Publications by authors named "Ana Florea"
Context: Chronic hepatitis B (CHB), caused by hepatitis B virus (HBV), is a risk factor for cirrhosis. The management of HBV-related cirrhosis is challenging, with guidelines recommending treatment initiation and regular monitoring for those affected.
Objective: Our study characterized Kaiser Permanente Southern California patients with HBV-related cirrhosis and assessed whether they received recommended laboratory testing and imaging monitoring.
Article Synopsis
- 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.
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.
View Article and Find Full Text PDFPurpose: Data on vaccine-associated corneal transplant rejections are limited. We examined the association between graft rejection and vaccination.
Design: Matched case-control METHODS: We used electronic health records to identify corneal transplant recipients between January 2008 and August 2022 at Kaiser Permanente Southern California.
Background: Identification of infection (CDI) in the community setting is increasing. We describe testing for CDI among patients with medically attended diarrhea (MAD) in the outpatient setting, and the incidence of outpatient CDI.
Methods: This was a retrospective cohort study among members ≥18 years of age from Kaiser Permanente Southern California and Kaiser Permanente Northwest from 1 January 2016 through 31 December 2021.
Both SARS-CoV-2 and influenza virus can be transmitted by asymptomatic, presymptomatic, or symptomatic infected persons. We assessed effects on work attendance while ill before and during the COVID-19 pandemic in the United States by analyzing data collected prospectively from persons with acute respiratory illnesses enrolled in a multistate study during 2018-2022. Persons with previous hybrid work experience were significantly less likely to work onsite on the day before through the first 3 days of illness than those without that experience, an effect more pronounced during the COVID-19 pandemic than during prepandemic influenza seasons.
View Article and Find Full Text PDFArticle Synopsis
- 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%).
Article Synopsis
- A cohort study was conducted at Kaiser Permanente Southern California to assess the connection between mRNA COVID-19 vaccines and the occurrence of herpes zoster (HZ), which is a viral infection also known as shingles.
- The study compared over 1 million vaccinated individuals who received either the mRNA-1273 or BNT162b2 vaccines to unvaccinated individuals, identifying HZ cases within 90 days post-vaccination using diagnosis codes and antiviral treatments.
- Results indicated a small increased risk of developing HZ after the second dose, especially in individuals aged 50 and older who hadn’t received the zoster vaccine, highlighting a potential safety concern for this age group.
Article Synopsis
- - The study analyzed the effectiveness of receiving a fourth dose of the mRNA-1273 vaccine compared to only three doses in people aged 50 and older, involving nearly 357,000 participants from Kaiser Permanente Southern California.
- - Results showed that the fourth dose significantly improved protection against SARS-CoV-2 infection (25.9% more effective), COVID-19 hospitalization (67.3% more effective), and death from COVID-19 (72.5% more effective).
- - However, the effectiveness of the fourth dose decreased over time, particularly 2-4 months after vaccination, indicating that while four doses offer better protection, the level of effectiveness can vary and diminish in various demographic groups.
Background: Data on the effectiveness of the 3-dose mRNA-1273 primary series are limited, particularly in comparison to 2 doses. Given suboptimal COVID-19 vaccine uptake among immunocompromised populations, it is important to monitor the effectiveness of fewer than the recommended doses in this population.
Methods: We conducted a matched cohort study at Kaiser Permanente Southern California to evaluate the relative vaccine effectiveness (rVE) of the 3-dose series vs 2 doses of mRNA-1273 in preventing SARS-CoV-2 infection and severe COVID-19 outcomes among immunocompromised individuals.
Background: Overuse of antibiotics contributes to antimicrobial resistance (AMR) and is a growing threat to human health worldwide. Previous work suggests a link between antimicrobial use in poultry and human AMR extraintestinal pathogenic Escherichia coli (E coli) urinary tract infections (UTIs). However, few US-based studies exist, and none have comprehensively assessed both foodborne and environmental pathways using advanced molecular and spatial epidemiologic methods in a quasi-experimental design.
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- A study estimated the effectiveness of two and three mRNA COVID-19 vaccine doses against symptomatic illness due to SARS-CoV-2 Delta and Omicron variants in adults seeking outpatient care between October 2021 and February 2022.
- The research involved 3,847 participants and found that vaccine effectiveness (VE) against symptoms was significantly higher for three doses compared to two doses, especially during the Delta variant period.
- The results indicated that the three-dose regimen offered substantial protection against symptomatic illness when the Omicron variant was predominant, reinforcing the recommendation for a third vaccine dose.
Article Synopsis
- * The study, including over 123,000 individuals, finds that while three doses of the mRNA-1273 vaccine provide strong initial protection against infections, effectiveness diminishes quickly for newer subvariants like BA.2.12.1, BA.4, and BA.5 after the third dose.
- * Hospitalization protection remains high with three doses but shows variability; four doses boost effectiveness but still drop significantly after a few months, indicating a need for evaluation of updated booster shots.
Introduction: This observational retrospective matched cohort study evaluated the safety of a prenatal tetanus, diphtheria, acellular pertussis (Tdap) vaccination, Boostrix. We previously reported on the risk of maternal and neonatal outcomes; here we report on the risk of congenital anomalies in infants at birth through 6 months of age.
Methods: The study included pregnant Kaiser Permanente Southern California members.
Background: In the United States, influenza activity during the 2021-2022 season was modest and sufficient enough to estimate influenza vaccine effectiveness (VE) for the first time since the beginning of the coronavirus disease 2019 pandemic. We estimated influenza VE against laboratory-confirmed outpatient acute illness caused by predominant A(H3N2) viruses.
Methods: Between October 2021 and April 2022, research staff across 7 sites enrolled patients aged ≥6 months seeking outpatient care for acute respiratory illness with cough.
Article Synopsis
- The study compared the effectiveness of a COVID-19 booster vaccine (mRNA-1273) to the original two-dose series among immunocompetent adults in Southern California, tracking outcomes like infection and hospitalization from October 2021 to January 2022.
- Results showed a significant increase in protection from the booster, with a relative vaccine effectiveness (rVE) of 61.3% against infection and even higher rates (89.0% for hospitalization and 96.0% for hospital death).
- The effectiveness of the booster decreased over time, illustrating that while it provided strong initial protection, immunity waned after a couple of months, emphasizing the importance of ongoing vaccination strategies.
Article Synopsis
- Individuals with Down syndrome (DS) have a lower risk of contracting COVID-19, with a 32% reduced infection rate compared to matched peers without DS.
- However, if they do get infected, they face a significantly higher risk (six times) of severe COVID-19 disease.
- The study suggests the need for improved monitoring, early treatment, and increased vaccination efforts for people with DS to better protect this vulnerable population.
The objective of this study was to evaluate the safety of prenatal tetanus, diphtheria, acellular pertussis (Tdap) vaccination. This cohort study was conducted among pregnant members at Kaiser Permanente Southern California (KPSC). The exposed cohort consisted of women who received Tdap vaccine on or after the 27th week of pregnancy between January 2018 and January 2019.
View Article and Find Full Text PDFBackground: We conducted a prospective cohort study at Kaiser Permanente Southern California to study the vaccine effectiveness (VE) of mRNA-1273 over time and during the emergence of the Delta variant.
Methods: The cohort for this planned interim analysis consisted of individuals aged ≥18 years receiving 2 doses of mRNA-1273 through June 2021, matched 1:1 to randomly selected unvaccinated individuals by age, sex, and race/ethnicity, with follow-up through September 2021. Outcomes were SARS-CoV-2 infection, and COVID-19 hospitalization and hospital death.
In the United States, annual vaccination against seasonal influenza is recommended for all persons aged ≥6 months except when contraindicated (1). Currently available influenza vaccines are designed to protect against four influenza viruses: A(H1N1)pdm09 (the 2009 pandemic virus), A(H3N2), B/Victoria lineage, and B/Yamagata lineage. Most influenza viruses detected this season have been A(H3N2) (2).
View Article and Find Full Text PDFSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron (B.1.1.
View Article and Find Full Text PDFHerpes Zoster Following Recombinant Zoster Vaccine With or Without Concomitant Vaccination.
Open Forum Infect Dis
March 2022
Background: The 2-dose recombinant zoster vaccine (RZV) series is recommended for prevention of herpes zoster (HZ) in adults aged ≥50 years, but data are limited on the impact of concomitant administration with other vaccines on subsequent HZ risk.
Methods: This cohort study included Kaiser Permanente Southern California members aged ≥50 years who received 2 doses of RZV 4 weeks to ≤6 months apart during 1 April 2018-30 September 2019. RZV recipients with and without same-day concomitant vaccination for either RZV dose were followed up for incident HZ beginning 31 days after the second RZV dose until 30 September 2020.
Background: Some vaccines elicit nonspecific immune responses that may protect against heterologous infections. We evaluated the association between recombinant adjuvanted zoster vaccine (RZV) and coronavirus disease 2019 (COVID-19) outcomes at Kaiser Permanente Southern California.
Methods: In a cohort design, adults aged ≥50 years who received ≥1 RZV dose before 1 March 2020 were matched 1:2 to unvaccinated individuals and followed until 31 December 2020.