| 1. |
- Bjork, Jonas, et al.
(author)
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COVID-19 vaccine effectiveness against severe disease from the Omicron BA.1 and BA.2 subvariants: surveillance results from southern Sweden, December 2021 to March 2022
- 2022
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Other publication (other academic/artistic)abstract
- We compared vaccine effectiveness (VE) against severe COVID-19 during calendar periods from December 2021 to March 2022 when Omicron BA.1 and BA.2, respectively, were the dominating virus variants in Scania county, Sweden. We used continuous density case-control sampling matched for sex and age, and with further adjustment for differences in comorbidities and prior infection. VE remained relatively stable after the transition from BA.1 to BA.2 among people with at least three doses but decreased markedly among those with only two doses. Protection from prior infection was also lower after the transition to BA.2. These findings suggest that booster vaccination is needed to maintain sufficient protection against severe COVID-19.Competing Interest StatementThe authors have declared no competing interest.Funding StatementThis study was supported by Swedish Research Council (VR; grant numbers 2019-00198 and 2021-04665), Sweden's Innovation Agency (Vinnova; grant number 2021-02648) and by internal grants for thematic collaboration initiatives at Lund University held by JB and MI. FK is supported by grants from the Swedish Research Council and Governmental Funds for Clinical Research (ALF), and CB is supported by Swedish Research Council for Health, Working life and Welfare (Forte; grant number 2020-00962). The funders played no role in the design of the study, data collection or analysis, decision to publish, or preparation of the manuscript.Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:Ethical approval was obtained from the Swedish Ethical Review Authority (2021-00059).I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.YesAggregated surveillance data from the present study are publicly available.https://sodrasjukvardsregionen.se/kliniskastudier/covid-vacciner-skyddseffekt/
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| 2. |
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| 3. |
- Björk, Jonas, et al.
(author)
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Effectiveness of the BNT162b2 vaccine in preventing COVID-19 in the working age population – first results from a cohort study in Southern Sweden
- 2021
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Other publication (other academic/artistic)abstract
- Background Vaccine effectiveness against COVID-19 needs to be assessed in diverse real-world population settings.Methods A cohort study of 805 741 residents in Skåne county, Southern Sweden, aged 18-64 years, of whom 26 587 received at least one dose of the BNT162b2 vaccine. Incidence rates of COVID-19 were estimated in sex- and age-adjusted analysis and stratified in two-week periods with substantial community spread of the disease.Results The estimated vaccine effectiveness in preventing infection ≥7 days after second dose was 86% (95% CI 72-94%) but only 42% (95% CI 14-63%) ≥14 days after a single dose. No difference in vaccine effectiveness was observed between females and males. Having a prior positive test was associated with 91% (95% CI 85 to 94%) effectiveness against new infection among the unvaccinated.Conclusion A satisfactory effectiveness of BNT162b2 after the second dose was suggested, but with possibly substantially lower effect before the second dose.Competing Interest StatementThe authors have declared no competing interest.Funding StatementThis study was supported by an internal grant for thematic collaboration initiatives at Lund University held by JB, and by Swedish Research Council (VR; grant number 2019-00198). FK is supported by grants from the Swedish Research Council and Governmental Funds for Clinical Research (ALF). The funders played no role in the design of the study, data collection or analysis, decision to publish, or preparation of the manuscript.Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:Ethical approval was obtained from the Swedish Ethical Review Authority (2021-00059). As the study is register-based, individual participant consent was not necessary.All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.YesThe dataset used in the present study is hosted by Scania county council, Sweden. Legal and ethical restrictions prevent public sharing of the dataset. Data can be made available for collaborations upon request to interested researchers but would generally require a new ethical permission.
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| 4. |
- Björk, Jonas, et al.
(author)
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High level of protection against COVID-19 after two doses of BNT162b2 vaccine in the working age population–first results from a cohort study in Southern Sweden
- 2022
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In: Infectious Diseases. - : Informa UK Limited. - 2374-4235 .- 2374-4243. ; 54:2, s. 128-133
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Journal article (peer-reviewed)abstract
- Background: Vaccine effectiveness against COVID-19 needs to be assessed in diverse real-world population settings. Methods: A cohort study of 805,741 residents in Skåne county, Southern Sweden, aged 18–64 years, of whom 26,587 received at least one dose of the BNT162b2 vaccine. Incidence rates of COVID-19 were estimated in sex- and age-adjusted analysis and stratified in two-week periods with substantial community spread of the disease. Results: The estimated vaccine effectiveness in preventing infection ≥7 days after second dose was 86% (95% CI 72–94%) but only 42% (95% CI 14–63%) ≥14 days after a single dose. No difference in vaccine effectiveness was observed between females and males. Having a prior positive test was associated with 91% (95% CI 85–94%) effectiveness against new infection among the unvaccinated. Conclusion: A satisfactory effectiveness of BNT162b2 after the second dose was suggested, but with possibly substantially lower effect before the second dose.
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| 5. |
- Björk, Jonas, et al.
(author)
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Surveillance of COVID-19 vaccine effectiveness : A real-time case-control study in southern Sweden
- 2022
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In: Epidemiology and Infection. - 0950-2688. ; 150
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Journal article (peer-reviewed)abstract
- The extensive register infrastructure available for coronavirus disease 2019 surveillance in Scania county, Sweden, makes it possible to classify individual cases with respect to hospitalisation and disease severity, stratify on time since last dose and demographic factors, account for prior infection and extract data for population controls automatically. In the present study, we developed a case-control sampling design to surveil vaccine effectiveness (VE) in this ethnically and socioeconomically diverse population with more than 1.3 million inhabitants. The first surveillance results show that estimated VE against hospitalisation and severe disease 0-3 months after the last dose remained stable during the study period, but waned markedly 6 months after the last dose in persons aged 65 years or over.
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| 6. |
- Boman, Fiffi, et al.
(author)
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Comparing parent and teacher assessments of mental health in elementary school children
- 2016
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 44:2, s. 168-176
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Journal article (peer-reviewed)abstract
- Background: Screening instruments are often used for detecting mental health problems in children and adolescents. The Strengths and Difficulties Questionnaire (SDQ) is one instrument for screening children's mental health. The SDQ can be used for assessment by different informants, i.e. parents, teachers and by 11-16 year olds for self-reporting. Aims: The aim was to compare the precision and validity of parental and teacher SDQ assessments in elementary school children, and to analyze whether assessments were affected by the child's sex and by socio-demographic factors. Methods: A total of 512 primary school students were included in a cross-sectional study. Exploratory factor analysis, sensitivity/specificity analysis, Cronbach's alphas, and logistic regression were applied. Results: Parents rated 10.9% and teachers 8.8% of the children as high-risk individuals, but the overlap was low (32.1%). Cronbach's alphas were 0.73 and 0.71 for parents and teachers, respectively. However, factor analysis showed that the five-factor solution could be confirmed only for teacher ratings. Moreover, only the parents' ratings were affected by maternal educational level and parental country of birth when rating the same children as the teachers. Conclusions: Construct validity was only confirmed for teacher assessments. However, parental assessments might capture a dimension of a child's mental health that seems to be sensitive to socioeconomic factors, which could be important when addressing equity issues, and for the dialogue between parents and school.
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| 7. |
- Bonander, Carl, et al.
(author)
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A regression discontinuity analysis of the social distancing recommendations for older adults in Sweden during COVID-19.
- 2022
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In: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 32:5, s. 799-806
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Journal article (peer-reviewed)abstract
- BACKGROUND: This paper investigates the impact of a non-mandatory and age-specific social distancing recommendation on isolation behaviors and disease outcomes in Sweden during the first wave of the COVID-19 pandemic (March to July, 2020). The policy stated that people aged 70 years or older should avoid crowded places and contact with people outside the household.METHODS: We used a regression discontinuity design-in combination with self-reported isolation data from COVID Symptom Study Sweden (n = 96,053; age range: 39-79 years) and national register data (age range: 39-100+ years) on severe COVID-19 disease (hospitalization or death, n = 21,804) and confirmed cases (n = 48,984)-to estimate the effects of the policy.RESULTS: Our primary analyses showed a sharp drop in the weekly number of visits to crowded places (-13%) and severe COVID-19 cases (-16%) at the 70-year-threshold. These results imply that the age-specific recommendations prevented approximately 1,800 to 2,700 severe COVID-19 cases, depending on model specification.CONCLUSION: It seems that the non-mandatory, age-specific recommendations helped control COVID-19 disease during the first wave of the pandemic in Sweden, as opposed to not implementing a social distancing policy aimed at older adults. Our study provides empirical data on how populations may react to non-mandatory, age-specific social distancing policies in the face of a novel virus.SUPPLEMENTARY MATERIAL: Online appendix with figures, tables, extra methods and results.
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| 8. |
- Canivet, Catarina, et al.
(author)
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Assessment of selection bias due to dropouts in the follow-up of the Scania Public Health Cohort
- 2021
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 49:4, s. 457-464
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Journal article (peer-reviewed)abstract
- Aims: To investigate potential differences between participants and dropouts in the 2005 follow-up of the Scania Public Health Cohort Study regarding the prevalence of commonly studied health determinants and whether these factors had differential associations with three health outcomes: all-cause mortality and purchase of prescribed cardiovascular or psychotropic drugs during a 10-year follow-up period. Methods: The Scania Public Health Cohort was initiated in 1999/2000, with randomly invited participants aged 18–80 years from the general population (58% participation). Questionnaire data from 10,462 participants and 2576 dropouts in the 2005 follow-up (80% participation) were linked to public registers on mortality and purchase of prescribed drugs. Results: Age, male gender, being born abroad, low educational level, low self-rated mental and general health and daily smoking were all related to dropping out. The 10-year mortality was higher among dropouts (13.4% versus 11.9%; age-adjusted hazard ratio 1.6, 95% confidence interval: 1.4–1.8). In 13 out of 18 analyses, similar associations between health determinants and outcomes were found across participants and dropouts. However, being born outside of Sweden was associated with higher risks for all three poor health outcomes among participants, but not so among dropouts. Conclusions: Despite selective participation at follow-up, there was little evidence of selection bias, insofar as estimated associations were generally similar across participants, dropouts and the whole cohort. This finding is important for the assessment of the validity of prospective findings from this cohort and similar ones, where the loss of individuals at consecutive follow-ups of exposure is non-negligible.
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| 9. |
- Canivet, Catarina, et al.
(author)
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Can high psychological job demands, low decision latitude, and high job strain predict disability pensions? A 12-year follow-up of middle-aged Swedish workers
- 2013
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In: International Archives of Occupational and Environmental Health. - Amsterdam : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 86:3, s. 307-319
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The aim of this study was to investigate whether job strain, psychological demands, and decision latitude are independent determinants of disability pension rates over a 12-year follow-up period. METHODS: We studied 3,181 men and 3,359 women, all middle-aged and working at least 30 h per week, recruited from the general population of Malmö, Sweden, in 1992. The participation rate was 41 %. Baseline data include sociodemographics, the Job Content Questionnaire, lifestyle, and health-related variables. Disability pension information was obtained through record linkage from the National Health Insurance Register. RESULTS: Nearly 20 % of the women and 15 % of the men were granted a disability pension during the follow-up period. The highest quartile of psychological job demands and the lowest quartile of decision latitude were associated with disability pensions when controlling for age, socioeconomic position, and health risk behaviours. In the final model, with adjustment also for health indicators and stress from outside the workplace, the hazard ratios for high strain jobs (i.e. high psychological demands in combination with low decision latitude) were 1.5 in men (95 % CI, 1.04-2.0) and 1.7 in women (95 % CI, 1.3-2.2). Stratifying for health at baseline showed that high strain tended to affect healthy but not unhealthy men, while this pattern was reversed in women. CONCLUSIONS: High psychological demands, low decision latitude, and job strain were all confirmed as independent risk factors for subsequent disability pensions. In order to increase chances of individuals remaining in the work force, interventions against these adverse psychosocial factors appear worthwhile.
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| 10. |
- Canivet, Catarina, et al.
(author)
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Conflict between the work and family domains and exhaustion among vocationally active men and women.
- 2010
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In: Social Science and Medicine. - : Elsevier BV. - 1873-5347 .- 0277-9536. ; 70, s. 1237-1245
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Journal article (peer-reviewed)abstract
- Exhaustion is consistently found to be more prevalent in women than in men. Women suffer from job strain more often, which may constitute a partial explanation for this phenomenon, but experienced shortcomings in combining work and family demands may also contribute to ill health. The aim of this study was to investigate, and analyse by gender, how work-related and family-related factors, as well as the interface between them, i.e. work-to-family conflict (WFC) and family-to-work conflict (FWC), are related to exhaustion. The study was cross-sectional with self-administered questionnaires assessing exposures and outcome with previously well-validated instruments. The participants were 2726 men and 2735 women, aged 45-64, vocationally active, and residing in Malmö, Sweden. Sixteen percent of the women and 8% of the men considered themselves exhausted. WFC, FWC, job strain, and low job support were all strongly correlated to exhaustion in both genders. In the multivariate analyses, adjusting for other work and family risk factors, WFC and FWC remained statistically significant risk factors for exhaustion in both men and women. Job strain, low job support, and having a somatic disorder were also independently associated with exhaustion. While WFC was more prevalent among men, it was more strongly associated with exhaustion in women than in men. In women, WFC and FWC contributed to a larger part of the explanatory power of the model, which amounted to 22% of the variance in women and 14% in men. The results imply that the concept of 'work stress' should be regarded in a wider context in order to understand gender related issues of exhaustion among vocationally active individuals.
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