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Payne LA, Wise LA, Wesselink AK, Wang S, Missmer SA, Edelman A. Association between COVID-19 vaccination and menstruation: a state of the science review. BMJ SEXUAL & REPRODUCTIVE HEALTH 2024; 50:212-225. [PMID: 38857991 PMCID: PMC11246222 DOI: 10.1136/bmjsrh-2024-202274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 04/25/2024] [Indexed: 06/12/2024]
Abstract
INTRODUCTION Menstrual health is a key patient-reported outcome beyond its importance as a general indicator of health and fertility. However, menstrual function was not measured in the clinical trials of COVID-19 vaccines. The purpose of this review was to synthesise the existing literature on the relationship between COVID-19 vaccination and menstrual health outcomes. METHODS A PubMed search to 31 October 2023 identified a total of 53 publications: 11 prospective cohort studies, 11 retrospective cohort studies or registry-based cohort studies, and 31 cross-sectional or retrospective case-control studies. RESULTS Identified studies were generally at moderate-to-high risk of bias due to retrospective design, interviewer bias, and failure to include a non-vaccinated control group. Nonetheless, the bulk of the literature demonstrates that COVID-19 vaccine is associated with temporary changes in menstrual characteristics (cycle length and flow) and menstrual pain. Follicular phase (at the time of vaccination) is associated with greater increases in cycle length. Evidence suggests temporary post-vaccine menstrual changes in adolescents, abnormal vaginal bleeding in postmenopausal individuals, and a potential protective effect of using hormonal contraception. CONCLUSIONS In this review we found evidence supporting an association between the COVID-19 vaccine and menstrual health outcomes. Given the importance of menstrual function to overall health, we recommend that all future vaccine trials include menstruation as a study outcome. Future vaccine studies should include rigorous assessment of the menstrual cycle as an outcome variable to limit sources of bias, identify biological mechanisms, and elucidate the impact of stress.
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Affiliation(s)
- Laura A Payne
- McLean Hospital, Belmont, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Lauren A Wise
- Boston University School of Public Health, Boston, Massachusetts, USA
| | | | - Siwen Wang
- Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Stacey A Missmer
- Harvard Medical School, Boston, Massachusetts, USA
- Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
- Michigan State University, East Lansing, Michigan, USA
| | - Alison Edelman
- Oregon Health & Science University, Portland, Oregon, USA
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2
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Levy MS, Hunt KN, Rinehart S, Brown AD, Kelly AG, Sundaram P, Crump A, Sinclair TJ, Dey K, Zoroufy A, Caban-Martinez AJ, Plowden TC. COVID-19 Vaccine Information and Infertility Posts on X: Insights on a Misinformation Pandemic. Perm J 2024; 28:47-54. [PMID: 38698715 PMCID: PMC11232903 DOI: 10.7812/tpp/23.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
OBJECTIVE This study aimed to evaluate misinformation surrounding infertility and the COVID-19 vaccine on X (formerly known as Twitter) by analyzing the prevalence and content of this misinformation across a sample of posts on X. METHODS This study is a retrospective review of posts on X (formerly known as tweets) from the COVID-19-TweetIDs dataset from July 2021 and November 2021. Included posts were from crucial time points in the COVID-19 vaccine discourse and contained at least one word related to COVID-19 vaccination and fertility. Posts were analyzed and categorized based on factuality, common words, and hashtags. Descriptive statistics on total followers, account verification status, and engagement were obtained. Differences between posts on X classified as factual and misinformation were examined using analysis of variance or χ2 tests. Sentiment analysis determined if post content was generally positive, neutral, or negative. RESULTS A total of 17,418 relevant posts on X were reviewed: 11,436 from timeframe 1 (July 2021) and 5982 from timeframe 2 (December 2021). Misinformation posts rose from 29.9% in July 2021 to 45.1% in November 2021. In both timeframes, accounts sharing factual information had more followers (p < 0.001), and verified users were more likely to share accurate posts (p ≤ 0.001). Factual and misinformation posts had similar engagement. Sentiment analysis identified that real posts were more positive and misinformation posts were more negative (p < 0.001). CONCLUSIONS AND RELEVANCE Misinformation about the COVID-19 vaccine and fertility is highly prevalent on X and threatens vaccine uptake in patients desiring future fertility. Accounts sharing factual information were likely to have more followers and be verified; therefore, verifying more physicians sharing accurate information is critical.
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Affiliation(s)
- Morgan S Levy
- Department of Medical Education, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kelby N Hunt
- Department of Medical Education, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sarah Rinehart
- Department of Medical Education, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Alyssa D Brown
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Amelia G Kelly
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, USA
| | - Padmaja Sundaram
- Department of Obstetrics and Gynecology, University of Massachusetts, Springfield, MA, USA
| | - Alisha Crump
- Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Kally Dey
- Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, IL, USA
| | | | - Alberto J Caban-Martinez
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Torie Comeaux Plowden
- Department of Gynecologic Surgery and Obstetrics, Uniformed Services University, Bethesda, MD, USA
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Doherty TM, Di Pasquale A, Finnegan G, Lele J, Philip RK. Sustaining the momentum for adult vaccination post-COVID-19 to leverage the global uptake of life-course immunisation: A scoping review and call to action. Int J Infect Dis 2024; 142:106963. [PMID: 38354849 DOI: 10.1016/j.ijid.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/22/2024] [Accepted: 02/08/2024] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVES The COVID-19 pandemic changed the adult vaccination landscape, possibly permanently. This review attempts to quantitate the magnitude of those changes. METHODS PubMed was searched for studies on adult / life-course vaccination between 1 January 2020 until 8 November 2022. RESULTS Twenty-one articles were identified and observations summarised as positive developments/impediments to life-course immunisation, and areas needing policy and structural reform. Unprecedented funding, international co-operation and technical advances led to COVID-19 vaccines authorised in record time. Investments in infrastructure and an expanded healthcare workforce streamlined vaccine delivery to adults. Constant media coverage and targeted messaging have improved health literacy. Conversely, the speed of vaccine development was perceived as a safety risk, and an 'infodemic' of misinformation propagated through social media negatively influenced vaccine uptake. Vaccine access and affordability remains inequitable among older adults and minority groups. CONCLUSIONS The COVID pandemic led to an opportunity to permanently change policies, attitudes, and systems for vaccine delivery to adults to establish a global life-course approach to immunisation. This is a call for action to sustain the momentum triggered by the COVID-19 pandemic. Addressing inequalities, improving health literacy and optimally using social media are critical to sustain adult vaccinations in post-COVID-19 era.
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Affiliation(s)
| | - Alberta Di Pasquale
- Takeda Pharmaceuticals International AG Singapore Branch, Singapore, Singapore
| | | | - Jayesh Lele
- Indian Medical Association, National Hospital Board of India, Mumbai, India
| | - Roy K Philip
- University Maternity Hospital Limerick, University of Limerick School of Medicine, Limerick, Ireland
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4
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Moriarty KL, Oyenuga RO, Olafuyi O, Schwartz DA. Causes and Effects of COVID-19 Vaccine Hesitancy Among Pregnant Women and its Association with Adverse Maternal, Placental, and Perinatal Outcomes. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2024; 97:73-84. [PMID: 38559465 PMCID: PMC10964823 DOI: 10.59249/lpoq5146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Populations identified to be severely affected by COVID-19, such as pregnant patients, require special consideration in vaccine counseling, access, and provider education. Maternal infection with COVID-19 poses a significant risk to the maternal-fetal dyad with known adverse placenta destruction [1-5]. Despite the widespread access and availability of vaccinations, vaccine hesitancy continues to persist and is highly prevalent in pregnant populations [6-9]. Addressing the multitude of social ecological factors surrounding vaccine hesitancy can aid in providing holistic counseling [10]. However, such factors are foremost shaped by maternal concern over possible fetal effects from vaccination. While changes in policy can help foster vaccine access and acceptance, increasing global provider education and incorporation of motivational interviewing skills are the first steps towards increasing maternal acceptance.
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Affiliation(s)
- Kristen Lee Moriarty
- Department of Obstetrics & Gynecology, University
of Connecticut School of Medicine, Farmington, CT, USA
| | - Roselyn O. Oyenuga
- Department of Obstetrics & Gynecology, University
of Connecticut School of Medicine, Farmington, CT, USA
| | - Olatoyosi Olafuyi
- Department of Obstetrics & Gynecology, University
of Connecticut School of Medicine, Farmington, CT, USA
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5
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Qureshi NS, Miller LG, Judge SP, Tran NDT, Henderson SO. Characterizing predictors of COVID-19 vaccine refusal in an urban southern California jail population. Vaccine 2024; 42:777-781. [PMID: 38195263 DOI: 10.1016/j.vaccine.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 01/11/2024]
Abstract
BACKGROUND Correctional populations have been disproportionately affected by COVID-19, and many large outbreaks have occurred in jails and prisons. Vaccination is a key strategy to reduce the SARS-CoV-2 transmission in carceral settings. Although implementation can be challenging due to vaccine hesitancy and medical mistrust, correctional settings provide largely equitable healthcare access and present a unique opportunity to identify potential predictors of vaccine hesitancy independent of access issues. METHODS We retrospectively analyzed electronic health record data for individuals offered COVID-19 vaccination at the Los Angeles County Jail between January 19, 2021, and January 31, 2023, and used multivariable logistic regression to determine predictors of COVID-19 vaccine refusal. RESULTS Of the 21,424 individuals offered COVID-19 vaccination, 2,060 (9.6 %) refused. Refusal was associated with male sex ([aOR] = 2.3, 95 % CI (1.9, 2.8)), age 18-34 ([aOR] = 1.2, 95 % CI (1.1, 1.4), referent group: age 45-54), Black race ([aOR] = 1.2, 95 % CI (1.1, 1.4)), reporting ever being houseless ([aOR] = 1.2, 95 % CI (1.1, 1.3)), and having a history of not receiving influenza vaccination while incarcerated ([aOR] = 2.4, 95 % CI (2.0, 2.8)). When analyzing male and female populations separately, male-specific trends reflected those seen in the overall population, whereas the only significant predictor of vaccine refusal in the female population was not receiving influenza vaccination while in custody ([aOR] = 6.5, 95 % CI (2.4, 17.6)). CONCLUSION Identifying predictors of vaccine refusal in correctional populations is an essential first step in the development and implementation of targeted interventions to mitigate vaccine hesitancy.
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Affiliation(s)
- Nazia S Qureshi
- Integrated Correctional Health Services-Los Angeles County Department of Health Services, 450 Bauchet St., Los Angeles, CA, USA.
| | - Loren G Miller
- Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA; David Geffen School of Medicine at UCLA, Los Angeles CA, USA; Harbor-UCLA Medical Center, 1000 West Carson Street, Box 466, Torrance, CA 90509, USA; Division of Infectious Diseases, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Stephen P Judge
- Integrated Correctional Health Services-Los Angeles County Department of Health Services, 450 Bauchet St., Los Angeles, CA, USA; Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA; David Geffen School of Medicine at UCLA, Los Angeles CA, USA; Harbor-UCLA Medical Center, 1000 West Carson Street, Box 466, Torrance, CA 90509, USA; Division of Infectious Diseases, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Ngoc Dung T Tran
- Integrated Correctional Health Services-Los Angeles County Department of Health Services, 450 Bauchet St., Los Angeles, CA, USA
| | - Sean O Henderson
- Integrated Correctional Health Services-Los Angeles County Department of Health Services, 450 Bauchet St., Los Angeles, CA, USA
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6
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Torche F, Nobles J. Vaccination, immunity, and the changing impact of COVID-19 on infant health. Proc Natl Acad Sci U S A 2023; 120:e2311573120. [PMID: 38011548 DOI: 10.1073/pnas.2311573120] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 10/19/2023] [Indexed: 11/29/2023] Open
Abstract
In utero exposure to COVID-19 infection may lead to large intergenerational health effects. The impact of infection exposure has likely evolved since the onset of the pandemic as new variants emerge, immunity from prior infection increases, vaccines become available, and vaccine hesitancy persists, such that when infection is experienced is as important as whether it is experienced. We examine the changing impact of COVID-19 infection on preterm birth and the moderating role of vaccination. We offer the first plausibly causal estimate of the impact of maternal COVID-19 infection by using population data with no selectivity, universal information on maternal COVID-19 infection, and linked sibling data. We then assess change in this impact from 2020 to 2023 and evaluate the protective role of COVID-19 vaccination on infant health. We find a substantial adverse effect of prenatal COVID-19 infection on the probability of preterm birth. The impact was large during the first 2 y of the pandemic but had fully disappeared by 2022. The harmful impact of COVID-19 infection disappeared almost a year earlier in zip codes with high vaccination rates, suggesting that vaccines might have prevented thousands of preterm births. The findings highlight the need to monitor the changing consequences of emerging infectious diseases over time and the importance of mitigation strategies to reduce the burden of infection on vulnerable populations.
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Affiliation(s)
- Florencia Torche
- Department of Sociology, Stanford University, Stanford, CA 94305
| | - Jenna Nobles
- Department of Sociology, Center for Demography and Ecology, University of Wisconsin-Madison, Madison, WI 53706
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Pinkney JA, Carroll KN, Rich KM, Hurtado RM, Ciaranello AL, Bogart LM, Ojikutu BO, Hyle EP. Need for open data on COVID-19 vaccine uptake among pregnant people in the Caribbean: a call to action. Rev Panam Salud Publica 2023; 47:e155. [PMID: 37937312 PMCID: PMC10627431 DOI: 10.26633/rpsp.2023.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 08/22/2023] [Indexed: 11/09/2023] Open
Abstract
Pregnant people with coronavirus disease 2019 (COVID-19) have a higher risk of adverse maternal and fetal outcomes compared with pregnant people without COVID-19. In 2021, large increases in maternal mortality were reported in Jamaica, almost half of which were attributable to COVID-19. COVID-19 vaccination has been shown to reduce these risks, but low- and middle-income countries lack free, publicly available data, known as open data, on COVID-19 vaccine uptake for their pregnant populations. The objectives of this paper were to: review how high-income countries use open data to detect trends in COVID-19 vaccine uptake among pregnant people and develop vaccination distribution strategies; outline barriers to making open data available for maternal COVID-19 vaccination in the Caribbean; and propose a multipronged strategy that would increase the availability of open data on maternal COVID-19 vaccination in the Caribbean. A multipronged strategy to fill the data void would involve: (i) utilizing existing Caribbean maternal immunization data collection entities; (ii) adapting digital software tools to establish maternal electronic immunization registries; and (iii) collaborating with local partners skilled in data analytics. Making open data available for COVID-19 vaccine uptake among pregnant people in the Caribbean could offer substantial benefits, including the development of measurable maternal COVID-19 vaccination goals and the facilitation of vaccine decision-making discussions between providers and pregnant people.
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Affiliation(s)
- Jodian A. Pinkney
- Medical Practice Evaluation CenterDepartment of MedicineMassachusetts General HospitalBostonUnited States of AmericaMedical Practice Evaluation Center, Department of Medicine, Massachusetts General Hospital, Boston, United States of America.
| | - Kamali N. Carroll
- University of the West IndiesMonaJamaicaUniversity of the West Indies, Mona, Jamaica.
| | - Katherine M. Rich
- Medical Practice Evaluation CenterDepartment of MedicineMassachusetts General HospitalBostonUnited States of AmericaMedical Practice Evaluation Center, Department of Medicine, Massachusetts General Hospital, Boston, United States of America.
| | - Rocio M. Hurtado
- Division of Infectious DiseasesDepartment of MedicineMassachusetts General HospitalBostonUnited States of AmericaDivision of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, United States of America.
| | - Andrea L. Ciaranello
- Medical Practice Evaluation CenterDepartment of MedicineMassachusetts General HospitalBostonUnited States of AmericaMedical Practice Evaluation Center, Department of Medicine, Massachusetts General Hospital, Boston, United States of America.
| | - Laura M. Bogart
- RAND CorporationSanta MonicaUnited States of AmericaRAND Corporation, Santa Monica, United States of America.
| | - Bisola O. Ojikutu
- Boston Public Health CommissionBostonUnited States of AmericaBoston Public Health Commission, Boston, United States of America.
| | - Emily P. Hyle
- Medical Practice Evaluation CenterDepartment of MedicineMassachusetts General HospitalBostonUnited States of AmericaMedical Practice Evaluation Center, Department of Medicine, Massachusetts General Hospital, Boston, United States of America.
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Fields NJ, Palmer KR, Rolnik DL, Yo J, Nold MF, Giles ML, Krishnaswamy S, Serpa Neto A, Hodges RJ, Marshall SA. CO-Sprout-A Pilot Double-Blinded Placebo-Controlled Randomised Trial of Broccoli Sprout Powder Supplementation for Pregnant Women with COVID-19 on the Duration of COVID-19-Associated Symptoms: Study Protocol. Nutrients 2023; 15:3980. [PMID: 37764764 PMCID: PMC10537772 DOI: 10.3390/nu15183980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/08/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Since its discovery in late 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been estimated to be responsible for at least 769.3 million infections and over 6.95 million deaths. Despite significant global vaccination efforts, there are limited therapies that are considered safe and effective for use in the management of COVID-19 during pregnancy despite the common knowledge that pregnant patients have a much higher risk of adverse outcomes. A bioactive compound found in broccoli sprout-sulforaphane-is a potent inducer of phase-II detoxification enzymes promoting a series of potentially beneficial effects notably as an antioxidant, anti-inflammatory, and anti-viral. A pilot, double-blinded, placebo-controlled randomised trial is to be conducted in Melbourne, Australia, across both public and private hospital sectors. We will assess a commercially available broccoli sprout extract in pregnant women between 20+0 and 36+0 weeks gestation with SARS-CoV-2 infection to investigate (i) the duration of COVID-19 associated symptoms, (ii) maternal and neonatal outcomes, and (iii) biomarkers of infection and inflammation. We plan to enrol 60 outpatient women with COVID-19 irrespective of vaccination status diagnosed by PCR swab or RAT (rapid antigen test) within five days and randomised to 14 days of oral broccoli sprout extract (42 mg of sulforaphane daily) or identical microcrystalline cellulose placebo. The primary outcome of this pilot trial will be to assess the feasibility of conducting a larger trial investigating the duration (days) of COVID-19-associated symptoms using a broccoli sprout supplement for COVID-19-affected pregnancies. Pregnant patients remain an at-risk group for severe disease following infection with SARS-CoV-2 and currently unclear consequences for the offspring. Therefore, this study will assess feasibility of using a broccoli sprout supplement, whilst providing important safety data for the use of sulforaphane in pregnancy.
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Affiliation(s)
- Neville J. Fields
- The Ritchie Centre, Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Melbourne 3168, Australia (D.L.R.); (M.F.N.); (M.L.G.); (R.J.H.); (S.A.M.)
- Monash Health, Monash Medical Centre, Melbourne 3168, Australia
| | - Kirsten R. Palmer
- The Ritchie Centre, Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Melbourne 3168, Australia (D.L.R.); (M.F.N.); (M.L.G.); (R.J.H.); (S.A.M.)
- Monash Health, Monash Medical Centre, Melbourne 3168, Australia
| | - Daniel L. Rolnik
- The Ritchie Centre, Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Melbourne 3168, Australia (D.L.R.); (M.F.N.); (M.L.G.); (R.J.H.); (S.A.M.)
- Monash Health, Monash Medical Centre, Melbourne 3168, Australia
| | - Jennifer Yo
- The Ritchie Centre, Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Melbourne 3168, Australia (D.L.R.); (M.F.N.); (M.L.G.); (R.J.H.); (S.A.M.)
- Monash Health, Monash Medical Centre, Melbourne 3168, Australia
| | - Marcel F. Nold
- The Ritchie Centre, Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Melbourne 3168, Australia (D.L.R.); (M.F.N.); (M.L.G.); (R.J.H.); (S.A.M.)
- Department of Paediatrics, Monash University, Melbourne 3168, Australia
- Monash Newborn, Monash Children’s Hospital, Melbourne 3168, Australia
| | - Michelle L. Giles
- The Ritchie Centre, Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Melbourne 3168, Australia (D.L.R.); (M.F.N.); (M.L.G.); (R.J.H.); (S.A.M.)
- Monash Health, Monash Medical Centre, Melbourne 3168, Australia
| | | | - Ary Serpa Neto
- Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Melbourne 3004, Australia;
- Department of Critical Care, Melbourne Medical School, University of Melbourne, Austin Hospital, Melbourne 3084, Australia
- Department of Intensive Care, Austin Hospital, Melbourne 3084, Australia
- Department of Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo 05652-900, Brazil
| | - Ryan J. Hodges
- The Ritchie Centre, Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Melbourne 3168, Australia (D.L.R.); (M.F.N.); (M.L.G.); (R.J.H.); (S.A.M.)
- Monash Health, Monash Medical Centre, Melbourne 3168, Australia
| | - Sarah A. Marshall
- The Ritchie Centre, Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Melbourne 3168, Australia (D.L.R.); (M.F.N.); (M.L.G.); (R.J.H.); (S.A.M.)
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Post S, Lynch CD, Costantine MM, Fox B, Wu J, Kiefer MK, Rood KM, Landon MB, Grobman WA, Venkatesh KK. Association between community-level political affiliation and peripartum vaccination. Am J Obstet Gynecol MFM 2023; 5:101007. [PMID: 37156464 DOI: 10.1016/j.ajogmf.2023.101007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/02/2023] [Accepted: 05/02/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Political affiliation has been associated with vaccine uptake, but whether this association holds in pregnancy, when individuals are recommended to receive multiple vaccinations, remains to be studied. OBJECTIVE This study aimed to examine the association between community-level political affiliation and vaccinations for tetanus, diphtheria, and pertussis; influenza; and COVID-19 in pregnant and postpartum individuals. STUDY DESIGN A survey was conducted about tetanus, diphtheria, and pertussis and influenza vaccinations in early 2021, with a follow-up survey of COVID-19 vaccination among the same individuals at a tertiary care academic medical center in the Midwest. Geocoded residential addresses were linked at the census tract to the Environmental Systems Research Institute 2021 Market Potential Index, which ranks a community in comparison to the US national average. The exposure for this analysis was community-level political affiliation, defined by the Market Potential Index as very conservative, somewhat conservative, centrist, somewhat liberal, and very liberal (reference). The outcomes were self-reported vaccinations for tetanus, diphtheria, and pertussis; influenza; and COVID-19 in the peripartum period. Modified Poisson regression was used and adjusted for age, employment, trimester at assessment, and medical comorbidities. RESULTS Of 438 assessed individuals, 37% lived in a community characterized by very liberal political affiliation, 11% as somewhat liberal, 18% as centrist, 12% as somewhat conservative, and 21% as very conservative. Overall, 72% and 58% of individuals reported receiving tetanus, diphtheria, and pertussis and influenza vaccinations, respectively. Of the 279 individuals who responded to the follow-up survey, 53% reported receiving COVID-19 vaccination. Individuals living in a community characterized by very conservative political affiliation were less likely to report vaccinations for tetanus, diphtheria, and pertussis (64% vs 72%; adjusted risk ratio, 0.83; 95% confidence interval, 0.69-0.99); influenza (49% vs 58%; adjusted risk ratio, 0.79; 95% confidence interval, 0.62-1.00); and COVID-19 (35% vs 53%; adjusted risk ratio, 0.65; 95% confidence interval, 0.44-0.96) than those in a community characterized by very liberal political affiliation. Individuals living in a community characterized by centrist political affiliation were less likely to report vaccinations for tetanus, diphtheria, and pertussis (63% vs 72%; adjusted risk ratio, 0.82; 95% confidence interval, 0.68-0.99) and influenza (44% vs 58%; adjusted risk ratio, 0.70; 95% confidence interval, 0.54-0.92) than those in a community characterized by very liberal political affiliation. CONCLUSION Compared with pregnant and postpartum individuals living in communities characterized by very liberal political beliefs, those living in communities characterized by very conservative political beliefs were less likely to report vaccinations for tetanus, diphtheria, and pertussis; influenza; and COVID-19, and those in communities characterized by centrist political beliefs were less likely to report vaccinations for tetanus, diphtheria, and pertussis and influenza. Increasing vaccine uptake in the peripartum period may need to consider engaging an individual's broader sociopolitical milieu.
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Affiliation(s)
- Sara Post
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH
| | - Courtney D Lynch
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH
| | - Maged M Costantine
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH
| | - Brandon Fox
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH
| | - Jiqiang Wu
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH
| | - Miranda K Kiefer
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH
| | - Kara M Rood
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH
| | - Mark B Landon
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH
| | - William A Grobman
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH
| | - Kartik K Venkatesh
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH.
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Pinkney JA, Bogart LM, Carroll KN, Bryan L, Witter G, Ashour D, Shebl FM, Hurtado RM, Goldfarb IT, Hyle EP, Psaros C, Ojikutu BO. Factors Associated With Coronavirus Disease 2019 Vaccine Uptake Among Pregnant Women and Nonpregnant Women of Reproductive Age in Jamaica. Open Forum Infect Dis 2023; 10:ofad201. [PMID: 37234512 PMCID: PMC10208745 DOI: 10.1093/ofid/ofad201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/10/2023] [Indexed: 05/28/2023] Open
Abstract
Background Despite high rates of coronavirus disease 2019 (COVID-19)-related maternal mortality, Jamaica currently has little data on COVID-19 vaccine uptake among pregnant women. Methods We conducted a cross-sectional, web-based survey of 192 reproductive-aged women in Jamaica from February 1 to 8, 2022. Participants were recruited from a convenience sample of patients, providers, and staff at a teaching hospital. We assessed self-reported COVID-19 vaccination status and COVID-19-related medical mistrust (operationalized as vaccine confidence, government mistrust, and race-based mistrust). We used multivariable modified Poisson regression to test the association between vaccine uptake and pregnancy. Results Of 192 respondents, 72 (38%) were pregnant. Most (93%) were Black. Vaccine uptake was 35% in pregnant women versus 75% in nonpregnant women. Pregnant women were more likely to cite healthcare providers versus the government as trustworthy sources of COVID-19 vaccine information (65% vs 28%). Pregnancy, low vaccine confidence, and government mistrust were associated with a lower likelihood of COVID-19 vaccination (adjusted prevalence ratio [aPR] = 0.68 [95% confidence interval {CI}, .49-.95], aPR = 0.61 [95% CI, .40-.95], and aPR = 0.68 [95% CI, .52-.89], respectively). Race-based mistrust was not associated with COVID-19 vaccination in the final model. Conclusions Pregnancy, low vaccine confidence, and government mistrust were associated with a lower likelihood of COVID-19 vaccination among reproductive-aged women in Jamaica. Future studies should evaluate the efficacy of strategies proven to improve maternal vaccination coverage, including standing "opt-out" vaccination orders and collaborative provider and patient-led educational videos tailored for pregnant individuals. Strategies that decouple vaccine messaging from government agencies also warrant evaluation.
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Affiliation(s)
- Jodian A Pinkney
- Correspondence: Jodian A. Pinkney, MD, Massachusetts General Hospital, 55 Fruit Street, Cox 5, Boston, MA 02114 (); Laura Bogart, PhD, RAND Corporation, 1776 Main Street, Santa Monica, CA ()
| | - Laura M Bogart
- Correspondence: Jodian A. Pinkney, MD, Massachusetts General Hospital, 55 Fruit Street, Cox 5, Boston, MA 02114 (); Laura Bogart, PhD, RAND Corporation, 1776 Main Street, Santa Monica, CA ()
| | | | - Lenroy Bryan
- University of the West Indies, Kingston, Jamaica
| | | | - Dina Ashour
- Medical Practice Evaluation Center, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Fatma M Shebl
- Medical Practice Evaluation Center, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Rocio M Hurtado
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Ilona T Goldfarb
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Emily P Hyle
- Medical Practice Evaluation Center, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Christina Psaros
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
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11
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Jun J, Tubbs Cooley H, O’Mathúna DP, Kim M, Pignatiello G, Fitzpatrick JJ, Tucker S. Individual and Work-Related Characteristics Associated with COVID-19 Vaccination Status among Ohio Nurses. Policy Polit Nurs Pract 2023; 24:81-90. [PMID: 36482714 PMCID: PMC9742733 DOI: 10.1177/15271544221141060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Uptake of the COVID-19 vaccine by nurses lags behind that of other health care professionals with minimal empirical evidence to understand this phenomenon. In this secondary analysis, we examined nurses' individual and work-related characteristics and their association with COVID-19 vaccination status. Alumni of three Ohio nursing colleges and members of a professional organization were invited to complete questionnaires from June through August 2021. Logistic regression models were used to evaluate associations between nurse characteristics and vaccination status. Among 844 respondents, 754 (80.30%) had received at least one dose of the vaccine. Older age, having a bachelor's degree or higher, and working in critical care were associated with vaccination. Providing direct care for COVID-19 patients in the last 7 days and a higher perception of one's work being affected by COVID-19 were significantly associated with being vaccinated, whereas prior COVID-19 infection was inversely associated with vaccination status. Our findings suggest that COVID-19 vaccine uptake among nurses is influenced by a host of factors related to virus knowledge, beliefs, and risk perceptions. Awareness of these factors can aid the development of interventions to increase nurses' acceptance of vaccines.
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Affiliation(s)
- Jin Jun
- College of Nursing, the Ohio State University, Columbus, OH, USA
| | | | | | - Minjin Kim
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | - Grant Pignatiello
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Joyce J. Fitzpatrick
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Sharon Tucker
- Fuld EBP Institute, College of Nursing, the Ohio State University, Columbus, OH, USA
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12
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Jorgensen P, Schmid A, Sulo J, Preza I, Hasibra I, Kissling E, Fico A, Sridhar S, Rubin-Smith JE, Kota M, Vasili A, Daja R, Nika M, Pebody R, Lafond KE, Katz MA, Bino S. Factors associated with receipt of COVID-19 vaccination and SARS-CoV-2 seropositivity among healthcare workers in Albania (February 2021-June 2022): secondary analysis of a prospective cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2023; 27:100584. [PMID: 37013112 PMCID: PMC9969343 DOI: 10.1016/j.lanepe.2023.100584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/23/2022] [Accepted: 01/03/2023] [Indexed: 03/02/2023]
Abstract
Background Healthcare workers (HCWs) have been disproportionally affected by COVID-19. We investigated factors associated with two- and three-dose COVID-19 vaccine uptake and SARS-CoV-2 seropositivity among 1504 HCWs enrolled (19 February-7 May 2021) in a prospective COVID-19 vaccine effectiveness cohort in Albania through a secondary analysis. Methods We collected sociodemographic, occupational, health, prior SARS-CoV-2 infection, and COVID-19 vaccination data from all HCWs at enrollment. Vaccination status was assessed weekly through June 2022. A serum sample was collected from all participants at enrollment and tested for anti-spike SARS-CoV-2 antibodies. We analyzed HCWs characteristics and outcomes using multivariable logistic regression. Findings By 11 June 2022, 1337 (88.9%) HCWs had received two COVID-19 vaccine doses, of whom 255 (19.1%) received a booster. Factors significantly associated with receiving three doses (adjusted odds ratio (aOR), 95% CIs) were being ≥35 years (35-44 years: 1.76 (1.05-2.97); 45-54 years: 3.11 (1.92-5.05); ≥55 years: 3.38 (2.04-5.59)) and vaccinated against influenza (1.78; 1.20-2.64). Booster dose receipt was lower among females (0.58; 0.41-0.81), previously infected (0.67; 0.48-0.93), nurses and midwives (0.31; 0.22-0.45), and support staff (0.19; 0.11-0.32). Overall 1076 (72%) were SARS-CoV-2 seropositive at enrollment. Nurses and midwifes (1.45; 1.05-2.02), support staff (1.57; 1.03-2.41), and HCWs performing aerosol-generating procedures (AGPs) (1.40; 1.01-1.94) had higher odds of being seropositive, while smokers had reduced odds (0.55; 0.40-0.75). Interpretation In a large cohort of Albanian HCWs, COVID-19 vaccine booster dose uptake was very low, particularly among younger, female, and non-physician HCWs, despite evidence demonstrating the added benefit of boosters in preventing infection and severe disease. Reasons behind these disparities should be explored to develop targeted strategies in order to promote uptake in this critical population. SARS-CoV-2 seroprevalence was higher among non-physicians and HCWs performing APGs. A better understanding of the factors contributing to these differences is needed to inform interventions that could reduce infections in the future. Funding This study was funded by the Task Force for Global Health (US Centers for Disease Control (CDC) cooperative agreement # NU51IP000873) and the World Health Organization, Regional Office for Europe.
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Affiliation(s)
- Pernille Jorgensen
- World Health Organization, Regional Office for Europe, Marmorvej 51, 2100, Copenhagen, Denmark
| | - Alexis Schmid
- Boston Children's Hospital Global Health Program, Boston, MA, USA
| | - Jonilda Sulo
- Southeast European Center for Surveillance and Control of Infectious Diseases, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | - Iria Preza
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | - Iris Hasibra
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | | | - Albana Fico
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | - Shela Sridhar
- Boston Children's Hospital Global Health Program, Boston, MA, USA
- Brigham and Women's Hospital, Department of Global Health Equity, 651 Huntington Avenue FXB, Building, 7th Floor, Boston, MA, USA
| | | | - Majlinda Kota
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | - Adela Vasili
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | - Rovena Daja
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | - Miljana Nika
- Tirana University Hospital “Mother Theresa”, Dibra Street N.372, 1001, Tirana, Albania
| | - Richard Pebody
- World Health Organization, Regional Office for Europe, Marmorvej 51, 2100, Copenhagen, Denmark
| | - Kathryn E. Lafond
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mark A. Katz
- World Health Organization, Regional Office for Europe, Marmorvej 51, 2100, Copenhagen, Denmark
| | - Silvia Bino
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
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13
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Kalok A, Razak Dali W, Sharip S, Abdullah B, Kamarudin M, Dasrilsyah RA, Abdul Rahman R, Kamisan Atan I. Maternal COVID-19 vaccine acceptance among Malaysian pregnant women: A multicenter cross-sectional study. Front Public Health 2023; 11:1092724. [PMID: 36908400 PMCID: PMC9992805 DOI: 10.3389/fpubh.2023.1092724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/02/2023] [Indexed: 02/24/2023] Open
Abstract
Introduction The coronavirus disease 2019 (COVID-19) caused a global pandemic that resulted in devastating health, economic and social disruption. Pregnant mothers are susceptible to COVID-19 complications due to physiological and immunity changes in pregnancy. We aimed to assess the maternal vaccine acceptance of the COVID-19 vaccine. Methods A multi-center study across four teaching hospitals in the Klang Valley, Malaysia was conducted between September 2021 and May 2022. A survey was conducted using a self-administered electronic questionnaire. The survey instruments included; (1) maternal perception and attitude toward COVID-19 vaccination, (2) COVID-19 pregnancy-related anxiety, and 3) generalized anxiety disorder. Results The response rate was 96.6%, with a final number for analysis of 1,272. The majority of our women were Malays (89.5%), with a mean age (standard deviation, SD) of 32.2 (4.6). The maternal vaccine acceptance in our study was 77.1%. Household income (p < 0.001), employment status (p = 0.011), and health sector worker (p = 0.001) were independent predictors of maternal willingness to be vaccinated. COVID-19 infection to self or among social contact and greater COVID-19 pregnancy-related anxiety were associated with increased odds of accepting the SARS-CoV-2 vaccine. Women who rely on the internet and social media as a source of vaccine information were more likely to be receptive to vaccination (adjusted odd ratio, AOR 1.63; 95% CI 1.14-2.33). Strong correlations were observed between maternal vaccine acceptance and the positive perception of (1) vaccine information (p < 0.001), (2) protective effects of vaccine (p < 0.001), and (3) getting vaccinated as a societal responsibility (p < 0.001). Discussion The high maternal vaccine acceptance rate among urban pregnant women in Malaysia is most likely related to their high socio-economic status. Responsible use of the internet and social media, alongside appropriate counseling by health professionals, is essential in reducing vaccine hesitancy among pregnant women.
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Affiliation(s)
- Aida Kalok
- Department of Obstetrics and Gynaecology, Faculty of Medicine, National University of Malaysia, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Wira Razak Dali
- Department of Obstetrics and Gynaecology, Faculty of Medicine, National University of Malaysia, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Shalisah Sharip
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Bahiyah Abdullah
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
- Maternofetal and Embryo (MatE) Research Group, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
| | - Maherah Kamarudin
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Rima Anggrena Dasrilsyah
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Selangor, Malaysia
| | - Rahana Abdul Rahman
- Department of Obstetrics and Gynaecology, Faculty of Medicine, National University of Malaysia, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Ixora Kamisan Atan
- Department of Obstetrics and Gynaecology, Faculty of Medicine, National University of Malaysia, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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Prosser LA, Wagner AL, Wittenberg E, Zikmund-Fisher BJ, Rose AM, Pike J. A Discrete Choice Analysis Comparing COVID-19 Vaccination Decisions for Children and Adults. JAMA Netw Open 2023; 6:e2253582. [PMID: 36716030 PMCID: PMC9887501 DOI: 10.1001/jamanetworkopen.2022.53582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
IMPORTANCE COVID-19 vaccination rates in the US remain below optimal levels. Patient preferences for different attributes of vaccine products and the vaccination experience can be important in determining vaccine uptake decisions. OBJECTIVE To assess preferences for attributes of adult and pediatric COVID-19 vaccination among US adults. DESIGN, SETTING, AND PARTICIPANTS An online survey of a national panel of 1040 US adults was conducted in May and June 2021. A discrete choice analysis was used to measure the relative value of each attribute in the decision to choose a COVID-19 vaccination option for adults or children. Six attributes were used to described hypothetical vaccination options: vaccine effectiveness, mild side effects, rare adverse events, number of doses, time required for vaccination, and regulatory approval. Respondents chose between hypothetical vaccination profiles or no vaccination. Additional survey questions asked about vaccination beliefs, COVID-19 illness experience, COVID-19 risk factors, vaccination status, and opinions about the risk of COVID-19. EXPOSURES Respondents chose which vaccine profile they would prefer to receive for themselves (or no vaccination). Respondents then considered an identical set of profiles for a hypothetical child aged 0 to 17 years. MAIN OUTCOMES AND MEASURES Relative value of vaccination-related attributes were estimated using Bayesian logit regression. Preference profiles for subgroups were estimated using latent class analyses. RESULTS A total of 1040 adults (610 [59%] female; 379 participants [36%] with an age of 55 years and older years) responded to the survey. When asked about vaccination choices for themselves, participants indicated that vaccine effectiveness (95% vs 60%) was a significant attribute (β, 9.59 [95% CrI, 9.20-10.00] vs β, 0.41 [95% CrI, 0-0.80]). Respondents also preferred fewer rare adverse events (β, 6.35 [95% CrI, 5.74-6.86), fewer mild side effects (β, 5.49; 95% CrI, 5.12-5.87), 1 dose (β, 5.41; 95% CrI, 5.04-5.78), FDA approval (β, 6.01; 95% CrI, 5.64-6.41), and shorter waiting times (β, 5.67; 95% CrI, 4.87-6.48). Results were very similar when framing the question as adult or child vaccination, with slightly stronger preference for fewer rare adverse events for children. Latent class analysis revealed 4 groups of respondents: (1) individuals sensitive to safety and regulatory status, (2) individuals sensitive to convenience, (3) individuals who carefully considered all attributes in making their choices, and (4) individuals who rejected the vaccine. CONCLUSIONS AND RELEVANCE In this survey study of US adults, the identification of 4 distinct preference groups provides new information to guide communications to support vaccine decision making. In particular, the group that prioritize convenience (less time required for vaccination and fewer doses) may present an opportunity to create actionable strategies to increase vaccination uptake for both adult and pediatric populations.
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Affiliation(s)
| | | | - Eve Wittenberg
- Harvard Chan School of Public Health, Boston, Massachusetts
| | | | | | - Jamison Pike
- Centers for Disease Control and Prevention, Atlanta, Georgia
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15
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Kupferwasser D, Flores EA, Merino P, Phan Tran D, Bolaris M, Gonzales M, Nguyen MH, Balo A, Abueg A, Da Silva W, Astorga-Cook L, Liu H, Mason H, Freund D, Nightingale J, Orr J, Xie B, Miller LG. Characterization of COVID-19 Vaccine Hesitancy Among Essential Workforce Members of a Large Safety Net Urban Medical Center. J Prim Care Community Health 2023; 14:21501319231159814. [PMID: 36941757 PMCID: PMC10028456 DOI: 10.1177/21501319231159814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVES Vaccine hesitancy among essential workers remains a significant public health challenge. We examined psychological constructs of perceived susceptibility, threat, and self-efficacy and their associations with COVID-19 vaccine hesitancy among a racially and ethnically diverse essential workforce population. METHODS We performed a cross-sectional survey of essential workers from September-December 2020 at a large Los Angeles safety-net medical center as part of a program offering free COVID-19 serology testing. Program participants completed a standardized survey at the time of phlebotomy. Hierarchical logistic regression was utilized to determine factors independently associated with vaccine hesitancy. RESULTS Among 1327 persons who had serology testing, 1235 (93%) completed the survey. Of these, 958 (78%) were healthcare workers. Based on expressed intent, 22% were vaccine-hesitant 78% were vaccine acceptors. In our multivariate model, vaccine hesitancy was associated with female gender [aOR = 2.09; 95% CI (1.44-3.05)], African American race [aOR = 4.32; (2.16-8.62)], LatinX ethnicity [aOR = 2.47; 95% CI (1.51-4.05)] and history of not/sometimes receiving influenza vaccination [aOR = 4.39; 95% CI (2.98-6.48)]. Compared to nurses, vaccine hesitancy was lower among physicians [aOR = 0.09; 95% CI (0.04-0.23)], non-nursing/non-physician healthcare workers [aOR = 0.55; 95% CI (0.33-0.92)], and non-healthcare care workers [aOR = 0.53; 95% CI (0.36-0.78)]. CONCLUSIONS Among a racially/ethnically diverse group of safety net medical center essential workers, COVID-19 vaccine hesitancy was associated with racial/ethnic minority groups, employment type, and prior influenza vaccination hesitancy. Interestingly, we found no association with the Health Belief Model construct measures of perceived susceptibility, threat, and self-efficacy. Psychological constructs not assessed may be drivers of vaccine hesitancy in our population.
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Affiliation(s)
- Deborah Kupferwasser
- Harbor-UCLA Medical Center, Torrance, CA, USA
- Claremont Graduate University, Claremont, CA, USA
| | | | | | | | | | - Mildred Gonzales
- Los Angeles County College of Nursing and Allied Health, Los Angeles, CA, USA
| | | | - Arlene Balo
- Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Angel Abueg
- Harbor-UCLA Medical Center, Torrance, CA, USA
| | | | | | - Honghu Liu
- University of California, Los Angeles, Los Angeles CA, USA
| | - Holli Mason
- Harbor-UCLA Medical Center, Torrance, CA, USA
| | | | | | - Jay Orr
- Claremont Graduate University, Claremont, CA, USA
| | - Bin Xie
- Claremont Graduate University, Claremont, CA, USA
| | - Loren G Miller
- Harbor-UCLA Medical Center, Torrance, CA, USA
- University of California, Los Angeles, Los Angeles CA, USA
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16
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Kapinos KA, DeYoreo M, Lawrence R, Waymouth M, Uscher-Pines L. COVID-19 vaccine uptake and attitudes among pregnant and postpartum parents. Am J Obstet Gynecol MFM 2022; 4:100735. [PMID: 36031149 PMCID: PMC9411101 DOI: 10.1016/j.ajogmf.2022.100735] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 08/22/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Pregnancy poses increased risks from COVID-19, including hospitalization and premature delivery. Yet pregnant individuals are less likely to have received a COVID-19 vaccine. OBJECTIVE This study aimed to investigate COVID-19 vaccine uptake and reasons for delay or refusal among perinatal parents. STUDY DESIGN A total of 1542 eligible parents who delivered between 2019 and 2021 were surveyed through the Ovia parenting app, which has a nationally representative user base. Adjusted and nationally weighted means were calculated. Multivariate logistic regression and survival models were used to examine uptake. RESULTS At least 1 dose of the COVID-19 vaccine was received by 70% of the parents. Those with a bachelor's or graduate degree were significantly more likely to have received a vaccine relative to those with some college or less (adjusted odds ratio for bachelor's degree, 1.854; 95% confidence interval, 1.19-2.90; adjusted odds ratio for graduate degree, 2.833; 95% confidence interval, 1.69-4.75). Parents living in rural areas were significantly less likely to have received a vaccine relative to those living in urban areas (adjusted odds ratio for small city, 0.62; 95% confidence interval, 0.45-0.86; adjusted odds ratio for rural area, 0.56; 95% confidence interval, 0.35-0.89); 56% (281/502) of unvaccinated parents considered that the vaccine "was too new." Among those pregnant in 2021, 44% (258/576) received at least 1 dose, and 34% (195/576) reported that pregnancy had "no impact" on their vaccine decision. CONCLUSION There was significant heterogeneity in vaccine uptake and attitudes toward vaccines during pregnancy by sociodemographics and over time. Public health experts need to consider and test more tailored approaches to reduce vaccine hesitancy in this population.
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Affiliation(s)
- Kandice A Kapinos
- RAND Corporation, Arlington, VA (Dr Kapinos, Ms Lawrence, Ms Waymouth, and Dr Uscher-Pines); Peter O'Donnell Jr. School of Public Health, The University of Texas Southwestern Medical Center, Dallas, TX (Dr Kapinos).
| | | | - Rebecca Lawrence
- RAND Corporation, Arlington, VA (Dr Kapinos, Ms Lawrence, Ms Waymouth, and Dr Uscher-Pines)
| | - Molly Waymouth
- RAND Corporation, Arlington, VA (Dr Kapinos, Ms Lawrence, Ms Waymouth, and Dr Uscher-Pines)
| | - Lori Uscher-Pines
- RAND Corporation, Arlington, VA (Dr Kapinos, Ms Lawrence, Ms Waymouth, and Dr Uscher-Pines)
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17
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Paul R, Raghuraman N, Carter EB, Odibo AO, Kelly JC, Foeller ME, Perez MJ. COVID Vaccine Information Sources Utilized by Female Healthcare Workers. Am J Obstet Gynecol MFM 2022; 4:100704. [PMID: 35931368 PMCID: PMC9345656 DOI: 10.1016/j.ajogmf.2022.100704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/13/2022] [Accepted: 07/28/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Clinical trials of the messenger RNA COVID-19 vaccines excluded individuals with active reproductive needs (attempting to conceive, currently pregnant, and/or lactating). Women comprise three-quarters of healthcare workers in the United States-an occupational field among the first to receive the vaccine. Professional medical and government organizations have encouraged shared decision-making and access to vaccination among those with active reproductive needs. OBJECTIVE This study aimed to characterize the information sources used by pregnancy-capable healthcare workers for information about the COVID-19 vaccines and to compare the self-reported "most important" source by the respondents' active reproductive needs, if any. STUDY DESIGN This was a web-based national survey of female, US-based healthcare workers in January 2021. Recruitment was done using social media and subsequent sharing via word of mouth. We classified the respondents into 6 groups on the basis of self-reported reproductive needs as follows: (1) preventing pregnancy, (2) attempting pregnancy, (3) currently pregnant, (4) lactating, (5) attempting pregnancy and lactating, and (6) currently pregnant and lactating. We provided respondents with a list of information sources (friends, family, obstetrician-gynecologists, pediatrician, news, social media, government organizations, their employer, and "other") and asked respondents which source(s) they used when looking for information about the vaccine and their most important source. We used descriptive statistics to characterize the information sources and compared the endorsement of government organizations and obstetrician-gynecologists, which were the most important information source between reproductive groups, using the chi-square test. The effect size was calculated using Cramér V. RESULTS Our survey had 11,405 unique respondents: 5846 (51.3%) were preventing pregnancy, 955 (8.4%) were attempting pregnancy, 2196 (19.3%) were currently pregnant, 2250 (19.7%) were lactating, 67 (0.6%) were attempting pregnancy and lactating, and 91 (0.8%) were currently pregnant and lactating. The most endorsed information sources were government organizations (88.7%), employers (48.5%), obstetrician-gynecologists (44.9%), and social media (39.6%). Considering the most important information source, the distribution of respondents endorsing government organizations was different between reproductive groups (P<.001); it was most common among respondents preventing pregnancy (62.6%) and least common among those currently pregnant (31.5%). We observed an inverse pattern among the respondents endorsing an obstetrician-gynecologist as the most important source; the source was most common among currently pregnant respondents (51.4%) and least common among those preventing pregnancy (5.8%), P<.001. The differences in the endorsement of social media as an information source between groups were significant but had a small effect size. CONCLUSION Healthcare workers use government and professional medical organizations for information. Respondents attempting pregnancy and those pregnant and/or lactating are more likely to use social media and an obstetrician-gynecologist as information sources for vaccine decision-making. These data can inform public health messaging and counseling for clinicians.
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Affiliation(s)
- Rachel Paul
- Divisions of Maternal-Fetal Medicine & Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (R. Paul and Drs Raghuraman, Carter, Odibo, Kelly, and Perez)
| | - Nandini Raghuraman
- Divisions of Maternal-Fetal Medicine & Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (R. Paul and Drs Raghuraman, Carter, Odibo, Kelly, and Perez)
| | - Ebony B Carter
- Divisions of Maternal-Fetal Medicine & Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (R. Paul and Drs Raghuraman, Carter, Odibo, Kelly, and Perez)
| | - Anthony O Odibo
- Divisions of Maternal-Fetal Medicine & Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (R. Paul and Drs Raghuraman, Carter, Odibo, Kelly, and Perez)
| | - Jeannie C Kelly
- Divisions of Maternal-Fetal Medicine & Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (R. Paul and Drs Raghuraman, Carter, Odibo, Kelly, and Perez)
| | - Megan E Foeller
- Maternal-Fetal Medicine, Saint Alphonsus Medical Center, Boise, ID (Dr Foeller)
| | - Marta J Perez
- Divisions of Maternal-Fetal Medicine & Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (R. Paul and Drs Raghuraman, Carter, Odibo, Kelly, and Perez).
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18
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Mustafa ZU, Bashir S, Shahid A, Raees I, Salman M, Merchant HA, Aldeyab MA, Kow CS, Hasan SS. COVID-19 Vaccine Hesitancy among Pregnant Women Attending Antenatal Clinics in Pakistan: A Multicentric, Prospective, Survey-Based Study. Viruses 2022; 14:v14112344. [PMID: 36366442 PMCID: PMC9694328 DOI: 10.3390/v14112344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/15/2022] [Accepted: 10/19/2022] [Indexed: 02/01/2023] Open
Abstract
This study aimed to assess the vaccination status and factors contributing to vaccine hesitancy among pregnant women in the largest province of Pakistan. A multicentric, prospective, survey-based study using an interviewer-administered tool was conducted among pregnant women attending antenatal clinics between 1 December 2021 through 30 January 2022 across seven hospitals in Pakistan. The healthcare professionals providing care at the participating hospitals administered the survey. Four hundred and five pregnant women fully consented and completed the study. The majority of the study participants (70.6%, n = 286) were aged between 25 and 34 and had a previous successful pregnancy history. More than half of the study participants (56.0%, n = 227) did not receive COVID-19 vaccination at the time of data collection despite their family members (93.9%, n = 372) had already received at least one dose of COVID-19 vaccine. Among those who received COVID-19 vaccination (n = 173), vaccine efficacy, protection for the foetus, and risk of COVID-19-associated hospitalisation were the main driving factors for vaccine hesitancy. The majority of the unvaccinated women (77.8%, n = 182) had no intention of receiving the vaccine. However, more than two-thirds (85.7%, n = 342) consulted the doctor about COVID-19 vaccines, and most were recommended to receive COVID-19 vaccines by the doctors (80.7%, n = 280). Women were significantly more likely to be vaccinated if they had employment (odds ratio [OR] 4.47, 95% confidence interval [CI]: 2.31-8.64) compared with their counterparts who were homemakers, consulted their doctors (OR 0.12, 95% CI: 0.04-0.35), and if they did not have pregnancy-related issues (OR 6.02, 95% CI: 2.36-15.33). In this study, vaccine hesitancy was prevalent, and vaccine uptake was low among pregnant women. Education and employment did impact COVID vaccination uptake, emphasising the need for more targeted efforts to enhance the trust in vaccines.
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Affiliation(s)
- Zia Ul Mustafa
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang 11800, Malaysia
- Department of Pharmacy Services, District Headquarters (DHQ) Hospital, Pakpattan 57400, Pakistan
| | - Shazma Bashir
- School of Health, Sport and Bioscience, University of East London, Stratford Campus, London W1S 3PR, UK
| | - Arfah Shahid
- Department of Medicine, Rawalpindi Medical University, Rawalpindi 46000, Pakistan
| | - Iqra Raees
- Department of Medicine, Faisalabad Medical University, Faisalabad 38000, Pakistan
| | - Muhammad Salman
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore 54000, Pakistan
| | - Hamid A. Merchant
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
| | - Mamoon A. Aldeyab
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
| | - Chia Siang Kow
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia
- Correspondence: (C.S.K.); (S.S.H.)
| | - Syed Shahzad Hasan
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
- Correspondence: (C.S.K.); (S.S.H.)
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19
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Kiefer MK, Mehl R, Rood KM, Germann K, Mallampati D, Manuck T, Costantine MM, Lynch CD, Grobman WA, Venkatesh KK. Association between social vulnerability and COVID-19 vaccination hesitancy and vaccination in pregnant and postpartum individuals. Vaccine 2022; 40:6344-6351. [PMID: 36167695 PMCID: PMC9489982 DOI: 10.1016/j.vaccine.2022.09.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To evaluate the association of community-level social vulnerability with COVID-19 vaccine hesitancy and vaccination among pregnant and postpartum individuals. METHODS Prospective cohort study assessing COVID-19 vaccine hesitancy among pregnant and postpartum individuals. We performed a baseline survey on COVID-19 vaccine hesitancy from 03/22/21 to 04/02/21, and a follow-up survey on COVD-19 vaccination status 3- to 6-months later. The primary exposure was the Centers for Disease Control and Prevention SVI (Social Vulnerability Index), measured in quartiles. Higher SVI quartiles indicated greater community-level social vulnerability with the lowest quartile (quartile 1) as the referent group. The primary outcome was COVID-19 vaccine hesitancy on the baseline survey (uncertainty or refusal of the vaccine), and the secondary outcome was self-report of not being vaccinated (unvaccinated) for COVID-19 on the follow-up survey. RESULTS Of 456 assessed individuals, 46% reported COVID-19 vaccine hesitancy on the baseline survey; and of 290 individuals (290/456, 64%) who completed the follow-up survey, 48% (140/290) were unvaccinated. The frequency of baseline vaccine hesitancy ranged from 25% in quartile 1 (low SVI) to 68% in quartile 4 (high SVI), and being unvaccinated at follow-up ranged from 29% in quartile 1 to 77% in quartile 4. As social vulnerability increased, the risk of COVID-19 vaccine hesitancy at baseline increased (quartile 2 aRR (adjusted relative risk): 1.46; 95% CI:0.98 to 2.19; quartile 3 aRR: 1.86; 95% CI:1.28 to 2.71; and quartile 4 aRR: 2.24; 95% CI:1.56 to 3.21), as did the risk of being unvaccinated at follow-up (quartile 2 aRR: 1.00; 95% CI:0.66 to 1.51; quartile 3 aRR: 1.68; 95% CI:1.17 to 2.41; and quartile 4 aRR: 1.82; 95% CI:1.30 to 2.56). CONCLUSIONS Pregnant and postpartum individuals living in an area with higher community-level social vulnerability were more likely to report COVID-19 vaccine hesitancy and subsequently to be unvaccinated at follow-up.
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Affiliation(s)
- Miranda K. Kiefer
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, United States,Corresponding author: Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, The Ohio State University, 395, West 12, Avenue, Floor 5, Columbus, OH 43210
| | - Rebecca Mehl
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Kara M. Rood
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Katherine Germann
- College of Medicine, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Divya Mallampati
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Tracy Manuck
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Maged M. Costantine
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Courtney D. Lynch
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, United States
| | - William A. Grobman
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Kartik K. Venkatesh
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, United States
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20
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Nakahara A, Biggio JR, Elmayan A, Williams FB. Safety-Related Outcomes of Novel mRNA COVID-19 Vaccines in Pregnancy. Am J Perinatol 2022; 39:1484-1488. [PMID: 35045574 DOI: 10.1055/a-1745-1168] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE The objective of this study was to describe the safety profile and demographic data for a cohort of pregnant individuals who received an mRNA coronavirus disease 2019 (COVID-19) vaccine. STUDY DESIGN Prospective cohort study (with exposure matching) of individuals with active pregnancy who underwent immunization with a novel mRNA COVID-19 vaccine matched 1:2 with vaccinated age-matched female nonregnant controls was carried out. The primary outcome was defined as any vaccine-related complaints as defined in the original safety data. Secondary outcomes included specific complaints, COVID-19 screening test, and positive COVID-19 test. RESULTS Eighty-three vaccinated pregnant persons were age-matched with 166 female controls, all of whom were vaccinated between December 2020 and January, 2021. There was no difference in race or ethnicity between the groups. The mean body mass index of pregnant patients was lower than that of controls (26.1 vs. 29.2, p = 0.002). The frequency of complaints following vaccine administration was not different between pregnant and nonpregnant patients (18.1 vs. 16.9%, p = 0.201). Pregnant individuals were more likely to report fever (4.8 vs. 0.6%, p = 0.044) and gastrointestinal symptoms (4.8 vs. 0%, p = 0.012). CONCLUSIONS Side effect profiles of COVID-19 vaccine administration at our institution were relatively similar between pregnant and nonpregnant individuals and no serious complications occurred in either group. As COVID-19 infection in pregnancy can have significant morbidity, our data support the continued use of the vaccine for pregnant patients. KEY POINTS · Pregnant and nonpregnant women had a similar frequency of complaints.. · No serious adverse outcomes were observed in either group.. · Pregnant women were more likely to report fever and gastrointestinal side effects which may reflect gestationally mediated physiological responses to immunization..
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Affiliation(s)
- Angela Nakahara
- Ochsner Health, Department of Women's Services, New Orleans, Louisiana
| | - Joseph R Biggio
- Ochsner Health, Department of Women's Services, New Orleans, Louisiana
| | - Ardem Elmayan
- Ochsner Health, Department of Women's Services, New Orleans, Louisiana
| | - Frank B Williams
- Ochsner Health, Department of Women's Services, New Orleans, Louisiana
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21
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Garcia L, Firek A, Freund D, Massai D, Khurana D, Lee JE, Zamarripa S, Sasaninia B, Michaels K, Nightingale J, Gatto NM. Decisions to Choose COVID-19 Vaccination by Health Care Workers in a Southern California Safety Net Medical Center Vary by Sociodemographic Factors. Vaccines (Basel) 2022; 10:1247. [PMID: 36016135 PMCID: PMC9412623 DOI: 10.3390/vaccines10081247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Limited information exists regarding COVID-19 vaccine hesitancy among healthcare workers (HCWs). Our previous survey analyzed the reasons for HCWs' decisions to accept vaccination, suggesting that a "one-size fits all" approach may not suffice to increase vaccine uptake. METHODS Based on the vaccination acceptance group (acceptor, hesitant, refuser), we examined differences by sociodemographic factors (race/ethnicity, household income, education) from Likert Scale responses to fourteen influences affecting a decision to be vaccinated using the Kruskal-Wallis test and multinomial logistic regression with mutual adjustment for these sociodemographic factors, age, and sex. RESULTS Non-Hispanic White vaccine acceptors ranked lower confidence in preventing, withstanding, or treating COVID-19, while Non-Hispanic Blacks more highly regarded the motivation of a religious leader, colleague, or family member. Social media was ranked more influential among Non-Hispanic Asians. Acceptors with lower incomes ranked a job requirement influential; conversely, higher income vaccine hesitant HCWs highly rated this reason. More highly educated acceptors ranked being motivated by colleagues, family, and other HCWs higher. Adjustment weakened some but not all the differences between groups. CONCLUSIONS Sociodemographic factors affect HCWs' decisions to be vaccinated against COVID-19. Our findings may help develop more focused and tailored strategies to improve vaccination acceptance.
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Affiliation(s)
- Lauren Garcia
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA; (L.G.); (D.F.); (D.M.)
| | - Anthony Firek
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
| | - Deborah Freund
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA; (L.G.); (D.F.); (D.M.)
- Department of Economic Sciences, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA;
| | - Donatella Massai
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA; (L.G.); (D.F.); (D.M.)
| | - Dhruv Khurana
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
- Division of Addiction Psychiatry, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, 10833 Le Conte Ave, Los Angeles, CA 90095, USA
| | - Jerusha E. Lee
- Department of Economic Sciences, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA;
| | - Susanna Zamarripa
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
| | - Bijan Sasaninia
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
| | - Kelsey Michaels
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
| | - Judi Nightingale
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
| | - Nicole M. Gatto
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (A.F.); (D.K.); (S.Z.); (B.S.); (K.M.); (J.N.)
- School of Public Health, Loma Linda University, 24951 Circle Dr, Loma Linda, CA 92354, USA
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1975 Zonal Ave., Los Angeles, CA 90089, USA
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22
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Klipstein S, Dionne JA, Feinberg EC, Kawwass JF, Pfeifer SM, Schlegel PN, Racowsky C. Data-driven commentary on SARS-CoV-2 infection, vaccination, and fertility. Fertil Steril 2022; 118:262-265. [PMID: 35779971 PMCID: PMC9240985 DOI: 10.1016/j.fertnstert.2022.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/06/2022] [Indexed: 01/28/2023]
Abstract
A recent study by Wesselink et al. (Am J Epidemiol. 2022 Jan 20;kwac011. doi: 10.1093/aje/kwac011. Online ahead of print) adds to the growing body of research finding that vaccination for coronavirus disease 2019 (COVID-19) is safe for individuals either seeking pregnancy or who are pregnant. The study's authors found no effect of COVID-19 vaccination on fecundity in a population of individuals with no known infertility who were attempting conception. The finding reinforces the messaging of the American Society for Reproductive Medicine COVID-19 Task Force, the aim of which is to provide data-driven recommendations to individuals contemplating pregnancy in the face of the COVID-19 pandemic. As safe and effective COVID-19 vaccines became available, and with an increasing number of studies showing a heightened risk of severe disease during pregnancy, an important role of the Task Force is to encourage vaccination during the preconceptual window and in early pregnancy. The Task Force supports ongoing research to address gaps in knowledge about safe and effective therapies and preventive measures for individuals contemplating pregnancy and during pregnancy. Such research will help optimize care for reproductive-age individuals in the face of current and future health crises.
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Affiliation(s)
- Sigal Klipstein
- Department of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois,InVia Fertility Specialists, Hoffman Estates, Illinois
| | - Jodie A. Dionne
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Eve C. Feinberg
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jennifer F. Kawwass
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics and Gynecology, Emory Medical School, Atlanta, Georgia
| | - Samantha M. Pfeifer
- Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York-Presbyterian Hospital, New York, New York
| | - Peter N. Schlegel
- Department of Urology, Weill Medical College of Cornell University, New York-Presbyterian Hospital, New York, New York
| | - Catherine Racowsky
- Department of Obstetrics, Gynecology and Reproductive Medicine, Hospital Foch, Suresnes, France,Correspondence: Dr. Catherine Racowsky, Department of Obstetrics, Gynecology and Reproductive Medicine, Foch Hospital, 92150 Suresnes, France;
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23
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Chen T, Fu X, Hensher DA, Li ZC, Sze NN. The effect of online meeting and health screening on business travel: A stated preference case study in Hong Kong. TRANSPORTATION RESEARCH. PART E, LOGISTICS AND TRANSPORTATION REVIEW 2022; 164:102823. [PMID: 35945969 PMCID: PMC9354449 DOI: 10.1016/j.tre.2022.102823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 06/15/2022] [Accepted: 06/29/2022] [Indexed: 05/12/2023]
Abstract
This study quantifies the effects of health control measures at the airport on passenger behaviour related to business travel. A stated preference survey was conducted over potential air travellers in Hong Kong in the context of COVID-19 pandemic. Panel latent class models were estimated to understand passenger preference toward new travel requirements given the applicability of online meeting. Online meeting is applicable in cases where it is a good substitute of air travel and achieves the same outcomes of a trip, and inapplicable otherwise. Empirical results indicate that traveller subgroups are affected in different ways. When an online meeting is inapplicable, nearly 75% of the respondents prefer to travel for business and undertake health screenings. These passengers (identified as "captive" business travellers) perceive such measures necessary to lower health related risks during air travel. As such, they are willing to spend up to 21 to 38 min on the health control measures such as vaccination record requirements and test involving sample collection. When an online meeting is applicable, the share of "choice" business travellers is about 45%, among whom the attitudes towards health control measures become more averse. The average weighted willingness-to-pay for the time saved at health checkpoints increase significantly. The aviation industry thus faces a "double-hit" problem: operation costs will increase due to pandemic control measures, and the resultant inconvenience, extra time and costs further reduces travel demand. Unlike previous short pandemics, business travel is likely to suffer with an extended decline until the pandemic is fully controlled. These identified challenges call for financial and operational support to help the aviation industry reach a sustainable "new normal". The high value of time saved at check points also justifies investments that make the pandemic control and health measures efficient and smooth. Travellers' time spent on airport health control should be within 20 min to avoid substantial negative impacts on business travel demand.
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Affiliation(s)
- Tiantian Chen
- Department of Industrial and Systems Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Xiaowen Fu
- Department of Industrial and Systems Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- Behaviour and Knowledge Engineering Research Centre, Department of Industrial and Systems Engineering, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - David A Hensher
- Institute of Transport and Logistics Studies, the University of Sydney Business School, the University of Sydney, Australia
| | - Zhi-Chun Li
- School of Management, Huazhong University of Science and Technology, Wuhan, China
| | - N N Sze
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
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24
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Abstract
Perinatal patients were faced with the decision to receive a COVID-19 vaccination in the absence of clinical trial data on COVID-19 vaccine safety and efficacy in pregnant and lactating patients. We used the Coronavirus Perinatal Experiences Impact Survey to explore the impact of the COVID-19 pandemic on the lives of perinatal patients. The mixed-method survey was distributed to all patients ≥ 18 years old who were pregnant between January 1st, 2020 – April 28, 2021 at a large academic health system in the upper Midwest. Open-ended responses were qualitatively analyzed. Of the 1182 respondents who completed the survey, 647 answered at least one open-ended question. Among these 647 participants, 85 discussed COVID-19 vaccination and were secondarily analyzed. The responses illustrated a wide range of perspectives regarding COVID-19 vaccination, with many citing concerns over the consequences of maternal vaccination on their child. Others highlighted the lack of information surrounding COVID-19 vaccination in perinatal women. Respondents also discussed challenges discussing their vaccination status with their healthcare provider and the impact of family member’s vaccination decisions on postpartum support and childcare. The unprompted discussion of concerns about COVID-19 vaccination suggests this decision weighed on many participants, especially in the context of lack of information early in the pandemic. Our findings support the need for open discussion of perinatal patients with their providers on COVID-19 vaccination during the pregnancy and postpartum period.
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25
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Rawal S, Tackett RL, Stone RH, Young HN. COVID-19 vaccination among pregnant people in the United States: a systematic review. Am J Obstet Gynecol MFM 2022; 4:100616. [PMID: 35283351 PMCID: PMC8908633 DOI: 10.1016/j.ajogmf.2022.100616] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Pregnant people are at increased risk of COVID-19–related morbidity and mortality, and vaccination presents an important strategy for preventing negative outcomes. However, pregnant people were not included in vaccine trials, and there are limited data on COVID-19 vaccines during pregnancy. The objectives of this systematic review were to identify the safety, immunogenicity, effectiveness, and acceptance of COVID-19 vaccination among pregnant people in the United States. DATA SOURCES Four databases (PubMed, Web of Science, CINAHL, and Google Scholar) were used to identify eligible studies published from January 1, 2020 through February 6, 2022. STUDY ELIGIBILITY CRITERIA Inclusion criteria were peer-reviewed empirical research conducted in the United States, publications in English, and research addressing 1 of the following topics: safety, immunogenicity, effectiveness, and acceptance of COVID-19 vaccination among pregnant people. METHODS A narrative synthesis approach was used to synthesize findings. Critical appraisal was done using the JBI (formerly Joanna Briggs Institute) tool. RESULTS Thirty-two studies were identified. Most studies (n=24) reported the use of Pfizer and Moderna COVID-19 vaccines among pregnant people; only 6 reported the Janssen vaccine. Of the 32 studies, 11 examined COVID-19 vaccine safety, 10 investigated immunogenicity and effectiveness, and 11 assessed vaccine acceptance among pregnant people. Injection-site pain and fatigue were the most common adverse events. One case study reported immune thrombocytopenia. COVID-19 vaccination did not increase the risk of adverse pregnancy or neonatal outcomes compared with unvaccinated pregnant people. After COVID-19 vaccination, pregnant people had a robust immune response, and vaccinations conferred protective immunity to newborns through breast milk and placental transfer. COVID-19 vaccine acceptance was low among pregnant people in the United States. African American race, Hispanic ethnicity, younger age, low education, previous refusal of the influenza vaccine, and lack of provider counseling were associated with low vaccine acceptance. CONCLUSION Peer-reviewed studies support COVID-19 vaccine safety and protective effects on pregnant people and their newborns. Future studies that use rigorous methodologies and include diverse populations are needed to confirm current findings. In addition, targeted and tailored strategies are needed to improve vaccine acceptance, especially among minorities.
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Affiliation(s)
- Smita Rawal
- Department of Clinical and Administrative Pharmacy, University of Georgia, Athens, GA.
| | - Randall L Tackett
- Department of Clinical and Administrative Pharmacy, University of Georgia, Athens, GA
| | - Rebecca H Stone
- Department of Clinical and Administrative Pharmacy, University of Georgia, Athens, GA
| | - Henry N Young
- Department of Clinical and Administrative Pharmacy, University of Georgia, Athens, GA
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26
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Germann K, Kiefer MK, Rood KM, Mehl R, Wu J, Pandit R, Lynch CD, Landon MB, Grobman WA, Costantine MM, Venkatesh KK. Association of initial COVID-19 vaccine hesitancy with subsequent vaccination among pregnant and postpartum individuals. BJOG 2022; 129:1352-1360. [PMID: 35429081 PMCID: PMC9111102 DOI: 10.1111/1471-0528.17189] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/29/2022] [Accepted: 04/12/2022] [Indexed: 12/24/2022]
Abstract
Objective To examine the association between initial COVID‐19 vaccine hesitancy and subsequent vaccination among pregnant and postpartum individuals. Design Prospective cohort. Setting A Midwestern tertiary‐care academic medical center. Individuals completed a baseline vaccine hesitancy assessment from 22 March 2021 to 2 April 2021, with subsequent ascertainment of vaccination status at 3–6 months follow‐up. Methods We used multivariable Poisson regression to estimate the relative risk of vaccination by baseline vaccine hesitancy status, and then characteristics associated with vaccination. Main outcome measures Self‐report of COVID‐19 vaccination, and secondarily, consideration of COVID‐19 vaccination among those not vaccinated. Results Of 456 individuals (93% pregnant, 7% postpartum) initially surveyed, 290 individuals (64%; 23% pregnant, 77% postpartum) provided subsequent vaccination status (median = 17 weeks). Of these 290 individuals, 40% (116/290) reported COVID‐19 vaccine hesitancy upon enrolment, of whom 52% reported subsequent vaccination at follow‐up. Few individuals transitioned during the study period from vaccine hesitant to vaccinated (10%); in comparison, 80% of those who were not vaccine hesitant were vaccinated at follow‐up (aRR 0.19, 95% CI 0.11–0.33). Among those who remained unvaccinated at follow‐up, 38% who were vaccine hesitant at baseline were considering vaccination, compared with 71% who were not vaccine hesitant (aRR 0.48, 95% CI 0.33–0.67). Individuals who were older, parous, employed and of higher educational attainment were more likely to be vaccinated, and those who identified as non‐Hispanic black, were Medicaid beneficiaries, and were still pregnant at follow‐up were less likely to be vaccinated. Conclusions COVID‐19 vaccine hesitancy persisted over time in the peripartum period, and few individuals who reported hesitancy at baseline were later vaccinated. Interventions that address vaccine hesitancy in pregnancy are needed. COVID‐19 vaccination hesitancy among pregnant and postpartum individuals persists over time, and few of the individuals who reported hesitancy were later vaccinated.
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Affiliation(s)
- Katherine Germann
- College of Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Miranda K Kiefer
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Kara M Rood
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Rebecca Mehl
- Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Jiqiang Wu
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Radhika Pandit
- College of Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Courtney D Lynch
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Mark B Landon
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - William A Grobman
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Maged M Costantine
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Kartik K Venkatesh
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio, USA
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Klipstein S, Dionne JA, Feinberg EC, Kawwass JF, Pfeifer SM, Schlegel PN, Racowsky C. Data-Driven Commentary on SARS-CoV-2 Infection, Vaccination, and Fertility. Am J Epidemiol 2022; 191:1343-1346. [PMID: 35766432 PMCID: PMC9278241 DOI: 10.1093/aje/kwac073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/01/2022] [Accepted: 04/06/2022] [Indexed: 01/28/2023] Open
Abstract
A recent study by Wesselink et al. (Am J Epidemiol. 2022;191(8):1383-1395) adds to the growing body of research finding that vaccination for coronavirus disease 2019 (COVID-19) is safe for individuals either seeking pregnancy or who are pregnant. The study's authors found no effect of COVID-19 vaccination on fecundity in a population of individuals with no known infertility who were attempting conception. The finding reinforces the messaging of the American Society for Reproductive Medicine COVID-19 Task Force, the aim of which is to provide data-driven recommendations to individuals contemplating pregnancy in the face of the COVID-19 pandemic. As safe and effective COVID-19 vaccines became available, and with an increasing number of studies showing a heightened risk of severe disease during pregnancy, an important role of the Task Force is to encourage vaccination during the preconceptual window and in early pregnancy. The Task Force supports ongoing research to address gaps in knowledge about safe and effective therapies and preventive measures for individuals contemplating pregnancy and during pregnancy. Such research will help optimize care for reproductive-age individuals in the face of current and future health crises.
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Affiliation(s)
| | | | | | | | | | | | - Catherine Racowsky
- Correspondence to Dr. Catherine Racowsky, Department of Obstetrics, Gynecology and Reproductive Medicine, Foch Hospital, 92150 Suresnes, France (e-mail: ; )
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28
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Bianchi FP, Stefanizzi P, Brescia N, Lattanzio S, Martinelli A, Tafuri S. COVID-19 vaccination hesitancy in Italian healthcare workers: a systematic review and meta-analysis. Expert Rev Vaccines 2022; 21:1289-1300. [PMID: 35757890 DOI: 10.1080/14760584.2022.2093723] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION As for other vaccines, vaccination hesitancy may be a determining factor in the success (or otherwise) of the COVID-19 immunization campaign in healthcare workers (HCWs). AREAS COVERED To estimate the proportion of HCWs in Italy who expressed COVID-19 vaccine hesitancy, we conducted a systematic review of the relevant literature and a meta-analysis. Determinants of vaccine compliance and options suggested by these studies to address vaccine hesitancy among HCWs were also analyzed. Seventeen studies were included in the meta-analysis and systematic review, selected from scientific articles available in the MEDLINE/PubMed, Google Scholar and Scopus databases between January 1, 2020 and January 25, 2022. The vaccine hesitancy rate among HCWs was 13.1% (95%CI: 6.9-20.9%). The vaccine hesitancy rate among HCWs investigated before and during the vaccination campaign was 18.2% (95%CI=12.8-24.2%) and 8.9% (95%CI=3.4-16.6%), respectively. That main reasons for vaccine hesitation were lack of information about vaccination, opinion that the vaccine is unsafe, and fear of adverse events. EXPERT OPINION Despite strategies to achieve a greater willingness to immunize in this category, mandatory vaccination appears to be one of the most important measures that can guarantee the protection of HCWs and the patients they care for.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
| | - Nazario Brescia
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
| | - Sabrina Lattanzio
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
| | - Andrea Martinelli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari
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29
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Peterson CJ, Lee B, Nugent K. COVID-19 Vaccination Hesitancy among Healthcare Workers-A Review. Vaccines (Basel) 2022; 10:948. [PMID: 35746556 PMCID: PMC9227837 DOI: 10.3390/vaccines10060948] [Citation(s) in RCA: 84] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/25/2022] [Accepted: 06/06/2022] [Indexed: 02/04/2023] Open
Abstract
The COVID-19 pandemic and its associated vaccine have highlighted vaccine hesitancy among healthcare workers (HCWs). Vaccine hesitancy among this group existed prior to the pandemic and particularly centered around influenza vaccination. Being a physician, having more advanced education, and previous vaccination habits are frequently associated with vaccine acceptance. The relationship between age and caring for patients on COVID-19 vaccination is unclear, with studies providing opposing results. Reasons for hesitancy include concerns about safety and efficacy, mistrust of government and institutions, waiting for more data, and feeling that personal rights are being infringed upon. Many of these reasons reflect previous attitudes about influenza vaccination as well as political beliefs and views of personal autonomy. Finally, several interventions to encourage vaccination have been studied, including education programs and non-monetary incentives with the most effective studies using a combination of methods.
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Affiliation(s)
- Christopher J. Peterson
- School of Medicine, Texas Tech University Health Sciences Center, 3601 4th St., Lubbock, TX 79430, USA;
| | - Benjamin Lee
- School of Medicine, Texas Tech University Health Sciences Center, 3601 4th St., Lubbock, TX 79430, USA;
- College of Engineering, Texas Tech University, 2500 Broadway, Lubbock, TX 79409, USA
| | - Kenneth Nugent
- Department of Internal Medicine, Texas Tech University Health Sciences Center, 3601 4th St., Lubbock, TX 79430, USA;
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Morra CN, Adkins-Jablonsky SJ, Barnes ME, Pirlo OJ, Almehmi SE, Convers BJ, Dang DL, Howell ML, Fleming R, Raut SA. Expert-Led Module Improves Non-STEM Undergraduate Perception of and Willingness to Receive COVID-19 Vaccines. Front Public Health 2022; 10:816692. [PMID: 35664101 PMCID: PMC9157538 DOI: 10.3389/fpubh.2022.816692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 04/12/2022] [Indexed: 12/23/2022] Open
Abstract
As evidence mounted that existing prevention methods would be insufficient to end the COVID-19 pandemic, it became clear that vaccines would be critical to achieve and maintain reduced rates of infection. However, vaccine-hesitant sentiments have become widespread, particularly in populations with lower scientific literacy. The non-STEM major (called non-major) college students represent one such population who rely on one or more science classes to develop their scientific literacy and thus, become candidates of interest for the success of the COVID-19 vaccine campaign. As these students have fewer opportunities to learn how to identify reputable scientific sources or judge the validity of novel scientific findings, it is particularly important that these skills are included in the science courses offered to non-majors. Two concurrent non-major biology courses (N = 98) at the University of Alabama at Birmingham in Spring 2021 completed Likert questionnaires with open-ended questions prior to and after an expert-led Vaccine Awareness educational intervention addressing vaccine-related concerns. In the module, experts gave presentations about COVID-19 related to microbiology, epidemiological factors, and professional experiences relating to COVID-19. Ten students agreed to participate in post-semester one-on-one interviews. Student interviews revealed that students perceived guest lecturers as providing more information and assurance. Questionnaire data showed an increase in student willingness to accept a COVID-19 vaccine as well as increased student perception of the COVID-19 vaccines as both safe and effective (Wilcoxon Rank Sum Test, p < 0.05). However, the questionnaire data revealed 10 of 98 students remained vaccine-resistant, and these students expressed insufficient research and side effects as leading vaccination concerns. Overall, we show expert-led modules can be effective in increasing non-majors willingness to accept COVID-19 vaccines. Future research should explore the experiences of non-majors and guest lectures, particularly as they relate to vaccination and vaccine concerns.
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Affiliation(s)
- Christina N Morra
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Sarah J Adkins-Jablonsky
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States.,Alabama College of Osteopathic Medicine, Dothan, AL, United States
| | - M Elizabeth Barnes
- Department of Biology, Middle Tennessee State University, Murfreesboro, TN, United States
| | - Obadiah J Pirlo
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Sloan E Almehmi
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Bianca J Convers
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Derek L Dang
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Michael L Howell
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Ryleigh Fleming
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Samiksha A Raut
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States
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Harapan H, Anwar S, Yufika A, Sharun K, Gachabayov M, Fahriani M, Husnah M, Raad R, Abdalla RYA, Adam RY, Khiri NME, Ismaeil MIH, Ismail AY, Kacem W, Dahman NBH, Teyeb Z, Aloui K, Hafsi M, Ferjani M, Deeb DA, Emad D, Abbas KS, Monib FA, Sami FS, Subramaniam R, Panchawagh S, Anandu S, Haque MA, Ferreto LED, Briones MFC, Morales RBI, Díaz SAL, Aburto JTO, Rojas JET, Balogun EO, Enitan SS, Yomi AR, Durosinmi A, Ezigbo ED, Adejumo EN, Babadi E, Kakemam E, Malik NI, Ullah I, Rosiello DF, Emran TB, Wendt GW, Arab-Zozani M, Wagner AL, Mudatsir M. Vaccine hesitancy among communities in ten countries in Asia, Africa, and South America during the COVID-19 pandemic. Pathog Glob Health 2022; 116:236-243. [PMID: 34928187 PMCID: PMC9132408 DOI: 10.1080/20477724.2021.2011580] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Vaccine hesitancy is considered one of the greatest threats to the ongoing coronavirus disease 2019 (COVID-19) vaccination programs. Lack of trust in vaccine benefits, along with concerns about side effects of the newly developed COVID-19 vaccine, might significantly contribute to COVID-19 vaccine hesitancy. The objective of this study was to determine the level of vaccine hesitancy among communities in particular their belief in vaccination benefits and perceived risks of new vaccines. An online cross-sectional study was conducted in 10 countries in Asia, Africa, and South America from February to May 2021. Seven items from the WHO SAGE Vaccine Hesitancy Scale were used to measure a construct of belief in vaccination benefit, and one item measured perceived riskiness of new vaccines. A logistic regression was used to determine which sociodemographic factors were associated with both vaccine hesitancy constructs. A total of 1,832 respondents were included in the final analysis of which 36.2% (range 5.6-52.2%) and 77.6% (range 38.3-91.2%) of them were classified as vaccine hesitant in terms of beliefs in vaccination benefits and concerns about new vaccines, respectively. Respondents from Pakistan had the highest vaccine hesitancy while those from Chile had the lowest. Being females, Muslim, having a non-healthcare-related job and not receiving a flu vaccination during the past 12 months were associated with poor beliefs of vaccination benefits. Those who were living in rural areas, Muslim, and those who did not received a flu vaccination during the past 12 months had relatively higher beliefs that new vaccines are riskier. High prevalence of vaccine hesitancy in some countries during the COVID-19 pandemic might hamper COVID-19 vaccination programs worldwide. Programs should be developed to promote vaccination in those sociodemographic groups with relatively high vaccine hesitancy.
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Affiliation(s)
- Harapan Harapan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Samsul Anwar
- Department of Statistics, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Amanda Yufika
- Department of Family Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Khan Sharun
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Mahir Gachabayov
- Department of Abdominal Surgery, Vladimir City Emergency Hospital, Vladimir, Russia
| | - Marhami Fahriani
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Milda Husnah
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Master Program of Biology, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Rawan Raad
- Faculty of Medicine and General Surgery, Sudan University of Science and Technology, Sudan
| | | | | | | | | | - Asma Y. Ismail
- Department of Internal Medicine, Faculty of Medicine, Sudan International University, Sudan
| | - Wajdi Kacem
- Department of Emergency Medicine, Faculty of Medicine of Tunis, University Tunis El Manar, Tunisia
| | - Nesrine BH. Dahman
- Department of Emergency Medicine, Faculty of Medicine of Tunis, University Tunis El Manar, Tunisia
| | - Zeineb Teyeb
- Department of Internal Medicine, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Khaoula Aloui
- Department of Emergency Medicine, Faculty of Medicine of Tunis, University Tunis El Manar, Tunisia
| | - Montacer Hafsi
- Faculty of Dental medicine, University of Monastir, Tunisia
| | - Manel Ferjani
- Faculty of Dental medicine, University of Monastir, Tunisia
| | | | - Dina Emad
- Faculty of Medicine, Ain Shams University, Nasr City, Cairo, Egypt
| | | | - Fatma A Monib
- Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Farah S. Sami
- Faculty of Medicine, Ain Shams University, Nasr City, Cairo, Egypt
| | - R Subramaniam
- Department of Public Health Dentistry, Indira Gandhi Institute of Dental Sciences, India
| | - Suhrud Panchawagh
- Department of General Medicine, Smt. Kashibai Navale Medical College and General Hospital, Pune, India
| | - Sunil Anandu
- Division of Veterinary Parasitology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Md Ariful Haque
- Division of Veterinary Parasitology, ICAR-Indian Veterinary Research Institute, Bareilly, India
- Department of Orthopedic Surgery, Yanan Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, China
| | - Lirane ED. Ferreto
- Department of Public Health and Postgraduate Program in Applied Health Sciences, Faculty of Medicine, Western Paraná State University, Brazil
| | | | | | | | - José TO. Aburto
- Faculty of Medicine, University of La Frontera, Temuco, Chile
| | - Jorge ET. Rojas
- Faculty of Medicine, University of La Frontera, Temuco, Chile
| | - Emmanuel O. Balogun
- Department of Biochemistry, Faculty of Life Sciences, Ahmadu Bello University, Zaria, Nigeria
| | | | | | | | - Eyiuche D. Ezigbo
- Department of Medical Laboratory Sciences, Faculty of Health Sciences & Technology University of Nigeria, Nigeria
| | | | - Elham Babadi
- Research Fellow, Mayo Clinic, Rochester, NY, USA
| | - Edris Kakemam
- Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Najma I. Malik
- Department of Psychology, University of Sargodha, Sargodha, Pakistan
| | - Irfan Ullah
- Department of Internal Medicine, Kabir Medical College, Gandhara University, Peshawar, Pakistan
| | - Dott F. Rosiello
- Department of Public Health and Infectious Disease, Sapienza-University of Rome, Rome, Italy
| | - Talha B. Emran
- Department of Pharmacy, Bgc Trust University Bangladesh, Bangladesh
| | - Guilherme W. Wendt
- Department of Life Sciences, Faculty of Medicine, Western Paraná State University, Brazil
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Abram L. Wagner
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Mudatsir Mudatsir
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
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32
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Galanis P, Vraka I, Siskou O, Konstantakopoulou O, Katsiroumpa A, Kaitelidou D. Uptake of COVID-19 Vaccines among Pregnant Women: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:766. [PMID: 35632521 PMCID: PMC9145279 DOI: 10.3390/vaccines10050766] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 01/27/2023] Open
Abstract
Mass vaccination against COVID-19 is essential to control the pandemic. COVID-19 vaccines are now recommended during pregnancy to prevent adverse outcomes. With this review, we aimed to evaluate the evidence in the literature regarding the uptake of COVID-19 vaccinations among pregnant women. A comprehensive search was performed in PubMed, Medline, Scopus, ProQuest, Web of Science, CINAHL, and medRxiv from inception to 23 March 2022. We performed a meta-analysis to estimate the overall proportion of pregnant women vaccinated against COVID-19. We found 11 studies including 703,004 pregnant women. The overall proportion of pregnant women vaccinated against COVID-19 was 27.5% (95% CI: 18.8-37.0%). Predictors of COVID-19 vaccination uptake were older age, ethnicity, race, trust in COVID-19 vaccines, and fear of COVID-19 during pregnancy. Mistrust in the government, diagnosis of COVID-19 during pregnancy, and fears about the safety and side effects of COVID-19 vaccines were reasons for declining vaccination. The global COVID-19 vaccination prevalence in pregnant women is low. A large gap exists in the literature on the factors influencing the decision of pregnant women to be vaccinated against COVID-19. Targeted information campaigns are essential to increase vaccine literacy among pregnant women.
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Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 15773 Athens, Greece;
| | - Irene Vraka
- Department of Radiology, P. & A. Kyriakou Children’s Hospital, 15773 Athens, Greece;
| | - Olga Siskou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 15773 Athens, Greece; (O.S.); (O.K.); (D.K.)
| | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 15773 Athens, Greece; (O.S.); (O.K.); (D.K.)
| | - Aglaia Katsiroumpa
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 15773 Athens, Greece;
| | - Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 15773 Athens, Greece; (O.S.); (O.K.); (D.K.)
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Yendewa SA, Ghazzawi M, James PB, Smith M, Massaquoi SP, Babawo LS, Deen GF, Russell JBW, Samai M, Sahr F, Lakoh S, Salata RA, Yendewa GA. COVID-19 Vaccine Hesitancy among Healthcare Workers and Trainees in Freetown, Sierra Leone: A Cross-Sectional Study. Vaccines (Basel) 2022; 10:757. [PMID: 35632513 PMCID: PMC9143387 DOI: 10.3390/vaccines10050757] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/04/2022] [Accepted: 05/09/2022] [Indexed: 02/01/2023] Open
Abstract
Despite having safe and efficacious vaccines against COVID-19, vaccine hesitancy is widespread. Although a trusted source of information, vaccine hesitancy has been reported among healthcare professionals, yet few studies have explored this phenomenon in sub-Saharan Africa. We conducted a cross-sectional survey of healthcare professionals in Sierra Leone from January to March 2022. Measures included sociodemographic/health-related information and COVID-19-related concerns. From the responses, we constructed a hesitancy (VAX) score, with higher scores implying negative attitudes or unwillingness to vaccinate. Multivariate linear regression was used to access factors associated with vaccine hesitancy. Overall, 592 participants submitted responses (67.2% female, mean age 29 years, 5.6% physicians/pharmacists, 44.3% medical students, 29.2% nurses, 20.9% nursing students). The mean VAX score was 43.27 ± 8.77, with 60.1% of respondents classified as vaccine hesitant (>50th percentile) and 13.8% as highly hesitant (>75th percentile). Worries about unforeseen future effects (76.3%), a preference for natural immunity (59.5%), and profiteering/mistrust of health authorities (53.1%) were the most common concerns. Being a medical student (β = 0.105, p = 0.011) and previously refusing a recommended vaccine (β = 0.177, p < 0.001) were predictors of COVID-19 vaccine hesitancy. Our findings call for addressing vaccine hesitancy among healthcare professionals as an essential component of strategies aimed at increasing COVID-19 vaccine uptake in this setting.
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Affiliation(s)
- Sahr A. Yendewa
- Ministry of Health and Sanitation, Freetown, Sierra Leone; (S.A.Y.); (M.S.); (S.P.M.); (G.F.D.); (J.B.W.R.); (M.S.); (F.S.); (S.L.)
- Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | | | - Peter B. James
- Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia;
| | - Mohamed Smith
- Ministry of Health and Sanitation, Freetown, Sierra Leone; (S.A.Y.); (M.S.); (S.P.M.); (G.F.D.); (J.B.W.R.); (M.S.); (F.S.); (S.L.)
- Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Samuel P. Massaquoi
- Ministry of Health and Sanitation, Freetown, Sierra Leone; (S.A.Y.); (M.S.); (S.P.M.); (G.F.D.); (J.B.W.R.); (M.S.); (F.S.); (S.L.)
| | - Lawrence S. Babawo
- Department of Nursing, School of Community Health Sciences, Njala University, Bo Campus, Bo, Sierra Leone;
| | - Gibrilla F. Deen
- Ministry of Health and Sanitation, Freetown, Sierra Leone; (S.A.Y.); (M.S.); (S.P.M.); (G.F.D.); (J.B.W.R.); (M.S.); (F.S.); (S.L.)
- Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
- Department of Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - James B. W. Russell
- Ministry of Health and Sanitation, Freetown, Sierra Leone; (S.A.Y.); (M.S.); (S.P.M.); (G.F.D.); (J.B.W.R.); (M.S.); (F.S.); (S.L.)
- Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
- Department of Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Mohamed Samai
- Ministry of Health and Sanitation, Freetown, Sierra Leone; (S.A.Y.); (M.S.); (S.P.M.); (G.F.D.); (J.B.W.R.); (M.S.); (F.S.); (S.L.)
- Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
- Department of Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Foday Sahr
- Ministry of Health and Sanitation, Freetown, Sierra Leone; (S.A.Y.); (M.S.); (S.P.M.); (G.F.D.); (J.B.W.R.); (M.S.); (F.S.); (S.L.)
| | - Sulaiman Lakoh
- Ministry of Health and Sanitation, Freetown, Sierra Leone; (S.A.Y.); (M.S.); (S.P.M.); (G.F.D.); (J.B.W.R.); (M.S.); (F.S.); (S.L.)
- Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown, Sierra Leone
- Department of Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Robert A. Salata
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA;
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
| | - George A. Yendewa
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA;
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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34
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Lu-Culligan A, Tabachnikova A, Pérez-Then E, Tokuyama M, Lee HJ, Lucas C, Silva Monteiro V, Miric M, Brache V, Cochon L, Muenker MC, Mohanty S, Huang J, Kang I, Dela Cruz C, Farhadian S, Campbell M, Yildirim I, Shaw AC, Ma S, Vermund SH, Ko AI, Omer SB, Iwasaki A. No evidence of fetal defects or anti-syncytin-1 antibody induction following COVID-19 mRNA vaccination. PLoS Biol 2022; 20:e3001506. [PMID: 35609110 PMCID: PMC9129011 DOI: 10.1371/journal.pbio.3001506] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 04/05/2022] [Indexed: 12/13/2022] Open
Abstract
The impact of Coronavirus Disease 2019 (COVID-19) mRNA vaccination on pregnancy and fertility has become a major topic of public interest. We investigated 2 of the most widely propagated claims to determine (1) whether COVID-19 mRNA vaccination of mice during early pregnancy is associated with an increased incidence of birth defects or growth abnormalities; and (2) whether COVID-19 mRNA-vaccinated human volunteers exhibit elevated levels of antibodies to the human placental protein syncytin-1. Using a mouse model, we found that intramuscular COVID-19 mRNA vaccination during early pregnancy at gestational age E7.5 did not lead to differences in fetal size by crown-rump length or weight at term, nor did we observe any gross birth defects. In contrast, injection of the TLR3 agonist and double-stranded RNA mimic polyinosinic-polycytidylic acid, or poly(I:C), impacted growth in utero leading to reduced fetal size. No overt maternal illness following either vaccination or poly(I:C) exposure was observed. We also found that term fetuses from these murine pregnancies vaccinated prior to the formation of the definitive placenta exhibit high circulating levels of anti-spike and anti-receptor-binding domain (anti-RBD) antibodies to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) consistent with maternal antibody status, indicating transplacental transfer in the later stages of pregnancy after early immunization. Finally, we did not detect increased levels of circulating anti-syncytin-1 antibodies in a cohort of COVID-19 vaccinated adults compared to unvaccinated adults by ELISA. Our findings contradict popular claims associating COVID-19 mRNA vaccination with infertility and adverse neonatal outcomes.
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Affiliation(s)
- Alice Lu-Culligan
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Alexandra Tabachnikova
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, United States of America
| | | | - Maria Tokuyama
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Microbiology and Immunology, The University of British Columbia, Vancouver, Canada
| | - Hannah J. Lee
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Carolina Lucas
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Valter Silva Monteiro
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Marija Miric
- Two Oceans in Health, Santo Domingo, Dominican Republic
| | - Vivian Brache
- Biomedical Research Department, Profamilia, Santo Domingo, Dominican Republic
| | - Leila Cochon
- Biomedical Research Department, Profamilia, Santo Domingo, Dominican Republic
| | - M. Catherine Muenker
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Subhasis Mohanty
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, United States of America
- Section of Infectious Diseases, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Jiefang Huang
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, United States of America
- Section of Infectious Diseases, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Insoo Kang
- Section of Rheumatology, Allergy and Immunology, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Charles Dela Cruz
- Section of Pulmonary and Critical Care Medicine, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Microbial Pathogenesis, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Shelli Farhadian
- Section of Infectious Diseases, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Melissa Campbell
- Section of Pediatric Infectious Diseases, Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Inci Yildirim
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- Section of Pediatric Infectious Diseases, Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, United States of America
- Yale Institute for Global Health, Yale University, New Haven, Connecticut, United States of America
| | - Albert C. Shaw
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, United States of America
- Section of Infectious Diseases, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Shuangge Ma
- Department of Biostatistics, Yale University, New Haven, Connecticut, United States of America
| | - Sten H. Vermund
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Albert I. Ko
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- Section of Infectious Diseases, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Saad B. Omer
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- Section of Infectious Diseases, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
- Yale Institute for Global Health, Yale University, New Haven, Connecticut, United States of America
| | - Akiko Iwasaki
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- Department of Molecular, Cellular and Developmental Biology, New Haven, Connecticut, United States of America
- Howard Hughes Medical Institute, Chevy Chase, Maryland, United States of America
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Ward C, Megaw L, White S, Bradfield Z. COVID-19 vaccination rates in an antenatal population: A survey of women's perceptions, factors influencing vaccine uptake and potential contributors to vaccine hesitancy. Aust N Z J Obstet Gynaecol 2022; 62:695-700. [PMID: 35451062 PMCID: PMC9111353 DOI: 10.1111/ajo.13532] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/18/2022] [Accepted: 03/27/2022] [Indexed: 12/13/2022]
Abstract
Background Pregnant women are at increased risk for severe COVID‐19 and are a priority group for vaccination. The discrepancy in vaccination rates between pregnant and non‐pregnant cohorts is concerning. Aims This study aimed to assess the perceptions and intentions of pregnant women toward COVID‐19 vaccination and explored vaccine uptake and reasons for vaccine hesitancy. Materials and method A cross‐sectional exploratory design was performed evaluating pregnant women receiving care in two metropolitan maternity units in Western Australia. The main measurable outcomes included vaccination status, intention to be vaccinated, and reasons for delaying or declining vaccination. Results In total, 218 women participated. Of these, 122 (56%) had not received either dose of the COVID‐19 vaccine. Sixty (28%) claimed that vaccination was not discussed with them and 33 (15%) reported being dissuaded from vaccination by a healthcare practitioner. Compared to vaccinated women, those who had not accepted vaccination were less likely to have had vaccination discussed by maternity staff, less aware that pregnant women are a priority group, and less aware that pregnancy increased the risk of severe illness. Unvaccinated women were concerned about the side effects of the vaccine for their newborn and their own health, felt there was inadequate information on safety during pregnancy, and felt that a lack of community transmission in Western Australia reduced the necessity to be vaccinated. Conclusion Vaccine delay and hesitancy is common among pregnant women in Western Australia. Education of healthcare professionals and pregnant women on the recommendation for COVID‐19 vaccination in pregnancy is required.
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Affiliation(s)
- Caoimhe Ward
- Department of Obstetrics, King Edward Memorial Hospital, Perth, Western Australia, Australia
| | - Lauren Megaw
- Department of Obstetrics, King Edward Memorial Hospital, Perth, Western Australia, Australia.,Division of Obstetrics and Gynaecology, Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Scott White
- Division of Obstetrics and Gynaecology, Medical School, University of Western Australia, Perth, Western Australia, Australia.,Maternal Fetal Medicine Service, King Edward Memorial Hospital, Perth, Western Australia, Australia
| | - Zoe Bradfield
- School of Nursing, Curtin University, Perth, Western Australia, Australia.,Department of Nursing, Midwifery Education and Research, King Edward Memorial Hospital, Perth, Western Australia, Australia
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36
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Lavoie K, Gosselin-Boucher V, Stojanovic J, Gupta S, Gagné M, Joyal-Desmarais K, Séguin K, Gorin SS, Ribeiro P, Voisard B, Vallis M, Corace K, Presseau J, Bacon S. Understanding national trends in COVID-19 vaccine hesitancy in Canada: results from five sequential cross-sectional representative surveys spanning April 2020-March 2021. BMJ Open 2022; 12:e059411. [PMID: 35383087 PMCID: PMC8983402 DOI: 10.1136/bmjopen-2021-059411] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/15/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To examine rates of vaccine hesitancy and their correlates among Canadian adults between April 2020 and March 2021. DESIGN Five sequential cross-sectional age, sex and province-weighted population-based samples who completed online surveys. SETTING Canada. PARTICIPANTS A total of 15 019 Canadians aged 18 years and over were recruited through a recognised polling firm (Leger Opinion). Respondents were 51.5% female with a mean age of 48.1 (SD 17.2) years (range 18-95 years) and predominantly white (80.8%). PRIMARY AND SECONDARY OUTCOME MEASURES Rates of vaccine hesitancy over the five surveys (time points) and their sociodemographic, clinical and psychological correlates. RESULTS A total of 42.2% of respondents reported some degree of vaccine hesitancy, which was lowest during surveys 1 (April 2020) and 5 (March 2021) and highest during survey 3 (November 2020). Fully adjusted multivariate logistic regression analyses revealed that women, those aged 50 and younger, non-white, those with high school education or less, and those with annual household incomes below the poverty line in Canada were significantly more likely to report vaccine hesitancy, as were essential and healthcare workers, parents of children under the age of 18 and those who do not get regular influenza vaccines. Endorsing prevention behaviours as important for reducing virus transmission and high COVID-19 health concerns were associated with 77% and 54% reduction in vaccine hesitancy, respectively. Having high personal financial concerns was associated with 1.33 times increased odds of vaccine hesitancy. CONCLUSIONS Results highlight the importance of targeting vaccine efforts to specific groups by emphasising the outsized health benefits compared with risks of vaccination. Future research should monitor changes in vaccine intentions and behaviour to better understand underlying factors.
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Affiliation(s)
- Kim Lavoie
- Psychology, Université du Québec à Montréal, Montreal, Québec, Canada
- Montreal Behavioural Medicine Centre, CIUSSS-NIM Research Centre, Montreal, Québec, Canada
| | - Vincent Gosselin-Boucher
- Psychology, Université du Québec à Montréal, Montreal, Québec, Canada
- Montreal Behavioural Medicine Centre, CIUSSS-NIM Research Centre, Montreal, Québec, Canada
| | - Jovana Stojanovic
- Montreal Behavioural Medicine Centre, CIUSSS-NIM Research Centre, Montreal, Québec, Canada
- Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Québec, Canada
| | - Samir Gupta
- Keenan Research Center, St Michael's Hospital Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada
- Medicine, St Michael's Hospital, Toronto, Ontario, Canada
| | - Myriam Gagné
- Medicine, St Michael's Hospital, Toronto, Ontario, Canada
| | - Keven Joyal-Desmarais
- Montreal Behavioural Medicine Centre, CIUSSS-NIM Research Centre, Montreal, Québec, Canada
- Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Québec, Canada
| | - Katherine Séguin
- Psychology, Université du Québec à Montréal, Montreal, Québec, Canada
- Montreal Behavioural Medicine Centre, CIUSSS-NIM Research Centre, Montreal, Québec, Canada
| | | | - Paula Ribeiro
- Montreal Behavioural Medicine Centre, CIUSSS-NIM Research Centre, Montreal, Québec, Canada
- Montreal Behavioural Medicine Centre, Montreal, Québec, Canada
| | - Brigitte Voisard
- Psychology, Université du Québec à Montréal, Montreal, Québec, Canada
- Montreal Behavioural Medicine Centre, CIUSSS-NIM Research Centre, Montreal, Québec, Canada
| | - Michael Vallis
- Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kimberly Corace
- Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
- Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada
| | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Simon Bacon
- Montreal Behavioural Medicine Centre, CIUSSS-NIM Research Centre, Montreal, Québec, Canada
- Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Québec, Canada
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Gual-Gonzalez L, McCarter MSJ, Dye-Braumuller K, Self S, Ross CH, Rodriguez-Ramos C, Daguise VG, Nolan MS. Determinants of COVID-19 Vaccinations among a State-Wide Year-Long Surveillance Initiative in a Conservative Southern State. Vaccines (Basel) 2022; 10:412. [PMID: 35335044 PMCID: PMC8949372 DOI: 10.3390/vaccines10030412] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 11/30/2022] Open
Abstract
By the end of 2021, the COVID-19 pandemic resulted in over 54 million cases and more than 800,000 deaths in the United States, and over 350 million cases and more than 5 million deaths worldwide. The uniqueness and gravity of this pandemic have been reflected in the public health guidelines poorly received by a growing subset of the United States population. These poorly received guidelines, including vaccine receipt, are a highly complex psychosocial issue, and have impacted the successful prevention of disease spread. Given the intricate nature of this important barrier, any single statistical analysis methodologically fails to address all convolutions. Therefore, this study utilized different analytical approaches to understand vaccine motivations and population-level trends. With 12,975 surveys from a state-wide year-long surveillance initiative, we performed three robust statistical analyses to evaluate COVID-19 vaccine hesitancy: principal component analysis, survival analysis and spatial time series analysis. The analytic goal was to utilize complementary mathematical approaches to identify overlapping themes of vaccine hesitancy and vaccine trust in a highly conservative US state. The results indicate that vaccine receipt is influenced by the source of information and the population's trust in the science and approval process behind the vaccines. This multifaceted statistical approach allowed for methodologically rigorous results that public health professionals and policy makers can directly use to improve vaccine interventions.
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Affiliation(s)
- Lídia Gual-Gonzalez
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.J.M.); (K.D.-B.); (S.S.); (C.H.R.); (C.R.-R.); (V.G.D.)
| | - Maggie S. J. McCarter
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.J.M.); (K.D.-B.); (S.S.); (C.H.R.); (C.R.-R.); (V.G.D.)
| | - Kyndall Dye-Braumuller
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.J.M.); (K.D.-B.); (S.S.); (C.H.R.); (C.R.-R.); (V.G.D.)
| | - Stella Self
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.J.M.); (K.D.-B.); (S.S.); (C.H.R.); (C.R.-R.); (V.G.D.)
| | - Connor H. Ross
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.J.M.); (K.D.-B.); (S.S.); (C.H.R.); (C.R.-R.); (V.G.D.)
| | - Chloe Rodriguez-Ramos
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.J.M.); (K.D.-B.); (S.S.); (C.H.R.); (C.R.-R.); (V.G.D.)
| | - Virginie G. Daguise
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.J.M.); (K.D.-B.); (S.S.); (C.H.R.); (C.R.-R.); (V.G.D.)
- South Carolina Department of Health and Environmental Control, Columbia, SC 29201, USA
| | - Melissa S. Nolan
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.J.M.); (K.D.-B.); (S.S.); (C.H.R.); (C.R.-R.); (V.G.D.)
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Perez MJ, Paul R, Raghuraman N, Carter EB, Odibo AO, Kelly JC, Foeller ME. Characterizing initial COVID-19 vaccine attitudes among pregnancy-capable healthcare workers. Am J Obstet Gynecol MFM 2022; 4:100557. [PMID: 34952227 PMCID: PMC8692248 DOI: 10.1016/j.ajogmf.2021.100557] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/06/2021] [Accepted: 12/17/2021] [Indexed: 12/03/2022]
Abstract
BACKGROUND Healthcare workers were prioritized for COVID-19 vaccination roll-out because of the high occupational risk. Vaccine trials excluded individuals who were trying to conceive and those who are pregnant and lactating, necessitating vaccine decision-making in the absence of data specific to this population. OBJECTIVE This study aimed to determine the initial attitudes about COVID-19 vaccination in pregnancy-capable healthcare workers by reproductive status and occupational exposure. STUDY DESIGN We performed a structured survey distributed via social media of US-based healthcare workers involved in patient care since March 2020 who were pregnancy-capable (biologic female sex without history of sterilization or hysterectomy) from January 8, 2021 to January 31, 2021. Participants were asked about their desire to receive the COVID-19 vaccine and their perceived safety of the COVID-19 vaccine using 5-point Likert items with 1 corresponding to "I strongly don't want the vaccine" or "very unsafe for me" and 5 corresponding to "I strongly want the vaccine" or "very safe for me." We categorized participants into the following 2 groups: (1) reproductive intent (preventing pregnancy vs attempting pregnancy, currently pregnant, or currently lactating), and (2) perceived COVID-19 occupational risk (high vs low). We used descriptive statistics to characterize the respondents and their attitudes about the vaccine. Comparisons between reproductive and COVID-19 risk groups were conducted using Mann-Whitney U tests. RESULTS Our survey included 11,405 pregnancy-capable healthcare workers: 51.3% were preventing pregnancy (n=5846) and 48.7% (n=5559) were attempting pregnancy, currently pregnant, and/or lactating. Most respondents (n=8394, 73.6%) had received a vaccine dose at the time of survey completion. Most participants strongly desired vaccination (75.3%) and very few were strongly averse (1.5%). Although the distribution of responses was significantly different between respondents preventing pregnancy and those attempting conception or were pregnant and/or lactating and also between respondents with a high occupational risk and those with a lower occupational risk of COVID-19, the effect sizes were small and the distribution was the same for each group (median, 5; interquartile range, 4-5). CONCLUSION Most of the healthcare workers desired vaccination. Negative feelings toward vaccination were uncommon but were significantly higher among those attempting pregnancy and those who are pregnant and lactating and also among those with a lower perceived occupational risk of contracting COVID-19, although the effect size was small. Understanding healthcare workers' attitudes toward vaccination may help guide interventions to improve vaccine education and uptake in the general population.
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Affiliation(s)
- Marta J Perez
- Divisions of Maternal-Fetal Medicine and Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO.
| | - Rachel Paul
- Divisions of Maternal-Fetal Medicine and Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO
| | - Nandini Raghuraman
- Divisions of Maternal-Fetal Medicine and Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO
| | - Ebony B Carter
- Divisions of Maternal-Fetal Medicine and Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO
| | - Anthony O Odibo
- Divisions of Maternal-Fetal Medicine and Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO
| | - Jeannie C Kelly
- Divisions of Maternal-Fetal Medicine and Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO
| | - Megan E Foeller
- Divisions of Maternal-Fetal Medicine and Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO
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Wang Y, Liu Y. Multilevel determinants of COVID-19 vaccination hesitancy in the United States: A rapid systematic review. Prev Med Rep 2022; 25:101673. [PMID: 34934611 PMCID: PMC8675390 DOI: 10.1016/j.pmedr.2021.101673] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/05/2021] [Accepted: 12/12/2021] [Indexed: 01/10/2023] Open
Abstract
Vaccine hesitancy is a challenge for the success and optimal implementation of COVID-19 immunization programs in the US. The objective of this study was to summarize multilevel determinants of COVID-19 vaccination intention in the US to inform future intervention opportunities. To this end, we conducted a rapid systematic review by searching published articles via PubMed published by October 5, 2021, following the PRISMA guidelines. One hundred and six articles were included. According to nationally representative studies, the overall COVID-19 acceptance rate ranges from 53.6% to 84.4%. Individual (demographics, health history, behaviors and health beliefs), interpersonal (having a close friend/family member impacted by COVID-19), healthcare and societal level factors (healthcare provider recommendations, source/credential of COVID-19 related information, and COVID-19 related conspiracy theories) all contributed to COVID-19 vaccine hesitancy in the US. This study demonstrates that the acceptance to COVID-19 vaccines is influenced by various factors, particularly the role of healthcare providers in enhancing public intent to vaccination. Potential interventions to mitigate people's concerns over the vaccines and address vaccine-related conspiracy/misinformation from social media are also critical to encourage vaccine uptake in the US.
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Affiliation(s)
- Ying Wang
- Department of Public Health Sciences, University of Rochester Medical Center, 265 Crittenden Blvd, BOX 420644, Rochester, NY 14642, USA
| | - Yu Liu
- Department of Public Health Sciences, University of Rochester Medical Center, 265 Crittenden Blvd, BOX 420644, Rochester, NY 14642, USA
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40
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Albanesi B, Clari M, Gonella S, Chiarini D, Aimasso C, Mansour I, Coggiola M, Charrier L, Dimonte V. The impact of COVID-19 on hospital-based workers influenza vaccination uptake: A two-year retrospective cohort study. J Occup Health 2022; 64:e12376. [PMID: 36514845 PMCID: PMC9748491 DOI: 10.1002/1348-9585.12376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 10/07/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES This study aimed at exploring 2020/2021 and 2019/2020 seasonal influenza vaccine uptake among healthcare and non-healthcare workers, hereafter hospital-based workers (HBWs); examining attitudes and motivations for uptake in the 2020/2021 season; and exploring the amount, types, and sources of information used by HBWs. METHODS A retrospective cohort study. Socio-demographics, working profile, working area, and vaccination status data were collected. Motivations for vaccination uptake in the 2020/2021 season were also explored. Descriptive and inferential statistics were used. RESULTS Overall, uptake increased from 14.8% in 2019/2020 to 31.7% in 2020/2021. Male workers show greater vaccination uptake than their female counterparts (20.4% vs. 12.6% in 2019/2020, and 36.5% vs. 29.8% in 2020/2021). Uptake increased for healthcare assistants (+8.9%), administrative/managerial staff (+17%), nurses/midwives (+17.1%), non-medical graduate staff (+22.8%), and physicians (+33.2%), while it decreased slightly for resident physicians despite still being one of the most vaccinated categories (-4.6%). Main reasons for vaccination were the desire to protect patients (33.0%) and relatives (51.1%). Lastly, 60.8% of HBWs relied on institutional sources of information; the remainder relied on non-institutional sources including social media and chatting with colleagues. CONCLUSIONS Vaccination uptake increased in the 2020/21 season. Tailored educational interventions are required on the impact of influenza in care settings, vaccine efficacy, and vaccination safety. Investments in improving HBWs' reliance on institutional sources, and their ability to find them, are also needed.
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Affiliation(s)
- Beatrice Albanesi
- Department of Public Health and PediatricsUniversity of TorinoTurinItaly
| | - Marco Clari
- Department of Public Health and PediatricsUniversity of TorinoTurinItaly
| | - Silvia Gonella
- Department of Public Health and PediatricsUniversity of TorinoTurinItaly
- Directorate of Allied Health ProfessionalsCittà della Salute e della Scienza di Torino University HospitalTurinItaly
| | - Daniela Chiarini
- Città della Salute e della Scienza di Torino University HospitalTurinItaly
| | - Carla Aimasso
- Occupational Health, Città della Salute e della Scienza di Torino University HospitalTurinItaly
| | - Ihab Mansour
- Department of Public Health and PediatricsUniversity of TorinoTurinItaly
| | - Maurizio Coggiola
- Occupational Health, Città della Salute e della Scienza di Torino University HospitalTurinItaly
| | - Lorena Charrier
- Department of Public Health and PediatricsUniversity of TorinoTurinItaly
| | - Valerio Dimonte
- Department of Public Health and PediatricsUniversity of TorinoTurinItaly
- Directorate of Allied Health ProfessionalsCittà della Salute e della Scienza di Torino University HospitalTurinItaly
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Jauhari S, Singh N. Awareness about transmission and preventive measures of COVID-19 from mother to child: A cross-sectional study among pregnant women. ASIAN PACIFIC JOURNAL OF REPRODUCTION 2022. [DOI: 10.4103/2305-0500.361222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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COVID-19 Vaccine Hesitancy and Attitude toward Booster Doses among US Healthcare Workers. Vaccines (Basel) 2021; 9:vaccines9111358. [PMID: 34835289 PMCID: PMC8617683 DOI: 10.3390/vaccines9111358] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/27/2021] [Accepted: 11/15/2021] [Indexed: 01/06/2023] Open
Abstract
Vaccine reluctance among healthcare workers (HCW) can have widespread negative ramifications, including modeling behavior for the general population and challenges with maintaining a healthy workforce so we can respond to a resurgence of the pandemic. We previously reported that only one-third of HCW were willing to take the vaccine as soon as it became available prior to its Emergency Use Authorization (EUA). Here, we re-examine the attitude toward COVID-19 vaccines among HCW several months after the vaccines have been made widely available. In this study, only 7.9% (n = 107) of respondents were hesitant to take the first or second dose of the vaccine. Younger age (18–40 years) and lower level of education attainment (GED or less) were associated with higher vaccine hesitancy, whereas self-identified Asian racial identity was associated with greater acceptance of COVID-19 vaccination. Among the vaccine-hesitant group, more respondents noted mistrust of regulatory authorities (45.3%), government (48.6%), and pharmaceutical companies (50%) than mistrust of doctors (25.4%). Nearly two-thirds of respondents were concerned that vaccination may be ineffective against new strains and booster doses may be required; however, vaccine-hesitant respondents’ acceptance of a hypothetical booster dose was only 14.3%. Overall, vaccine hesitancy was observed to have demographic predictors similar to those previously reported; the hesitancy of some US HCW to receive booster doses may reflect a general hesitancy to receive other forms of vaccination.
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Gatto NM, Lee JE, Massai D, Zamarripa S, Sasaninia B, Khurana D, Michaels K, Freund D, Nightingale J, Firek A. Correlates of COVID-19 Vaccine Acceptance, Hesitancy and Refusal among Employees of a Safety Net California County Health System with an Early and Aggressive Vaccination Program: Results from a Cross-Sectional Survey. Vaccines (Basel) 2021; 9:vaccines9101152. [PMID: 34696260 PMCID: PMC8540702 DOI: 10.3390/vaccines9101152] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 11/16/2022] Open
Abstract
Since health professionals provide frontline care to COVID-19 patients, information on vaccine acceptance among healthcare workers is needed. We developed and implemented an anonymous internet-based cross-sectional survey with direct solicitation among employees of a safety net health system. Items queried demographic and health-related characteristics, experience with and knowledge of COVID-19, and determinants of decisions to vaccinate. COVID-19 vaccine acceptance groups (acceptors, hesitant, refusers) were defined; an adapted version of the WHO vaccine hesitancy scale was included. The survey demonstrated good reliability (Cronbach’s alpha = 0.92 for vaccine hesitancy scale; 0.93 for determinants). General linear and logistic regression methods examined factors which were univariately associated with vaccine hesitancy and vaccine acceptance, respectively. Multivariable models were constructed with stepwise model-building procedures. Race/ethnicity, marital status, job classification, immunocompromised status, flu vaccination and childhood vaccination opinions independently predicted hesitancy scale scores. Gender, education, job classification and BMI independently predicted acceptance, hesitancy, and refusal groups. Among hesitant employees, uncertainty was reflected in reports of motivating factors influencing their indecision. Despite a strong employee-support environment and job protection, respondents reported physical and mental health effects. The appreciation of varied reasons for refusing vaccination should lead to culturally sensitive interventions to increase vaccination rates amongst healthcare workers.
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Affiliation(s)
- Nicole M. Gatto
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA; (D.M.); (D.F.)
- Correspondence:
| | - Jerusha E. Lee
- Department of Economic Sciences, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA;
| | - Donatella Massai
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA; (D.M.); (D.F.)
| | - Susanna Zamarripa
- Riverside University Health System, Comparative Effectiveness and Clinical Outcomes Research Center, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (S.Z.); (B.S.); (D.K.); (K.M.); (J.N.); (A.F.)
| | - Bijan Sasaninia
- Riverside University Health System, Comparative Effectiveness and Clinical Outcomes Research Center, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (S.Z.); (B.S.); (D.K.); (K.M.); (J.N.); (A.F.)
| | - Dhruv Khurana
- Riverside University Health System, Comparative Effectiveness and Clinical Outcomes Research Center, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (S.Z.); (B.S.); (D.K.); (K.M.); (J.N.); (A.F.)
| | - Kelsey Michaels
- Riverside University Health System, Comparative Effectiveness and Clinical Outcomes Research Center, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (S.Z.); (B.S.); (D.K.); (K.M.); (J.N.); (A.F.)
| | - Deborah Freund
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA; (D.M.); (D.F.)
- Department of Economic Sciences, Claremont Graduate University, 150 E 10th St, Claremont, CA 91711, USA;
| | - Judi Nightingale
- Riverside University Health System, Comparative Effectiveness and Clinical Outcomes Research Center, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (S.Z.); (B.S.); (D.K.); (K.M.); (J.N.); (A.F.)
| | - Anthony Firek
- Riverside University Health System, Comparative Effectiveness and Clinical Outcomes Research Center, 26520 Cactus Avenue, Moreno Valley, CA 92555, USA; (S.Z.); (B.S.); (D.K.); (K.M.); (J.N.); (A.F.)
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