Lab Matters Fall 2024 | Page 121

APHL 2024 POSTER ABSTRACTS

SOCIO-ECONOMIC ISSUES

Insidious : How the Presence of Bias Negatively Impacts Each of the Core Functions of Public Health

G . Suarez Rivera 1 , M . Freeman 2 , Pennsylvania Department of Environmental Protection 1 , Virginia Division of Consolidated Laboratory Services 2

Background : What is always present , yet we rarely know it ’ s there ? Bias . Bias is one of many saboteurs to the mission of public health , which is defined as the science to both protect and improve the health of communities as defined by the CDC . Bias exists in many forms and can be implicit without knowledge of its presence or it can be explicit and done with intention . Most concerning is the scientific evidence that demonstrates that bias is widespread and is seen at both an individual level and at a community level . The impact of bias in public health manifests in several ways that undermine the mission of public health . This poster presentation will demonstrate evidence of bias in the 11 core function of the public health laboratory and discuss ways to mitigate bias to improve health equity .

Method : In 2000 and revised in 2010 and 2014 , APHL published the white paper titled The Core Functions of Public Health Laboratories . This poster will present each core function and describe ways that bias may impact them . The core functions are disease prevention , control and surveillance ; integrated data management ; reference and specialized testing , environmental health and protection ; food safety ; laboratory improvement and regulation ; policy development ; public health preparedness and response ; public health related research ; training and education ; and partnerships and communication .

Conclusion : Health equity is defined as ensuring everyone has what they need to be their most healthy . As public health practitioners make decisions on what the needs of our communities may be and what services we provide in response to them , we must be intentional in the execution of individual roles and responsibilities , acknowledging that bias is in everything we do and each decision made . We must begin to recognize the patterns in behavior , policy and practice that are impartial . This poster begins the conversation to challenge each of us to consciously look at every service we provide , policy we make , or other actions we take through a diversity , equity , inclusion and accessibility lens to avoid bias and bolster health equity .

Presenter : Marilyn Freeman , marilyn . bibbs @ dgs . virginia . gov

Vaccine-induced Humoral Immunity Against Influenza Viruses in Healthy Weight to Morbidly Obese Healthcare Personnel Aged 18-64 During the 2018-19 season

S . Lingatlu 1 , D . Eddins 1 , Y . Wang 1 , F . Gross 1 , J . Lee 1 , J . Pohl 1 , B . Flannery 1 , M . Gaglani 2 , A . Naleway 3 , M . Levine 1 , F . Dawood 1 , S . Sambhara 1 , S . Gangappa 1 , Centers for Disease Control and Prevention 1 , Baylor Scott & White Health , Baylor College of Medicine – Temple , Texas A & M University , College of Medicine 2 , Center for Health Research , Kaiser Permanente Northwest 3

Influenza viruses are a leading cause of respiratory infections in the United States with significant morbidity and mortality in at-risk populations . Obesity ( body mass index [ BMI ] of ≥30 ) has emerged as an independent risk factor for increased influenza disease severity and worsened prognosis . Despite the increasing prevalence of obesity in the US population ( estimated at 41.9 % in adults ), there remains a notable gap in our understanding of whether obesity influences seasonal influenza vaccine-induced immune response , particularly in highly vaccinated adults where immunogenicity may be affected by multiple factors . We sought to determine if BMI was associated with the neutralizing antibody response to different influenza vaccine types : egg-based ( IIV4 ), cell culture-based ( ccIIV4 ) and recombinant ( RIV4 ). We performed secondary analyses of data collected in a randomized controlled trial from 727 healthcare personnel aged 18-64 years enrolled during the 2018-19 influenza season ( 82 % females ; age 43.8 ± 11.1 ); participants had sera collected at baseline , and one and six months after vaccination for hemagglutination inhibition assay . Vaccinees were stratified into four BMI categories — healthy weight ( BMI < 25 ), overweight ( BMI 25-29 ), obese ( BMI 30-34 ) and morbidly obese ( BMI ≥ 35 ). After stratification by BMI , there were 212 individuals classified as healthy ( 30.1 %), 212 overweight ( 30.1 %), 142 obese ( 20.1 %) and 139 morbidly obese ( 19.7 %). Baseline geometric mean titers ( GMT ) for different influenza antigens varied among vaccinees in different BMI categories . Healthy weight IIV4 recipients had significantly higher baseline titers to A / H3N2 antigens versus the morbidly obese ( p < 0.01 ). Even when the three vaccine types were pooled , healthy weight vaccinees had significantly higher baseline titers to A / H3N2 antigens versus the morbidly obese ( p < 0.001 ). However , baseline B / Victoria titers in the morbidly obese were significantly higher than titers in each of the healthy weight ( p = 0.02 ) and the overweight ( p = 0.04 ). GMT at one- and six-months post-vaccination overall were not associated with BMI category , with a difference in A / H1N1 titers significantly higher in the morbidly obese ( GMT = 95.8 , 95 % CI = 68.0 – 135.0 ) versus the overweight ( GMT = 51.1 , 95 % CI = 37.5 – 69.8 ) for IIV4 recipients at one-month post vaccination ( p = 0.04 ). There were no differences in the mean fold-rise or seroconversion rate across the BMI categories , indicating antibody titers were not attenuated with increasing BMI . RIV4 generated higher antibody responses to A / H3N2 antigens than each of IIV4 and ccIIV4 across all four BMI categories and to A / H1N1 antigens among the healthy and overweight . In this analysis , weight category was not associated with reduced humoral immune responses to seasonal influenza vaccination , supporting the potential benefit to reduce risk of influenza illness in individuals with obesity .

Presenter : Sidarth Lingatlu , sidlingatlu @ gmail . com

STRENGTHENING LABORATORY SYSTEMS AND STRATEGIC PLANNING

Advantages and Disadvantages of Laboratory Automation in the Virology Serology Unit at Kansas Health and Environment Laboratories

L . Large , H . Tangari , G . Hurr , W . Rogers , K . Short , J . Gibbs , A . Hoad , Kansas Health and Environment Laboratories

The Kansas Health and Environment Laboratories ( KHEL ) Virology Serology Unit employs a wide range of automated and manual assays to service Kansas residents and clients . These automated assays range from nucleic acid amplification tests ( NAAT ) to enzyme-linked immunosorbent assays ( ELISA ), performed on