Young children of parents who declined the COVID-19 vaccine were about 25 percent less likely to receive vaccination against measles, mumps, and rubella (MMR), according to the results of a new study. Historic political and socioeconomic disparities remain important predictors of MMR vaccine hesitancy, but the pandemic appears to have further increased MMR skepticism, researchers said.
“Our research highlights the link between parental characteristics and MMR vaccine uptake, showing how pandemic-related hesitancy may affect other routine vaccines,” said Eric G. Zhou, PhD, Instructor, Pediatrics, Cardiology, and Population Health Science and Policy at the Icahn School of Medicine at Mount Sinai, a lead author of the study. “Addressing these disparities, through equitable access and fostering trust and transparency in vaccine safety, is key to protecting children from preventable diseases like measles.”
The researchers conducted a cross-sectional study from July 2023 to April 2024 using a digital health survey to examine national population characteristics.
They analyzed responses from more than 19,000 parents of children younger than 5 years old to examine the association between self-reported parental characteristics (i.e., sociodemographics, politics, COVID-19 vaccination status) and children’s MMR vaccination rates, using logistic regression. The study was published January 16 in the American Journal of Public Health.
Children of parents who received at least one dose of the COVID-19 vaccine had higher MMR vaccination rates (80.8 percent) than did children of unvaccinated parents (60.9 percent). The researchers found higher MMR vaccination rates in the Northeast and Midwest regions of the United States.
“In the United States, we are experiencing a concerning resurgence of childhood vaccine-preventable diseases,” said Ben Rader, PhD, of Boston Children’s Hospital, the study’s corresponding author. “Our research suggests that COVID-19 vaccine hesitancy has fueled increasing MMR vaccine hesitancy, leaving children more vulnerable to highly contagious and life-threatening illnesses like measles.”
When their son Salvatore was born in 2023 at a hospital in northern New Jersey, Kaitlyn Romano, his mother, and her husband both felt an overwhelming surge of joy and love, emotions they had been anticipating for months. Holding his tiny body, they marveled at how perfect he was. But the pediatrician had heard a heart murmur and ordered an echocardiogram, which would eventually send them to The Mount Sinai Hospital for a lifesaving procedure.
In this first-person account, Salvatore’s mother describes the emotional ups and downs the family experienced, eventually putting their faith in the team at Mount Sinai, which supported the family as Salvatore underwent the procedure. Salvatore is now thriving and living the normal life of a toddler.
When the doctor said they would need to do the test, that wonderful feeling of euphoria slipped away, and our worst fears set in. Mount Sinai pediatric cardiologist Marjorie Gayanilo, MD, interpreted the echocardiogram. Sadly, our beautiful boy’s pulmonary valve was 80 percent blocked. It was clear that he had pulmonary stenosis, which is a thickened heart valve that does not open all the way, making it difficult for blood to flow to the lungs. He needed care immediately.
We’re so thankful we chose to have Salvatore transferred to The Mount Sinai Hospital, where he underwent a minimally invasive procedure called a balloon valvuloplasty that opens and widens the blocked valve. The procedure was performed by Barry Love, MD, Director of the Congenital Cardiac Catheterization program at the Mount Sinai Children’s Heart Center.
As a mother, I had immense fears as my baby boy was sent off from my arms and transferred. Each time I heard the lullaby music that went off throughout Valley Health System’s speaker system to let people know another baby was born, I cried. I longed to hold my boy in my arms and bring him safely home. My husband and I had varied emotions, and we often had to put on a brave face. We longed to protect our son, but there was nothing we could do but have faith and trust the doctors. We were both assured that Dr. Love, as well as the entire medical team at Mount Sinai, were the very best. Thankfully, we can both attest to this being absolutely true and nothing less.
Following the procedure, Salvatore continued his care at the Neonatal Intensive Care Unit at Mount Sinai Kravis Children’s Hospital for three weeks. He made strides and progressed each day in recovery. Each day felt like an emotional roller coaster, and our lives had suddenly been flipped upside down. But the Mount Sinai team was very communicative and thorough. They shared updates each day on our son’s progress, his condition, and the effect that the procedure had on his heart, and whether it was effective enough and what would be the next steps to take.
The hospital staff became our lifeline, from the nurses, to the social workers, and doctors who explained any type of procedure, test, or treatment that was administered. We will never forget the doctors who took the time to explain what his condition was, who drew a heart on a piece of paper to describe to us clearly what was wrong, and the nurses who took care of our son and went above and beyond. Each time we called the unit, the nurses reassured us that they would tell Salvatore how much we loved him and this helped put our minds at ease.
Our strong baby boy recovered fully and finally, after three weeks, Salvatore was able to come home with us without any complications or further treatments needed, thanks to the exceptional care and support of the staff at Mount Sinai.
Each month since he returned home, Salvatore has been evaluated and cared for by Dr. Gayanilo. Dr. Gayanilo is nothing short of amazing. She is patient, kind, reassuring, and vigilant. She always took her time to explain in detail updates about Salvatore’s condition. She always made us feel at ease. Thanks to Dr. Gayanilo and the incredible skill and close collaboration between the doctors at The Mount Sinai Hospital and Valley Health System, we feel Salvatore’s recovery was even more remarkable.
Salvatore is now playing and living his life like any normal one-year-old.
We are filled with immense gratitude for every staff member who was involved in our son’s day-to-day care. We would especially like to thank Salvatore’s social worker who went above and beyond to ensure that we were provided with resources and support. Thanks to the pediatrician who saw our son when he was born, to Dr. Gayanilo, Dr. Love, and the entire team at Mount Sinai. Thanks to you, our son is alive and thriving. His heart may have been born imperfect, but in every other way, he is perfect to us.
If your child has a heart condition, schedule an appointment or refer a patient to Dr. Gayanilo at Mount Sinai Kravis Children’s Hospital. Call 844-733-7692 or visit our website.
From left: Betty Chen, FNP; Rachelle Mallare, RN; Margaret Garrett, FNP; Christian Malatesta, FNP; Berenissis Valenzuela, MA; Karmiely Morillo, Patient Coordinator
The Clinical Research Unit (CRU) is a valued resource hub for researchers at Mount Sinai—providing everything from exam rooms, to research space and specimen storage, to compassionate nursing support, and help with administrative and procedural tasks.
Manisha Balwani, MD, MS, Chief of the Division of Genetics and Genomics, is appreciative of the skill and compassion of the team. “The CRU team have truly been excellent partners in getting rare disease treatments to patients. They have the skills to navigate administering complex therapies while creating a safe environment for patients who are vulnerable and anxious.”
The center was established in 1963 as part of a nationwide effort by the National Institutes of Health to provide dedicated space and resources for conducting medical research across medical disciplines within academic medical centers. Located in the Annenberg Building at The Mount Sinai Hospital, the CRU is a comprehensive resource hub for investigators and the Mount Sinai community who wish to undertake clinical research. Currently there are 122 active ongoing studies across multiple disciplines.
Christian Malatesta, FNP, on staff at the CRU, and at Mount Sinai for 30 years, calls the unit a “hidden gem” that is especially valuable for investigators who do not have the time or resources to implement the clinical procedures required for clinical trials. Along with Betty Chen, FNP, and Unit Nursing Director, Margaret Garrett, FNP, the team of nurse practitioners, one registered nurse, and one medical technician, are able to assist with study-related medical evaluations of research participants, including:
Performing physical examinations
Administering study medications
Adverse event monitoring including telemetry monitoring
Obtaining electrocardiograms
The team also assists with reviewing signed consent forms and the required study-related schedules of events to ensure that all elements are in place to safely and effectively proceed with clinical procedures.
Investigators across the system value their partnership with the CRU.
Alexander Kolevson, MD, a principal investigator on studies in autism spectrum disorder as part of the Seaver Autism Center for Research and Treatment, says, “We believe our work has made major contributions to the field of autism and neurodevelopmental disorders and I’m not exaggerating when I say that we could not have done it without the outstanding CRU team. They are highly skilled and consistently flexible and accommodating. Importantly, our most severely disabled and behaviorally challenging patients are treated effectively with kindness and empathy.”
Stephen Krieger, MD, FAAN, a neurologist at The Corinne Goldsmith Dickinson Center for Multiple Sclerosis, also praises the CRU. “We are currently the only recruiting site in New York City for a trial of a new infused monoclonal antibody for progressive multiple sclerosis (frexalimab), and my team has worked hand-in-hand with the CRU from our initial site assessment and activation through to the enrollment and infusion of our patients. I am very grateful to the CRU team for their professionalism and the warm and compassionate way they have worked with our patients, many of whom have significant disability from their neurological disease.”
“Our teams think of AI as augmented intelligence, versus artificial intelligence,” says Robbie Freeman, DNP, RN, Vice President of Digital Experience and Chief Nursing Informatics Officer at the Mount Sinai Health System. “The goal is to leverage AI as a supportive tool to enhance clinical decision-making—not to replace it.”
He adds, “Risk assessment models and tools for guiding care have always been integral to nursing practice. By combining nursing expertise and critical thinking with the ability to analyze vast amounts of data, AI is transforming how we deliver care, elevating quality and safety to unprecedented levels. In the coming years, this technology will continue to support nursing practice by enabling the creation of highly targeted, personalized care plans for every patient.”
Shown from let: Eric Kim; Prem Timsina, ScD; Arianna Goldman; Dhaval Patel; Maria ‘Vickee’ Sevillano, RN; Kim-Anh-Nhi Nguyen, MSc; Robbie Freeman, DNP, RN; and Arash Kia, MD, MsC
“Every AI project starts with a working group,” says Dr. Freeman, “and that working group always includes the people who are delivering care. For example, if we’re working on a falls-related initiative, we sit down with front-line nurses, with geriatricians, with nurse leaders, and from day one we’re talking together about what might be helpful.”
Currently, Mount Sinai nurses are using a machine learning model that predicts which patients are most likely to fall while in the hospital. The data behind this tool largely came from examining electronic medical record (EMR) data. By combing through nursing notes using recognition algorithms, Mount Sinai also developed an AI tool to better identify which patients are at higher risk for becoming delirious while in the hospital so that tailored preventive interventions could be put in place at the earliest opportunity.
From left: Prem Timsina, ScD; David Reich, MD, Chief Clinical Officer, Mount Sinai Health System, and President of The Mount Sinai Hospital; Robbie Freeman; Matt Levin, MD, and Arash Kia, MD, MsC
Mount Sinai is leading the world in developing a variety of AI products that support nurses and keep patients safe, according to Dr. Freeman.
Another AI product came about when Maria ‘Vickee’ Sevillano, BSN, RN, CWCN, COCN, a Mount Sinai clinical nurse, proposed an idea focused on the prevention of pressure injuries, also known as bed sores.
“We embraced the idea, collaboratively explored its nuances through a co-design process, and partnered with our internal data scientists and software engineers to transform it into a fully realized product,” says Dr. Freeman. “We tested and fine-tuned it, and in early 2024 the idea brought forward was introduced to the clinical setting. This predictive software is currently embedded in our EMR at The Mount Sinai Hospital, and we hope to expand its use as we continue to evaluate the product.”
Mount Sinai has also done a lot of work with a new type of AI called large language models, which, among other tasks, can recognize and generate large amounts of text. One particular study involved examining nursing triage notes to identify predictors for which Emergency Department patients were likely to be admitted to the hospital.
“In many cases the nursing documentation can really power AI,” says Dr. Freeman. “Much of nursing documentation data reflects their expert observations and has predictive power. So, using things like natural language processing algorithms, the nursing observations and assessments are really helpful in the development of AI tools that have broader use and impact. ”Mount Sinai is also using AI to help reduce the amount of time nurses spend doing documentation by rolling out macros—a sequence of computer instructions to automate a task—and tools that can streamline the process and relieve the documentation burden.
Kim-Anh-Nhi Nguyen, MSc, left, and Maria ‘Vickee’ Sevillano, BSN, RN, CWCN, COCN
As this emerging field continues to grow, Dr. Freeman says it is important to note that Mount Sinai has governance in place to ensure there is a solid understanding of how these tools work, that they are safe, and that they are being used in ways that are ethical and sound before they are being used in patient care.
“There’s a science and methodology for ensuring AI products are used responsibly,” Dr. Freeman says. The shared decision-making structure plays a critical role. Mount Sinai is also part of the nonprofit Coalition for Health AI, which brings together a diverse array of stakeholders to drive the development, evaluation, and appropriate use of AI in health care.
“AI is here and has proven it holds promise for thoughtfully revolutionizing care delivery in ways never imagined,” he says.
“Learning to live with MS is an enduring, educational process. We feel strongly that this holistic approach improves people’s long-term prognosis and significantly improves their quality of life,” says Ilana Katz Sand, MD,Co-Director of the C. Olsten Wellness Program. “We want to be able to offer this to every person we treat.”
A multiple sclerosis (MS) diagnosis is life-changing. The challenge of managing doctor appointments, MRI exams, and treatments, while also focusing on how you feel, can be extraordinarily stressful. Many essential things in life, such as exercise, nutrition, sleep, work, and family, often receive insufficient attention in the face of these demands.
“Many of our patients seek and can benefit from a more holistic approach to their MS,” says Ilana Katz Sand, MD, Co-Director of the C. Olsten Wellness Program at The Corinne Goldsmith Dickinson Center for Multiple Sclerosis. “Empowering people living with MS to take ownership of their health is the goal of our Wellness Program.”
The Wellness Program is designed to enable people with MS to live their lives as fully as possible by creating healthier habits. Since its inception in 2020, more than 500 people have participated in this program, the first of its kind at a comprehensive MS care center in the United States.
The program is open to both newly diagnosed patients and those who have been receiving care from neurologists, nurse practitioners, and other Center staff for many years. Some of the original participants from 2020 are still engaged in their wellness activities, while others have found satisfaction in charting a course of action after just a few visits.
“The duration of participation is up to the patient,” Dr. Katz Sand says. “We partner one-on-one with our patients, offering each individual options that help with changing behaviors, such as assistance with scheduling workout routines, adjustments to food shopping and eating habits, or support for addressing mental health. These are all key components of comprehensive MS care.”
Deciding to participate in the Wellness Program begins with conversations between patients and their health care providers. Before the first visit, patients undergo an evaluation through the Center’s Comprehensive Annual Assessment Program at the MS Neuropsychology Clinic, which helps identify potential areas of need. The initial visit is extensive, lasting two and a half hours, and involves individual meetings with staff.
Each specialist—nurse practitioners, dietitian, physical therapist, and social worker—assess various aspects of the patient’s health, including their abilities, living environment, and support systems. Nurse practitioners Stacie Lyras, FNP-BC, and Gretchen Mathewson, NP, conduct an overall assessment and help each patient set goals. Dietitian Jessica Gelman, MS, RDN, CDN, reviews food choices, eating schedules, how groceries are obtained, and how meals are prepared. Elizabeth Pike, PT, DPT, NCS, physical therapist, evaluates the patient’s current physical activity level and exercise program. Finally, social worker Konul Azimzade, LCSW, assesses the patient’s emotional health.
At the end of each new evaluation session, the Wellness staff meet with Belenmarie Mixon, program coordinator, and Dr. Katz Sand to make sure all providers are on the same page. Each patient has a unique set of circumstances and different ways that MS affects their life. A customized plan is prepared for and discussed with the patient.
Dr. Katz Sand notes that several of her patients have had life-changing experiences with the Wellness Program. Using strategies learned from the program, some patients regained mobility through exercise. Others addressed longstanding mental health issues, or were finally able to manage their fatigue by changing diet or other lifestyle habits.
“Patients are so appreciative of the way our team listens to what is going on in their lives and what they need to feel better. Providing care that is truly holistic is a different approach that puts patients at the center,” says Dr. Katz Sand.
Dr. Katz Sand joined the Center in 2011 on a National Multiple Sclerosis Society-sponsored fellowship and became a full-time staff member in 2013. Today, she serves as the Center’s Associate Director. In addition to treating MS patients, she has spearheaded research for more than a decade on the connections between gut health and MS. Her groundbreaking work on nutrition and how food choices affect MS was key to forming the holistic approach embraced by the Wellness Program.
To further encourage people living with MS in managing their nutrition, Dr. Katz Sand’s team, led by Ms. Gelman, has produced a 73-page cookbook. It puts into practice the nutrition guidance Dr. Katz Sand has long advocated. The cookbook covers the basics of kitchen equipment, nutrition guidelines, and detailed recipes. It’s user-friendly for both beginners and more experienced home chefs. The Wellness Program cookbook is available to Wellness Program participants upon request.
As the Wellness Program becomes more popular, expansion will be necessary to accommodate more patients. This growth will require more space and staff so that more patients can take advantage of its unique offerings.
“Learning to live with MS is an enduring, educational process. We feel strongly that this holistic approach improves people’s long-term prognosis and significantly improves their quality of life,” says Dr. Katz Sand. “We want to be able to offer this to every person we treat.”
By Kenneth Bandler, a multiple sclerosis patient, advocate, and member of The Corinne Goldsmith Dickinson Center for Multiple Sclerosis Advisory Board
Mount Sinai Phillips School of Nursing graduates attend commencement at The Stern Auditorium at The Mount Sinai Hospital on December 19, 2024.
On December 19, 2024, the Mount Sinai Phillips School of Nursing celebrated the graduation of 103 students of Cohort 12, the class of students who began their studies in September 2023. The Stern Auditorium at The Mount Sinai Hospital was filled to capacity with proud families and friends of the graduates and school faculty.
Beth Oliver, DNP, RN, FAAN, Chief Nurse Executive, Senior Vice President, Cardiac Services, while in transit, offered her congratulations virtually. She stated that nursing is a profession not just known for clinical skill but significant for the compassion, resilience, and dedication to the well-being of others. And she emphasized the importance of direct patient care.
“The bedside, or chairside, is where the essence of nursing comes alive. You may step into roles as educators, researchers, administrators, or leaders in the field of nursing. You will become the mentors, advocates, and champions for the next generation of nurses. But regardless of where your path takes you, always remember the foundation of your practice: bedside is the best side. Every role you take on will ultimately come back to that fundamental connection with the people you serve.”
Brendan Carr, MD, MA, MS, with Kimberly Glassman, PhD, RN, NEA-BC, FAONL, FAAN (left) and Vivian Lien, DNP, RN, CNE, Senior Associate Dean for Academic Affairs and Wellbeing and Clinical Associate Professor at the Mount Sinai Phillips School of Nursing
Brendan Carr, MD, MA, MS, Chief Executive Officer, Professor and Kenneth L. Davis, MD, Distinguished Chair, Mount Sinai Health System, spoke to the new graduates about their essential role in health care, how nurses make special connections not only to patients and patients’ families, but also to their colleagues.
“As a young physician, I learned that nurses are the engine of teamwork, especially with physician partners, because they understand the patient as a whole. You have a superpower.” He added that the graduates were very special to Mount Sinai and hoped they would continue as professional nurses in the Mount Sinai Health System.
Janet Green, Chair of the Board of the Mount Sinai Phillips School of Nursing, whose family was integral to the founding of the school, relayed congratulations, noting that nursing is a calling and “an integral part of patient health care.”
The Valedictorian, Jennifer Moffa, thanked her fellow classmates and faculty, giving them credit for her achievement. She added that it was “bittersweet” to complete her education at the Mount Sinai Phillips School of Nursing, but was thankful for “everlasting connections” and reminded her peers to “choose kindness.”
Before the recitation of the International Pledge for Nurses by the graduating class, and the flipping of their cap tassels from right to left, Kimberly Glassman, PhD, RN, NEA-BC, FAONL, FAAN, Dean, Mount Sinai Phillips School of Nursing, reiterated that there are diverse career paths open to the graduating class, saying, “the entire world is open to you.”
When their son Salvatore was born in 2023 at a hospital in northern New Jersey, Kaitlyn Romano, his mother, and her husband both felt an overwhelming surge of joy and love, emotions they had been anticipating for months. Holding his tiny body, they marveled at how perfect he was. But the pediatrician had heard a heart murmur and ordered an echocardiogram, which would eventually send them to The Mount Sinai Hospital for a lifesaving procedure.
