Adjuvanted recombinant zoster vaccine is effective against herpes zoster ophthalmicus, and is associated with lower risk of acute myocardial infarction and stroke in adults aged ≥50 years.

Background: Herpes zoster (HZ) and HZ ophthalmicus (HZO) are associated with an increased risk of cardiovascular complications, such as acute myocardial infarction (AMI) and stroke. We evaluated the association between recombinant zoster vaccine (RZV) and risk of HZO, hospitalized AMI, and hospitalized stroke in adults ≥50 years of age (YoA) at Kaiser Permanente Southern California.

Methods: We conducted a matched cohort analysis of adults ≥50 YoA who received 2 doses of RZV 4 weeks-6 months apart during 01 April 2018-31 December 2020 and were matched 1:4 to RZV-unvaccinated individuals on age, sex, race/ethnicity, and index date (date of second dose among vaccinated; unvaccinated match assigned same date).

Effectiveness of the Adjuvanted Recombinant Zoster Vaccine in Adults ≥50 Years in the United States.

Background: Recombinant zoster vaccine (RZV) was approved for adults aged ≥50 years in the United States to prevent herpes zoster (HZ) and postherpetic neuralgia (PHN). This study evaluated real-world vaccine effectiveness (VE) of RZV in adults aged ≥50 years.

Methods: A cohort study was conducted at Kaiser Permanente Southern California (KPSC).

Validation of ICD-10 Diagnosis Codes for Identification of Acute Myocardial Infarction From a US Integrated Healthcare System.

Purpose: Contemporary epidemiologic research on acute myocardial infarction (AMI) using electronic health records (EHR) relies on International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes, but limited studies have been conducted to validate these codes in the United States. Therefore, this study aimed to validate AMI events identified by ICD-10-CM diagnosis codes.

Methods: The study was conducted as part of a hepatitis B vaccine safety study.

Screening and vaccination rates for tetanus, hepatitis A, and hepatitis B among individuals with substance use disorders who are hospitalized in an integrated U.S. health system.

Background: Hepatitis A virus infection (HAV), hepatitis B virus infection (HBV), and tetanus are important vaccine-preventable infections among individuals with substance use disorder (SUD). Hospitalizations may represent opportunities for preventive care. Up-to-date data on screening and vaccination practices for this high-risk population are needed in these settings.

Respiratory syncytial virus vaccine uptake among adults aged ≥60 years in a large, integrated healthcare system in Southern California 2023-2024.

During the 2023-2024 respiratory syncytial virus (RSV) season, vaccination was recommended for adults ≥60 years based on shared clinical decision-making with their healthcare providers. We examined RSV vaccine uptake and characteristics associated with uptake among age-eligible Kaiser Permanente Southern California (KPSC) patients. Our study cohort included all patients ≥60 years from September 23, 2023 (i.

Risk of Incident Tuberculosis Disease in a Large Integrated Health Care System in California, 2004-2022.

Background: Few studies have assessed tuberculosis (TB) disease incidence and risk in a large US-based cohort with long-term longitudinal follow-up.

Methods: In a retrospective cohort study from 2004 to 2022, we assessed risk of incident microbiologically confirmed TB disease using Cox proportional hazards models. Primary exposures were (1) nativity and (2) high-risk medical conditions for progression to TB disease.

Effectiveness and safety of the recombinant zoster vaccine in individuals ≥50 years of age with rheumatoid arthritis: a matched cohort and self-controlled case series study.

Objectives: In an interim analysis, we evaluated vaccine effectiveness (VE) against herpes zoster (HZ) and postherpetic neuralgia (PHN) and safety of recombinant zoster vaccine (RZV) in adults aged ≥50 years with rheumatoid arthritis (RA).

Methods: VE was assessed using a retrospective matched cohort analysis of Kaiser Permanente Southern California members aged ≥50 years with RA receiving 2 RZV doses (≥4 weeks apart) and matched up to 1:3 to RZV-unvaccinated individuals. Stratified Cox proportional hazards regression was used to estimate adjusted hazard ratios and VE against HZ and PHN.

Comparative Effectiveness of Cell-Based Versus Egg-Based Influenza Vaccines in Prevention of Influenza Hospitalization During the 2022-2023 Season Among Adults 18-64 Years.

This retrospective cohort study evaluated the comparative vaccine effectiveness (cVE) of licensed standard-dose cell-based versus egg-based influenza vaccines in preventing influenza hospitalization among adults 18-64 years during the 2022-2023 season. The cohort included eligible Kaiser Permanente Southern California members who received ≥ 1 dose of influenza vaccine (n = 848,334). The adjusted cVE against influenza hospitalization was -10.

Immune escape and attenuated severity associated with the SARS-CoV-2 BA.2.86/JN.1 lineage.

The SARS-CoV-2 BA.2.86 lineage, and its sublineage JN.

Association of Pneumococcal Conjugate Vaccination With Severe Acute Respiratory Syndrome Coronavirus 2 Infection Among Older Adult Recipients of Coronavirus Disease 2019 Vaccines: A Longitudinal Cohort Study.

Background: Pneumococcal carriage is associated with increased acquisition and duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among adults. While pneumococcal conjugate vaccines (PCVs) prevent carriage of vaccine-serotype pneumococci, their potential impact on coronavirus disease 2019 (COVID-19)-related outcomes remains poorly understood in populations with prevalent immunity against SARS-CoV-2.

Methods: We undertook a retrospective cohort study of adults aged ≥65 years in the Kaiser Permanente Southern California healthcare system who had received ≥2 COVID-19 vaccine doses, comparing risk of SARS-CoV-2 infection between 1 January 2021 and 31 December 2022 among recipients and nonrecipients of 13-valent PCV (PCV13) employing multiple strategies to mitigate bias from differential test-seeking behavior.

Effectiveness of BNT162b2 XBB Vaccine Against XBB and JN.1 Sublineages.

We provide updated results (11 October 2023 through 29 February 2024) from our previously conducted test-negative case-control study in Kaiser Permanente Southern California to evaluate sublineage-specific effectiveness of the BNT162b2 XBB1.5-adapted vaccine. Results suggest that XBB1.

Risk Factors for Recurrent Urinary Tract Infections Among Women in a Large Integrated Health Care Organization in the United States.

Background: Urinary tract infections (UTIs) occur commonly and often recur. However, recent data on the epidemiology of recurrent UTI (rUTI) are scarce.

Methods: Between 1 January 2016 and 31 December 2020, index uncomplicated UTIs (uUTIs) from office, emergency department, hospital, and virtual care settings were identified from the electronic health records of women at Kaiser Permanente Southern California.

Estimated Effectiveness of the BNT162b2 XBB Vaccine Against COVID-19.

Importance: Data describing the early additional protection afforded by the recently recommended BNT162b2 XBB vaccine (Pfizer-BioNTech; 2023-2024 formulation) are limited.

Objective: To estimate the association between receipt of the BNT162b2 XBB vaccine and medically attended COVID-19 outcomes among US adults 18 years and older.

Design, Setting, And Participants: This test-negative case-control study was performed to estimate the effectiveness of the BNT162b2 XBB vaccine against COVID-19-associated hospitalization and emergency department (ED) or urgent care (UC) encounters among adults in the Kaiser Permanente Southern California health system between October 10, 2023, and December 10, 2023.

Immune escape and attenuated severity associated with the SARS-CoV-2 BA.2.86/JN.1 lineage.

The SARS-CoV-2 BA.2.86 lineage, and its sublineage JN.

Predictors of nirmatrelvir-ritonavir receipt among COVID-19 patients in a large US health system.

A clear understanding of real-world uptake of nirmatrelvir-ritonavir for treatment of SARS-CoV-2 can inform treatment allocation strategies and improve interpretation of effectiveness studies. We used data from a large US healthcare system to describe nirmatrelvir-ritonavir dispenses among all SARS-CoV-2 positive patients aged ≥ 12 years meeting recommended National Institutes of Health treatment eligibility criteria for the study period between 1 January and 31 December, 2022. Overall, 10.

Effectiveness of BNT162b2 BA.4/5 bivalent mRNA vaccine against a range of COVID-19 outcomes in a large health system in the USA: a test-negative case-control study.

Background: XBB-related omicron sublineages have recently replaced BA.4/5 as the predominant omicron sublineages in the USA and other regions globally. Despite preliminary signs of immune evasion of XBB sublineages, few data exist describing the real-world effectiveness of bivalent COVID-19 vaccines, especially against XBB-related illness.

Real-World Evidence to Supplement Randomized Clinical Trials: Tocilizumab for Severe COVID-19 Pneumonia vs. a Cohort Receiving Standard of Care.

Randomized controlled trials (RCTs) remain the gold standard for evaluating treatment efficacy, but real-world evidence can supplement RCT results. Tocilizumab was not found to reduce 28-day mortality in a phase III, double-blind, placebo-controlled trial (COVACTA) among hospitalized patients with severe coronavirus disease 2019 (COVID-19) pneumonia. We created a real-world external comparator arm mirroring the COVACTA trial to confirm findings and assess the feasibility of using an external comparator arm to supplement an RCT.