geoffrey modest medical blogs

  An article assessed vaccine effectiveness for both mRNA vaccines and the J&J one against symptomatic Covid infection, including hospitalization, admission to the ICU, or ambulatory care in an emergency department or urgent care clinic (see  covid vaccine effectiveness in outpt and inpt setting nejm2021 in dropbox, or DOI: 10.1056/NEJMoa2110362 )   Details:  -- 41,552 hospital admissions to 187 hospitals and 21,522 visits to 221 emergency departments or urgent care clinics, from January 1 through June 22, 2021, for adults at least 50 years old with a Covid-like illness     -- this analysis was done through the CDC’s VISION Network, in collaboration with seven US healthcare systems having a total of 187 hospitals and research centers with integrated medical, laboratory, and vaccination records     -- Covid-like illness was a defined as a clinical diagnosis of acute respiratory illness, or signs and symptoms that have been ...

  A recent VA study assessed mRNA vaccine effectiveness in veterans with cirrhosis (see  covid mRNA vaccine in cirrhosis jamaintmed2021  in dropbox, or doi:10.1001/jamainternmed.2021.4325 ).    Details:  -- mRNA vaccines were administered to 20,037 veterans (51% Moderna, 49% Pfizer), from Dec 18,2020 to March 17, 2021      -- 99.7% of those receiving a first dose who had a follow-up of least 42 days received a second dose  -- median age 69, 97% male, 45% age 60-70yo/43% 70-85yo, 61% white/23% Black/8% Latinx, 42% alcohol-associated cirrhosis, 77% overweight or obese, 52% diabetes, 39% current smoker/32% former  -- propensity matching for the control group (also 20,037 veterans as controls) to achieve similarity regarding age, sex, race or ethnicity, duration of follow-up, comorbidities, alcohol-associated liver disease, and severity of liver disease estimated by the Child-Turcotte-Pugh score  -- primary outcome: Covid-19 i...