Mona Marin - Academia.edu (original) (raw)
Papers by Mona Marin
MMWR. Morbidity and Mortality Weekly Report
MMWR. Morbidity and Mortality Weekly Report
Open Forum Infectious Diseases
Background Varicella is typically a self-limiting disease but it can be more severe in adolescent... more Background Varicella is typically a self-limiting disease but it can be more severe in adolescents and adults. In 2007, 2-doses of varicella vaccine were routinely recommended for children, with a catch-up second dose for persons who received 1 prior dose. Methods We used 2007–2014 NIS-Teen data to examine trends in ≥2 dose varicella vaccination coverage and proportions of adolescents with/without evidence of immunity to varicella. Evidence of immunity included receipt of ≥2 doses of varicella vaccine or varicella disease history. Additionally, using 2014 data, we assessed characteristics of ≥2 dose varicella vaccination coverage: 1) factors associated with ≥2 dose vaccination, 2) timing of receipt of second dose and 3) missed opportunities for second dose vaccination among adolescents who had received 1 prior dose of varicella vaccine. Results During 2007–2014, the proportion of adolescents with ≥2 doses of varicella vaccine increased from 8.3% to 66.9% in 13–15 year olds, and from...
Open Forum Infectious Diseases
Background Numerous mumps outbreaks occurred in the United States over the last decade, with outb... more Background Numerous mumps outbreaks occurred in the United States over the last decade, with outbreaks affecting young adults on college campuses being among the largest and most widely publicized. However, at least half of mumps cases and outbreaks occurred in other age-groups and settings. We describe reported mumps cases among children and adolescents during 2015 through 2017. Methods The Centers for Disease Control and Prevention (CDC) analyzed reports of confirmed and probable mumps cases in persons aged ≤18 years (defined here as pediatric mumps) transmitted electronically through the Nationally Notifiable Diseases Surveillance System (NNDSS) by the 52 reporting jurisdictions. Results Between January 1, 2015 and December 31, 2017, 49 jurisdictions reported 4,886 pediatric mumps cases (35% of all US reported cases, 13,807); 8 jurisdictions reported >100 cases each, representing 82% of all pediatric cases. Overall, 29 (1%) cases were in infants <1 yr, 406 (8%) were in chil...
Journal of American College Health
Tropical Medicine & International Health
Journal of Public Health Management and Practice
Journal of Public Health Management and Practice
Clinical Infectious Diseases
Background. Mumps is an acute viral illness that classically presents with parotitis. Although th... more Background. Mumps is an acute viral illness that classically presents with parotitis. Although the United States experienced a 99% reduction in mumps cases following implementation of the 2-dose vaccination program in 1989, mumps has resurged in the past 10 years. Methods. We assessed the epidemiological characteristics of mumps outbreaks with ≥20 cases reported in the United States electronically through the National Notifiable Diseases Surveillance System and from supplemental outbreak data through direct communications with jurisdictions from July 2010 through December 2015. Mumps cases were defined using the 2012 Council of State and Territorial Epidemiologists case definition. Results. Twenty-three outbreaks with 20-485 cases per outbreak were reported in 18 jurisdictions. The duration of outbreaks ranged from 1.5 to 8.5 months (median, 3 months). All outbreaks involved close-contact settings; 18 (78%) involved universities, 16 (70%) occurred primarily among young adults (median age, 18-24 years), and 9 (39%) occurred in highly vaccinated populations (2-dose measles-mumps-rubella vaccine coverage ≥85%). Conclusions. During 2010-2015, multiple mumps outbreaks among highly vaccinated populations in close-contact settings occurred. Most cases occurred among vaccinated young adults, suggesting that waning immunity played a role. Further evaluation of risk factors associated with these outbreaks is warranted. Keywords. mumps; mumps outbreaks; MMR vaccine. METHODS Case Definitions and Reporting We conducted a detailed review of cases sent electronically through the National Notifiable Diseases Surveillance System (NNDSS), and collected supplemental outbreak data through direct communications with jurisdictions on outbreaks and outbreak-associated cases occurring from 1 July 2010 (the month after the large 2009-2010 outbreak in the northeast ended)
Human Vaccines & Immunotherapeutics
We reported previously that the annual average mortality rate in the United States in 2008-2011 f... more We reported previously that the annual average mortality rate in the United States in 2008-2011 for varicella listed as the underlying cause declined 87% compared with the prevaccine period (1990-1994). Here, we update the analysis with five additional years of data. We used varicella death data from the 2012-2016 Mortality Multiple Cause-of Death records to calculate mortality rates during 2012-2016 and trends since the prevaccine period and end of 1-dose vaccination program (2005-2007). The annual average age-adjusted mortality rate for varicella as the underlying cause was 0.03 per million population during 2012-2016, a 94% reduction from prevaccine years and a 47% reduction from 2005-2007. Varicella deaths continue to decline due to the varicella vaccination program in the United States.
Open forum infectious diseases, 2018
The United States is experiencing mumps outbreaks in settings with high 2-dose measles-mumps-rube... more The United States is experiencing mumps outbreaks in settings with high 2-dose measles-mumps-rubella (MMR) vaccine coverage, mainly universities. The economic impact of mumps outbreaks on public health systems is largely unknown. During a 2015-2016 mumps outbreak at the University of Iowa, we estimated the cost of public health response that included a third dose of MMR vaccine. Data on activities performed, personnel hours spent, MMR vaccine doses administered, miles traveled, hourly earnings, and unitary costs were collected using a customized data tool. These data were then used to calculate associated costs. Approximately 6300 hours of personnel time were required from state and local public health institutions and the university, including for vaccination and laboratory work. Among activities demanding time were case/contact investigation (36%), response planning/coordination (20%), and specimen testing and report preparation (13% each). A total of 4736 MMR doses were administe...
Journal of public health management and practice : JPHMP, Jan 7, 2018
Since 2007, 2 doses of varicella vaccine have been routinely recommended, with a catch-up second ... more Since 2007, 2 doses of varicella vaccine have been routinely recommended, with a catch-up second dose recommended for those who received only 1 prior dose. To examine varicella vaccination coverage with 2 or more doses and the proportions of adolescents with evidence of immunity to varicella (≥2 doses of vaccine or varicella history) during 2007-2014. To assess timing of second-dose receipt, factors associated with 2 or more vaccine doses, and missed second-dose opportunities during 2014. We used data from the 2007-2014 National Immunization Survey-Teen (NIS-Teen), which collects information on adolescents aged 13 to 17 years in the United States. From 2007 to 2014, varicella vaccination coverage with 2 or more doses increased from 8.3% to 66.9% in 13- to 15-year-olds and from 3.6% to 56.7% in 16- to 17-year-olds. The proportions with evidence of immunity also increased from 68.0% to 84.1% (13- to 15-year-olds) and 78.6% to 83.4% (16- to 17-year-olds). In 2014, 13.4% of 13- to 15-ye...
Journal of the Pediatric Infectious Diseases Society, Jan 7, 2018
In 2007, a routine second dose of varicella vaccine was recommended in the United States for chil... more In 2007, a routine second dose of varicella vaccine was recommended in the United States for children aged 4 to 6 years to better control varicella-zoster virus circulation and outbreaks. Sentinel varicella outbreak surveillance was established to assess feasibility of surveillance and describe outbreaks that are occurring. Through the Centers for Disease Control and Prevention Epidemiology Laboratory Capacity funding, health departments conducted active surveillance for varicella outbreaks in schools from 2012 to 2015. Outbreaks of varicella were defined as ≥5 cases in a school within at least 1 incubation period (21 days). School nurses, healthcare providers, or laboratories reported cases and outbreaks of varicella to health departments; demographic, vaccination, and clinical data were collected. Georgia, Houston, Maine, Minnesota, New York City, and Philadelphia participated in all 3 years; Puerto Rico and West Virginia participated in 2012 to 2013; and Kansas and Arkansas parti...
Expert Review of Vaccines
Varicella vaccines are highly effective at preventing disease, but varicella may occur among vacc... more Varicella vaccines are highly effective at preventing disease, but varicella may occur among vaccinated persons (termed breakthrough varicella). Breakthrough varicella is generally mild, but severe cases have been reported. The objective of this review is to describe severe breakthrough varicella. Areas covered: We conducted a systematic review of articles published during 1974-2016. A total of 34 articles were included in our review: 21 described breakthrough varicella with disseminated varicella-zoster virus (VZV) infection with other organ involvement in addition to skin (none among two-dose vaccinees); 9 described hospitalized breakthrough varicella without mention of other organ involvement in addition to skin (of which 2 reported 4 two-dose vaccinees); and 4 described both. A total of 52-60 unique breakthrough varicella cases with disseminated VZV infection with other organ involvement in addition to skin reported with the following complications, not mutually exclusive: pneumonia (n = 8-9 cases), neurologic (n = 18-24 cases), hematologic (n = 10-11 cases), ocular (n = 5 cases), renal (n = 2 cases), hepatic (n = 3 cases), secondary infection with bacteremia or sepsis (n = 8 cases), and other complication (n = 4 cases). There were 6 cases of fatal breakthrough varicella. Expert commentary: With >31 million doses distributed annually worldwide since 2007, severe breakthrough varicella can occur but they appear to be uncommon.
Journal of Correctional Health Care
U.S. Immigration and Customs Enforcement (ICE) is responsible for detaining unauthorized aliens d... more U.S. Immigration and Customs Enforcement (ICE) is responsible for detaining unauthorized aliens during immigration proceedings. During 2014-2015, adult ICE detainees at a California facility were invited to complete a survey concerning self-reported varicella history and risk factors. Participants underwent serological testing for varicella-zoster virus (VZV) IgG; susceptible individuals were offered varicella vaccination. Among 400 detainees with available serology results, 48 (12%) were susceptible to varicella. Self-reported varicella history was negatively
Open Forum Infectious Diseases
Open Forum Infectious Diseases
New England Journal of Medicine
The effect of a third dose of the measles-mumps-rubella (MMR) vaccine in stemming a mumps outbrea... more The effect of a third dose of the measles-mumps-rubella (MMR) vaccine in stemming a mumps outbreak is unknown. During an outbreak among vaccinated students at the University of Iowa, health officials implemented a widespread MMR vaccine campaign. We evaluated the effectiveness of a third dose for outbreak control and assessed for waning immunity. Of 20,496 university students who were enrolled during the 2015-2016 academic year, mumps was diagnosed in 259 students. We used Fisher&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s exact test to compare unadjusted attack rates according to dose status and years since receipt of the second MMR vaccine dose. We used multivariable time-dependent Cox regression models to evaluate vaccine effectiveness, according to dose status (three vs. two doses and two vs. no doses) after adjustment for the number of years since the second dose. Before the outbreak, 98.1% of the students had received at least two doses of MMR vaccine. During the outbreak, 4783 received a third dose. The attack rate was lower among the students who had received three doses than among those who had received two doses (6.7 vs. 14.5 cases per 1000 population, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Students had more than nine times the risk of mumps if they had received the second MMR dose 13 years or more before the outbreak. At 28 days after vaccination, receipt of the third vaccine dose was associated with a 78.1% lower risk of mumps than receipt of a second dose (adjusted hazard ratio, 0.22; 95% confidence interval, 0.12 to 0.39). The vaccine effectiveness of two doses versus no doses was lower among students with more distant receipt of the second vaccine dose. Students who had received a third dose of MMR vaccine had a lower risk of mumps than did those who had received two doses, after adjustment for the number of years since the second dose. Students who had received a second dose of MMR vaccine 13 years or more before the outbreak had an increased risk of mumps. These findings suggest that the campaign to administer a third dose of MMR vaccine improved mumps outbreak control and that waning immunity probably contributed to propagation of the outbreak. (Funded by the Centers for Disease Control and Prevention.).
MMWR. Morbidity and Mortality Weekly Report
MMWR. Morbidity and Mortality Weekly Report
Open Forum Infectious Diseases
Background Varicella is typically a self-limiting disease but it can be more severe in adolescent... more Background Varicella is typically a self-limiting disease but it can be more severe in adolescents and adults. In 2007, 2-doses of varicella vaccine were routinely recommended for children, with a catch-up second dose for persons who received 1 prior dose. Methods We used 2007–2014 NIS-Teen data to examine trends in ≥2 dose varicella vaccination coverage and proportions of adolescents with/without evidence of immunity to varicella. Evidence of immunity included receipt of ≥2 doses of varicella vaccine or varicella disease history. Additionally, using 2014 data, we assessed characteristics of ≥2 dose varicella vaccination coverage: 1) factors associated with ≥2 dose vaccination, 2) timing of receipt of second dose and 3) missed opportunities for second dose vaccination among adolescents who had received 1 prior dose of varicella vaccine. Results During 2007–2014, the proportion of adolescents with ≥2 doses of varicella vaccine increased from 8.3% to 66.9% in 13–15 year olds, and from...
Open Forum Infectious Diseases
Background Numerous mumps outbreaks occurred in the United States over the last decade, with outb... more Background Numerous mumps outbreaks occurred in the United States over the last decade, with outbreaks affecting young adults on college campuses being among the largest and most widely publicized. However, at least half of mumps cases and outbreaks occurred in other age-groups and settings. We describe reported mumps cases among children and adolescents during 2015 through 2017. Methods The Centers for Disease Control and Prevention (CDC) analyzed reports of confirmed and probable mumps cases in persons aged ≤18 years (defined here as pediatric mumps) transmitted electronically through the Nationally Notifiable Diseases Surveillance System (NNDSS) by the 52 reporting jurisdictions. Results Between January 1, 2015 and December 31, 2017, 49 jurisdictions reported 4,886 pediatric mumps cases (35% of all US reported cases, 13,807); 8 jurisdictions reported >100 cases each, representing 82% of all pediatric cases. Overall, 29 (1%) cases were in infants <1 yr, 406 (8%) were in chil...
Journal of American College Health
Tropical Medicine & International Health
Journal of Public Health Management and Practice
Journal of Public Health Management and Practice
Clinical Infectious Diseases
Background. Mumps is an acute viral illness that classically presents with parotitis. Although th... more Background. Mumps is an acute viral illness that classically presents with parotitis. Although the United States experienced a 99% reduction in mumps cases following implementation of the 2-dose vaccination program in 1989, mumps has resurged in the past 10 years. Methods. We assessed the epidemiological characteristics of mumps outbreaks with ≥20 cases reported in the United States electronically through the National Notifiable Diseases Surveillance System and from supplemental outbreak data through direct communications with jurisdictions from July 2010 through December 2015. Mumps cases were defined using the 2012 Council of State and Territorial Epidemiologists case definition. Results. Twenty-three outbreaks with 20-485 cases per outbreak were reported in 18 jurisdictions. The duration of outbreaks ranged from 1.5 to 8.5 months (median, 3 months). All outbreaks involved close-contact settings; 18 (78%) involved universities, 16 (70%) occurred primarily among young adults (median age, 18-24 years), and 9 (39%) occurred in highly vaccinated populations (2-dose measles-mumps-rubella vaccine coverage ≥85%). Conclusions. During 2010-2015, multiple mumps outbreaks among highly vaccinated populations in close-contact settings occurred. Most cases occurred among vaccinated young adults, suggesting that waning immunity played a role. Further evaluation of risk factors associated with these outbreaks is warranted. Keywords. mumps; mumps outbreaks; MMR vaccine. METHODS Case Definitions and Reporting We conducted a detailed review of cases sent electronically through the National Notifiable Diseases Surveillance System (NNDSS), and collected supplemental outbreak data through direct communications with jurisdictions on outbreaks and outbreak-associated cases occurring from 1 July 2010 (the month after the large 2009-2010 outbreak in the northeast ended)
Human Vaccines & Immunotherapeutics
We reported previously that the annual average mortality rate in the United States in 2008-2011 f... more We reported previously that the annual average mortality rate in the United States in 2008-2011 for varicella listed as the underlying cause declined 87% compared with the prevaccine period (1990-1994). Here, we update the analysis with five additional years of data. We used varicella death data from the 2012-2016 Mortality Multiple Cause-of Death records to calculate mortality rates during 2012-2016 and trends since the prevaccine period and end of 1-dose vaccination program (2005-2007). The annual average age-adjusted mortality rate for varicella as the underlying cause was 0.03 per million population during 2012-2016, a 94% reduction from prevaccine years and a 47% reduction from 2005-2007. Varicella deaths continue to decline due to the varicella vaccination program in the United States.
Open forum infectious diseases, 2018
The United States is experiencing mumps outbreaks in settings with high 2-dose measles-mumps-rube... more The United States is experiencing mumps outbreaks in settings with high 2-dose measles-mumps-rubella (MMR) vaccine coverage, mainly universities. The economic impact of mumps outbreaks on public health systems is largely unknown. During a 2015-2016 mumps outbreak at the University of Iowa, we estimated the cost of public health response that included a third dose of MMR vaccine. Data on activities performed, personnel hours spent, MMR vaccine doses administered, miles traveled, hourly earnings, and unitary costs were collected using a customized data tool. These data were then used to calculate associated costs. Approximately 6300 hours of personnel time were required from state and local public health institutions and the university, including for vaccination and laboratory work. Among activities demanding time were case/contact investigation (36%), response planning/coordination (20%), and specimen testing and report preparation (13% each). A total of 4736 MMR doses were administe...
Journal of public health management and practice : JPHMP, Jan 7, 2018
Since 2007, 2 doses of varicella vaccine have been routinely recommended, with a catch-up second ... more Since 2007, 2 doses of varicella vaccine have been routinely recommended, with a catch-up second dose recommended for those who received only 1 prior dose. To examine varicella vaccination coverage with 2 or more doses and the proportions of adolescents with evidence of immunity to varicella (≥2 doses of vaccine or varicella history) during 2007-2014. To assess timing of second-dose receipt, factors associated with 2 or more vaccine doses, and missed second-dose opportunities during 2014. We used data from the 2007-2014 National Immunization Survey-Teen (NIS-Teen), which collects information on adolescents aged 13 to 17 years in the United States. From 2007 to 2014, varicella vaccination coverage with 2 or more doses increased from 8.3% to 66.9% in 13- to 15-year-olds and from 3.6% to 56.7% in 16- to 17-year-olds. The proportions with evidence of immunity also increased from 68.0% to 84.1% (13- to 15-year-olds) and 78.6% to 83.4% (16- to 17-year-olds). In 2014, 13.4% of 13- to 15-ye...
Journal of the Pediatric Infectious Diseases Society, Jan 7, 2018
In 2007, a routine second dose of varicella vaccine was recommended in the United States for chil... more In 2007, a routine second dose of varicella vaccine was recommended in the United States for children aged 4 to 6 years to better control varicella-zoster virus circulation and outbreaks. Sentinel varicella outbreak surveillance was established to assess feasibility of surveillance and describe outbreaks that are occurring. Through the Centers for Disease Control and Prevention Epidemiology Laboratory Capacity funding, health departments conducted active surveillance for varicella outbreaks in schools from 2012 to 2015. Outbreaks of varicella were defined as ≥5 cases in a school within at least 1 incubation period (21 days). School nurses, healthcare providers, or laboratories reported cases and outbreaks of varicella to health departments; demographic, vaccination, and clinical data were collected. Georgia, Houston, Maine, Minnesota, New York City, and Philadelphia participated in all 3 years; Puerto Rico and West Virginia participated in 2012 to 2013; and Kansas and Arkansas parti...
Expert Review of Vaccines
Varicella vaccines are highly effective at preventing disease, but varicella may occur among vacc... more Varicella vaccines are highly effective at preventing disease, but varicella may occur among vaccinated persons (termed breakthrough varicella). Breakthrough varicella is generally mild, but severe cases have been reported. The objective of this review is to describe severe breakthrough varicella. Areas covered: We conducted a systematic review of articles published during 1974-2016. A total of 34 articles were included in our review: 21 described breakthrough varicella with disseminated varicella-zoster virus (VZV) infection with other organ involvement in addition to skin (none among two-dose vaccinees); 9 described hospitalized breakthrough varicella without mention of other organ involvement in addition to skin (of which 2 reported 4 two-dose vaccinees); and 4 described both. A total of 52-60 unique breakthrough varicella cases with disseminated VZV infection with other organ involvement in addition to skin reported with the following complications, not mutually exclusive: pneumonia (n = 8-9 cases), neurologic (n = 18-24 cases), hematologic (n = 10-11 cases), ocular (n = 5 cases), renal (n = 2 cases), hepatic (n = 3 cases), secondary infection with bacteremia or sepsis (n = 8 cases), and other complication (n = 4 cases). There were 6 cases of fatal breakthrough varicella. Expert commentary: With >31 million doses distributed annually worldwide since 2007, severe breakthrough varicella can occur but they appear to be uncommon.
Journal of Correctional Health Care
U.S. Immigration and Customs Enforcement (ICE) is responsible for detaining unauthorized aliens d... more U.S. Immigration and Customs Enforcement (ICE) is responsible for detaining unauthorized aliens during immigration proceedings. During 2014-2015, adult ICE detainees at a California facility were invited to complete a survey concerning self-reported varicella history and risk factors. Participants underwent serological testing for varicella-zoster virus (VZV) IgG; susceptible individuals were offered varicella vaccination. Among 400 detainees with available serology results, 48 (12%) were susceptible to varicella. Self-reported varicella history was negatively
Open Forum Infectious Diseases
Open Forum Infectious Diseases
New England Journal of Medicine
The effect of a third dose of the measles-mumps-rubella (MMR) vaccine in stemming a mumps outbrea... more The effect of a third dose of the measles-mumps-rubella (MMR) vaccine in stemming a mumps outbreak is unknown. During an outbreak among vaccinated students at the University of Iowa, health officials implemented a widespread MMR vaccine campaign. We evaluated the effectiveness of a third dose for outbreak control and assessed for waning immunity. Of 20,496 university students who were enrolled during the 2015-2016 academic year, mumps was diagnosed in 259 students. We used Fisher&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s exact test to compare unadjusted attack rates according to dose status and years since receipt of the second MMR vaccine dose. We used multivariable time-dependent Cox regression models to evaluate vaccine effectiveness, according to dose status (three vs. two doses and two vs. no doses) after adjustment for the number of years since the second dose. Before the outbreak, 98.1% of the students had received at least two doses of MMR vaccine. During the outbreak, 4783 received a third dose. The attack rate was lower among the students who had received three doses than among those who had received two doses (6.7 vs. 14.5 cases per 1000 population, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Students had more than nine times the risk of mumps if they had received the second MMR dose 13 years or more before the outbreak. At 28 days after vaccination, receipt of the third vaccine dose was associated with a 78.1% lower risk of mumps than receipt of a second dose (adjusted hazard ratio, 0.22; 95% confidence interval, 0.12 to 0.39). The vaccine effectiveness of two doses versus no doses was lower among students with more distant receipt of the second vaccine dose. Students who had received a third dose of MMR vaccine had a lower risk of mumps than did those who had received two doses, after adjustment for the number of years since the second dose. Students who had received a second dose of MMR vaccine 13 years or more before the outbreak had an increased risk of mumps. These findings suggest that the campaign to administer a third dose of MMR vaccine improved mumps outbreak control and that waning immunity probably contributed to propagation of the outbreak. (Funded by the Centers for Disease Control and Prevention.).