UMBC Emergency and Distaster Health Systems

Permanent URI for this collectionhttp://hdl.handle.net/11603/38

The Department of Emergency Health Services offers a unique opportunity for the education of future Emergency Medical Services, Emergency Public Health, and Emergency Management professionals. This is accomplished by providing a broad liberal-arts and sciences education which enhances the graduate employment opportunities as pre-hospital providers, policy makers, and managers.The Department of Emergency Health Services also provides a cutting edge education for advancement to graduate, medical, and professional studies. The Graduate program is primarily focused on preparing professionals for leadership roles in Disaster Health, Emergency Public Health and Policy Development. The two-track curriculum is designed to provide graduate level training and education to health care providers, researchers, educators, policy makers, and administrators. An Education concentration can be combined with either track. A post-baccalaureate certificate in Emergency Management is also offered. The Academic Department of Emergency and Disaster Health Systems offers a unique opportunity for the education of future Emergency Medical Services, Emergency Public Health, and Emergency Management professionals. This is accomplished by providing broad liberal arts and sciences education which enhances the graduate employment opportunities as pre-hospital providers, policymakers, and managers. The Department of Emergency and Disaster Health Systems also provides a cutting-edge education for advancement to graduate, medical, and professional studies. The Graduate program is primarily focused on preparing professionals for leadership roles in Disaster Health, Emergency Public Health, and Policy Development. The two-track curriculum is designed to provide graduate-level training and education to health care providers, researchers, educators, policymakers, and administrators. An Education concentration can be combined with either track. A post-baccalaureate certificate in Emergency Management is also offered. As of Fall 2017, in conjunction with the School of Public Policy, we now offer concentrations in Emergency Health or Emergency Management within the Public Policy Ph.D. program.

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Colonialism’s legacy has left Caribbean nations much more vulnerable to hurricanes
(The Conversation, 2024-10-22) Nibbs, Farah
The islands’ vulnerability has roots deep in the exploitative systems forced on them by colonialism, from slave-based land policies to ill-suited development that put lives in harm’s way.
Enhancing Stress Understanding Through Team Reflection: Technology-Driven Insights in High-Stress Training Scenarios
(ACM, 2024-06-25) Akiri, Surely; Joshi, Vasundhara; Taherzadeh, Sanaz; Jenkins, J. Lee; Williams, Gary; Mentis, Helena; Kleinsmith, Andrea
Systems aimed at stress awareness and reflection training by those in high-stress work environments may aid the development of stress management skills to alleviate and manage future workplace traumas. However, there is a notable gap in research addressing the insights and awareness individuals gain about their stress when they engage in team-based reflection on team-based data. To this end, we designed the Stress Reflection system as a proof-of-concept educational tool to foster and promote stress reflection and awareness by presenting trainees with both internal and external behavioral information, i.e., electrodermal activity (EDA) and corresponding situated simulation videos. We conducted a study within paramedic simulation training to qualitatively assess the insights gained and the depth of reflection achieved by trainees while interacting with each other and their data. Our findings revealed that reflecting together facilitated valuable insights into the emotions, self-expression, and behaviors that manifest during periods of stress. Trainees interacting collaboratively demonstrated emotional intelligence, predominantly engaging in higher-level dialogic reflections. Nonetheless, similar to other studies, transformative and critical reflection was largely absent. We conclude by discussing the primary findings and recommendations for expanding reflective frameworks to assess reflection in collaborative settings. This research contributes to the HCI community by offering empirically supported insights into team-based stress reflection in work and its implications for stress management in high-stress work environments.
Social Enterprise and Democracy in China: The Case of Environmental Nonprofit Organizations
(De Gruyter, 2024-08-19) Xie, Ming; Eikenberry, Angela M.
China is an important example in contemporary society regarding the power relations between government, nonprofit organizations and social enterprise, and the development of civil society and democracy in transitional and authoritarian regimes. Scholars have raised concerns about the impact of a growing reliance on social enterprise on democratic participation and outcomes. This work has largely focused on the US, UK, and other Western democracies. Some scholars alternatively suggest that social enterprise may help organizations to become more independent from the state, alleviating fund-seeking pressure and facilitating the development of civil society. Focusing on lessons learned through three case studies of environmental nonprofit organizations in China, this chapter examines how these organizations have responded to neoliberalization, leveraged social enterprise, and developed public participation. Data shows that the organizations studied adopted developmental approaches to embrace or resist neoliberalization and practice social enterprise and demonstrated limited autonomy and democratic participation.
Dialogue about Syllabus for Education of Research Methods in Journalism and Communication: A Contract, a Plan, a Cognitive Map, or a Communication Device?
(AEJMC, 2023) Xie, Ming; Chao, Chin-Chung
This study explores how the teaching of research methods in journalism and communication is embodied through syllabi in U.S. classrooms. Through emails and an online search, this study collects and reviews syllabi from the 102 accredited programs by Accrediting Council on Education in Journalism and Mass Communications. Based on four major distinct purposes of a syllabus —as a contract, a communication device, a plan, and a cognitive map—we examined the current education status of research methods courses and identified strategies of using syllabi as a learner-centered tool which can empower students to be motivated and self-directed learners
Make Hay While the Sun Shines: How Community Organizations Help Refugees in Preparation for Disasters
(2023-03-02) Xie, Ming; Chen, Li
This article examines community-based nonprofit organizations' (CBOs') perspectives and practices regarding cultivating refugees' disaster resilience. Adopting the theoretical framework of structural and cognitive social capital, we conducted in-depth interviews with leaders, staff members, and volunteers from refugee-serving organizations. The research findings offer new insights into how CBOs help refugees obtain multiple forms of social capital and develop disaster resilience through education and training, resource mobilization, planning, and coordination. The research findings also reveal the flow of social capital exchange during the disaster resilience cultivation process. Similar CBOs can rely on our research findings to develop evidence-based programs and interventions to help culturally and linguistically diverse groups gain social capital and improve disaster resilience.
Rural Young Adults' PerceptTioITnLsEof Cannabis: A Survey Study
(2024-03-07) Chen, Li; Xie, Ming
This project examines rural young adults’ perceptions of cannabis (marijuana). The results of a paper-and-pencil and an online survey yielded four major findings. The research findings show the associations between exposure to social media messages about cannabis, moral foundations, perceived risks of cannabis, attitudes toward cannabis legalization, and word of mouth intentions to talk about cannabis in person and online. Data analysis suggests that young adults’ attitudes toward recreational cannabis and cannabis legalization are not predicted by time spent on social media, but are associated with specific moral foundations. The research findings show that health educators may consider embedding latent moral values in their drug-prevention campaigns that target rural young adults.
West Texas A&M University experts talk on preparation for emergency situations
(2023-08-23) Frazier, KyLeah; Xie, Ming
The recent disaster in Maui coupled with an approaching dry winter season here in the Panhandle highlights the dangers of wildfires and how being prepared makes a big difference.
I am in the Homeless Home or I Am Always on the Way Home: Formatting Identity and Transcultural Adaptation Through Ethnic and Host Communication
(De Gruyter, 2024-03-22) Chao, Chin-Chung; Xie, Ming
This study uses a phenomenological approach and 25 in-depth interviews to better understand ethnic and host communication by Chinese international students in U.S. higher education and the impact of such communication practices on their cultural identity transformation and transcultural adaptation. The research findings reveal that their ethnic communication reflects their dynamic negotiation of cultural identities and their efforts to integrate their original cultural background and their expectations of others to redefine their own cultural identities and communicative behaviors. It also highlights that Chinese students engage in ethnic communication not only for community building and cultural identity reinforcement but also assertively to express themselves and educate others.
The platformation and transformation of the digital public sphere: An introduction
(Sage, 2024-03-01) Xie, Ming
This article introduces the complex landscape of social media platforms and their evolving integration within social and political contexts. Focusing on the concept of platform society, this article discusses the emergence and growth of new platforms as well as the localization trends of mobile communication. This article examines the interplay between technological structures and social, cultural, and political dimensions of mobile communication, focusing on issues such as privacy policies, data protection, and profit-seeking motives of platform owner companies. In addition, this article introduces the six papers chosen for this special issue. The diverse viewpoints presented in this special issue contribute to a deeper understanding of digital communication’s role in advancing democracy, encouraging citizen participation, and transforming public spheres.
Turning every disaster into an opportunity: An exploratory study on refugees’ perceived emergency management capacity and community resilience
(ELSEVIER, 2024-09-01) Xie, Ming; Chen, Li
This article explores the perceived emergency management capabilities and community resilience among refugees residing in Texas. Adopting the theoretical framework of structural and cognitive social capital, we conducted in-depth interviews with refugees from Afghanistan, Congo, Iran, Myanmar, Somalia, and Thailand. The study identifies the specific needs of the refugee community regarding disaster management and their simultaneous vulnerability and resilience. Based on our research findings, we suggest that local disaster management agencies identify and collaborate with the community leaders in refugee communities to efficiently achieve their communication goals, strengthen refugees' community resilience, and better integrate refugee communities into the local community's resilience development.
Responsible Computing: A Longitudinal Study of a Peer-led Ethics Learning Framework
(ACM, 2022-09-15) McDonald, Nora; Akinsiku, Adegboyega; Hunter-Cevera, Jonathan; Sanchez, Maria; Kephart, Kerrie; Berczynski, Mark; Mentis, Helena
We studied the impact of introducing first-year computer science (CS) students to ethical thinking about the social justice impacts of data collection, tracking, bias, internet privacy, and competitive “real world” system design and critique activities. While basic content was consistent for all, one group was involved throughout the course in peer discussions designed to foster greater engagement, with the anticipation that this would enable students to reach new levels of sensitivity through peer-to-peer interaction. This article reports on our observation of this design, interview, and project data collected throughout the course as well interviews conducted eight months later to learn about how students were retaining and applying what they learned. We found that students are sensitive to the technology-related risks and vulnerabilities encountered by individuals based on race, gender, and, to some extent, age, but they struggle to assess who is responsible for these risks, what to do about bias in technology design, and how to mitigate harms for individuals whom they perceive to be vulnerable, furthering the argument for an integrated ethics curriculum. We explore the value of formal peer-led discussion to evolve social justice thinking with a focus on identity, though note that opportunities for any group discussion are meaningful to students’ thinking about social justice. Over the longer term, students tend to recall and apply ethics that is closely related to their identity, suggesting that empathy has limits.
Sargassum is choking the Caribbean’s white sand beaches, fueling an economic and public health crisis
(The Convesation, 2024-06-04) Nibbs, Farah
A leading driver of this seaweed invasion is pollution, carried down rivers and into the Atlantic Ocean from the continents.
Implementation of a prehospital whole blood program: Lessons learned
(WILEY, 2024-03-21) Levy, Matthew; Garfinkel, Eric M.; May, Robert; Cohn, Eric; Tillett, Zachary; Wend, Christopher; Sikorksi, Robert A.; Troncoso Jr, Ruben; Jenkins, J. Lee; Chizmar, Timothy P.; Margolis, Asa M.
Early blood administration by Emergency Medical Services (EMS) to patients suffering from hemorrhagic shock improves outcomes. Prehospital blood programs represent an invaluable resuscitation capability that directly addresses hemorrhagic shock and mitigates subsequent multiple organ dysfunction syndrome. Prehospital blood programs must be thoughtfully planned, have multiple safeguards, ensure adequate training and credentialing processes, and be responsible stewards of blood resources. According to the 2022 best practices model by Yazer et al, the four key pillars of a successful prehospital program include the following: (1) the rationale for the use and a description of blood products that can be transfused in the prehospital setting, (2) storage of blood products outside the hospital blood bank and how to move them to the patient in the prehospital setting, (3) prehospital transfusion criteria and administration personnel, and (4) documentation of prehospital transfusion and handover to the hospital team. This concepts paper describes our operational experience using these four pillars to make Maryland's inaugural prehospital ground-based low-titer O-positive whole blood program successful. These lessons learned may inform other EMS systems as they establish prehospital blood programs to help improve outcomes and enhance mass casualty response.
SEEe Immersive Analytics System: Enhancing Data Analysis Experience within Complex Data Visualization Environments
(ACM, 2024-06-07) Rajasagi, Damaruka Priya; Boot, Lee; Wilson, Lucy; King, Tristan; Zuber, James; Stockwell, Ian; Komlodi, Anita
The current state-of-the-art 2D data visualizations fall short in capturing the intricate complexity and depth of available information crucial for integrated decision-making. In response to this limitation, the Systems Exploration and Engagement environment (SEEe) emerges as a cutting-edge virtual immersive analytics data experience. We developed this system through a user-centered design process involving an interdisciplinary design and development team. Through virtual reality, SEEe seamlessly integrates geo-referenced spatial data, abstract data visualization, and qualitative data encompassing text, images, videos, and conceptual diagrams to support sensemaking from large amounts of multiformat data and integrated decision making. We aim to redefine the experience of analyzing extensive amounts of abstract data by creating an environment that accommodates both quantitative and qualitative data for visualization and analysis. How these novel immersive analytics experiences fit into data analysis workflows in various domains have not been studied widely. We carried out a user study with 10 public health graduate students to test the usability, learnability, and utility of the SEEe experience and to explore how these immersive data visualization experiences can fit into traditional data analysis processes. While SEEe is designed to be adaptable across various domains, we evaluated its performance within the public health context. The results of the evaluation affirm that SEEe is not only usable and useful but also provides a learnable environment conducive to immersive analytics.
Thirsty in Paradise: The Growing Water Crises Across the Caribbean islands
(CounterPunch, 2024-05-16) Nibbs, Farah
In the popular imagination, the Caribbean is paradise, an exotic place to escape to. But behind the images of balmy beaches and lush hotel grounds lies a crisis, the likes of which its residents have never experienced.
Carbapenem-resistant Acinetobacter baumannii complex in the United States – an epidemiological and molecular description of isolates collected through the Emerging Infections Program, 2019
(Elsevier, 2024-04-29) Bulens, Sandra N.; Campbell, Davina; McKay, Susannah L.; Vlachos, Nicholas; Burgin, Alex; Burroughs, Mark; Padila, Jasmine; Grass, Julian E.; Jacob, Jesse T.; Smith, Gillian; Muleta, Daniel B.; Maloney, Meghan; Macierowski, Bobbie; Wilson, Lucy; Vaeth, Elisabeth; Lynfield, Ruth; O’Malley, Sean; Snippes Vagnone, Paula M.; Dale, Jennifer; Janelle, Sarah J.; Czaja, Christopher A.; Johnson, Helen; Phipps, Erin C.; Flores, Kristina G.; Dumyati, Ghinwa; Tsay, Rebecca; Beldavs, Zintars G.; Maureen Cassidy, P.; Hall, Amanda; Walters, Maroya S.; Guh, Alice Y.; Magill, Shelley S.; Lutgring, Joseph D.
Background: Understanding the epidemiology of carbapenem-resistant A. baumannii complex (CRAB) and the patients impacted is an important step towards informing better infection prevention and control practices and improving public health response. Methods: Active, population-based surveillance was conducted for CRAB in 9 U.S. sites from January 1-December 31, 2019. Medical records were reviewed, isolates were collected and characterized including antimicrobial susceptibility testing and whole genome sequencing. Results: Among 136 incident cases in 2019, 66 isolates were collected and characterized; 56.5% were from cases who were male, 54.5% were from persons of Black or African American race with non-Hispanic ethnicity, and the median age was 63.5 years. Most isolates, 77.2%, were isolated from urine, and 50.0% were collected in the outpatient setting; 72.7% of isolates harbored an acquired carbapenemase gene (aCP), predominantly blaₒₓₐ₋₂₃ or blaₒₓₐ₋₂₄/₄₀; however, an isolate with blaₙᴅₘ was identified. The antimicrobial agent with the most in vitro activity was cefiderocol (96.9% of isolates were susceptible). Conclusions: Our surveillance found that CRAB isolates in the U.S. commonly harbor an aCP, have an antimicrobial susceptibility profile that is defined as difficult-to-treat resistance, and epidemiologically are similar regardless of the presence of an aCP.
Characteristics of healthcare personnel who reported concerns related to PPE use during care of COVID-19 patients
(Cambridge University Press, 2022-05-16) Chea, Nora; Tavitian, Stephanie; Brown, Cedric; Eure, Taniece; Alkis, Rebecca; Blazek, Gregory; Penna, Austin; Nadle, Joelle; Frank, Linda; Czaja, Christopher; Johnston, Helen; Barter, Devra; Angell, Kathleen; Marshall, Kristen; Meek, James; Brackney, Monica; Carswell, Stacy; Thomas, Stepy; Fridkin, Scott; Wilson, Lucy; Fell, Ashley; Lovett, Sara; Lim, Sarah; Lynfield, Ruth; SarahShrum, Ruth; Phipps, Erin C.; Sievers, Marla; Dumyati, Ghinwa; Concannon, Cate; McCullough, Kathryn; Woods; Seshadri, Sandhya; Myers, Christopher; Pierce, Rebecca; Ocampo, Valerie; Guzman-Cottrill, Judith; Escutia, Gabriela; Samper, Monika; Pena, Sandra; Adre, Cullen; Markus, Tiffanie; Billings, Kathryn; Groenewold, Matthew; Sinkowitz-Cochran, Ronda; Magill, Shelley; Grigg, Cheri; Miller, Betsy
Background: Healthcare facilities have experienced many challenges during the COVID-19 pandemic, including limited personal protective equipment (PPE) supplies. Healthcare personnel (HCP) rely on PPE, vaccines, and other infection control measures to prevent SARS-CoV-2 infections. We describe PPE concerns reported by HCP who had close contact with COVID-19 patients in the workplace and tested positive for SARS-CoV-2. Method: The CDC collaborated with Emerging Infections Program (EIP) sites in 10 states to conduct surveillance for SARS-CoV-2 infections in HCP. EIP staff interviewed HCP with positive SARS-CoV-2 viral tests (ie, cases) to collect data on demographics, healthcare roles, exposures, PPE use, and concerns about their PPE use during COVID-19 patient care in the 14 days before the HCP’s SARS-CoV-2 positive test. PPE concerns were qualitatively coded as being related to supply (eg, low quality, shortages); use (eg, extended use, reuse, lack of fit test); or facility policy (eg, lack of guidance). We calculated and compared the percentages of cases reporting each concern type during the initial phase of the pandemic (April–May 2020), during the first US peak of daily COVID-19 cases (June–August 2020), and during the second US peak (September 2020–January 2021). We compared percentages using mid-P or Fisher exact tests (α = 0.05). Results: Among 1,998 HCP cases occurring during April 2020–January 2021 who had close contact with COVID-19 patients, 613 (30.7%) reported >=1 PPE concern (Table 1). The percentage of cases reporting supply or use concerns was higher during the first peak period than the second peak period (supply concerns: 12.5% vs 7.5%; use concerns: 25.5% vs 18.2%; p Conclusions: Although lower percentages of HCP cases overall reported PPE concerns after the first US peak, our results highlight the importance of developing capacity to produce and distribute PPE during times of increased demand. The difference we observed among selected groups of cases may indicate that PPE access and use were more challenging for some, such as nonphysicians and nursing home HCP. These findings underscore the need to ensure that PPE is accessible and used correctly by HCP for whom use is recommended.
4MS AGE-FRIENDLY HEALTHCARE INITIATIVE IMPLEMENTATION ON AN ACUTE CARE FOR ELDERS UNIT
(Oxford University Press, 2022-12-20) Wilson, Lucy; Rick, Chelsea; Welch, Sarah; Nelson, Sarah; Lawson, Olivia; Boren, Hannah; Duggan, Mariu
Although evidence supports 4Ms [Medication, Mentation, What Matters Most (WMM), Mobility] care for older adults, successful implementation at an academic hospital is not well described. The aim of this study was to describe the implementation methods and process measures for 4Ms delivery on the Acute Care for Elders (ACE) unit at an academic hospital. We used the Institute for Healthcare Improvement’s Model for Improvement to guide efforts. We set SMART goals for each M: best possible medication reconciliation, identification of potentially inappropriate medications, and recommendations to deprescribe (medication), delirium screen documented 2x/day and delirium nonpharmacologic protocol in place (mentation), documentation of WMM and care alignment (WMM), Johns Hopkins-Highest Level of Mobility screen assessed during the patient’s hospitalization, mobilization of patient 3x/day offered and documented, and restraints avoided (mobility). We mapped current and ideal workflows. We sought community grant funding to expand the implementation team, supporting a nurse educator to train the unit and data analyst to extract real-time data from the electronic medical record to inform improvement processes. Multiple Plan-Do-Study-Act cycles were run iteratively and discussed at weekly team meetings. We included patients >65 years old, admitted for >48 hours, and excluded patients admitted on hospice. Of 519 eligible patients admitted from 04/2021-01/2022, goals were met by 454 (87%) for medication, 187 (36%) for mentation, 130 (25%) for WMM, and 6 (1%) for mobility. We found implementing 4M care processes at an academic hospital to be feasible. Further exploration of barriers to meeting the mobility target is warranted.
Epidemiology of carbapenem-resistant and extended-spectrum beta-lactamase-producing Enterobacterales in US children, 2016–2020
(Cambridge University Press, 2023-09-29) Grome, Heather; Grass, Julian; Duffy, Nadezhda; Bulens, Sandra; Jacob, Jesse; Smith, Gillian; Wilson, Lucy; Vaeth, Elisabeth; Evenson, Bailey; Dumyati, Ghinwa; Tsay, Rebecca; Phipps, Erin C.; Flores, Kristina; Wilson, Christopher; Czaja, Christopher; Johnston, Helen; Lynfield, Ruth; O’Malley, Sean; Maloney, Meghan; Stabach, Nicole; Nadle, Joelle; Guh, Alice
Background: The Centers for Disease Control and Prevention’s Emerging Infections Program conducts active laboratory- and population-based surveillance for carbapenem-resistant Enterobacterales (CRE) and extended spectrum beta-lactamase-producing Enterobacterales (ESBL-E). To better understand the U.S. epidemiology of these organisms among children, we determined the incidence of pediatric CRE and ESBL-E cases and described their clinical characteristics. Methods: Surveillance was conducted among children <18 years of age for CRE from 2016–2020 in 10 sites, and for ESBL-E from 2019–2020 in 6 sites. Among catchment-area residents, an incident CRE case was defined as the first isolation of Escherichia coli, Enterobacter cloacae complex, Klebsiella aerogenes, K. oxytoca, or K. pneumoniae in a 30-day period resistant to ≥1 carbapenem from a normally sterile site or urine. An incident ESBL-E case was defined as the first isolation of E. coli, K. pneumoniae, or K. oxytoca in a 30-day period resistant to any third-generation cephalosporin and non-resistant to all carbapenems from a normally sterile site or urine. Case records were reviewed. Results: Among 159 CRE cases, 131 (82.9%) were isolated from urine and 19 (12.0%) from blood; median age was 5 years (IQR 1–10) and 94 (59.1%) were female. Combined CRE incidence rate per 100,000 population by year ranged from 0.47 to 0.87. Among 207 ESBL-E cases, 160 (94.7%) were isolated from urine and 6 (3.6%) from blood; median age was 6 years (IQR 2–15) and 165 (79.7%) were female. Annual ESBL incidence rate per 100,000 population was 26.5 in 2019 and 19.63 in 2020. Incidence rates of CRE and ESBL-E were >2-fold higher in infants (children <1 year) than other age groups. Among those with data available, CRE cases were more likely than ESBL-E cases to have underlying conditions (99/158 [62.7%] versus 59/169 [34.9%], P<0.0001), prior healthcare exposures (74/158 [46.8%] versus 38/169 [22.5%], P<0.0001), and be hospitalized for any reason around time of their culture collection (75/158 [47.5%] versus 38/169 [22.5%], P<0.0001); median duration of admission was 18 days [IQR 3–103] for CRE versus 10 days [IQR 4–43] for ESBL-E. Urinary tract infection was the most frequent infection for CRE (89/158 [56.3%]) and ESBL-E (125/169 [74.0%]) cases. Conclusion: CRE infections occurred less frequently than ESBL-infections in U.S. children but were more often associated with healthcare risk factors and hospitalization. Infants had highest incidence of CRE and ESBL-E. Continued surveillance, infection prevention and control efforts, and antibiotic stewardship outside and within pediatric care are needed
Effectiveness of a Messenger RNA Vaccine Booster Dose Against Coronavirus Disease 2019 Among US Healthcare Personnel, October 2021–July 2022
(Oxford University Press, 2023-09-08) Plumb, Ian D.; Mohr, Nicholas M.; Hagen, Melissa; Wiegand, Ryan; Dumyati, Ghinwa; Harland, Karisa K.; Krishnadasan, Anusha; Gist, Jade James; Abedi, Glen; Fleming-Dutra, Katherine E.; Chea, Nora; Lee, Jane; Barter, Devra; Brackney, Monica; Fridkin, Scott K.; Wilson, Lucy; Lovett, Sara A.; Ocampo, Valerie; Phipps, Erin C.; Marcus, Tiffanie M.; Smithline, Howard A.; Hou, Peter C.; Lee, Lilly C.; Moran, Gregory J.; Krebs, Elizabeth; Steele, Mark T.; Lim, Stephen C.; Schrading, Walter A.; Chinnock, Brian; Beiser, David G.; Faine, Brett; Haran, John P.; Nandi, Utsav; Chipman, Anne K.; LoVecchio, Frank; Talan, David A.; Pilishvili, Tamara
Background: Protection against symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (coronavirus disease 2019 [COVID-19]) can limit transmission and the risk of post-COVID conditions, and is particularly important among healthcare personnel. However, lower vaccine effectiveness (VE) has been reported since predominance of the Omicron SARS-CoV-2 variant. Methods: We evaluated the VE of a monovalent messenger RNA (mRNA) booster dose against COVID-19 from October 2021 to June 2022 among US healthcare personnel. After matching case-participants with COVID-19 to control-participants by 2-week period and site, we used conditional logistic regression to estimate the VE of a booster dose compared with completing only 2 mRNA doses >150 days previously, adjusted for multiple covariates. Results: Among 3279 case-participants and 3998 control-participants who had completed 2 mRNA doses, we estimated that the VE of a booster dose against COVID-19 declined from 86% (95% confidence interval, 81%–90%) during Delta predominance to 65% (58%–70%) during Omicron predominance. During Omicron predominance, VE declined from 73% (95% confidence interval, 67%–79%) 14–60 days after the booster dose, to 32% (4%–52%) >=120 days after a booster dose. We found that VE was similar by age group, presence of underlying health conditions, and pregnancy status on the test date, as well as among immunocompromised participants. Conclusions: A booster dose conferred substantial protection against COVID-19 among healthcare personnel. However, VE was lower during Omicron predominance, and waning effectiveness was observed 4 months after booster dose receipt during this period. Our findings support recommendations to stay up to date on recommended doses of COVID-19 vaccines for all those eligible.

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