Engaging Multistakeholder Perspectives to Identify Patient-Centered Research Priorities Regarding Vaccine Uptake Among Adults With Autoimmune Conditions

Objective: The study objective was to prioritize topics for future patient-centered research to increase uptake of common vaccines, such as for pneumococcal pneumonia, influenza, herpes zoster, human papillomavirus, and severe acute respiratory syndrome coronavirus 2, among adults living with autoimmune conditions. Methods: A steering committee (SC) was formed that included clinicians, patients, patient advocates, and researchers associated with rheumatic diseases (psoriatic arthritis, rheumatoid arthritis, vasculitis), inflammatory bowel disease, and multiple sclerosis. Through a scoping review and discussions, SC members identified research topics regarding vaccine uptake and/or hesitancy for prioritization. A larger multistakeholder alliance that included patients and patient advocates, clinicians, researchers, policy makers, regulators, and vaccine manufacturers conducted a modified Delphi exercise online with three rating rounds and one ranking round. Frequency analysis and comparisons across stakeholder groups were conducted. A weighted ranking score was generated for each item in the ranking round for final prioritization. Results: Through the Delphi process, 33 research topics were identified, of which 13 topics were rated as critical by more than 70% of all stakeholders (n = 31). The two highest ranked critical topics per the full stakeholder group were “How well a vaccine works for adults with autoimmune conditions” and “How beliefs about vaccine safety affect vaccine uptake.”. Conclusion: A multistakeholder group identified key topics as critically important priorities for future research to decrease vaccine hesitancy and improve uptake of vaccines for adults with autoimmune conditions

Can resource dilution explain differences in height by birth order and family size? A study of 389,287 male recruits in twentieth-century Netherlands

‘Resource dilution’ has been invoked as a possible mechanism to explain the inverse relation between sibship size and sibling heights in European populations (Öberg, 2015). Alternative explanations include confounding of the relation by other measured or unmeasured family characteristics including socio-economic position or birth order. It is difficult to quantify the contribution of any factor in isolation. To examine the question, we accessed data from the national birth cohort of 389,287 Dutch conscripts born in 1944–1947 and examined for military service at age 18. The records include all men of Dutch nationality born between January 1, 1944 and December 31, 1947 examined for military service in the Netherlands. The birth cohorts provide a well-defined study population to reliably assess the impact of family size and birth order on adult height, accounting for potential confounders. The cohorts include a large number of high-parity families, provide reliable information on both family size and birth order, and differentiate between all birth orders. The military examinations provide reliable information on height for all study subjects and uniform measurements at age 18. We show that recruits from larger families are shorter than recruits from smaller families; that birth order effects are small in relation to family size effects; and that birth order and family size effects are comparable in recruits from higher to lower socio-economic backgrounds. Recruits from higher backgrounds are significantly taller however. Our findings are compatible with a ’resource dilution’ hypothesis, but our data provide no information on any specific differences in the childhood environment in terms of nutrition, education, or other family behaviours could explain the observed height differences at age 18. Additional studies will be needed to identify what differences in specific family behaviours could lead to changes in height development