Publications by authors named "Nong Shang"

Background: To protect infants aged <2 months against pertussis, the United States recommends Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) vaccination during each pregnancy. Data are limited on the strategy's effectiveness against pertussis in infants aged ≥2 months.

Methods: Pertussis case infants aged 2 to <6 months with cough onset between 1 January 2011 and 31 December 2014 were identified in 6 US states.

View Article and Find Full Text PDF
Article Synopsis
  • The study focused on the effectiveness of mRNA monovalent booster doses against new SARS-CoV-2 subvariants BA.2/BA.2.12.1 and BA.4/BA.5, which have mutations allowing them to evade immunity better than previous variants.
  • Data from over 760,000 cases and 817,000 controls showed that three vaccine doses provided 45% to 74% effectiveness against symptomatic COVID-19 in individuals over 12 years old, but this protection decreased to 0% within 5-7 months.
  • For adults aged 50 and older, those who received four doses had ongoing protection against infection, with effectiveness remaining significant at over 3 months
View Article and Find Full Text PDF
Article Synopsis
  • On June 18, 2022, ACIP recommended the 2-dose Moderna vaccine for children 6 months-5 years and the 3-dose Pfizer-BioNTech vaccine for those 6 months-4 years based on safety and limited efficacy data.
  • Studies showed that the effectiveness of Moderna's vaccine in children aged 3-5 was 60% two weeks to two months after the second dose, while Pfizer's vaccine for children aged 3-4 had an effectiveness of 31% within two to four months after the third dose.
  • The CDC later expanded vaccine recommendations to include updated bivalent vaccines for children aged 6 months and older on December 9, 2022, to improve protection against current COVID
View Article and Find Full Text PDF
Article Synopsis
  • The Omicron sublineage XBB emerged in the U.S. in August 2022 and became prevalent, representing over 50% of sequenced COVID-19 cases by January 2023.* * Vaccine effectiveness against COVID-19 can differ by variant, and recent data showed that bivalent boosters reduced symptomatic infections by 52% against BA.5 and 48% against XBB/XBB.1.5 in adults aged 18-49.* * Monitoring the effectiveness of COVID-19 vaccines is crucial as new variants arise, and bivalent vaccines are proving to offer additional protection against symptomatic infections caused by these emerging strains.*
View Article and Find Full Text PDF

Importance: The association of 13-valent pneumococcal conjugate vaccine (PCV13) use with pneumonia hospitalization in older adults, especially those with underlying medical conditions, is not well described.

Objective: To evaluate the association of PCV13 use with pneumonia, non-health care-associated (non-HA) pneumonia, and lobar pneumonia (LP) hospitalization among US Medicare beneficiaries 65 years or older.

Design, Setting, And Participants: This cohort study with time-varying exposure assignment analyzed claims data from US Medicare beneficiaries 65 years or older enrolled in Parts A/B with a residence in the 50 US states or the District of Columbia by September 1, 2014.

View Article and Find Full Text PDF
Article Synopsis
  • On September 1, 2022, ACIP recommended bivalent COVID-19 mRNA vaccines targeting both the ancestral and Omicron BA.4/BA.5 strains to improve immunity following monovalent vaccine use.
  • Initially, these vaccines were recommended for individuals aged 12 and older, later expanding to children aged 5-11 on October 12, 2022, though clinical efficacy data were lacking at that time.
  • A study analyzed the effectiveness of the bivalent booster, showing varying degrees of protection against symptomatic SARS-CoV-2 infection, with higher relative vaccine effectiveness found in individuals aged 18-49 compared to older age groups.
View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to identify risk factors for community-acquired bacterial infections in infants under 2 months old in South Asia, which could help enhance prevention and antibiotic use.
  • Five sites in Bangladesh, India, and Pakistan analyzed data from mother-child pairs, employing advanced modeling techniques to determine potential causes of infections among infants with signs of serious bacterial infection.
  • Key findings revealed that low birth weight, male sex, breathing issues at birth, premature rupture of membranes, and low socioeconomic status were significant risk factors associated with these infections.
View Article and Find Full Text PDF
Article Synopsis
  • - Neonatal mortality is a significant issue, accounting for nearly half of all child deaths under 5, and identifying the causes of neonatal infections is challenging due to non-specific symptoms.
  • - The study analyzed data from the ANISA cohort involving infants in South Asia to categorize acute neonatal illnesses based on WHO criteria, focusing on infectious causes identified through PCR and blood culture.
  • - Findings showed that bacterial infections were responsible for approximately 32.7% of critically ill cases, with a high percentage (58-82%) of infants in various illness categories remaining without identified infectious causes.
View Article and Find Full Text PDF
Article Synopsis
  • Childhood mortality has decreased globally due to better hygiene and vaccinations; however, newborn mortality, particularly from Group B Streptococcus (GBS), remains a major issue, contributing significantly to infant meningitis.
  • Research supports the idea of maternal vaccination against GBS to protect infants, with at least three vaccine candidates currently in clinical trials, but large study populations of 40,000 to 60,000 participants are necessary for effective clinical trials.
  • A recent workshop focused on establishing a correlate of protection (CoP) for GBS, agreeing that IgG binding antibodies in cord blood may be a key marker, while further studies are needed to confirm their effectiveness and establish safe antibody concentration thresholds that account for various factors.
View Article and Find Full Text PDF
Article Synopsis
  • * A study used data from nearly 75,000 tests involving children and adolescents to assess the vaccine's effectiveness during the Omicron surge by comparing vaccinated individuals to those unvaccinated.
  • * The analysis included significant sample sizes, revealing important insights into the relationship between prior vaccination and the occurrence of symptomatic COVID-19 infections among youth during a key period.
View Article and Find Full Text PDF
Article Synopsis
  • * As vaccine immunity declined, the CDC recommended all individuals aged 12 and older get a booster, while immunocompromised residents, common in nursing homes, should receive an extra primary dose.
  • * An analysis of data during the Omicron surge showed that additional primary or booster doses provided 46.9% greater vaccine effectiveness against infection in nursing home residents compared to just completing the initial vaccine series.
View Article and Find Full Text PDF
Article Synopsis
  • The study aims to assess the effectiveness of three COVID-19 vaccines (BNT162b2, mRNA-1273, and Ad26.COV2.S) over time and during the Delta variant surge to inform vaccination strategies.
  • Data was collected from 6884 US testing sites, involving over 1.8 million tests to analyze the correlation between symptomatic SARS-CoV-2 infections and vaccination status in adults and adolescents from March to October 2021.
  • Results showed that the odds of symptomatic infection post-vaccination increased over time, particularly during the Delta variant period, indicating a reduced effectiveness of vaccines in preventing infections as time since vaccination lengthened.
View Article and Find Full Text PDF

Importance: Assessing COVID-19 vaccine performance against the rapidly spreading SARS-CoV-2 Omicron variant is critical to inform public health guidance.

Objective: To estimate the association between receipt of 3 doses of Pfizer-BioNTech BNT162b2 or Moderna mRNA-1273 vaccine and symptomatic SARS-CoV-2 infection, stratified by variant (Omicron and Delta).

Design, Setting, And Participants: A test-negative case-control analysis among adults 18 years or older with COVID-like illness tested December 10, 2021, through January 1, 2022, by a national pharmacy-based testing program (4666 COVID-19 testing sites across 49 US states).

View Article and Find Full Text PDF

Background: Streptococcus pneumoniae, or pneumococcus, is a leading cause of morbidity and mortality in children worldwide. Pneumococcal conjugate vaccines (PCV) reduce carriage in the nasopharynx, preventing disease. We conducted a pneumococcal carriage study to estimate the prevalence of pneumococcal colonization, identify risk factors for colonization, and describe antimicrobial susceptibility patterns among pneumococci colonizing young children in Port-au-Prince, Haiti, before introduction of 13-valent PCV (PCV13).

View Article and Find Full Text PDF
Article Synopsis
  • - Residents of nursing homes are at high risk for severe COVID-19, prompting the US to prioritize them for early vaccination with mRNA vaccines like Pfizer-BioNTech and Moderna.
  • - Observational studies showed that vaccine effectiveness (VE) ranged from 53% to 92% against SARS-CoV-2 infection, but concerns about waning immunity and the Delta variant necessitated ongoing monitoring of VE.
  • - Analysis of data from skilled nursing facilities indicated a drop in adjusted VE over time: 74.7% before the Delta variant, 67.5% in the intermediate period, and 53.1% during the Delta period, highlighting the impact of the variant on vaccine effectiveness.
View Article and Find Full Text PDF
Article Synopsis
  • Clinical trials show that COVID-19 vaccines authorized for use in the U.S. (Pfizer-BioNTech, Moderna, and Johnson & Johnson) are highly effective against symptomatic disease.
  • Real-world studies of over 7,000 patients indicate that these vaccines are particularly effective in preventing hospitalizations among adults aged 65 and older.
  • Specifically, vaccine effectiveness rates in preventing hospitalizations during early 2021 ranged from 84% to 96% depending on the vaccine type and age group, highlighting the importance of increasing vaccination coverage among older adults to lower hospitalization risks.
View Article and Find Full Text PDF

Residents of long-term care facilities (LTCFs), particularly those in skilled nursing facilities (SNFs), have experienced disproportionately high levels of COVID-19-associated morbidity and mortality and were prioritized for early COVID-19 vaccination (1,2). However, this group was not included in COVID-19 vaccine clinical trials, and limited postauthorization vaccine effectiveness (VE) data are available for this critical population (3). It is not known how well COVID-19 vaccines protect SNF residents, who typically are more medically frail, are older, and have more underlying medical conditions than the general population (1).

View Article and Find Full Text PDF
Article Synopsis
  • This study focused on the causes of severe acute respiratory infections (SARI) in adults across six countries, using advanced testing methods to identify multiple pathogens.
  • Researchers enrolled 2,388 SARI patients and 1,135 asymptomatic adults, finding that 76% of SARI patients had at least one detectable pathogen, commonly Haemophilus influenzae and Streptococcus pneumoniae.
  • The analysis suggested that specific pathogens, including various strains of influenza and RSV, significantly contributed to SARI cases, highlighting the potential benefits of flu vaccination and the need for RSV vaccine development to lessen SARI prevalence.
View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to assess how the implementation of the 10th revision of clinical coding affected pneumonia hospitalization rates, following an initial decline due to the pneumococcal vaccine introduction in 2000.
  • Researchers analyzed hospital records before and after the October 2015 coding implementation to evaluate sensitivity and predictive accuracy of identifying pneumonia cases.
  • Results showed that the coding algorithm was reliable for children, but there were concerns about how adult pneumonia cases were being recoded as COPD exacerbations, indicating a need for further investigation.
View Article and Find Full Text PDF
Article Synopsis
  • - The study examines the relationship between the MenACWY vaccine, introduced for adolescents aged 11-12 in 2005 with a booster at 16, and the incidence of meningococcal disease among U.S. adolescents from 2000 to 2017.
  • - Using surveillance data, researchers utilized Poisson segmented regression analysis to assess changes in the disease incidence over three time periods: before the vaccine, after the primary dose recommendation, and after the booster recommendation.
  • - Results showed a significant decline in meningococcal disease cases, dropping from 0.61 to 0.15 cases per 100,000 population, particularly among young adolescents for serogroups C, W, and Y after the vaccine was
View Article and Find Full Text PDF

Background: Globally, over 400,000 neonatal deaths in 2015 were attributed to sepsis, however, the incidence and etiologies of these infections are largely unknown in low-middle income countries. We aimed to determine incidence and etiology of community-acquired early-onset (<72 hours age) sepsis (EOS) using culture and molecular diagnostics.

Methods: This was a prospective observational study, in which we conducted a surveillance for pathogens using a combination of blood culture and a polymerase chain reaction (PCR)-based test.

View Article and Find Full Text PDF

Background: More than 500 000 neonatal deaths per year result from possible serious bacterial infections (pSBIs), but the causes are largely unknown. We investigated the incidence of community-acquired infections caused by specific organisms among neonates in south Asia.

Methods: From 2011 to 2014, we identified babies through population-based pregnancy surveillance at five sites in Bangladesh, India, and Pakistan.

View Article and Find Full Text PDF

Purpose: Despite high national vaccination coverage with tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccines among U.S. adolescents, rates of adolescent pertussis disease are increasing.

View Article and Find Full Text PDF

Background: Infants aged <1 year are at highest risk for pertussis-related morbidity and mortality. In 2012, Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) vaccine was recommended for women during each pregnancy to protect infants in the first months of life; data on effectiveness of this strategy are currently limited.

Methods: We conducted a case-control evaluation among pertussis cases <2 months old with cough onset between 1 January 2011 and 31 December 2014 from 6 US Emerging Infection Program Network states.

View Article and Find Full Text PDF