Most state COVID vaccine plans likely didn’t focus on health equity
Only 20 US state and District of Columbia COVID-19 vaccination plans included mention of a health equity committee, and only 8 specifically mentioned including minority group representatives, according to a JAMA Network Open research letter late last week.
The researchers looked at the 51 state and District of Columbia COVID-19 vaccination plans publicly available on their respective department of health websites, although 41 had not been finalized by the time of review.
Overall, only 12 of the 20 states that mentioned health equity committees specified who would serve on the committees, with minority group representatives mentioned in only 8. Other members included physicians (11), government officials (6), clergy (5), and ethicists (4). A little more than half of all plans (26) said they would collaborate with organizations that serve minority populations; however, the researchers say this is not enough.
Across the plans, high-risk criteria and medical conditions varied. For instance, some states considered those above 65 at higher risk, while others listed the cutoff as 75 years. Diabetes and obesity were the most common high-risk conditions mentioned in plans, but sickle cell disease was considered high risk in only 36.
“It wasn’t surprising to find that there was variability across states, but it was surprising to find that most states didn’t have a committee of diverse stakeholders to help address this equity problem,” said senior author Juan C. Rojas, MD, in a University of Chicago press release. “There weren’t many places where patient advocates were included on the committee to add a voice about the additional challenges that might exist for these vulnerable patients.”
Jul 2 JAMA Netw Open study
Jul 2 University of Chicago press release
Long COVID-19 after 1 year can include neurologic, other symptoms
Long COVID symptoms can persist for at least 1 year after acute infection, significantly reducing quality of life, according to a study yesterday in Clinical Infectious Diseases. The researchers add that lingering neurocognitive symptoms may include difficulty concentrating and finding words.
The researchers followed 96 German COVID-19 patients for a year after COVID-19 symptom onset from Feb 22 to Apr 18, 2020. By a year, only 22.9% of patients were completely symptom free. The most common long COVID-19 symptoms at a year were reduced exercise capacity (56.3%), fatigue (53.1%), concentration issues (39.6%), shortness of breath (37.5%), difficulty finding words (32.3%), and sleeping problems (26.0%).
A little over half (55.2%) were females, and the median age was 57. Almost a third (32.3%) were hospitalized during the original symptom presentation. In addition after their acute infection, seven developed high blood pressure, three developed diabetes, and one each had new diagnoses of perimyocarditis, depression, sleep apnea, asthma, and cardiovascular health disease.
The researchers say that quality of life on the self-reported SF-12 questionnaire was significantly reduced in those with long COVID-19 on both the physical and mental component scales. At 12 months, 43.6% of patients had high antinuclear antibody (ANA) titers (at least 1:160), which were associated with neurocognitive symptoms and higher overall symptom frequency.
When stratifying by sex, a higher proportion of women had high ANA titers than did men. High ANA levels were significantly linked with a higher likelihood of concentration problems and body aches in women.
“Unexpectedly, in our patient cohort symptom frequency remained unchanged for most neurocognitive symptoms analyzed. This high degree of symptom persistence may in part be due to a selection bias as 50 of the 146 patients initially included at 5 months were lost to 12-months follow-up, likely due to being less symptomatic,” write the researchers, noting that the long pandemic may have also have affected patients’ psyches.
Jul 5 Clin Infect Dis study