Mark Grabowsky
National Institutes of Health
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The Journal of Infectious Diseases | 2004
Samuel L. Katz; Sonja S. Hutchins; Mark J. Papania; Robert W. Amler; Edward F. Maes; Mark Grabowsky; Kenneth Bromberg; Victoria Glasglow; Tamika Speed; William J. Bellini; Walter A. Orenstein
An accurate system of identifying and classifying suspected measles cases is critical for the measles surveillance system in the United States. To examine the performance of the clinical case definition in predicting laboratory confirmation of suspected cases of measles, we reviewed 4 studies conducted between 1981 and 1994. A clinical case definition was examined that included a generalized maculopapular rash, fever (>or=38.3 degrees C, if measured), and either a cough, coryza, or conjunctivitis. Serological confirmation of measles was done either by hemagglutination inhibition assay, complement fixation assay, or enzyme immunoassays. The positive predictive value of the clinical case definition decreased from 74% to 1% as incidence decreased from 171 cases/100000 population to 1.3 cases/100000 population. Sensitivity was high, and for the larger studies with the most precise estimates, sensitivity was 76%-88%. The low positive predictive value of the clinical case definition in settings of low incidence demonstrates that serological confirmation is essential to ensure an accurate diagnosis of measles when measles is rare.
Pediatric Infectious Disease Journal | 1996
David P. Wood; Neal Halfon; Margaret Pereyra; Julie Shea Hamlin; Mark Grabowsky
BACKGROUND Missed opportunities to vaccinate occur commonly and contribute to the underimmunization of young children. They are related to provider knowledge of the immunization schedule and contraindications to vaccination. METHODS We surveyed private physicians (n = 50) and public health department physicians and nurses (n = 47). The questionnaire presented two sets of clinical scenarios in which they had to assess what immunizations were due and assess whether there were any contraindications to vaccination. RESULTS The mean percent correct responses on the immunization schedule questions was 64% (sd = 3.6%) for the private physicians, 71% (SD = 4.7%) for the public physicians and 78% (SD = 2.8%) for the public nurses (P = 0.04). The mean percent correct responses on the contraindications to vaccinate questions was 73% (SD = 5.4%) for public physicians, 58% (SD = 3.3%) for private physicians, and 55% (SD = 4.7%) for public health nurses (P = 0.02). CONCLUSIONS Our survey shows that providers in the public and private sectors have important deficits in their knowledge of the immunization schedule and the appropriate contraindications to vaccinate which might lead to missed opportunities to vaccinate and low immunization coverage.
Public Health Reports | 2014
Tammy A. Santibanez; Peng Jun Lu; Alissa O'Halloran; Ankita Meghani; Mark Grabowsky; James A. Singleton
Objective. We compared estimates of childhood influenza vaccination coverage by health status, age, and racial/ethnic group across eight consecutive influenza seasons (2004 through 2012) based on two survey systems to assess trends in childhood influenza vaccination coverage in the U.S. Methods. We used National Health Interview Survey (NHIS) and National Immunization Survey-Flu (NIS-Flu) data to estimate receipt of at least one dose of influenza vaccination among children aged 6 months to 17 years based on parental report. We computed estimates using Kaplan-Meier survival analysis methods. Results. Based on the NHIS, overall influenza vaccination coverage with at least one dose of influenza vaccine among children increased from 16.2% during the 2004–2005 influenza season to 47.1% during the 2011–2012 influenza season. Children with health conditions that put them at high risk for complications from influenza had higher influenza vaccination coverage than children without these health conditions for all the seasons studied. In seven of the eight seasons studied, there were no significant differences in influenza vaccination coverage between non-Hispanic black and non-Hispanic white children. Influenza vaccination coverage estimates for children were slightly higher based on NIS-Flu data compared with NHIS data for the 2010–2011 and 2011–2012 influenza seasons (4.1 and 4.4 percentage points higher, respectively); both NIS-Flu and NHIS estimates had similar patterns of decreasing vaccination coverage with increasing age. Conclusions. Although influenza vaccination coverage among children continued to increase, by the 2011–2012 influenza season, only slightly less than half of U.S. children were vaccinated against influenza. Much improvement is needed to ensure all children aged ≥6 months are vaccinated annually against influenza.
AIDS Research and Human Retroviruses | 1999
Geoffrey J. Gorse; Lawrence Corey; Gira B. Patel; Mahendra Mandava; Ray Hahn Hsieh; Thomas J. Matthews; Mary Clare Walker; M. Julie Mcelrath; Phillip W. Berman; Martha M. Eibl; Robert B. Belshe; David C. Schwartz; Clayton Harro; Mary Lou Clements-Mann; Sharon E. Frey; Donald J. Kennedy; Mark J. Mulligan; Paul A. Goepfert; Jiri Mestecky; Susan Jackson; Edward W. Hook; Michael C. Keefer; Raphael Dolin; Barney S. Graham; Paul Spearman; Peter F. Wright; Kent J. Weinhold; Dani P. Bolognesi; Barbara Savarese; Mark Grabowsky
We evaluated prime-boost immunization with two recombinant envelope glycoprotein subunit vaccines (HIV-1MN recombinant gp160 vaccine in alum adjuvant [MN rgp160] and HIV-1MN recombinant gp120 vaccine in alum adjuvant [MN rgp120]) for safety and immunogenicity in healthy, HIV-1-uninfected adults. The rationale was to combine the helper T cell memory and binding antibody responses typically induced by rgp160 vaccines with the superior neutralizing antibody responses induced by rgp120 vaccines. In a double-blinded, controlled trial, volunteers were randomly assigned to receive MN rgp160 or adjuvant placebo, and a subset later received MN rgp120. The two vaccines were safe, but reactions to MN rgp160 and its adjuvant placebo exceeded those to MN rgp120. MN rgp160 induced IgG binding antibodies, including all IgG subclasses, to MN rgp160 in all vaccine recipients. HIV-1MN-neutralizing and anti-V3 MN peptide-binding antibodies were observed in a majority of volunteers after the fourth MN rgp160 immunization, but at lower levels compared with immunization with MN rgp120 in historical controls. HIV-1-binding, neutralizing, and fusion inhibition antibodies were boosted to the highest levels among MN rgp160 recipients after MN rgp120 booster injections. MN rgp120 boosting appeared to alter the distribution of MN rgp160 vaccine-induced, anti-MN rgp160 IgG subclass antibodies. MN rgp160 induced helper T cell memory, measured by lymphocyte proliferation, Thl and Th2 cytokine production, and skin testing. Strategies including both subunit vaccines may help maximize antibody and helper T cell memory responses to HIV-1 envelope glycoprotein.
Pediatrics | 1995
David L. Wood; Cathy D. Sherbourne; Neal Halfon; M. B. Tucker; Vilma Ortiz; Julie Shea Hamlin; Naihua Duan; Rebecca Mazel; Mark Grabowsky; Philip A. Brunell; Howard E. Freeman
JAMA | 1998
David P. Wood; Neal Halfon; Cathy Donald-Sherbourne; Rebecca Mazel; Mark A. Schuster; Julie Shea Hamlin; Margaret Pereyra; Patricia Camp; Mark Grabowsky; Naihua Duan
Pediatrics | 1996
Mark Grabowsky; Walter A. Orenstein; Edgar K. Marcuse
Archive | 1998
David L. Wood; Neal Halfon; Cathy D. Sherbourne; Rebecca Mazel; Mark A. Schuster; Julie Shea Hamlin; Margaret Pereyra; Patricia Camp; Mark Grabowsky; Naihua Duan
Journal of Health Care for the Poor and Underserved | 1994
David P. Wood; Neal Halfon; Cathy D. Sherbourne; Mark Grabowsky
Public Health Reports | 2013
Walter A. Orenstein; Bruce G. Gellin; Richard H. Beigi; Tawny Buck; Sarah Despres; Philip LaRussa; Ruth Lynfield; Yvonne Maldonado; Julie Morita; Charles P. Mouton; Amy Pisani; Mitchel C. Rothholz; Thomas E. Stenvig; Litjen Tan; Catherine Torres; Kasisomayajula Viswanath; Seth Hetherington; Clement Lewin; Anne Bailowitz; Carol J. Baker; Robert S. Daum; Charlene Douglas; Claire Hannan; Paul E. Jarris; Wayne Rawlins; Vesta Richardson; David Salisbury; Matthew Burke; Richard Church; Geoffrey Evans