Browsing by Author "Schleiss, Mark R."

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    Children are the key to the Endgame: A case for routine pediatric COVID vaccination
    (Elsevier, 2021-09-07) Schleiss, Mark R.; John, Chandy C.; Permar, Sallie R.; Pediatrics, School of Medicine
    The rapid development and deployment of effective vaccines against SARS-CoV-2 infection has been a historic achievement. Children, while not the primary age group affected by severe COVID-19 disease, have endured direct and indirect negative consequences of this pandemic that warranted vaccine testing in young age groups. In March 2021, Pfizer/BioNTech announced results from a controlled Phase 3 trial of its BNT162b2 COVID-19 vaccine in >2200 children and adolescents, age 12 to 15. The 18 symptomatic cases of COVID-19 reported during the trial were all in the placebo group – yielding a vaccine efficacy of 100% [1]. Vaccine-related symptoms were mild. These results were submitted to the FDA with a request to expand emergency use authorization (EUA) for children between ages 12 to 15, which was granted on 5-10-2021. Moderna vaccines has demonstrated similar safety and efficacy data for its COVID vaccine in children aged 12–17, and the European Medicines Agency has approved the vaccine for this age group, with a similar request for approval to the FDA currently pending. Both companies are conducting studies in younger children spanning ages 6 months through 12 years.
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    Cytomegalovirus reactivation and acute and chronic complications in children with cerebral malaria: a prospective cohort study
    (Springer Nature, 2025-02-17) Mayhew, Jonathan A.; Witten, Andrew J.; Bond, Caitlin A.; Opoka, Robert O.; Bangirana, Paul; Conroy, Andrea L.; Hernandez‑Alvarado, Nelmary; Schleiss, Mark R.; John, Chandy C.; Pediatrics, School of Medicine
    Background: Virus co-infection or reactivation may modify the host response during cerebral malaria. Cytomegalovirus (CMV) DNAemia has been associated with increased morbidity and mortality in adults with sepsis; however, the impact of CMV DNAemia on adverse outcomes in children with cerebral malaria is unknown. Methods: Clinical, physiological, and neurocognitive outcomes were compared in children aged 18 months to 12 years with cerebral malaria (N = 242) based on the presence or absence of CMV DNAemia 24 h after admission. The primary study outcome was subsequent in-hospital mortality. Secondary outcomes included the presence of acute kidney injury, neurocognitive impairment over a 2-year follow-up, and chronic kidney disease at the 1-year follow-up. Markers of platelet and endothelial cell activation and oxidative and nitrosative stress were measured to characterize the mechanisms by which CMV DNAemia might contribute to pathogenesis. Results: CMV DNAemia was present in 33 children with cerebral malaria (13.6%) 24 h after admission. CMV DNAemia was not significantly associated with mortality in this study. Children with CMV-DNAemia had a higher prevalence of acute kidney injury than those without CMV-DNAemia (59.4% vs. 38.6%, p = 0.03). There was no difference in the prevalence of chronic kidney disease or long-term neurocognitive impairment based on the presence of DNAemia. CMV DNAemia was associated with elevated plasma levels of P-selectin, angiopoietin-1, asymmetric dimethylarginine, and platelet counts. Conclusions: In children with cerebral malaria, CMV DNAemia is associated with acute kidney injury but not in-hospital mortality, chronic kidney disease, or long-term neurocognitive impairment.
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    What are the key pediatric public policy priorities as the COVID-19 pandemic persists?
    (Springer Nature, 2023) Schleiss, Mark R.; Permar, Sallie R.; John, Chandy C.; Pediatrics, School of Medicine
    The COVID-19 pandemic is not over, and its impact is just beginning to be felt on children. COVID-19 vaccines protect both the pregnant patient and newborns, and breastfeeding provides a key component of passive protective immunity. "Long COVID" has contributed to the current crisis in pediatric mental health, and vaccines confer protection against this long-term complication of COVID-19 disease. Vaccine misinformation is not only impacting compliance with maternal and pediatric COVID-19 immunization efforts, but also other routine childhood vaccinations. As a public health priority, we must improve our response to vaccine misinformation and find novel strategies to improve vaccine compliance.