Clinical ShowCase™: Developing a Personalized Treatment Plan for a Patient with Sickle Cell Disease

Clinical Showcase Sickle Cell 

John Jesitus is a medical writer based in Westminster, CO.

A skin-cancer prevention video produced durable knowledge gains and behavioral changes at a California high school, according to a study published in 

 Additionally, the project resulted in updates to health education curricula for California Public Schools.

To assess students’ sun-safety knowledge and behaviors, investigators surveyed 2688 students at Franklin High School, the largest high school in Elk Grove, California. Survey return rate was 38.1% (n = 1025).

Investigators reported the following results:

Compared to baseline, the percentage of correct answers to 15 of 17 skin-cancer knowledge questions increased immediately after the video lesson and remained higher one month later.

The number of students who reported never wearing sunscreen decreased by approximately 12.5% (P = 0.007) one month post-video, while the number of students wearing sunscreen 5 to 7 days weekly increased more than 50% (P <0.001).

68% of respondents said that the video’s content should be taught in schools.

84% agreed that the lesson could be applied directly to their life.

“We should be teaching skin-cancer prevention starting from elementary school,” said Jeanine B. Downie, MD, who was not involved with the study. “I would go in and lecture to my daughter’s friends all the time.” She also has spoken to her daughter’s teachers, as well as staff and students at other area schools.

“I talk about skin cancer, sun safety, no tanning beds, no smoking, no vaping. I say there’s no such thing as a safe tan,” added Downey, director of image Dermatology PC in Montclair, New Jersey.

“I explain that New Jersey is one of the tanning bed capitals of the country, and that the average tanning bed gives you 12 to 15 times the ultraviolet radiation of the sun, according to the Skin Cancer Foundation.” Additionally, she discusses basal cell and squamous cell cancers, as well as melanoma, and the need to be mindful of changing lesions and nonhealing pimples. “We all could do more of that.”

Childhood and adolescence provide a valuable window for instilling sun-protection behaviors to combat rising rates of melanoma and nonmelanoma skin cancers, particularly among young people, study authors wrote. “With cumulative sun exposure well accepted as a driving cause of skin cancer,”

 they added, “the habits formed in childhood lay the foundations on how populations protect themselves from the sun.”

Several factors may explain the lesson’s overall success. Most notably, the 4-minute video featured an Elk Grove student (and lead study author, Shay N. Sharma) speaking at a high-school level of language complexity. “The importance of peer influence on modifying adolescent behavior is well established,” authors wrote, “and hearing sun-safety recommendations from a classmate could resonate more strongly than from an adult healthcare provider.”

 Showing the video to the entire school may have reduced the influence of peer pressure and body-image concerns that typically make teenagers unlikely to adopt sun-protection behaviors.

Bureaucratic challenges and state and federal laws hinder schools’ ability to identify and incorporate timely health information, authors noted. But ultimately, California Public Schools revised its Health Education Framework to correct ambiguous information (e.g., sun protection is needed on cloudy days), highlight key practices (e.g., the importance of reapplying sunscreen), and add new information (e.g., May is skin cancer awareness month).

Originally published on our sister brand, 

Downie is a Skin Cancer Foundation fellow but reports no relevant financial interests.

1. Sharma SN, Sharma SN, Sharma AN, Sharma AN, Sharma JK. Implementing a skin cancer prevention lesson to enact institutional change: a schoolwide survey [published online ahead of print, 2022 Mar 28]. 

2. Madan V, Lear JT, Szeimies RM. Non-melanoma skin cancer. 

. 2010;375(9715):673-685. doi:10.1016/S0140-6736(09)61196-X

3. Supovitz J, Sirinides P, May H. How principals and peers influence teaching and learning. 

Articles

A single lesson made an impact on high school students' knowledge and behavior when it came to sun protection.

Video lesson boosts skin-cancer awareness at school

Regeneron Pharmaceuticals recently announced positive results from a pivotal phase 3 trial evaluating evinacumab (Evkeeza; Regeneron) in children aged 5 to 11 years with homozygous familial hypercholesterolemia (HoFH).

 The results were presented at the 5th European Atherosclerosis Society Pediatric Familial Hypercholesterolemia symposium.

HoFH is categorized as a rare inherited disorder resulting in “extremely elevated low-density lipoprotein cholesterol levels and premature atherosclerotic cardiovascular disease (ASCVD),” according to 

The study met its primary end point, showing children who added evinacumab to other lipid-lowering therapies reduced low-density lipoprotein-cholesterol (LDL-C) by 48% on average at week 24, according to a press release announcing the results.

Study participants entered the trial with reported dangerously high LDL-C (264 mg/dL on average) and 79% saw their LDL-C reduced by at least half with an absolute 132 mg/dL reduction in LDL-C on average from baseline.

“Despite treatment with other lipid-lowering therapies, children (n = 14) entered the trial with an average LDL-C level of 264 mg/dL, more than twice the target (<130 mg/dL) for pediatric patients with HoFH. After 24 weeks of [evinacumab] treatment (15 mg/kg every 4 weeks delivered intravenously [IV]), the phase 3 trial met its primary endpoint,” according to the Regeneron release.

Investigators saw reductions in levels of all lipid end point parameters assessed—generally observed with the first 8-weeks of treatment—including apolipoprotein B, non-high-density lipoprotein cholesterol, lipoprotein(a), and total cholesterol.

The most common adverse events (AEs) were oropharyngeal pain (21%), upper abdominal pain, diarrhea, headache, and nasopharyngitis (all 14%). Two severe AEs reported were aortic stenosis and tonsilitis, but both were considered unrelated to treatment.

Trial results will form the basis of a US Food and Drug Administration (FDA) regulatory submission later this year.

Evkeeza (evinacumab) phase 3 trial demonstrates 48% LDL-C reduction in children with ultra-rare form of high cholesterol. Regeneron Pharmaceuticals. Published May 21, 2022. Accessed May 23, 2022. 

https://investor.regeneron.com/news-releases/news-release-details/evkeezar-evinacumab-phase-3-trial-demonstrates-48-ldl-c

Tromp TR, Hartgers ML, Hovingh GK, et al. Worldwide experience of homozygous familial hypercholesterolaemia: retrospective cohort study. 

Evinacumab phase 3 results show a 48% LDL-C reduction in children with homozygous familial hypercholesterolemia.

Regeneron reports evinacumab phase 3 results for children 5 to 11 years old with HoFH

The COVID-19 pandemic has created unique learning challenges for children with attention-deficit/hyperactivity disorder (ADHD). The transition to remote learning changed schedules and routines for a group of children who need consistency.

 Now back at school, these children continue to face problems academically and socially.

The challenges these children have faced transitioning to new remote learning were illustrated in studies including the 

Research on Child and Adolescent Psychopathology

 which show that during the height of the pandemic children with ADHD had more sleep problems, difficulty with distance learning, greater rule-breaking actions related to COVID-19 rules, family conflict, and were not as prepared for the following school year as their peers.

 found that children with ADHD had greater home learning difficulties compared to children without ADHD during the pandemic.

 However, it’s important to note that every child with ADHD is different and remote learning experiences varied from child to child.

One factor to learning success was support at home, says Fadiyla Dopwell, MD, a developmental-behavioral pediatrician at Pediatrix Developmental Medicine of Dallas, Texas. “I’ve seen many of our kids, not just with ADHD, but any special needs, who have flourished being at home because they’ve had one-on-one attention from their parents. They were able to go at their own pace. So, they weren’t as easily distracted.”

Dopwell noted that if children were not able to receive support from their parents, especially if they had additional developmental disorders, children were more likely to struggle. “There are a lot of children with ADHD that have learning difficulties. So, if the parent can’t support the learning differences and the child finds it hard to learn through the virtual medium while not receiving one-on-one support, the child may struggle even moreso with learning. When learning virtually, children with learning difficulties are expected to learn differently and may not get the support from their teacher the same way they may if they were in school.”

Similar to how children with ADHD did during the pandemic, the current learning status of these children varied from child to child based upon the support they received and if they had a learning disability in addition to their ADHD diagnosis added Dopwell.

As a pediatrician, Dopwell believes the best way to support a child with ADHD in September 2022 is “making sure that the child has support for their diagnosis in place.” Pediatricians should check with caregivers to make sure academic supports such as a 504 plan, an IEP, behavioral strategies, and therapy are utilized. Dopwell continued to say that parents should encourage their children to use those supports and to communicate with the school to ensure that the plan in place is being used and that progress is being made.

Dopwell noticed that children with ADHD didn’t only academically suffer from the pandemic but also socially. When children were not able to socialize with their peers, they were not able to practice navigating social situations. It made it hard for them to practice avoiding “impulsive engagement” and maintain “personal space.” Pediatric health care providers should recommend that caregivers offer opportunities for children to practice social situations that prepare them for school in the fall.

Dopwell emphasized the importance of behavioral therapy and counseling for any child who struggled during the pandemic, with or without learning challenges. The strategies that children learn will help them navigate school and social interactions and help control their impulse behaviors as well.

When children have a difficult time with home education, it can increase anxiety and make ADHD symptoms more apparent. Using behavioral therapy or other strategies can be helpful to manage their ADHD symptoms. Dopwell noted that some of these children need to talk through their anxiety to their health care providers or school professionals.She felt that, if possible, these strategies could be done before medication changes were made.

As Dopwell observed, youth with ADHD already faced multiple challenges before the pandemic and this recent study from the 

 noted that it did not improve with the pandemic. “As such, we also found children with ADHD were reported by their parents to be significantly less prepared for the upcoming school year during Spring 2020 than reported by parents in the control group. Thus, pandemic interruptions to schooling may have exacerbated existing educational challenges faced by youth with ADHD.”

Dopwell and other experts in the area have seen the impact that the pandemic has had on children with ADHD. One of the unifying factors that these experts commented on was how parental involvement affected how a child performed during and after the pandemic. Other factors were school involvement and family conflict. The best thing pediatric health care providers can do to help these patients now that they are back to live learning is ensuring academic supports are in place, encourage cargivers to provide socialization opportunities, and offer behavioral therapy.

1. Rosenthal E, Franklin-Gillette S, Jung HJ, et al. Impact of COVID-19 on youth with ADHD: Predictors and moderators of response to pandemic restrictions on daily life. 

. 2022;26(9):1223-1234. doi:10.1177/10870547211063641

2. Dvorsky MR, Breaux R, Cusick CN, et al. Coping with COVID-19: longitudinal impact of the pandemic on adjustment and links with coping for adolescents with and without ADHD. 

. 2022;50(5):605-619. doi:10.1007/s10802-021-00857-2

3. Jackson A, Melvin GA, Mulraney M, et al. Associations between anxiety and home learning difficulties in children and adolescents with ADHD during the COVID-19 pandemic. 

. 2022:1-13. doi:10.1007/s10578-022-01338-3

Now that all children have returned to in-school learning and playing with their peers, some practical solutions to help those with ADHD achieve optimal academic and social success.

Helping children with ADHD readjust to in-person learning and socializing

On May 19, the American Academy of Pediatrics (AAP) released a statement urging the White House and House of Representatives to take urgent action to address the infant formula shortage. The academy wrote 2 letters to federal officials asking for immediate action at every level of government to increase the supply of safe formula in the United States.

In the release, the AAP stated that although the recent steps announced by the White House are appreciated, more needs to be done. Highlighting low-income families who rely on the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) for their formula, the letter advocates for a clear timeline for families to know when supplies will return to base level and how scarce supplies can be prioritized to those most in need.

AAP appealed to the White House to “use every tool at its disposal to remedy this situation as quickly as possible and provide clear communication to families.”

The shortage—which began in February with the closure of Abbott Nutrition’s Sturgis, Michigan, facility after concerns of bacterial contamination, and which Abbott Nutrition was quick to address—continues to deepen inequalities for families with limited resources including stable transportation to visit different stores every week or pay inflated formula prices, according to the AAP.

“Pediatricians across the country are providing guidance to families, caring for children who are now hospitalized due to not having access to formula products, and doing our best to connect our patients with what little supply exists, but we need help,” said AAP president Moira A. Szilagyi, MD, PhD, FAAP, in the release announcing the letters. “This moment calls for innovative ideas, rapid action, and clear, coordinated communication. Families are panicking and infants’ health and nutrition is at stake.”

Th academy also urged congress to implement certain actions. One of such actions was to provide additional resources to the US Food and Drug Administration (FDA) to address the current shortage, ensure safety of products, and prevent future shortages. They also urged that infant formula manufacturers notify the FDA if they expect a “meaningful disruption to their domestic supply,” according to the release. In times of future emergency, product recall, or supply chain disruptions, the AAP advocated for the ability of the USDA to immediately increase of the number of infant formula products available to WIC participants nationwide.

On the topic of donor human milk, the letter stated that a greater federal regulatory oversight is needed by the FDA and that Congress must ensure families can access such products based on medical necessity and not financial status.

For families, the academy advised that pediatricians should be contacted if formula is not available to an infant as they may have samples in stock, connections to local organizations, or alternative ideas. They recommend against making homemade formula or watering down store bought products. If families do find infant formula stock on the shelves, the AAP advises buying no more than a 1-day to 2-week supply to ease shortages. Most babies in good health can switch to any available FDA formula if a preferred brand is unavailable.

“We are especially concerned about formula-fed infants younger than six months who rely on formula as their sole source of nutrition, and children with metabolic and other conditions who rely on specialty formulas no longer in production in the United States,” Szilagyi said, in the release. “These families have even fewer options. Pediatricians are here to support them, but we need an urgent solution to this crisis. Every parent and pediatrician knows that a hungry baby cannot wait an hour, let alone several more weeks or months.”

American Academy of Pediatrics urges White House, Congress to take comprehensive, urgent action to address infant formula shortage. American Academy of Pediatrics. Published May 19, 2022. Accessed May 20, 2022. 

https://www.aap.org/en/news-room/news-releases/aap/2022/american-academy-of-pediatrics-urges-white-house-congress-to-take-comprehensive-urgent-action-to-address-infant-formula-shortage/

The AAP sent 2 letters to federal officials urging for immediate action to increase the supply of safe formula in the United States.

AAP advocates for increased action from White House, Congress on infant formula shortage

Donna Hallas discusses the Pfizer-BioNTech vaccine booster for children 5 to 11 years old

® Editorial Advisory Board member Donna Hallas shares her thoughts on the recent authorization of a Pfizer-BioNTech COVID-19 booster shot for children 5-11 years old.

Butyrylcholiesterase may be key biomarker in SIDS identification, prevention

Investigators may have found a piece of the puzzle into what causes sudden infant death syndrome.

FDA implements increased flexibilities for foreign importation of infant formula

This week, the agency announced it is encouraging importation of infant formula from usually unutilized foreign means in hopes of increasing access to the product in the wake of the country-wide shortage.

House of Representatives democrats propose $28 million aid bill for infant formula shortage

The proposed aid bill would give the FDA funds to increase staff and prepare for future infant formula shortages.

Getting to the heart of pediatric vision loss and blindness

Seconds Matter: A Pearl for Improving Communication During Surgery

Study examines best practices for managing perinatal depression

Significant OSA prevalence in pediatric patients with pulmonary hypertension

First patient treated in adolescent epilepsy trial assessing NeuroPace RNS system

FDA Authorizes Pfizer-BioNTech Booster Shot for Children Ages 5 to 11

Self-tests for COVID-19 are accurate and tolerable for children

Pfizer-BioNTech vaccine prevented more than 100,000 US deaths in 2021

Preexisting CV conditions may increase COVID-19 severity among pediatric patients

Meet the Board: Vivian P. Hernandez-Trujillo, MD, FAAP, FAAAAI, FACAAI

A look at what the Contemporary Pediatrics® team covered this week.

Must-read news from the week of May 16

 had a deadline of May 16 to notify the public that the Public Health Emergency would end in 60 days. Because the deadline has come and gone with no word, it is expected that the PHE will be extended past the current July 16 end date, but how far is unknown.

The American Medical Association in conjunction with the American Nurses Association and the American Hospital Association wrote Department of Health and Human Services Secretary Xavier Becerra 

Becerra told health care leaders after the first extension that he would give them a 60-day warning if it will not be renewed.

, allowing Medicare reimbursement and elimination of various site and security requirements, giving doctors and patients the ability to use whatever technology they had access to. While the Biden administration has pushed to make some of these changes permanent, congressional action is required.

While much of the country has moved on as if the pandemic was over, the CDC shows a rising number of cases in recent weeks, with a rise in hospitalizations, as well. These rising numbers concern the professional medical groups, who point out that new variants may emerge that strain hospital and health systems.

The end of the PHE will have far-reaching effects across the health system. For example, all states will need to reassess Medicaid eligibility resulting in a projected 13 million to 16 million people losing their coverage. Up to one-third of those may be eligible for a subsidized marketplace health plan, but getting them moved to the new program presents massive challenges to Medicaid officials because of the sheer volume of people. Planning is difficult, because there is uncertainty as to when the PHE will end. Officials will need to determine eligibility requirements and direct people to the appropriate program.

Fifteen million or more current Medicaid enrollees will potentially be ineligible for Medicaid at the end of the PHE, so states face a monumental task catching up on delayed renewals and redeterminations, according to a report from the 

. A lack of funding is expected to hamper this effort in many states, and those that have funding don’t want to hire staff until there is work to be done, but no one knows when that will start. Staff training is needed beforehand, but with no known start date for the end of PHE, timing is difficult for Medicaid officials.

Another challenge for state officials, according to the report, is to reduce the number of people who fall through the cracks and become uninsured. People will need targeted messaging to direct them to the right plan and program, and states aren’t always successful with their messaging. When confronted with an overwhelming volume of complicated plan choices, many consumers make no decision at all.

Another concern is that Marketplace plans have narrow provider networks that may be inadequate to meet the needs of the large influx of new enrollees. If a large share of people in a given service area gravitate to just one or two narrow-network plans in a short period of time, they may face delays or difficulties accessing timely appointments for needed services, according to the report.

The Department of Health and Human Services did not notify the public by the May 16 deadline that the Public Health Emergency will be ending.

Public Health Emergency expected to be extended

The US Centers for Disease Control and Prevention have been following the severe hepatitis outbreaks in children that have, to date, been detected in 36 states. 

' editor-in-chief, Tina Tan, MD, FAAP, FIDSA, FPIDS, discusses what pediatricians should know about these cases, the chances of an outbreak in their own patient population, and what they should be discussing with caregivers.

Videos

Tina Tan, MD, FAAP, FIDSA, FPIDS, editor-in-chief of Contemporary Pediatrics, shares her insights on the recent outbreaks of hepatitis in children.

What pediatricians should know about the current hepatitis outbreaks

Ms. Hester is Content Specialist with Contemporary OB/GYN and Contemporary Pediatrics.

 editorial advisory board is key to ensuring that the magazine is providing the practical clinical guidance the pediatric provider needs to offer the best care possible. The series "Meet the Board" offers a chance to get to know the people who help shape the magazine.

For our next episode in the series, we sat down with one of our newest members: Vivian P. Hernandez-Trujillo, MD, FAAP, FAAAAI, FACAAI, who is a board-certified allergist/ immunologist and clinical professor at Florida International University Herbert Wertheim College of Medicine; director of the Division of Allergy & Immunology and Fellowship Training Program director at Nicklaus Children’s Hospital; and founder of the Allergy and Immunology Care Center of South Florida in Miami, Florida.

Podcasts

Contemporary Pediatrics sat down with one of our newest editorial advisory board members: Vivian P. Hernandez-Trujillo, MD, FAAP, FAAAAI, FACAAI to discuss what led to her career in medicine and what she thinks the future holds for pediatrics.

Meet the Board: Vivian P. Hernandez-Trujillo, MD, FAAP, FAAAAI, FACAAI 

 were found to be associated with increased COVID-19 severity among pediatric patients in the United States, according to new findings.

The magnitude of these associations in the study varied across the 26 cardiovascular conditions studied, but suggested a high overall cardiovascular burden associated with severe COVID-19, noted the study investigators.

“The data presented in this study highlight the need for pediatric health care professionals to provide careful monitoring and timely care to pediatric patients with preexisting cardiovascular disease and SARS-CoV-2 infection,” wrote corresponding author Louis Ehwerhemuepha, PhD, Children’s Health of Orange County.

Despite limits on early data relating to pediatric COVID-19 cases, systematic reviews found that underlying cardiovascular defects were prevalent, with congenital heart disease (CHD) associated with poor clinical outcomes. The current study evaluated cardiovascular factors associated with severe COVID-19 in pediatrics and to estimate corresponding odds ratios (ORs).

Investigators hypothesized substantial differences in the magnitude of the ORs among cardiovascular factors associated with severe COVID-19 that may translate to clinically useful information for the treatment of these patients. Their study used data on COVID-19-related encounters from 85 health systems between March 2020 - January 2021 from a large, electronic health records database in the US.

Its cohort consisted of patients between 2 months and 17 years of age who had a laboratory-confirmed diagnosis of COVID-19 or a diagnosis code indicating infection or exposure to SARS-CoV-2. Investigators identified 26 cardiovascular conditions for a comprehensive list of congenital and acquired conditions affecting the cardiovascular system.

A binary outcome variable of mild versus severe COVID-19 outcome was defined by investigators. Those who received oxygen therapy and discharged to home alive were defined as having mild COVID-19, while those who received oxygen therapy or died in the hospital were defined as having severe COVID-19.

They noted mixed-effects, random intercept logistic regression modeling assessed the significance and magnitude of associations between 26 cardiovascular conditions and COVID-19 severity.

A total of 171,416 pediatric patients from 85 health systems were found to meet inclusion criteria, with a mean age of 8 years and 50.28% male patients. From these patients, 17,065 (9.96%) had severe COVID-19.

The random intercept model reported that the following cardiovascular conditions were associated with severe COVID-19:

cardiac arrest (OR, 9.92; 95% CI, 6.93 - 14.20)

cardiogenic shock (OR, 3.07; 95% CI, 1.90 - 4.96)

heart surgery (OR, 3.04; 95% CI, 2.26 - 4.08)

cardiopulmonary disease (OR, 1.91; 95% CI, 1.56 - 2.34)

heart failure (OR, 1.82; 95% CI, 1.46 - 2.26)

hypotension (OR, 1.57; 95% CI, 1.38 - 1.79)

nontraumatic cerebral hemorrhage (OR, 1.54; 95% CI, 1.24 - 1.91)

pericarditis (OR, 1.50; 95% CI, 1.17 - 1.94)

simple biventricular defects (OR, 1.45; 95% CI, 1.29 - 1.62)

From the 258 patients with previous cardiac arrest, a total of 205 (79.46%) had severe COVID-19, with a mortality rate of 27.91% (n = 72 deaths). Investigators noted 194 of these patients (75.19%) with previous cardiac arrest were younger than 12 years.

Furthermore, the diagnosis of a cardiovascular condition during a COVID-19-related encounter was associated with a 204% increase in the odds of severe COVID-19 (OR, 4.04; 95% CI, 3.22 - 5.07; 

Association of Congenital and Acquired Cardiovascular Conditions with COVID-19 Severity Among Pediatric Patients in the US

New data suggest pediatric patients with a history of cardiac arrest are highly susceptible to hospitalization if infected with SARS-CoV-2.

 vaccine (BNT162b2) prevented about 110,000 deaths and 700,000 hospitalizations in the U.S. and saved more than $70 billion in health care costs and lost productivity in 2021, a 

The vaccine, which first became available in December 2020, was the only one with FDA approval in 2021. The Centers for Disease Control and Prevention estimates that fifty-seven percent of fully vaccinated individuals in 2021 received the 

, the highest proportion of the vaccinated population.

The study’s authors all received funding from Pfizer, either as employees, consultants or employed of companies paid by Pfizer. To carry out the study, the authors first developed a combined Markov and decision tree model. Then they entered both real-world and trial data into the model to estimate the one-year public health impact of the Pfizer-BioNTech vaccine compared with no vaccine.

The data they used included the number of vaccines administered, and the vaccine’s efficacy in different age groups, as well as the probability of catching COVID-19, developing symptoms and being hospitalized. They also accounted for the effects of 

 and the number of working days likely to have been lost due to short-term illness and the economic cost of premature deaths.

They found that compared to no vaccination, the two-dose series of the Pfizer-BioNTech vaccine prevented almost 8.7 million symptomatic cases of the disease, averted approximately 690,000 hospitalizations, and saved over 110,000 lives.

In addition, the reductions in COVID-19 symptomatic cases were associated with $43.7 billion in productivity gains. Around 36% of the gain came from preventing productivity loss due to early death, with the remainder due to avoiding workdays lost to illness.

The authors note their findings didn’t include the vaccine’s potential to reduce transmission of COVID-19 or its severity, and thus may underestimate the full impact of the vaccine.

“The analyses show that the Pfizer-BioNTech COVID-19 vaccine contributed substantial public health impact in the U.S. in 2021, and had a deep effect on the trajectory of the pandemic,” Manuela Di Fusco, senior director, health economics and outcomes research at Pfizer and one of the study’s authors, said in an accompanying press release. She added that the results “highlight the opportunity to continue widespread vaccination uptake to prevent COVID-19 related disease and generate societal benefits.”

The study, “Public health impact of the Pfizer-BioNTech COVID-19 vaccine (BNT162b2) in the first year of rollout in the United States,” appears in the 

Nearly 9 million symptomatic cases also avoided.