Audiological Intervention for Late-Identified Children and Teenagers with Hearing Loss

Abstract 1 - Introduction: The family of every child referred for definitive care after a newborn hearing screening should follow up with an audiologist to rule out hearing impairment. Early identification, diagnosis, and intervention are crucial for individualized planning and outcomes. Children who need binaural amplification and are not managed appropriately become exposed to sound deprivation, which leads to diminished speech audibility, sound localization, and speech and language development. Case Presentation: A young child presented to the clinic with an unspecified bilateral mild to moderate hearing loss at 500, 2000, and 4000 Hz. Discussion: Children with monaural amplification have shown decreased speech recognition scores when compared to those fitted binaurally. Decreased speech audibility can affect speech and language development over a lifetime. Conclusion: Children who are prescribed monaural amplification, when binaural amplification is indicated, may demonstrate problems with the development of speech and language. Abstract 2 - Introduction: Teenagers may have difficulty accepting hearing aids, due to a perceived negative self-image and what their peers will think of them when seen wearing hearing aids. Case Presentation: A teenager presented to the clinic with unilateral conductive hearing loss in the right ear. A hearing aid was selected, and adult Desired Sensation Level targets were utilized for the prescription. Discussion: Teenagers with a hearing impairment want to be socially compatible with their normal-hearing peers. This raises personal concerns about the aesthetic appearance of their hearing-assistive devices, causing some teenagers to abandon their hearing aids and avoid wearing them. Audiologists and other healthcare professionals should help teenagers to see the purpose and value of hearing aids, accept their hearing loss, and learn to self- advocate. Conclusion: Family support is important for teenagers to gain acceptance of their hearing aids, increase wear time of the device, and advocate for themselves

Application of a life table approach to assess duration of BNT162b2 vaccine-derived immunity by age using COVID-19 case surveillance data during the Omicron variant period.

BackgroundSARS-CoV-2 Omicron variants have the potential to impact vaccine effectiveness and duration of vaccine-derived immunity. We analyzed U.S. multi-jurisdictional COVID-19 vaccine breakthrough surveillance data to examine potential waning of protection against SARS-CoV-2 infection for the Pfizer-BioNTech (BNT162b) primary vaccination series by age.MethodsWeekly numbers of SARS-CoV-2 infections during January 16, 2022-May 28, 2022 were analyzed by age group from 22 U.S. jurisdictions that routinely linked COVID-19 case surveillance and immunization data. A life table approach incorporating line-listed and aggregated COVID-19 case datasets with vaccine administration and U.S. Census data was used to estimate hazard rates of SARS-CoV-2 infections, hazard rate ratios (HRR) and percent reductions in hazard rate comparing unvaccinated people to people vaccinated with a Pfizer-BioNTech primary series only, by age group and time since vaccination.ResultsThe percent reduction in hazard rates for persons 2 weeks after vaccination with a Pfizer-BioNTech primary series compared with unvaccinated persons was lowest among children aged 5-11 years at 35.5% (95% CI: 33.3%, 37.6%) compared to the older age groups, which ranged from 68.7%-89.6%. By 19 weeks after vaccination, all age groups showed decreases in the percent reduction in the hazard rates compared with unvaccinated people; with the largest declines observed among those aged 5-11 and 12-17 years and more modest declines observed among those 18 years and older.ConclusionsThe decline in vaccine protection against SARS-CoV-2 infection observed in this study is consistent with other studies and demonstrates that national case surveillance data were useful for assessing early signals in age-specific waning of vaccine protection during the initial period of SARS-CoV-2 Omicron variant predominance. The potential for waning immunity during the Omicron period emphasizes the importance of continued monitoring and consideration of optimal timing and provision of booster doses in the future

Reconfigured schematic of the open vaccination cohorts defining the time origin from the date of vaccination.

The solid lines with arrows indicate subjects in vaccination who subsequently had a positive SARS-Cov-2 test at various points in calendar time. The dotted lines subjects in the vaccination cohort without an observed SARS-Cov-2 test (right-censored). Lines with the same color have the same duration since vaccination to an observed SARS-Cov-2 test. These subjects are pooled to display an analysis with a single common hazard function across the cohorts with time since vaccination as the x-axis. (TIF)</p

Completed STROBE checklist for observational study and analysis plan information.

Completed STROBE checklist for observational study and analysis plan information.</p

Sensitivity analysis for standardized percent reduction in hazard rate for COVID-19 cases.

Adjusted by an estimate of differential prior infection based on seroprevalence data among the unvaccinated. Shaded area are 95% confidence intervals. A dashed reference line is plotted at a VE of 80%.</p

COVID-19 hazard rates and 95% confidence intervals—22 U.S. jurisdictions, May 1–28, 2022.

Vaccination cohorts 1–4 reached ≥14 days after vaccination with a Pfizer-BioNTech primary series during: January 16–February 5, February 6–26, February 27–April 2, April 3–30, 2022, respectively.</p

Weekly trends in the percent reduction in hazard rate for COVID-19 cases (with 95% confidence intervals) among children 5–17 years vaccinated with a Pfizer-BioNTech primary series as compared to unvaccinated persons by age group and vaccination cohort—22 U.S. jurisdictions, January 16 to May 28, 2022. Vaccination cohorts 1–4 reached ≥14 days after vaccination with a Pfizer-BioNTech primary series during: January 16–February 5, February 6–26, February 27–April 2, April 3–30, 2022, respectively.

Black dashed reference line plotted at a VE of 80%. (TIF)</p