Emerging reports suggest that obese patients who are hospitalized with COVID-19 may have worse outcomes; whether this association extends to those who are not hospitalized is unclear. This study ex... Visual Obesity and Mortality Among Patients Diagnosed With COVID-19 Emerging reports suggest that obese patients who are hospitalized with COVID-19 may have worse outcomes; whether this as... Background: Obesity, race/ethnicity, and other correlated characteristics have emerged as high-profile risk factors for adverse coronavirus disease 2019 (COVID-19)–associated outcomes, yet studies ...

OBJECTIVE: To assess the risk of pertussis by time since vaccination in children in Minnesota and Oregon who received 5 doses of acellular pertussis vaccines (DTaP). METHODS: These cohort analyses included Minnesota and Oregon children born between 1998 and 2003 who had 5 DTaP doses recorded in state Immunization Information Systems. Immunization records and statewide pertussis surveillance data were combined. Incidence rates and risk ratios for pertussis were calculated for the 6 years after receipt of the fifth DTaP dose. RESULTS: The cohorts included 224 378 Minnesota children and 179 011 from Oregon; 458 and 89 pertussis cases were identified in Minnesota and Oregon, respectively. Pertussis incidence rates rose each year of follow-up: 15.6/100 000 (95% confidence interval [CI]: 11.1–21.4) at year 1 to 138.4/100 000 (CI: 113.3–166.9) at year 6 (Minnesota); 6.2/100 000 (CI: 3.3–10.6) in year 1 to 24.4/100 000 (CI: 15.0–37.8) in year 6 (Oregon). Risk ratios increased from 1.9 (CI: 1.3–2.9) in year 2 to 8.9 (CI: 6.0–13.0) in year 6 (Minnesota) and from 1.3 (CI: 0.6–2.8) in year 2 to 4.0 (CI: 1.9–8.4) in year 6 (Oregon). CONCLUSIONS: This evaluation reports steady increase in risk of pertussis in the years after completion of the 5-dose DTaP series. This rise is likely attributable in part to waning immunity from DTaP vaccines. Continuing to monitor disease burden and vaccine effectiveness in fully vaccinated children in coming years will be important to assess ongoing risk as additional cohorts vaccinated solely with acellular pertussis vaccines are introduced.

Wildfires have become more frequent and intense due to climate change and outdoor wildfire fine particulate matter (PM _2.5 ) concentrations differ from relatively smoothly varying total PM _2.5 . Thus, we introduced a conceptual model for computing long-term wildfire PM _2.5 and assessed disproportionate exposures among marginalized communities. We used monitoring data and statistical techniques to characterize annual wildfire PM _2.5 exposure based on intermittent and extreme daily wildfire PM _2.5 concentrations in California census tracts (2006 to 2020). Metrics included: 1) weeks with wildfire PM _2.5 > 5 μg/m ³ ; 2) days with non-zero wildfire PM _2.5 ; 3) mean wildfire PM _2.5 during peak exposure week; 4) smoke waves (≥2 consecutive days with >15 μg/m ³ wildfire PM _2.5 ); and 5) mean annual wildfire PM _2.5 concentration. We classified tracts by their racial/ethnic composition and CalEnviroScreen (CES) score, an environmental and social vulnerability composite measure. We examined associations of CES and racial/ethnic composition with the wildfire PM _2.5 metrics using mixed-effects models. Averaged 2006 to 2020, we detected little difference in exposure by CES score or racial/ethnic composition, except for non-Hispanic American Indian and Alaska Native populations, where a 1-SD increase was associated with higher exposure for 4/5 metrics. CES or racial/ethnic × year interaction term models revealed exposure disparities in some years. Compared to their California-wide representation, the exposed populations of non-Hispanic American Indian and Alaska Native (1.68×, 95% CI: 1.01 to 2.81), white (1.13×, 95% CI: 0.99 to 1.32), and multiracial (1.06×, 95% CI: 0.97 to 1.23) people were over-represented from 2006 to 2020. In conclusion, during our study period in California, we detected disproportionate long-term wildfire PM _2.5 exposure for several racial/ethnic groups.