Effectiveness of COVID-19 Vaccines Against SARS-CoV-2 Infection During a Delta Variant Epidemic Surge in Multnomah County, Oregon, July 2021

Background: Coronavirus disease 2019 (COVID-19) vaccines have been shown to be highly effective in preventing SARS-CoV-2 infection within controlled trials and real-world vaccine effectiveness (VE) studies. Recent reports have estimated reduced VE with the emergence and dissemination of the B.1.617.2 variant (Delta variant). During July 2021, Multnomah County experienced an epidemic expansion coinciding with increased Delta variant prevalence. We assess COVID-19 VE during this time. Methods: A test-negative design (TND) matched case-control analysis was performed to estimate the effectiveness of vaccination against SARS-CoV-2 infection during July 2021. Cases included a random sample of individuals that tested positive for SARS-CoV-2 and were reported by electronic laboratory report, were >15 years of age, and had no prior known SARS-CoV-2 infections. Controls were age and postal code matched individuals that tested negative for SARS-CoV-2 during July 2021. Immunization status was assessed using the Oregon ALERT Immunization Information system (ALERT IIS). Results: 500 case-control pairs were matched (n=1000). Overall effectiveness of any completed COVID-19 immunization was 73% (95% Confidence Interval [CI] 49-86%) and 74% (95% CI 65-85%) for mRNA immunizations and 72% (95% CI 47-85%) for individuals that had started but not completed mRNA immunizations. Conclusions: Our findings estimate high, yet reduced, VE during Delta variant dissemination. These results highlight the importance of COVID-19 immunizations for reducing SARS-CoV-2 infection while juxtaposing the need for additional non-pharmaceutical interventions. Importantly, the reduced VE identified here may predict future reductions in vaccine performance in the context of ongoing viral genetic drift.

Firearm-Related Deaths in Multnomah County, Oregon, 2010-2016: Linking Medical Examiner Data to State Vital Records Data

Objectives: Violence due to firearms is a substantial public health problem. Death data from medical examiner and vital records were linked to evaluate the use of medical examiner data to augment routine surveillance and determine any differences in sex, age, manner of death, or race and ethnicity between the 2 data systems. Materials and Methods: Medical examiner data were searched for keywords of interest, and vital records data were obtained and linked for deaths occurring in Multnomah County, Oregon, from January 1, 2010, through December 31, 2016. Both data sets were compared for the number and proportion of firearm-related deaths by sex, age, manner of death, and race/ethnicity. Sensitivity and positive predictive values were calculated for variables that had discordant results. Results: A total of 568 firearm-related deaths were identified in the medical examiner data. After matching with manual review, the 2 data systems had 100% case agreement. A reverse match showed that most cases not found in medical examiner data were due to transfer of case jurisdiction. The 2 systems matched nearly perfectly in sex, age, and manner of death but differed in characterization of race and ethnicity. Sensitivity was 62% for Hispanic ethnicity but 93% for white and black race. Practice Implications: Using medical examiner data was a useful way to augment routine surveillance of firearm-related deaths in our jurisdiction in close to real time. However, caution is needed when analyzing data by subgroups because of discordant classifications of race between the data systems.

A powerful convergence

Communities around the country are converging on a new approach to raising achievement for low-income children. This approach draws on two reform movements: (1) full-service community schools that provide wraparound health and social services to children and families, and (2) Prenatal through Grade 3 initiatives to improve quality, alignment, and coordination across early childhood and early elementary education. Examples in Cincinnati, Omaha, and Multnomah County demonstrate how communities can develop effective, results-oriented partnerships among elementary schools, community-based preschools, and other early childhood organizations.

Counting on Context: Cross-Sector Collaborations for Education and the Legacy of James Coleman’s Sociological Vision

Many localities across the United States are pursuing efforts to improve outcomes for children and youth through place-based, cross-sector collaborations among education, business, government, philanthropy, and social services agencies. In this article, we examine these place-based initiatives, investigating how they attempt to ameliorate educational inequity and how they might reflect the broader sociological vision of James S. Coleman. We draw from publicly available information on a set of 182 cross-sector collaborations across the United States and from in-depth case studies of collaborations in Buffalo, New York; Milwaukee, Wisconsin; and Portland/Multnomah County, Oregon. We find evidence that in some ways, cross-sector collaborations contribute to improving schools, offer interventions and resources to support families and communities, and attempt to revitalize localities with strong norms and social ties to support education and equity. However, these outcomes are not yet fully formed, widespread, or guaranteed to last over time.