About

Charlene Wong is an Adjunct Associate Professor in the Department of Pediatrics at Duke University, specializing in General Pediatrics and Adolescent Health. Her role involves contributing to the academic and clinical missions of the department, with a focus on pediatric health and adolescent medicine. The page does not provide additional details about her research focus, background, or key contributions.

Research topics

• Computer Science
• Medicine
• Political Science
• Psychology
• Internal medicine
• Internet privacy
• Virology
• Environmental health

Selected publications

• US State Actions Related to COVID-19 Vaccination Infrastructure and Access Amid Federal Shifts

  JAMA · 2026-04-20

  articleOpen accessSenior author

  This study analyzes US state actions taken in 2025 that strengthened or weakened COVID-19 vaccination infrastructure and access.

  PublisherOA PDFDOI

• The health and economic repercussions of declining MMR coverage in the United States

  medRxiv · 2026-02-20 · 2 citations

  articleOpen access

  Abstract The resurgence of measles in the United States, driven by declining childhood vaccination coverage, poses a substantial public health and economic threat. Using county-level MMR vaccine coverage data and spatial incidence models, we quantified the economic burden of measles in 2025 and projected the impact of continued declines in vaccine uptake. In 2025, the estimated cost per measles case was $104,629 (50% High-Density Interval [HDI]: $100,729–$110,140), yielding a national burden of $244.2 million (50% HDI: $69.9–$872.5 million). The cost per case varied widely across counties and was inversely correlated with local population immunity levels (Spearman correlation = -0.75, p < 0.001). We modeled a scenario in which coverage among children aged 0–6 years declined by 1% per year, reaching a 5% absolute reduction by year 5 relative to baseline. Under this scenario, we projected a nonlinear surge in cases, hospitalizations, and annual expenditures arising from outbreak response, direct medical costs, and productivity losses. This scenario produced 17,232 (50% HDI: 9,177–26,428), 4,085 (50% HDI: 2,184–6,210) hospitalizations, 36 (50% HDI: 19–54) deaths, and $1.50 (50% HDI: $0.90–$2.85) billion in annual costs in 2030, with a cumulative cost of $7.77 billion (50% HDI: $5.56–$11.58 billion) over 5 years. These findings demonstrate that even marginal reductions in MMR vaccine uptake can result in disproportionately large health and economic burdens. Significance Statement The United States is experiencing a resurgence of measles amid recent declines in childhood MMR vaccination. Using mathematical modeling informed by spatially resolved data on vaccination coverage, incidence, and associated economic costs, we quantified both the current and projected financial burden of measles in the United States under continued declines in coverage. For 2025, we estimated that measles imposes a cost of $244.2 million nationwide, with substantial heterogeneity in cost per case across counties driven by gaps in population immunity. Even modest annual reductions in vaccine coverage among young children generate a nonlinear increase in cases and hospitalizations, with costs totaling $7.77 billion over a five-year period.

  PublisherOA PDFDOI

• North Carolina Integrated Care for Kids: A Model to Support Whole-Child Health

  SSRN Electronic Journal · 2025-01-01

  preprintOpen access1st authorCorresponding
  PublisherDOI

• The Essential Role of States in Protecting Immunization Access

  New England Journal of Medicine · 2025-12-17 · 2 citations

  articleSenior author
  PublisherDOI

• Association Of Unemployment With Medicaid Enrollment By Social Vulnerability In North Carolina During COVID-19

  UNC Libraries · 2025-05-14

  articleOpen access1st authorCorresponding

  The COVID-19 pandemic precipitated an unemployment crisis in the US that surpassed the Great Recession of 2007-09 within the first three months of the pandemic. This article builds on the limited early evidence of the relationship between the pandemic and health insurance coverage, using county-level unemployment and Medicaid enrollment data from North Carolina, a large state that did not expand Medicaid. We used linear and county fixed effects models to assess this relationship, accounting for county-level social vulnerability, physical and virtual access to Medicaid enrollment, and COVID-19 case burden. Using data from January 2018 through August 2020, we estimated that the passthrough rate-the share of unemployed people who gained Medicaid coverage-was approximately 15 percent statewide but higher in more socially vulnerable counties. This low passthrough rate during a period of increased unemployment resulting from the COVID-19 pandemic means that Medicaid was unable to completely fulfill its countercyclical role, in which it grows to meet greater need during periods of widespread economic hardship, because of North Carolina's stringent Medicaid eligibility criteria. Working toward greater adoption of Medicaid expansion may help ensure that the US is better prepared for the next crisis by ensuring access to health insurance coverage.

  PublisherDOI

• Returning Individual-Level Urgent or Emergent Research Results to Participants: The Project Baseline Health Study Experience

  American Journal of Medicine Open · 2025-02-15

  articleOpen access

  • We describe a process for communicating urgent and emergent results to participants engaged in an observational research study. • Among 2002 participants enrolled in the Project Baseline Health Study, 39.7% had at least one urgent or emergent finding returned, and a total of 1159 results were returned by study clinicians over the course of 3 years. • The most commonly returned results were eye findings, pulmonary nodules, abnormal stress echocardiograms, abnormal rest electrocardiograms (bradycardia), and lung parenchyma findings. • We present a roadmap for return of results that has the potential to help ongoing and future studies in the democratization of participant data. Returning results to research participants is increasingly recognized as an ethical mandate, yet little is known about best practices to optimally communicate urgent or emergent results. We describe the development of and experience with a process to return results to participants in the Project Baseline Health Study (PBHS), which was a prospective observational cohort study of 2502 participants enrolled from 2017 to 2019 and followed through 2023. Urgent or emergent results were returned during or after the baseline visit from vital signs; clinical laboratory testing; and ocular, cardiovascular, and pulmonary imaging. Among 2002 participants in this analysis, 39.7% had at least one urgent or emergent finding returned, representing a total of 1159 results returned over 3 years. The most commonly returned results were eye findings ( n = 246), pulmonary nodules ( n = 159), abnormal stress echocardiograms ( n = 123), abnormal rest electrocardiograms (bradycardia) ( n = 74), and lung parenchyma findings ( n = 55). Participants with urgent or emergent incidental findings were older (mean [SD] 58.0 [16.2] years vs 48.0 [16.6] years) with a greater burden of cardiovascular, metabolic, or cancer comorbidities than those without urgent or emergent incidental findings. This report from the PBHS study is one of the first to describe a process to systematically return urgent or emergent results to research participants. This process led to the successful return of clinically important results to participants but also required significant time and effort from study clinicians and staff.

  PublisherDOI

• Comparing health care use and costs among new Medicaid enrollees before and during the COVID-19 pandemic

  UNC Libraries · 2025-06-04

  articleOpen access
  PublisherDOI

• Public Health Supports Whole Health

  Value in Health · 2025-04-23 · 2 citations

  editorialSenior author
  PublisherDOI

• An introduction to North Carolina Integrated Care for Kids (NC InCK): A model to support whole-child health

  Healthcare · 2025-12-19

  articleOpen access1st author

  We describe the design of the North Carolina Integrated Care for Kids (NC InCK) model. NC InCK is one of seven nationwide CMMI-funded pediatric health care delivery models that integrate services to promote whole-child health. NC InCK was collaboratively designed by health care systems, the state Medicaid agency, Medicaid managed care organizations, child-serving organizations across multiple sectors, and families. The model uses three key approaches to integrate care: 1) a risk stratification algorithm using data across healthcare, education, and social systems to holistically understand needs and identify children who may benefit from additional supports; 2) a family-centered, longitudinal care management model to integrate cross-sector services for children and youth needing clinical and nonclinical support; and 3) an alternative payment model with innovative measures around social needs and school readiness to drive investment in child and family well-being. Early success designing NC InCK has been driven by cross-sector and multi-level governance from the start of model design, garnering deep trust and alignment around shared goals. NC InCK is a step toward supporting whole-child health via cross-sector service integration and timely identification of children and families experiencing medical and social complexity. Lessons learned from design of this demonstration model can be applied to pediatric health initiatives nationwide.

  PublisherDOI

• Procedure Patterns and Survival in Advanced Non-Small Cell Lung Cancer With Malignant Airway Obstruction

  CHEST Journal · 2025-08-27 · 1 citations

  article
  PublisherDOI

Recent grants

• Financial and Social Behavioral Economic Incentives to Increase Physical Activity in Adolescents and Young Adults for Cardiovascular Health

  NIH · $245k · 2018–2023

Frequent coauthors

• Carol A. Ford

  University of Pennsylvania

  70 shared

• Raina M. Merchant

  University of Pennsylvania

  51 shared

• Peter A. Ubel

  Duke University

  41 shared

• Sarah Armstrong

  University of Tennessee at Knoxville

  34 shared

• David A. Asch

  33 shared

• Robert Town

  30 shared

• Gail B. Slap

  Children's Hospital of Philadelphia

  30 shared

• Asheley Cockrell Skinner

  Duke University

  30 shared