82.7%).
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Randomized controlled trials (RCTs) remain the gold standard for evaluating treatment efficacy, but real-world evidence can supplement RCT results. Tocilizumab was not found to reduce 28-day mortality in a phase III, double-blind, placebo-controlled trial (COVACTA) among hospitalized patients with severe coronavirus disease 2019 (COVID-19) pneumonia. We created a real-world external comparator arm mirroring the COVACTA trial to confirm findings and assess the feasibility of using an external comparator arm to supplement an RCT.

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Background: Hispanic infants bear the burden of pertussis infection. We examined pertussis protection from vaccination in infants with US-born and foreign-born Hispanic mothers.

Methods: Retrospective cohort study of infants up to 1 year of age.

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