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Safrai M, Kremer E, Atias E, Ben-Meir A. BNT162b2 COVID-19 vaccine does not affect fertility as explored in a pilot study of women undergoing IVF treatment. Minerva Obstet Gynecol 2024; 76:215-221. [PMID: 36193832 DOI: 10.23736/s2724-606x.22.05148-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND The COVID-19 pandemic spreads worldwide, causing devastating consequences. BioNTech (BioNTech SE, Mainz, Germany) and Pfizer's (Pfizer Inc., Brooklyn, NY, USA) BNT162b2 vaccine was one of the first vaccines to receive emergency-use authorization. However, its impact on women's fertility has not been primarily assessed leading to spread of unfounded rumors, causing vaccine hesitancy. We investigate the possible impact of BNT162b2 COVID-19 vaccine on in-vitro fertilization (IVF) outcomes. METHODS We compared data from 42 women undergoing their first IVF following 2 doses of BNT162b2 vaccination to 42 unvaccinated women undergoing their first IVF. The first outcome consisted of the pregnancy based on first hCG value; secondary outcomes were IVF cycle outcomes. A second analysis was done on 29 paired patients from both groups based on age, FSH, and the indication for IVF. RESULTS We report different levels of the pregnancy formation; oocyte's development: numbers of oocytes retrieved (9.3±6.8 vs. 11.5±7.9, P=0.19) and matured (6.9±4.8 vs. 9.1±6.6, P=0.14), and embryonal stage: fertilization rates (64.1±26.6 vs. 66.3±23.3, P=0.14), the quantity (4.3±3.2 vs. 5.7±4.4, P=0.23) and qualities of embryos (good/fair/poor) at day 3 were comparable. The analysis showed no significant difference between the groups, and the odds for pregnancy were similar (OR=0.9, 95% CL [0.3-2.8] P value 0.833). CONCLUSIONS From our results, this vaccine does not affect IVF performance and outcomes from the early stage of oocyte development through to the early beginning of pregnancy; therefore, it seems that the BNT162b2 vaccine does not compromise women's fertility.
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Affiliation(s)
- Myriam Safrai
- Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel -
| | - Einav Kremer
- Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Eyal Atias
- Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Assaf Ben-Meir
- Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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2
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Simsekoglu N, Akyuz E, Guven R, Pasin O. Attitudes toward COVID-19 vaccines during pregnancy and breastfeeding. Front Public Health 2024; 12:1286891. [PMID: 38496391 PMCID: PMC10940332 DOI: 10.3389/fpubh.2024.1286891] [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: 08/31/2023] [Accepted: 02/20/2024] [Indexed: 03/19/2024] Open
Abstract
Background Although vaccination is one of the most effective means of controlling the spread of COVID-19, public concerns and indecision about vaccination still continue. Because pregnant and breastfeeding individuals are at high risk for severe outcomes in case of infections, determining their level of hesitation and attitude toward COVID-19 vaccines will guide the management of the disease. This study aimed to determine pregnant and breastfeeding women's levels of hesitation and attitude toward COVID-19 vaccines as well as their related factors. Methods The sample of this descriptive research consisted of 103 pregnant or breastfeeding individuals who were seen at the obstetrics and gynecology outpatients clinic of a state hospital in Istanbul, Turkey. The data were collected using a 'demographic data form', the 'Vaccine Hesitancy Scale in Pandemic', and the 'Attitudes toward COVID-19 Vaccine Scale'. The research data were analyzed with appropriate statistical methods. Results The mean age of the participants was 29.71 ± 4.75, 51% were pregnant, and 74.8% had received the COVID-19 vaccine. The mean score of the 'Vaccination Hesitancy Scale in Pandemic' was 30.83 ± 6.91, and the mean score for the 'Attitude Scale toward the COVID-19 Vaccine' was 25.50 ± 5.20. A significant difference was found between the total score of the 'Vaccine Hesitation Scale in the Pandemic' and the mean score of the 'Lack of Confidence' sub-dimension between the 'working status' and the 'influenza vaccination' status. In terms of the mean score of the 'Risk' sub-dimension, a significant difference was found between the 'period of vaccination' (p < 0.05). According to the mean total score of the 'Attitude Towards COVID-19 Vaccine Scale', there was a significant difference between the 'smoking' status. There was a significant difference in the 'Positive Attitude' sub-dimension in terms of the 'flu vaccination' status. There was a significant difference in the 'Negative Attitude' sub-dimension in terms of the 'chronic disease' status. A positive correlation was found between the total scores of the scales. Conclusion It was concluded that although the participants had a high level of hesitation toward the COVID-19 vaccine, they had a positive attitude. The results obtained will be guided in determining the strategies to be developed for these specific groups in future pandemics.
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Affiliation(s)
- Nesibe Simsekoglu
- Department of Home Patient Care, Hamidiye Vocational School of Health Services, University of Health Sciences, Istanbul, Turkey
| | - Enes Akyuz
- Department of Biophysics, Faculty of International Medicine, University of Health Sciences, Istanbul, Turkey
| | - Rabia Guven
- Division of Obstetrics and Gynaecology, Beykoz State Hospital, Istanbul, Turkey
| | - Ozge Pasin
- Department of Biostatistics, Faculty of Medicine, Bezmialem University, Istanbul, Turkey
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Yang X, Chen M, Cao L, Zhao M. Bibliometric analysis of scientific papers on adverse reactions to COVID-19 vaccines published between 2019 and 2023. Hum Vaccin Immunother 2023; 19:2270194. [PMID: 37885372 PMCID: PMC10760317 DOI: 10.1080/21645515.2023.2270194] [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: 06/24/2023] [Accepted: 10/09/2023] [Indexed: 10/28/2023] Open
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic has now persisted globally for four years, resulting in a staggering death toll of over 4 million individuals. The COVID-19 vaccine has emerged as a highly effective tool in controlling the spread of this virus. However, as the number of individuals receiving COVID-19. In this context, the investigation of adverse reactions related to COVID-19 vaccines holds paramount importance in relevant research. The purpose is to evaluate the current research status regarding adverse reactions associated with COVID-19 vaccines, offering insights for future research. A total of 3,746 articles were included in this analysis, and there has been a notable upward trajectory in the volume of published articles. The CiteSpace v6.1.R6, VOSviewer, SCImago Graphica, and Excel 2019 were employed to analyze and visualize the results. The institutions, countries, journals, authors, co-cited references, and keywords of these articles were analyzed. Furthermore, this study delves into the characteristics of articles on adverse reactions associated with COVID-19 vaccines. It was observed that the number of studies on COVID-19 vaccines has increased year by year since 2019 and witnessed a surge in output in 2021. The vast majority of studies have affirmed the overall safety of COVID-19 vaccines, with adverse reactions tending to be more concentrated in specific diseases. These findings provide valuable ideas for future research in this field and suggest the importance of strengthening international cooperation on adverse reactions to COVID-19 vaccines.
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Affiliation(s)
- Xuan Yang
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Mingcong Chen
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lin Cao
- Academician Workstation, Changsha Medical University, Changsha, China
- Hunan Provincial Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, Changsha Medical University, Changsha, China
| | - Mingyi Zhao
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
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4
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Changizi N, Eshrati B, Salehi M, Beheshtian M, Hadipour Jahromy L, Emami Afshar N, Hejazi S, Hantoushzadeh S, Eslamian L, Savaie M, Raeisi A, Pooransari P. Vaccination effects on reducing COVID-19 complications in pregnancy: A large-scale report from Iran. Int J Gynaecol Obstet 2023; 163:1012-1017. [PMID: 37655467 DOI: 10.1002/ijgo.15077] [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: 04/26/2023] [Revised: 07/29/2023] [Accepted: 08/17/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVE The objective of this study was to evaluate the effects of maternal coronavirus disease 2019 (COVID-19) vaccination on preventing severe complications of COVID-19 in pregnant women. METHODS A retrospective study was conducted in pregnant women infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy and/or for up to 6 weeks postpartum between September 1, 2021, to January 30, 2022. The data was retrieved from a national database. The pregnant women were divided into two groups of vaccinated and unvaccinated. The proposed outcomes (the need for hospitalization, intensive care unit admission, and mechanical ventilation and products of conception complications) were compared between the two groups. RESULTS Approximately 90 000 pregnant women infected with COVID-19 were included in the study. The data of the vaccinated (19 922) and unvaccinated (70 147) groups were analyzed and compared. Pregnant patients in the vaccinated group had a significantly lower rate of hospitalization (21.2% vs 29.4%) (odds ratio [OR], 0.648 [95% confidence interval (CI), 0.625-0.673], P = 0.0001) and intensive care unit admission (3.7% vs 7.8%) (OR, 0.453 [95% CI, 0.382-0.535], P = 0.0001). The need for mechanical ventilation was also lower, although not statistically significant, in the vaccinated group than in the unvaccinated group (30 of 155 [19.4%] vs 418 of 1597 [26.2%]) (OR, 0.677 [95% CI, 0.448-1.024], P = 0.063). Cesarean section (54.3% vs 58.1%) (OR, 0.856 [95% CI, 0.751-0.977], P = 0.021) and stillbirth (0.4% vs 3.6%) (OR, 0.097 [95% CI, 0.026-0.252], P = 0.0001) were also significantly lower in the vaccinated patients. Most pregnant women in the vaccinated group (18 484-96.14%) received Sinopharm BIBP COVID-19 inactivated vaccine. No significant differences were seen in the effect of different types of COVID-19 vaccines on reducing COVID-19 complications in infected pregnant patients. CONCLUSION Maternal COVID-19 immunization is effective in reducing COVID-19 complications in infected pregnant women.
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Affiliation(s)
- Nasrin Changizi
- Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Eshrati
- Department of Community and Family Medicine, Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Salehi
- Research Center for Antibiotic Stewardship and Anti-microbial Resistance, Imam Khomeini Hospital Complex, Infectious Diseases Department, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | | | - Sedigheh Hantoushzadeh
- Department of Obstetrics and Gynecology, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Laleh Eslamian
- Department of Obstetrics and Gynecology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Savaie
- Department of Anesthesiology, School of Medicine, Pain Research Center, Razi Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Alireza Raeisi
- Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parichehr Pooransari
- Department of Obstetrics and Gynecology, School of Medicine, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Gaur P, Darwin KC, Kohn JR, Uribe KA, Shippey E, Eke AC. The relationship between COVID-19 vaccination status in pregnancy and birthweight. Am J Obstet Gynecol MFM 2023; 5:101057. [PMID: 37330010 PMCID: PMC10268810 DOI: 10.1016/j.ajogmf.2023.101057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/04/2023] [Accepted: 06/12/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Despite findings that maternal COVID-19 infection in pregnancy is associated with low birthweight (weight of ≤2500 g), previous studies demonstrate no difference in low birthweight risk between COVID-19 vaccinated and unvaccinated pregnant persons. Few studies, however, have examined the association between unvaccinated, incomplete vaccination, and complete vaccination on low birthweight, and they have been limited by small sample sizes and lack of adjustment for covariates. OBJECTIVE We sought to address key limitations of prior work and evaluate this association between unvaccinated, incomplete, and complete COVID-19 vaccination status in pregnancy and low birthweight. We predicted a protective association of vaccination on low birthweight that varies by number of doses received. STUDY DESIGN We performed a population-based retrospective study using the Vizient clinical database, which included data from 192 hospitals in the United States. Our sample included pregnant persons who delivered between January 2021 and April 2022 at hospitals that reported maternal vaccination data and birthweight at delivery. Pregnant persons were categorized into 3 groups as follows: unvaccinated; incompletely vaccinated (1 dose of Pfizer or Moderna); or completely vaccinated (1 dose of Johnson & Johnson or ≥2 doses of Moderna or Pfizer). Demographics and outcomes were analyzed using standard statistical tests. We performed multivariable logistic regression to account for potential confounders between vaccination status and low birthweight in the original cohort. Propensity score matching was used to reduce bias related to the likelihood of vaccination, and the multivariable logistic regression model was then applied to the propensity score-matched cohort. Stratification analysis was performed for gestational age and race and ethnicity. RESULTS Of the 377,995 participants, 31,155 (8.2%) had low birthweight, and these participants were more likely to be unvaccinated than those without low birthweight (98.8% vs 98.5%, P<.001). Incompletely vaccinated pregnant persons were 13% less likely to have low birthweight neonates compared to unvaccinated persons (odds ratio, 0.87; 95% confidence interval, 0.73-1.04), and completely vaccinated persons were 21% less likely to have low birthweight neonates (odds ratio, 0.79; 95% confidence interval, 0.79-0.89). After controlling for maternal age, race or ethnicity, hypertension, pregestational diabetes, lupus, tobacco use, multifetal gestation, obesity, use of assisted reproductive technology, and maternal or neonatal COVID-19 infections in the original cohort, these associations remained significant for only complete vaccination (adjusted odds ratio, 0.80; 95% confidence interval, 0.70-0.91) and not incomplete vaccination (adjusted odds ratio, 0.87; 95% confidence interval, 0.71-1.04). In the propensity score-matched cohort, pregnant persons who were completely vaccinated against COVID-19 were 22% less likely to have low birthweight neonates compared to unvaccinated and incompletely vaccinated individuals (adjusted odds ratio, 0.78; 95% confidence interval, 0.76-0.79). CONCLUSION Pregnant persons who were completely vaccinated against COVID-19 were less likely to have low birthweight neonates compared to unvaccinated and incompletely vaccinated individuals. This novel association was observed among a large population after adjusting for confounders of low birthweight and factors influencing the likelihood of receiving the COVID-19 vaccine.
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Affiliation(s)
- Priyanka Gaur
- Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, MD (Drs Gaur and Uribe).
| | - Kristin C Darwin
- Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, MD (Drs Darwin, Kohn, and Eke)
| | - Jaden R Kohn
- Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, MD (Drs Darwin, Kohn, and Eke)
| | - Katelyn A Uribe
- Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, MD (Drs Gaur and Uribe)
| | | | - Ahizechukwu C Eke
- Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, MD (Drs Darwin, Kohn, and Eke); Division of Clinical Pharmacology, Johns Hopkins University School of Medicine, Baltimore, MD (Dr Eke)
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Pandit NB, Fulmali PR, Chandrayan P, Chauhan K, Bhil DL, Rasania MN. How safe is COVID-19 vaccination among pregnant women and its outcome - A hospital-based retrospective study in Indian population. J Family Med Prim Care 2023; 12:2140-2145. [PMID: 38024942 PMCID: PMC10657075 DOI: 10.4103/jfmpc.jfmpc_333_23] [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: 02/21/2023] [Revised: 06/13/2023] [Accepted: 06/19/2023] [Indexed: 12/01/2023] Open
Abstract
Background Although getting the Covid infection is equal for every person, during pregnancy, the women's immunity is a little lower than usual, so they are more prone to infection. That is why they should be taken care of with more precautions. A vaccine is the best weapon to fight such infection. Covishield and Covaxin are the two vaccines first introduce in country India including for pregnant women. The safety of the vaccine was a big concern as one of them is a newer type of vaccine. The current study was planned with objectives to understand the safety aspect of Covid19 vaccine on pregnancy outcome and Adverse events following immunization (AEFI) following vaccination. Materials and Methods This was a hospital-based retrospective cohort study. The sample size was all the pregnant women who delivered a baby from July 2021 to April 2022 at the tertiary care hospital in Vadodara. These women were retrospectively assessed for the status of vaccination based on the record and other information related to ANC from the record. Total of 1974 women were eligible for study after inclusion-exclusion criteria. The collected data was analysed. Result Of the 1974 pregnant women, 531 (27%) took any of one covid19 vaccine and 1443 (73%) did not take vaccine. There were 511 (96%) women opted for Covishield vaccine and 20 (4%) women who opted for Covaxin. Of 531 women who took vaccination, 46% women had AEFI. The risk of low birth weight (LBW) baby was 40% among vaccinated v/s 39% among non-vaccinated and congenital malformation was 0.6% among vaccinated v/s 1% among non-vaccinated women. On the contrary, the risk of premature birth was 8% among the vaccinated group v/s 13% among the non-vaccinated group and NICU admission following delivery was 8% among the vaccinated group v/s 12% among the non-vaccinated group. Conclusion AEFI among pregnant women were found less compared to the general population. The study also revealed that both Covishield and Covaxin are found safe for pregnancy outcomes and can be given to pregnant women during any trimester of pregnancy message for a family physician.
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Affiliation(s)
- Niraj B. Pandit
- Department of Community Medicine, SBKS MI and RC, Sumandeep Vidypeeth, Vadodara, Gujarat, India
| | - Purvi R. Fulmali
- Department of Community Medicine Healthy Mother Healthy Child Project, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Piyusha Chandrayan
- Department of Obstetrics and Gynaecology, Dhiraj Hospital, SBKS MIRC, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Kishor Chauhan
- Department of Obstetrics and Gynaecology, Dhiraj Hospital, SBKS MIRC, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Dipika L. Bhil
- Department of Paediatrics, Dhiraj Hospital, SBKS MIRC, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Manish N. Rasania
- Department of Paediatrics, Dhiraj Hospital, SBKS MIRC, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
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Lotfi H, Mazar MG, Ei NMH, Fahim M, Yazdi NS. Vaccination is the most effective and best way to avoid the disease of COVID-19. Immun Inflamm Dis 2023; 11:e946. [PMID: 37647441 PMCID: PMC10408370 DOI: 10.1002/iid3.946] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 06/26/2023] [Accepted: 07/06/2023] [Indexed: 09/01/2023] Open
Abstract
Most of the vaccines that are effective against SARS-CoV-2 have used the following functional strategies: inactivated viruses, live attenuated viruses, viral vector-based vaccines, subunit vaccines, recombinant proteins, and DNA/RNA vaccines. Among the vaccines that stimulate the host's immune system with the help of DNA are: undergoing Phase 2/3 trials including INO-4800 (International Vaccine Institute; Inovio Pharmaceuticals), Symvivo, Canada-COVID19 (AnGes, Inc.); GX-19 (Genexine, Inc.). BNT162b2 and mRNA-1273 vaccines were made by BioNTech/Pfizer/Fosun Pharma group and Moderna/NIAID group, respectively, which are considered as types of RNA vaccines. Vaccines that are based on the viral vector are AstraZeneca, Sputonium, and Johnson-Jensen. Among the inactive viral vaccines, the following can be mentioned: CoronaVac (Sinovac) WIBP vaccine (Wuhan Institute of Biological Products, Sinopharm), BBIBPCorV (Beijing Institute of Biological Products, Sinopharm), BBV152/Covaxin (Bharat Biotech, ICMR, National Institute of Virology) And among the protein-based/subunit vaccines, the following can be counted: NVX-CoV2373: (Novavax); SCB-2019 vaccine (Clover Biopharmaceuticals AUS Pty Ltd.); Covax-19 (GeneCure Biotechnologies; Vaxine Pty Ltd.) mRNA vaccines, viral vector vaccines, and protein subunit vaccines cannot cause disease because these vaccines stimulate the immune system to produce antibodies against virus proteins instead of the virus itself (or its antigen). MRNA vaccines increase SARS-CoV-2 proteins and ultimately stimulate the production of T and B lymphocytes. The epidemic of HCoVs and their destructive and harmful effects on life has caused the scientific community to seek the production of an effective and efficient vaccine before its catastrophic release. We all need to know that none of us will be healed until the other is healed. The purpose of this review article is to present a selection of existing knowledge in the field of fighting and preventing the coronavirus.
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Affiliation(s)
- Hadi Lotfi
- Leishmaniasis Research CenterSabzevar University of Medical SciencesSabzevarIran
- Department of Medical MicrobiologySabzevar University of Medical SciencesSabzevarIran
| | - Mina G. Mazar
- Department of Medical Laboratory ScienceVarastegan Institute for Medical ScienceMashhadIran
| | - Negar M. H. Ei
- Department of Medical Laboratory ScienceVarastegan Institute for Medical ScienceMashhadIran
| | | | - Nafiseh S. Yazdi
- Department of Pediatrics, Faculty of MedicineSabzevar University of Medical SciencesSabzevarIran
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Bonilla E, Fogel J, Hubley R, Anand R, Liu PC. Survey of COVID-19 Vaccine Attitudes in Predominately Minority Pregnant Women. South Med J 2023; 116:677-682. [PMID: 37536694 PMCID: PMC10417252 DOI: 10.14423/smj.0000000000001587] [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] [Accepted: 02/01/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVES Despite recommendations for coronavirus disease (COVID-19) vaccination during pregnancy, some pregnant women are concerned about COVID-19 vaccines and decline to be vaccinated. This study focuses on attitudes in a sample of mostly minority pregnant Hispanic and Black women that may influence vaccine hesitancy. METHODS This was a cross-sectional survey of 400 pregnant women. Participants were provided with a one-page information sheet on pregnancy health, COVID-19 health, and COVID-19 vaccines. They were then asked to complete a survey on attitudes about these topics. RESULTS We found that attitudes for knowing about the health topics were in the range from agree to strongly agree, whereas attitudes for knowing about topics pertaining to COVID-19 messenger RNA (mRNA) vaccines were in a lower-level range from neutral to agree. Negative vaccine attitudes were significantly associated with decreased agreement for knowing about health attitudes, but not significantly associated with COVID-19 mRNA vaccine attitudes. CONCLUSIONS COVID-19 vaccine mRNA technology was a lesser understood topic than attitudes for knowing about other health topics. This finding suggests the need for physician intervention and that further education about COVID-19 vaccine mRNA technology may influence patient attitudes toward acceptance of the COVID-19 mRNA vaccine in pregnancy.
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Affiliation(s)
- Engelbert Bonilla
- From the Department of Obstetrics & Gynecology, Nassau University Medical Center, East Meadow, New York
| | - Joshua Fogel
- From the Department of Obstetrics & Gynecology, Nassau University Medical Center, East Meadow, New York
- Department of Business Management, Brooklyn College of the City University of New York, Brooklyn
| | - Robert Hubley
- New York Institute of Technology College of Osteopathic Medicine, Old Westbury
| | - Rahul Anand
- New York Institute of Technology College of Osteopathic Medicine, Old Westbury
| | - Paul C. Liu
- From the Department of Obstetrics & Gynecology, Nassau University Medical Center, East Meadow, New York
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Marchand G, Masoud AT, Grover S, King A, Brazil G, Ulibarri H, Parise J, Arroyo A, Coriell C, Goetz S, Moir C, Govindan M, Moberly A, Proctor A, Sainz K, Blumrick R. Maternal and neonatal outcomes of COVID-19 vaccination during pregnancy, a systematic review and meta-analysis. NPJ Vaccines 2023; 8:103. [PMID: 37454153 PMCID: PMC10349851 DOI: 10.1038/s41541-023-00698-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 06/27/2023] [Indexed: 07/18/2023] Open
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is associated with increased pregnancy complications. Despite effective vaccination strategies for the general population, the evidence on the safety and efficacy of Coronavirus disease 2019 (COVID-19) vaccinations in pregnancy is limited due to a lack of well-powered studies. The present study compares the maternal, neonatal, and immunological outcomes between vaccinated pregnant and unvaccinated pregnant women using a systematic review and meta-analysis approach. We included 37 studies with a total of 141,107 pregnant women (36.8% vaccinated) spread across all outcomes. Our evidence indicates a higher rate of cesarean section in the 1898 vaccinated pregnant women compared to the 6180 women who did not receive vaccination (OR = 1.20, CI = (1.05, 1.38), P = 0.007, I2 = 45%). Regarding immunological outcomes, the risk of SARS-CoV-2 infection during pregnancy or postpartum was significantly reduced in 6820 vaccinated pregnant women compared to 17,010 unvaccinated pregnant women (OR = 0.25, CI = 0.13-0.48, P < 0.0001, I2 = 61%), as evident from qualitative assessment indicating significantly higher postpartum antibody titers compared to that observed in both unvaccinated mothers and mothers who have recently recovered from a SARS-CoV-2 infection. Our analysis represents high quality evidence showing that COVID-19 vaccination effectively raises antibody titers against SARS-CoV-2. This may confer protection against infection during pregnancy and the postpartum period. In addition to being protective against SARS-CoV-2, the vaccine was associated with decreased odds of preterm delivery. Furthermore, COVID-19 vaccination may also be associated with higher odds of cesarean section.
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Affiliation(s)
- Greg Marchand
- Marchand Institute for Minimally Invasive Surgery, Mesa, AZ, USA.
| | - Ahmed Taher Masoud
- Marchand Institute for Minimally Invasive Surgery, Mesa, AZ, USA
- Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Sandeep Grover
- Center for Human Genetics, Universitatsklinikum Giessen und Marburg, Marburg, Germany
| | - Alexa King
- Marchand Institute for Minimally Invasive Surgery, Mesa, AZ, USA
| | - Giovanna Brazil
- Marchand Institute for Minimally Invasive Surgery, Mesa, AZ, USA
| | - Hollie Ulibarri
- Marchand Institute for Minimally Invasive Surgery, Mesa, AZ, USA
| | - Julia Parise
- Marchand Institute for Minimally Invasive Surgery, Mesa, AZ, USA
| | - Amanda Arroyo
- Marchand Institute for Minimally Invasive Surgery, Mesa, AZ, USA
| | | | - Sydnee Goetz
- Marchand Institute for Minimally Invasive Surgery, Mesa, AZ, USA
| | - Carmen Moir
- Marchand Institute for Minimally Invasive Surgery, Mesa, AZ, USA
| | - Malini Govindan
- Marchand Institute for Minimally Invasive Surgery, Mesa, AZ, USA
| | - Atley Moberly
- Marchand Institute for Minimally Invasive Surgery, Mesa, AZ, USA
| | - Anna Proctor
- University of Iowa, College of Public Health, Iowa City, IA, USA
| | - Katelyn Sainz
- Tucson Medical Center, Department of Pediatrics, Tucson, AZ, USA
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10
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Ayieko S, Baker K, Messiah SE, Lewis B, Markham C. Determinants of COVID-19 Vaccination Decision-Making Behaviors among Pregnant Women in Sub-Saharan Africa: A Scoping Review. Vaccines (Basel) 2023; 11:1233. [PMID: 37515048 PMCID: PMC10384512 DOI: 10.3390/vaccines11071233] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/23/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023] Open
Abstract
Despite the availability of the coronavirus disease 2019 (COVID-19) vaccination, uptake among pregnant women in Sub-Saharan Africa has been low. This scoping review aimed to identify and characterize determinants influencing COVID-19 vaccination decision-making behaviors among pregnant women in Sub-Saharan Africa. We searched five online databases for articles on COVID-19 vaccination among pregnant women in Sub-Saharan Africa. We identified studies published in English between March 2020 and April 2023 that assessed vaccine-specific issues, psychosocial constructs, and contextual factors associated with COVID-19 vaccination decision-making behaviors. Of the fourteen studies identified, over half (57.1%) were cross-sectional; three used qualitative research methods; and three involved multi-country participants. Most studies assessed COVID-19 vaccination acceptability and willingness. Overall, 85.7% of the publications examined knowledge, attitudes, or both as critical factors associated with COVID-19 vaccination. The prevalence of COVID-19 vaccine uptake during pregnancy was low in Sub-Saharan Africa (14.4-28%). While most current studies assess COVID-19 vaccination knowledge, research on maternal vaccination in Sub-Saharan Africa would benefit from the inclusion of theory-informed and driven studies that measure additional psychosocial factors and contextual constructs. Future studies should also employ study designs that can determine causal pathways of vaccination determinants and vaccination uptake.
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Affiliation(s)
- Sylvia Ayieko
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX 77030, USA
| | - Kimberly Baker
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX 77030, USA
| | - Sarah E Messiah
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Dallas, TX 75207, USA
- Center for Pediatric Population Health, The University of Texas Health Science Center at Houston School of Public Health, Dallas, TX 75207, USA
- Department of Pediatrics, McGovern Medical School, Houston, TX 77030, USA
| | - Brianna Lewis
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX 77030, USA
| | - Christine Markham
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX 77030, USA
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11
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Movahedi M, Siahafshari KM, Hajhashemi M, Khorvash F, Saeidi M, Allameh Z. Evaluation of Maternal and Fetal Outcomes in Pregnant Women with COVID-19 based on Different Trimesters. Adv Biomed Res 2023; 12:165. [PMID: 37564445 PMCID: PMC10410429 DOI: 10.4103/abr.abr_173_22] [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: 05/25/2022] [Revised: 07/06/2022] [Accepted: 07/16/2022] [Indexed: 08/12/2023] Open
Abstract
Background COVID-19 is the leading cause of the recent pandemic in the globe. This disease might have different effects on the maternal and fetal outcomes in pregnancy. The aim of this study was to assess these outcomes in pregnant women with COVID-19 infections in different trimesters. Materials and Methods This is a prospective cohort study that was performed in February 2020 to August 2021 in Isfahan on 430 pregnant women with definite diagnosis of COVID-19 infection admitted to our medical centers. The included cases were followed based on the gestational age in which they were diagnosed with COVID-19 infection. Patients were divided into three groups (first, second, and third trimesters) based on COVID-19 infection. Results The frequency of requiring mechanical ventilation was higher in mothers with COVID-19 in the second trimester (P = 0.049) and the frequency of PIH was significantly higher in mothers with COVID-19 in the third trimester compared to other women (P = 0.009). Fetal growth restriction (FGR) was also observed in 22 patients (5.3%) that was mostly observed with COVID-19 in the third trimester (P = 0.012). Oligohydramnios and fetal distress leading to C/S were observed in 19 patients (4.6%) and 12 patients (2.9%), respectively. The majority of maternal mortality was among cases with COVID-19 infection in the third trimester (44.4%). Conclusion We observed higher maternal and fetal complications in women especially those in the third trimester. Our results were in line with the findings of previous studies. Women with COVID-19 infection in the third trimester had highest frequencies of preterm labor and FGR.
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Affiliation(s)
- Minoo Movahedi
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Khadijeh M. Siahafshari
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Hajhashemi
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzin Khorvash
- Infectious Diseases Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Milad Saeidi
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Allameh
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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12
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Schilder NKM, Tiesjema B, Theunissen PT, Rengerink KO, van der Laan JW. Evaluation of non-clinical toxicity studies of COVID-19 vaccines. Regul Toxicol Pharmacol 2023:105438. [PMID: 37356612 DOI: 10.1016/j.yrtph.2023.105438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/15/2023] [Accepted: 06/21/2023] [Indexed: 06/27/2023]
Abstract
In this study we evaluated the outcomes of non-clinical toxicity studies of various SARS-CoV-2 vaccines produced with different manufacturing technologies, with focus on Repeated Dose Toxicity (RDT) and Developmental and Reproductive Toxicity (DART) studies. We found that RDT and DART studies at doses relevant for human treatment showed no adverse effects while remaining observations were expected findings including local reactogenicity, immune response and macroscopic findings at the injection site. We have also reviewed the European Medicines Agency (EMA) nonclinical assessment reports for market authorization. Regardless of utilized vaccine manufacturing technology EMA assessment of the non-clinical studies consisted most frequently of comments related to study design, species selection and missing data. Sponsors have often submitted platform studies (vaccine studies with the same technology/construct but using other antigens) as supplementary data. Animal model-based toxicity testing has shown rather small effects, which have been never serious adverse effects. The translational value to support clinical development is mainly to inflammatory effects, indicative of the primary action of the vaccines. From a 3R perspective supportive platform technology data consisting of previously executed RDT and DART studies from the same platform technology are encouraged to be implemented in the vaccine assessment process.
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Affiliation(s)
- N K M Schilder
- Section on Pharmacology, Toxicology and Kinetics, Medicines Evaluation Board, Graadt van Roggenweg 500, 3531AH, Utrecht, the Netherlands; Division of Toxicology, Leiden Academic Center for Drug Research, Einsteinweg 55, 2333CC, Leiden, the Netherlands.
| | - B Tiesjema
- Section on Pharmacology, Toxicology and Kinetics, Medicines Evaluation Board, Graadt van Roggenweg 500, 3531AH, Utrecht, the Netherlands.
| | - P T Theunissen
- Section on Pharmacology, Toxicology and Kinetics, Medicines Evaluation Board, Graadt van Roggenweg 500, 3531AH, Utrecht, the Netherlands.
| | - K Oude Rengerink
- Section of Methodology Working Group. Medicines Evaluation Board, Graadt van Roggenweg 500, 3531AH, Utrecht, the Netherlands.
| | - J W van der Laan
- Section on Pharmacology, Toxicology and Kinetics, Medicines Evaluation Board, Graadt van Roggenweg 500, 3531AH, Utrecht, the Netherlands; Division of Toxicology, Leiden Academic Center for Drug Research, Einsteinweg 55, 2333CC, Leiden, the Netherlands.
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13
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Chanda BM, Chen XQ. Breastfeeding during the COVID-19 pandemic. Front Pediatr 2023; 11:1120763. [PMID: 37342530 PMCID: PMC10277472 DOI: 10.3389/fped.2023.1120763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 05/10/2023] [Indexed: 06/23/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused many significant changes to all aspects of day to day life. The disease has spread and reached pandemic proportions. The principle route of transmission is the respiratory route. Infants, pregnant women and breastfeeding mothers have all been affected. Many interventions and guidelines from important societies have been instituted in order to curb the transmission of the disease. These have involved both pharmacological and non-pharmacological methods. COVID-19 vaccines have also emerged as important methods of primary prevention of the disease. But several questions have been raised concerning the safety and efficacy of their use in pregnant and breastfeeding mothers. It has also not been clear if the vaccines are effective in generating a robust immune response in the pregnant women and breastfeeding mothers to confer passive immunity to the fetuses and infants, respectively. And they have not been tested in infants. The aspect of infant feeding has equally been affected. Although breast milk has not been known to serve as the vehicle of transmission of the virus, there is still some lack of uniformity of practice regarding breastfeeding when a mother has SARS-CoV-2 infection. This has led to infant feeding being done by the use of commercial formula feeds, pasteurized human donor breast milk, feeding on the mother's own expressed breast milk by a care giver and directly breastfeeding with skin to skin contact. This is despite breast milk being the most physiologically appropriate type of feed for infants. Therefore the pertinent question remains; should breastfeeding continue during the pandemic continue? This review also seeks to analyse the vast amount of scientific information regarding the subject and to synthesize science-based information.
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Affiliation(s)
- Bwalya Mpelwa Chanda
- Department of Pediatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao-Qing Chen
- Department of Pediatrics, First Affiliation Hospital of Nanjing Medical University, Nanjing, China
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14
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Messas T, Lim RK, Burns L, Yumeen S, Kroumpouzos G. A critical review of COVID-19 course and vaccination in dermatology patients on immunomodulatory/biologic therapy: recommendations should not differ between non-pregnant and pregnant individuals. Front Med (Lausanne) 2023; 10:1121025. [PMID: 37332768 PMCID: PMC10272467 DOI: 10.3389/fmed.2023.1121025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 04/24/2023] [Indexed: 06/20/2023] Open
Abstract
COVID-19 can have detrimental effects on immunosuppressed patients. Here, we evaluate the evidence regarding continuing immunomodulatory/biologic (IMBI) therapy in pregnant dermatology patients during the COVID-19 pandemic. Also, we discuss the risks of COVID-19 vaccination in pregnant dermatology patients on IMBI therapy. As indicated in this review, regarding continuing IMBI therapy in pregnant dermatology patients during the pandemic, there is no compelling reason for treating them differently than non-pregnant. The body of evidence indicates that mRNA COVID-19 vaccines are safe during pregnancy. Studies on rheumatology patients, a group that overlaps significantly with the dermatology group, provided essential findings. IMBI in a non-pregnant rheumatology patient was not associated with COVID-19 mortality (except for rituximab), and vaccination of the rheumatology patient during pregnancy improved the obstetric outcomes compared to the unvaccinated patient. Based on this data, it can be stated that after weighing the benefit-risk profile of the available COVID-19 vaccines, the recommendation for the pregnant dermatology patient speaks in favor of the COVID-19 vaccination. COVID-19 vaccine recommendations in pregnant dermatology patients on IMBI should not differ from those for their non-pregnant counterparts.
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Affiliation(s)
- Tassahil Messas
- Department of Dermatology, University Hospital Centre, University of Constantine III, Constantine, Algeria
| | - Rachel K. Lim
- Alpert Medical School, Brown University, Providence, RI, United States
| | - Laura Burns
- Department of Dermatology, Alpert Medical School, Brown University, Providence, RI, United States
| | - Sara Yumeen
- Department of Dermatology, Alpert Medical School, Brown University, Providence, RI, United States
| | - George Kroumpouzos
- Department of Dermatology, Alpert Medical School, Brown University, Providence, RI, United States
- GK Dermatology, PC, South Weymouth, MA, United States
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15
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Basu M, Howdeshell KL, Rasmussen SA, Rychlik KA, Knudsen TB, Shuey DL, Slikker W. Society for birth defects research and prevention's multidisciplinary research needs workshop 2022: A call to action. Birth Defects Res 2023; 115:959-966. [PMID: 37218073 PMCID: PMC10641708 DOI: 10.1002/bdr2.2186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 04/21/2023] [Indexed: 05/24/2023]
Abstract
The Society for Birth Defects Research and Prevention (BDRP) strives to understand and protect against potential hazards to developing embryos, fetuses, children, and adults by bringing together scientific knowledge from diverse fields. The theme of 62nd Annual Meeting of BDRP, "From Bench to Bedside and Back Again", represented the cutting-edge research areas of high relevance to public health and significance in the fields of birth defects research and surveillance. The multidisciplinary Research Needs Workshop (RNW) convened at the Annual Meeting continues to identify pressing knowledge gaps and encourage interdisciplinary research initiatives. The multidisciplinary RNW was first introduced at the 2018 annual meeting to provide an opportunity for annual meeting attendees to participate in breakout discussions on emerging topics in birth defects research and to foster collaboration between basic researchers, clinicians, epidemiologists, drug developers, industry partners, funding agencies, and regulators to discuss state-of-the-art methods and innovative projects. Initially, a list of workshop topics was compiled by the RNW planning committee and circulated among the members of BDRP to obtain the most popular topics for the Workshop discussions. Based on the pre-meeting survey results, the top three discussion topics selected were, A) Inclusion of pregnant and lactating women in clinical trials. When, why, and how? B) Building multidisciplinary teams across disciplines: What cross-training is needed? And C) Challenges in applications of Artificial Intelligence (AI) and machine learning for risk factor analysis in birth defects research. This report summarizes the key highlights of the RNW workshop and specific topic discussions.
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Affiliation(s)
- Madhumita Basu
- Center for Cardiovascular Research and Heart Center, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, United States of America
- MelliCell Inc. Newton, Massachusetts, United States of America
| | - Kembra L. Howdeshell
- Division of Translational Toxicology, National Institute of Environmental Health Sciences (NIEHS), North Carolina, United States of America
| | - Sonja A. Rasmussen
- Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Kristal A. Rychlik
- Public Health Program, School of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, Texas, United States of America
| | - Thomas B. Knudsen
- US Environmental Protection Agency, Center for Computational Toxicology and Exposure, Research Triangle Park, North Carolina, United States of America
| | - Dana L. Shuey
- Incyte Corporation, Wilmington, Delaware, United States of America
| | - William Slikker
- Retired, Formerly of the Office of the Director, National Center for Toxicological Research, US Food and Drug Administration (FDA), Jefferson, Arkansas, United States of America
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16
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Juliá-Burchés C, Martínez-Varea A. An Update on COVID-19 Vaccination and Pregnancy. J Pers Med 2023; 13:jpm13050797. [PMID: 37240967 DOI: 10.3390/jpm13050797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/27/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
Pregnant women are more prone to experience severe COVID-19 disease, including intensive care unit (ICU) admission, use of invasive ventilation, extracorporeal membrane oxygenation (ECMO), and mortality compared to non-pregnant individuals. Additionally, research suggests that SARS-CoV-2 infection during pregnancy is linked to adverse pregnancy outcomes, such as preterm birth, preeclampsia, and stillbirth, as well as adverse neonatal outcomes, including hospitalization and admission to the neonatal intensive care unit. This review assessed the available literature from November 2021 to 19 March 2023, concerning the safety and effectiveness of COVID-19 vaccination during pregnancy. COVID-19 vaccination administered during pregnancy is not linked to significant adverse events related to the vaccine or negative obstetric, fetal, or neonatal outcomes. Moreover, the vaccine has the same effectiveness in preventing severe COVID-19 disease in pregnant individuals as in the general population. Additionally, COVID-19 vaccination is the safest and most effective method for pregnant women to protect themselves and their newborns from severe COVID-19 disease, hospitalization, and ICU admission. Thus, vaccination should be recommended for pregnant patients. While the immunogenicity of vaccination in pregnancy appears to be similar to that in the general population, more research is needed to determine the optimal timing of vaccination during pregnancy for the benefit of the neonate.
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Affiliation(s)
- Cristina Juliá-Burchés
- Department of Obstetrics and Gynaecology, La Fe University and Polytechnic Hospital, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain
| | - Alicia Martínez-Varea
- Department of Obstetrics and Gynaecology, La Fe University and Polytechnic Hospital, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain
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17
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Dehaene I, Van Holsbeke C, Roelens K, van Oostrum NN, Nulens K, Smets K, Van Hoestenberghe MR, Naulaers G, Devlieger R. Preterm birth during the COVID-19 pandemic: more, less, or just the same? Acta Clin Belg 2023; 78:140-159. [PMID: 35731600 DOI: 10.1080/17843286.2022.2091321] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Coronavirus disease (COVID-19) and its mitigation measures have been associated with changes in preterm birth (PTB) incidences. The objective of this paper is to summarize and comment on the literature on COVID-19 and PTB and to compare PTB incidence between 2019 (pre-COVID-19) and 2020 (COVID-19) in three Belgian tertiary care hospitals. METHODS A non-systematic review on COVID-19 and PTB was performed, and literature was summarized in a table. Preterm birth rates at Ghent University Hospital, Ziekenhuis Oost-Limburg, and University Hospital Leuven in 2019 and 2020 were compared. Chi-square and Fisher's exact tests were used to compare PTB rates between 2019 and 2020, and Kaplan Meier survival analysis was used to compare pregnancy duration. The mean outcome measure was PTB incidence in 2020 (COVID-19) compared with PTB incidence in 2019 (pre-COVID-19). RESULTS Some (parts of) countries report decreases in PTB rates, others report no differences in incidence, and a minority of countries report an increased incidence of PTB. Almost all studies only consider live-births. In three tertiary care hospitals in Flanders, there were no differences in PTB rates before and during the COVID-19 pandemic. CONCLUSION The impact of the (mitigation measures during the) COVID-19 pandemic on PTB incidence is unclear and difficult to explore. To enable a correct interpretation, all conceptions before and during the pandemic should be taken into consideration, as well as all births, still or alive.
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Affiliation(s)
- Isabelle Dehaene
- Department of Obstetrics and Gynaecology, Ghent University Hospital, Ghent, Belgium
| | | | - Kristien Roelens
- Department of Obstetrics and Gynaecology, Ghent University Hospital, Ghent, Belgium
| | | | - Katrien Nulens
- Department of Development and Regeneration, Cluster Woman and Child, Biomedical Sciences, KU Leuven, Leuven, Belgium.,Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
| | - Koenraad Smets
- Neonatal Intensive Care Unit, Ghent University Hospital, Ghent, Belgium
| | | | - Gunnar Naulaers
- Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Roland Devlieger
- Department of Development and Regeneration, Cluster Woman and Child, Biomedical Sciences, KU Leuven, Leuven, Belgium.,Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium.,Department of Obstetrics and Gynaecology, GZA Hospitals, St-Augustinus, Belgium
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18
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Sekulovski M, Bogdanova-Petrova S, Peshevska-Sekulovska M, Velikova T, Georgiev T. COVID-19 related liver injuries in pregnancy. World J Clin Cases 2023; 11:1918-1929. [PMID: 36998958 PMCID: PMC10044960 DOI: 10.12998/wjcc.v11.i9.1918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/17/2023] [Accepted: 02/21/2023] [Indexed: 03/16/2023] Open
Abstract
While severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) quickly spread across the globe, our understanding of its pathogenic mechanisms evolved. Importantly, coronavirus disease 2019 (COVID-19) is now considered a syndromic multisystem inflammatory disease involving not only the respiratory system but also the cardiovascular, excretory, nervous, musculoskeletal, and gastrointestinal systems. Moreover, a membrane-bound form of angiotensin-converting enzyme 2, the entry receptor for SARS-CoV-2, is expressed on the surface of cholangiocytes and hepatocytes, suggesting the potential of COVID-19 to involve the liver. With the widespread distribution of SARS-CoV-2 throughout the population, infection during pregnancy is no longer a rare occurrence; however, little is known about the course of hepatic injuries and related outcomes in pregnant SARS-CoV-2-positive women. Thus, the understudied topic of COVID-related liver disease during pregnancy poses a great challenge for the consulting gynecologist and hepatologist. In this review, we aim to describe and summarize potential liver injuries in pregnant women with COVID-19.
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Affiliation(s)
- Metodija Sekulovski
- Department of Anesthesiology and Intensive Care, University Hospital Lozenetz, Sofia 1407, Bulgaria
- Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria
| | - Simona Bogdanova-Petrova
- First Department of Internal Medicine, Medical University-Varna, Varna 9010, Bulgaria
- Clinic of Rheumatology, University Hospital “St. Marina”, Varna 9010, Bulgaria
| | - Monika Peshevska-Sekulovska
- Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria
- Department of Gastroenterology, University Hospital Lozenetz, Sofia 1407, Bulgaria
| | - Tsvetelina Velikova
- Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria
- Department of Clinical Immunology, University Hospital Lozenetz, Sofia 1407, Bulgaria
| | - Tsvetoslav Georgiev
- First Department of Internal Medicine, Medical University-Varna, Varna 9010, Bulgaria
- Clinic of Rheumatology, University Hospital “St. Marina”, Varna 9010, Bulgaria
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19
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Chaubey I, Vijay H, Govindaraj S, Babu H, Cheedarla N, Shankar EM, Vignesh R, Velu V. Impact of COVID-19 Vaccination on Pregnant Women. Pathogens 2023; 12:431. [PMID: 36986353 PMCID: PMC10056326 DOI: 10.3390/pathogens12030431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/16/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023] Open
Abstract
In light of the COVID-19 pandemic, researchers across the world hastened to develop vaccines that would aid in bolstering herd immunity. Utilizing mRNA coding and viral vector technology, the currently approved vaccines were required to undergo extensive testing to confirm their safety for mass usage in the general population. However, clinical trials failed to test the safety and efficacy of the COVID-19 vaccines in groups with weakened immune systems, especially pregnant women. Lack of information on the effects of vaccinations in pregnancy and the safety of fetuses are among the topmost reasons preventing pregnant women from receiving immunization. Thus, the lack of data examining the effects of COVID-19 vaccinations on pregnant women must be addressed. This review focused on the safety and efficacy of the approved COVID-19 vaccinations in pregnancy and their impact on both maternal and fetal immune responses. For that, we took the approach of combined systematic review/meta-analysis and compiled the available data from the original literature from PubMed, Web of Science, EMBASE and Medline databases. All articles analyzed presented no adverse effects of vaccination in pregnancy, with varying conclusions on the degree of effectiveness. The majority of the findings described robust immune responses in vaccinated pregnant women, successful transplacental antibody transfer, and implications for neonatal immunity. Hence, findings from the cumulative data available can be helpful in achieving COVID-19 herd immunization, including pregnant women.
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Affiliation(s)
- Ishaan Chaubey
- Molecular and Cellular Biology, Department of Biology, Vanderbilt University, Nashville, TN 37235, USA
| | - Harini Vijay
- College of Arts and Sciences, University of Washington, Seattle, WA 98195, USA
| | - Sakthivel Govindaraj
- Division of Microbiology and Immunology, Emory Vaccine Center, Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
- Laboratory Medicine, Department of Pathology, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Hemalatha Babu
- Division of Microbiology and Immunology, Emory Vaccine Center, Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
- Laboratory Medicine, Department of Pathology, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Narayanaiah Cheedarla
- Laboratory Medicine, Department of Pathology, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Esaki M. Shankar
- Infection and Inflammation, Department of Biotechnology, Central University of Tamil Nadu, Thiruvarur 610005, India
| | - Ramachandran Vignesh
- Preclinical Department, Faculty of Medicine, Royal College of Medicine Perak, Universiti Kuala Lumpur, Ipoh 30405, Malaysia
| | - Vijayakumar Velu
- Division of Microbiology and Immunology, Emory Vaccine Center, Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
- Laboratory Medicine, Department of Pathology, School of Medicine, Emory University, Atlanta, GA 30322, USA
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20
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Romero-Ibarguengoitia ME, Flores-Salazar ZL, Arroyo-García KD, Soto-Gámez R, Leal-Meléndez JA, René Garza-Herrera M, Bennett-Vidales G, Cabrera MH, González-Habib R, Jiménez LP, Garza-Bulnes R, Barco-Flores IA, Castillo-Figueroa LF, Garza-Silva A, Rivera-Cavazos A, Rivera-Salinas D, González-Cantú A, Sanz-Sánchez MÁ. Evaluation of Transplacental Antibody Transfer in Pregnant Women Immunized with Different SARS-CoV-2 Homologous or Heterologous Schemes. Vaccines (Basel) 2023; 11:vaccines11020415. [PMID: 36851294 PMCID: PMC9961240 DOI: 10.3390/vaccines11020415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023] Open
Abstract
There is scarce information related to transplacental antibody transfer against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with different homologous and heterologous vaccination schemes. This study aimed to correlate the magnitude of transplacental transfer anti-SARS-CoV-2 antibodies in different homologous and heterologous schemes. An observational cross-sectional study was developed to identify pregnant women vaccinated against SARS-CoV-2. They were questioned about their immunization status; blood samples from the mother, umbilical cord during labor, and the newborn 72 h after birth were taken to measure anti-S1 and anti-S2 specific IgG antibodies for SARS-CoV-2. We recruited 104 women with a median age of 29 (SD 1.17). We found antibodies in all newborns with vaccinated mothers. Homologous BNT162b2 mRNA regimen had the highest mean (SD) antibody titers (AU/mL) in maternal (994.93 (3.08), p = 0.039), umbilical cord (1316.43 (2.79), p = 0.016), and newborn (1192.02 (3.55), p = 0.020) blood. The generalized linear model showed a positive effect over antibodies with at least one dose in maternal (β = -1.1, p = 0.002) and newborn (β= -0.717, p = 0.044) blood, and with two doses (β = -0.684, p = 0.026) in umbilical cord blood. In conclusion, antibodies were detected in all vaccinated women and their newborns. Transfer of antibodies was found from the first dose, and the levels increased with the number of vaccine doses. Vaccination should be encouraged in pregnant women with any available scheme.
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Affiliation(s)
- Maria Elena Romero-Ibarguengoitia
- Research Department, Hospital Clínica Nova de Monterrey, San Nicolás de los Garza 66450, Nuevo León, Mexico
- Especialidades Médicas, Escuela de Medicina, Universidad de Monterrey, Avenida Morones Prieto, 4500-Pte, Zona Valle Poniente, San Pedro Garza García 66238, Nuevo León, Mexico
- Dirección de Enseñanza e Investigación en Salud, Hospital Christus Muguerza Sistema de Salud, Calle Miguel Hidalgo y Costilla 2525, Obispado, Monterrey 64000, Nuevo León, Mexico
- Correspondence: ; Tel.: +52-81-8865-5656
| | - Zulema Lourdes Flores-Salazar
- Especialidades Médicas, Escuela de Medicina, Universidad de Monterrey, Avenida Morones Prieto, 4500-Pte, Zona Valle Poniente, San Pedro Garza García 66238, Nuevo León, Mexico
- Departamento de Neonatología, Hospital Christus Muguerza Conchita, Calle 15 de Mayo 1822, María Luisa, Nuevo Obispado, Monterrey 64040, Nuevo León, Mexico
| | - Kimberly Dariela Arroyo-García
- Especialidades Médicas, Escuela de Medicina, Universidad de Monterrey, Avenida Morones Prieto, 4500-Pte, Zona Valle Poniente, San Pedro Garza García 66238, Nuevo León, Mexico
- Departamento de Ginecología, Hospital Christus Muguerza Conchita, Calle 15 de Mayo 1822, María Luisa, Nuevo Obispado, Monterrey 64040, Nuevo León, Mexico
| | - Rafael Soto-Gámez
- Especialidades Médicas, Escuela de Medicina, Universidad de Monterrey, Avenida Morones Prieto, 4500-Pte, Zona Valle Poniente, San Pedro Garza García 66238, Nuevo León, Mexico
- Departamento de Ginecología, Hospital Clínica Nova de Monterrey, Avenida del Bosque 139, Cuauhtémoc, Cuauhtémoc, San Nicolás de los Garza 66450, Nuevo León, Mexico
| | | | | | - Gordon Bennett-Vidales
- Departamento de Neonatología, Hospital Christus Muguerza Conchita, Calle 15 de Mayo 1822, María Luisa, Nuevo Obispado, Monterrey 64040, Nuevo León, Mexico
| | - Mauricio Hurtado Cabrera
- Research Department, Hospital Clínica Nova de Monterrey, San Nicolás de los Garza 66450, Nuevo León, Mexico
| | - Roberto González-Habib
- Departamento de Ginecología, Hospital Christus Muguerza Conchita, Calle 15 de Mayo 1822, María Luisa, Nuevo Obispado, Monterrey 64040, Nuevo León, Mexico
- Dirección de Enseñanza e Investigación en Salud, Hospital Christus Muguerza Conchita, Calle 15 de Mayo 1822, María Luisa, Nuevo Obispado, Monterrey 64040, Nuevo León, Mexico
| | - Liliann Peña Jiménez
- Research Department, Hospital Clínica Nova de Monterrey, San Nicolás de los Garza 66450, Nuevo León, Mexico
| | - Raúl Garza-Bulnes
- Departamento de Neonatología, Hospital Christus Muguerza Conchita, Calle 15 de Mayo 1822, María Luisa, Nuevo Obispado, Monterrey 64040, Nuevo León, Mexico
| | | | - Luis Fernando Castillo-Figueroa
- Departamento de Neonatología, Hospital Christus Muguerza Conchita, Calle 15 de Mayo 1822, María Luisa, Nuevo Obispado, Monterrey 64040, Nuevo León, Mexico
- Departamento de Neonatología, Hospital Clínica Nova de Monterrey, Avenida del Bosque 139, Cuauhtémoc, Cuauhtémoc, San Nicolás de los Garza 66450, Nuevo León, Mexico
| | - Arnulfo Garza-Silva
- Research Department, Hospital Clínica Nova de Monterrey, San Nicolás de los Garza 66450, Nuevo León, Mexico
| | - Andrea Rivera-Cavazos
- Research Department, Hospital Clínica Nova de Monterrey, San Nicolás de los Garza 66450, Nuevo León, Mexico
| | - Diego Rivera-Salinas
- Research Department, Hospital Clínica Nova de Monterrey, San Nicolás de los Garza 66450, Nuevo León, Mexico
| | - Arnulfo González-Cantú
- Research Department, Hospital Clínica Nova de Monterrey, San Nicolás de los Garza 66450, Nuevo León, Mexico
- Especialidades Médicas, Escuela de Medicina, Universidad de Monterrey, Avenida Morones Prieto, 4500-Pte, Zona Valle Poniente, San Pedro Garza García 66238, Nuevo León, Mexico
- Dirección de Enseñanza e Investigación en Salud, Hospital Christus Muguerza Sistema de Salud, Calle Miguel Hidalgo y Costilla 2525, Obispado, Monterrey 64000, Nuevo León, Mexico
| | - Miguel Ángel Sanz-Sánchez
- Research Department, Hospital Clínica Nova de Monterrey, San Nicolás de los Garza 66450, Nuevo León, Mexico
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Dellino M, Vimercati A, D’Amato A, Damiani GR, Laganà AS, Cicinelli E, Pinto V, Malvasi A, Scacco S, Ballini A, Resta L, Ingravallo G, Maiorano E, Cazzato G, Cascardi E. "GONE WITH THE WIND": The Transitory Effects of COVID-19 on the Gynecological System. J Pers Med 2023; 13:jpm13020312. [PMID: 36836546 PMCID: PMC9962077 DOI: 10.3390/jpm13020312] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/05/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023] Open
Abstract
The coronavirus disease no longer seems to represent an insurmountable global problem. This is thanks to the advent of coronavirus vaccines, which have alleviated the most serious symptoms associated with this disease. On the other hand, there are still many extrapulmonary symptoms of COVID-19, and among these also those of a gynecological nature. At the moment, there are several questions in this field, one above all concerns the causal link between COVID-19, vaccines and gynecological alterations. Furthermore, another important aspect is represented by the clinical impact of post-COVID-19 gynecological alterations on the female population which, to date, would seem to be mainly due to their duration, even if the extent of these symptoms is still poorly understood. Furthermore, it is not possible to foresee eventual long-term aggravations, or more serious symptoms caused by other viral variants that may arrive in the future. In this review, we focus on this theme and attempt to reorganize the different pieces of a puzzle which, to date, does not seem to have shown us its complete picture.
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Affiliation(s)
- Miriam Dellino
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70121 Bari, Italy
| | - Antonella Vimercati
- Department of Precision and Regenerative Medicine and Jonic Area, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Antonio D’Amato
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70121 Bari, Italy
| | | | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS “Civico—Di Cristina—Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
| | - Ettore Cicinelli
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70121 Bari, Italy
| | - Vincenzo Pinto
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70121 Bari, Italy
| | - Antonio Malvasi
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70121 Bari, Italy
| | - Salvatore Scacco
- Department of Basic Medical Sciences and Neurosciences, University of Bari “Aldo Moro”, 70121 Bari, Italy
- Correspondence: (S.S.); (E.C.)
| | - Andrea Ballini
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Leonardo Resta
- Department of Precision and Regenerative Medicine and Jonic Area, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Giuseppe Ingravallo
- Department of Precision and Regenerative Medicine and Jonic Area, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Eugenio Maiorano
- Department of Precision and Regenerative Medicine and Jonic Area, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Gerardo Cazzato
- Department of Precision and Regenerative Medicine and Jonic Area, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Eliano Cascardi
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
- Pathology Unit, FPO-IRCCS Candiolo Cancer Institute, 10060 Candiolo, Italy
- Correspondence: (S.S.); (E.C.)
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22
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Scendoni R, Fedeli P, Cingolani M. The State of Play on COVID-19 Vaccination in Pregnant and Breastfeeding Women: Recommendations, Legal Protection, Ethical Issues and Controversies in Italy. Healthcare (Basel) 2023; 11:healthcare11030328. [PMID: 36766904 PMCID: PMC9913898 DOI: 10.3390/healthcare11030328] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/16/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023] Open
Abstract
To date, extensive research has been conducted on vaccination against COVID-19 during pregnancy to verify the safety and efficacy of the vaccines, despite the fact that pregnant women were excluded from the initial clinical trials. The ever-increasing number of scientific publications has confirmed the absence of biological mechanisms associating mRNA vaccines with adverse effects in pregnancy and breastfeeding, although few studies have been carried out on their effect on fertility. While the Italian legal system provides for maternity protection measures and indemnity for vaccination damages pursuant to law no. 210/1992, it is not exempt from controversy. This contribution describes the state of play on COVID-19 vaccination in pregnant and lactating women, including: current recommendations for pregnant and lactating women; ethical issues related to vaccination hesitancy among pregnant women; the legislative paradox whereby sanctions may be imposed on women in certain professional categories who refuse vaccination because they are pregnant; and the possible legal consequences in the event of harm to the unborn child due to vaccination. All of this is considered in accordance with the principles of medical ethics, taking into account the national legislation.
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Affiliation(s)
- Roberto Scendoni
- Department of Law, Institute of Legal Medicine, University of Macerata, 62100 Macerata, Italy
| | | | - Mariano Cingolani
- Department of Law, Institute of Legal Medicine, University of Macerata, 62100 Macerata, Italy
- Correspondence:
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23
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Yin J, Wang Y, Tao L, Chen L, Liu P, Li R. Impact of vaccination against COVID-19 on the outcomes of in vitro fertilization-embryo transfer: a retrospective cohort study. Chin Med J (Engl) 2023; 136:207-212. [PMID: 36801859 PMCID: PMC10106135 DOI: 10.1097/cm9.0000000000002444] [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: 06/20/2022] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Vaccination against coronavirus disease 2019 (COVID-19) has become the primary approach in the fight against the spread of COVID-19. Studies have shown that vaccination against COVID-19 has adverse effects, particularly on human reproductive health, despite the fact that vaccination rates are still on the rise. However, few studies have reported whether vaccination affects the outcome of in vitro fertilization-embryo transfer (IVF-ET) or not. In this study, we compared the outcome of IVF-ET and the development of follicles and embryos between vaccinated and unvaccinated groups. METHODS A single-center retrospective cohort study of 10,541 in vitro fertilization (IVF) cycles was conducted from June 2020 to August 2021. 835 IVF cycles with a history of vaccination against COVID-19 and 1670 IVF cycles that served as negative controls were selected and analyzed utilizing the Matchlt package of R software ( http://www.R-project.org/ ) and the nearest neighbor matching algorithm for propensity-matched analysis at a 1:2 ratio. RESULTS The number of oocytes collected in the vaccinated group and the unvaccinated group were 8.00 (0, 40.00) and 9.00 (0, 77.00) ( P = 0.073) and the good-quality embryo rates of the two groups were 0.56±0.32 and 0.56±0.31 averagely ( P = 0.964). Clinical pregnancy rates for the vaccinated group and unvaccinated group were 42.4% (155/366) and 40.2% (328/816) ( P = 0.486) and biochemical pregnancy rates were 7.1% (26/366) and 8.7% (71/816) ( P = 0.355). Two other factors were analyzed in this study; vaccination among different genders and different types (inactivated vaccine or recombinant adenovirus vaccine) showed no statistically significant effect on the above outcomes. CONCLUSIONS In our findings, vaccination against COVID-19 showed no statistically significant effect on the outcomes of IVF-ET and the development of follicles and embryos, nor did the gender of the vaccinated person or the formulation of vaccines show significant effects.
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Affiliation(s)
- Jingwen Yin
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - Yang Wang
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing 100191, China
| | - Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China
| | - Lixue Chen
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing 100191, China
| | - Ping Liu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing 100191, China
| | - Rong Li
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing 100191, China
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24
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Ibroci E, Liu X, Lieb W, Jessel R, Gigase FAJ, Chung K, Graziani M, Lieber M, Ohrn S, Lynch J, Castro J, Marshall C, Tubassum R, Mutawakil F, Kaplowitz ET, Ellington S, Molenaar N, Sperling RS, Howell EA, Janevic T, Dolan SM, Stone J, De Witte LD, Bergink V, Rommel AS. Impact of prenatal COVID-19 vaccination on delivery and neonatal outcomes: Results from a New York City cohort. Vaccine 2023; 41:649-656. [PMID: 36526507 PMCID: PMC9749885 DOI: 10.1016/j.vaccine.2022.09.095] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 12/15/2022]
Abstract
Research suggest prenatal vaccination against coronavirus disease-19 (COVID-19) is safe. However, previous studies utilized retrospectively collected data or examined late pregnancy vaccinations. We investigated the associations of COVID-19 vaccination throughout pregnancy with delivery and neonatal outcomes. We included 1,794 mother-neonate dyads enrolled in the Generation C Study with known prenatal COVID-19 vaccination status and complete covariate and outcome data. We used multivariable quantile regressions to estimate the effect of prenatal COVID-19 vaccination on birthweight, delivery gestational age, and blood loss at delivery; and Poisson generalized linear models for Caesarean delivery (CD) and Neonatal Intensive Care Unit (NICU) admission. Using the above methods, we estimated effects of trimester of vaccine initiation on these outcomes. In our sample, 13.7% (n = 250) received at least one prenatal dose of any COVID-19 vaccine. Vaccination was not associated with birthweight (β = 12.42 g [-90.5, 114.8]), gestational age (β = 0.2 days [-1.1, 1.5]), blood loss (β = -50.6 ml [-107.0, 5.8]), the risks of CD (RR = 0.8; [0.6, 1.1]) or NICU admission (RR = 0.9 [0.5, 1.7]). Trimester of vaccine initiation was also not associated with these outcomes. Our findings suggest that there is no associated risk between prenatal COVID-19 vaccination and adverse delivery and neonatal outcomes in a cohort sample from NYC.
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Affiliation(s)
- Erona Ibroci
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Xiaoqin Liu
- National Centre for Register-based Research, Aarhus University, Aarhus 8000, Denmark
| | - Whitney Lieb
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA; Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York 10029, NY USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Rebecca Jessel
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Frederieke A J Gigase
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Kyle Chung
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Mara Graziani
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Molly Lieber
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Sophie Ohrn
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Jezelle Lynch
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Juliana Castro
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Christina Marshall
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Rushna Tubassum
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Farida Mutawakil
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Elianna T Kaplowitz
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Sascha Ellington
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta 30329, GA, USA
| | - Nina Molenaar
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Rhoda S Sperling
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA; Department of Medicine, Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Elizabeth A Howell
- Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia 109104, PA, USA
| | - Teresa Janevic
- Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York 10029, NY USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Siobhan M Dolan
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Joanne Stone
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Lotje D De Witte
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Veerle Bergink
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA
| | - Anna-Sophie Rommel
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York 10029, NY, USA.
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25
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Zhao Y, Zhao Y, Zhang Y, Li M, Su X, Zhou Y, Zhang Z, Jin L. Association of COVID-19 vaccination before conception with maternal thyroid function during early pregnancy: A single-center study in China. J Med Virol 2023; 95:e28245. [PMID: 36262113 PMCID: PMC9874602 DOI: 10.1002/jmv.28245] [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: 08/10/2022] [Revised: 10/03/2022] [Accepted: 10/17/2022] [Indexed: 01/28/2023]
Abstract
Despite the high vaccination coverage, potential COVID-19 vaccine-induced adverse effects, especially in pregnant women, have not been fully characterized. We examined the association between COVID-19 vaccination before conception and maternal thyroid function during early pregnancy. We conducted a retrospective cohort study in Shanghai, China. A total of 6979 pregnant women were included. Vaccine administration was obtained from electronic vaccination records. Serum levels of thyroid hormone were measured by fluorescence and chemiluminescence immunoassays. Among the 6979 included pregnant women, 3470 (49.7%) received at least two doses of an inactivated vaccine. COVID-19 vaccination had a statistically significant association with both maternal serum levels of free thyroxine (FT4) and thyroid stimulating hormone (TSH). Compared with unvaccinated pregnant women, the mean FT4 levels were lower in pregnant women who had been vaccinated within 3 months before the date of conception by 0.27 pmol/L (β = -0.27, 95% confidence interval [CI], -0.42, -0.12), and the mean TSH levels were higher by 0.08 mIU/L (β = 0.08, 95% CI, 0.00, 0.15). However, when the interval from vaccination to conception was prolonged to more than 3 months, COVID-19 vaccination was not associated with serum FT4 or TSH levels. Moreover, we found that COVID-19 vaccination did not significantly associate with maternal hypothyroidism. Our study suggested that vaccination with inactivated COVID-19 vaccines before conception might result in a small change in maternal thyroid function, but this did not reach clinically significant levels.
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Affiliation(s)
- Yan Zhao
- Shanghai Key Laboratory of Maternal‐Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Yongbo Zhao
- Shanghai Key Laboratory of Maternal‐Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Yijun Zhang
- Shanghai Key Laboratory of Maternal‐Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Mengyuan Li
- Shanghai Key Laboratory of Maternal‐Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Xin Su
- Shanghai Key Laboratory of Maternal‐Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Yicheng Zhou
- Shanghai Key Laboratory of Maternal‐Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Ziyi Zhang
- Shanghai Key Laboratory of Maternal‐Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Liping Jin
- Shanghai Key Laboratory of Maternal‐Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of MedicineTongji UniversityShanghaiChina
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26
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Boychuk AV, Yakymchuk YB, Shevchuk OО, Vari SG, Nikitina IM. PREGNANT WOMEN WITH COVID-19 AND PLACENTA ANGIOGENESIS. POLSKI MERKURIUSZ LEKARSKI : ORGAN POLSKIEGO TOWARZYSTWA LEKARSKIEGO 2023; 51:441-447. [PMID: 38069843 DOI: 10.36740/merkur202305101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
OBJECTIVE Aim of our research was to conduct a clinical and laboratory analysis of the impact of COVID-19 on pregnancy and the condition of the fetus. PATIENTS AND METHODS Materials and Methods: At the first stage, we conducted a retrospective examination of 50 pregnant women treated at Ternopil Municipal Hospital No.2 (Ukraine) between November 2020 and January 2022 with the history of COVID-19, confirmed by PCR test, and 25 pregnant COVID-19 negative pregnant women (control group). At the second stage, we performed prospective cohort study and involved 40 pregnant women treated with the history of COVID-19, confirmed by PCR, and 10 pregnant COVID-19 negative women with a physiological course of pregnancy as a control group.Women were divided into the following groups: group I -10 women diagnosed with COVID-19 during the first trimester of pregnancy: group II-15 women diagnosed during the second trimester; group III-15 women diagnosed during the third trimester. Ultrasound examination and cardiotocograms were performed to assess fetus status. Blood samples were collected at delivery. To determine whether COVID-19 could alter placental angiogenesis, vascular endothelial growth factor A (VEGFA), PlGF and interleuin-32-α were assessed. RESULTS Results: We identified that concentration of VEGFA was 95.30±5.65 pg/ml in control group. In women who had COVID-19 in first trimester, this index was 1.3 times higher, in second trimester 1.63 times higher and in third trimester by 2 times compared to control group. PlGF concentration was only 27,4 percent in group I, 16 percent in group II and 30 percent in group III,compared to control group. Concentration of interleuin-32-α was 67.27±5.63 pg/ml in control group and increased to 167 percent in group I, by 2.8 times in group II and by 6.3 times in group III compared to control group. CONCLUSION Conclusions: COVID-19 has a negative impact on placental angiogenesis, including VEGFA and PlGF. Fetal post-COVID-19 syndrome requires timely diagnosis of disorders and further study. Post-COVID-19 syndrome is an immune-dependent pathology in which the processes of protracted cytokine activation occur in the body of a pregnant woman.
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Affiliation(s)
- Alla V Boychuk
- I. HORBACHEVSKY TERNOPIL NATIONAL MEDICAL UNIVERSITY, TERNOPIL, UKRAINE
| | | | - Oksana О Shevchuk
- I. HORBACHEVSKY TERNOPIL NATIONAL MEDICAL UNIVERSITY, TERNOPIL, UKRAINE
| | - Sandor G Vari
- INTERNATIONAL RESEARCH AND INNOVATION IN MEDICINE PROGRAM, CEDARS-SINAI MEDICAL CENTER, LOS ANGELES, CA, USA
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Narasimhan S, Perry TL, Johnson LC. "I was having an internal conflict with myself." COVID-19 vaccination decision-making processes among pregnant women. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231218211. [PMID: 38130103 DOI: 10.1177/17455057231218211] [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] [Indexed: 12/23/2023]
Abstract
BACKGROUND Vaccination serves as an efficient primary means of control for infectious diseases. However, in the case of the COVID-19 pandemic, pregnant women within the United States had the lowest rates of COVID-19 vaccination and reported the lowest intent to vaccinate. OBJECTIVES To explore the decision-making process for COVID-19 vaccination for people pregnant during the pandemic. DESIGN A secondary analysis of data from a mixed-methods study that examined the impact of COVID-19 on experiences of prenatal care, birth support, and delivery in the Southern United States. METHODS This study used a descriptive phenomenological approach to thematically analyze in-depth interviews (n = 20) with adult women who were pregnant by January 2020 and had their prenatal care and delivery during the pandemic beginning in March 2020. The transcripts were de-identified, coded, and thematically analyzed to saturation to identify drivers of COVID-19 vaccine decision-making based on COVID-19 vaccination status and timing. Comparative analyses were conducted to assess differences in decision-making processes based on race/ethnicity and parity. Participants also completed a sociodemographic survey that included their COVID-19 vaccination status. RESULTS Two themes emerged, the weighing of parallel risks and priorities from different sources resulting in vaccine decisional conflict and the need to reconcile that conflict via multiple strategies. All participants weighed priorities and risks from multiple areas of their lives and described internal conflict around vaccination. Participants described tailoring decisions to household dynamics, reconciling public and private values around vaccination, and the impact of their identities on the decision-making process. While many described concerns over vaccine safety and fetal health, uniquely, many highlighted weighing the impact of prior pregnancy loss history, with some choosing other preventive measures like social distancing or mask-wearing, which they deemed less risky. CONCLUSION Pregnant people make complex COVID-19 vaccination decisions, which must be considered in future vaccine messaging and advocacy for this group.
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Affiliation(s)
- Subasri Narasimhan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Center for Reproductive Health Research in the Southeast, Emory University, Atlanta, GA, USA
| | - Tahira L Perry
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Leslie Cm Johnson
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA
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COVID-19 Vaccination Prioritization Strategies in Malaysia: A Retrospective Analysis of Early Evidence. Vaccines (Basel) 2022; 11:vaccines11010048. [PMID: 36679893 PMCID: PMC9861551 DOI: 10.3390/vaccines11010048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) that can cause extreme acute respiratory syndrome has posed a catastrophic threat to public health. The vaccines had indeed restored optimism and, after more than two years of battling the pandemic, there is renewed hope for the transition to endemicity. At the start of vaccination efforts, when supply shortages of vaccines were inevitable, every nation determined the high-risk population groups to be given priority for the COVID-19 vaccines. In this paper, the characteristics of the initial COVID-19 vaccine recipients in Malaysia are described. In line with the policies of many other countries, Malaysia firstly inoculated frontline healthcare workers, and subsequently the list of front liners grew to include defense and security personnel and those involved in the provision of essential services. People with disabilities or those with special needs and several underlying medical conditions that increased their risk of developing severe COVID-related illnesses were included in the priority categories. These included patients with severe lung disease, chronic heart disease, chronic kidney disease, chronic liver disease, neurological disease, diabetes mellitus and obesity in adults, splenic dysfunction, and severe mental illness. With little information and under circumstances of great uncertainty, the Health Ministry of a middle-income country had developed a vaccination priority-list based on the disease's epidemiology and clinical data, vaccine type, operational considerations, and risk evaluation. Early evidence was presented and suggested that the full vaccination with any of the three predominant vaccines (AZD1222, BNT162b2, and CoronaVac) in the country had been highly effective in preventing COVID-19 infections, COVID-19-related ICU admissions, and death. As many SARS-CoV-2 variants of concern (VoC), such as the Omicron BA.2/4/5, are emerging, future vaccination strategies may necessitate the need to change the immunogen of the vaccine, as well as considerations for when to give high-risk groups booster injections. These considerations are valuable for future planning by policymakers and healthcare providers to make vaccination policy and decisions, especially for the inclusion of the COVID-19 vaccines into national immunization programs.
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29
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Haghighi M, Khorasani A, Karimi P, Keshavarz R, Mahdavi M. Different Formulations of Inactivated SARS-CoV-2 Vaccine Candidates in Human Compatible Adjuvants: Potency Studies in Mice Showed Different Platforms of Immune Responses. Viral Immunol 2022; 35:663-672. [PMID: 36534465 DOI: 10.1089/vim.2022.0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Several inactivated SARS-CoV-2 vaccines have been approved for human use, but are not highly potent. In this study, different formulations of the inactivated SARS-CoV-2 virus were developed in Alum, Montanide 51VG, and Montanide ISA720VG adjuvants, followed by assessment of immune responses. The SARS-CoV-2 virus was inactivated with formalin and formulated in the adjuvants. BALB/c mice were immunized subcutaneously with 4 μg of vaccines on days 0 and 14; (IL-4) and (IFN-g), cytotoxic T lymphocyte (CTL) activity, and specific immunoglobulin G (IgG) titer and IgG1, IgG2a, and IgG2a/IgG1 ratio, and anti-receptor-binding domain (RBD) IgG response were assessed 2 weeks after the final immunization. Immunization with SARS-CoV-2-Montanide ISA51VG showed a significant increase in the IFN-γ cytokine versus SARS-CoV-2-Alum, SARS-CoV-2-Montanide ISA720VG, and control groups (p < 0.0033). Cytokine IL-4 response in SARS-CoV-2-Alum group showed a significant increase compared with SARS-CoV-2-Montanide ISA51VG, SARS-CoV-2-Montanide ISA720VG, and control groups (p < 0.0206). In addition, SARS-CoV-2-Montanide ISA51VG vaccine induced the highest IFN-γ/IL-4 cytokine ratio versus other groups (p < 0.0004). CTL activity in SARS-CoV-2-Montanide ISA51VG and SARS-CoV-2-Montanide ISA720VG groups showed a significant increase compared with SARS-CoV-2-Alum and control groups (p < 0.0075). Specific IgG titer in SARS-CoV-2-Montanide ISA51 VG and SARS-CoV-2-Montanide ISA720VG showed a significant increase compared with SARS-CoV-2-Alum and control groups (p < 0.0143). Results from specific IgG1and IgG2a in SARS-CoV-2-Alum, SARS-CoV-2-Montanide ISA51VG, and SARS-CoV-2-Montanide ISA720VG vaccine showed a significant increase compared with phosphate buffer saline (PBS) group (p < 0.0001), but SARS-CoV-2-Montanide ISA51VG and SARS-CoV-2-Montanide ISA 720VG groups showed the highest IgG2a/IgG1 ratio and a significant increase compared with SARS-CoV-2-Alum group (p < 0.0379). Moreover, inactivated SARS-CoV-2+Alum and SARS-CoV-2-Montanide ISA 720VG groups demonstrated a significant increase in anti-RBD IgG response versus the SARS-CoV-2-Montanide ISA51VG group. It seems that the type of vaccine formulation is a critical parameter, influencing the immunologic pattern and vaccine potency and human-compatible oil-based adjuvants were more potent than Alum adjuvant in the vaccine formulation.
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Affiliation(s)
- Melika Haghighi
- Department of FMD Vaccine Production, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Akbar Khorasani
- Department of FMD Vaccine Production, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Pegah Karimi
- Department of Biochemistry, Faculty of Basic Sciences, Islamic Azad University, Tehran, Iran
| | - Rouhollah Keshavarz
- PPD Tuberculin Department, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Mehdi Mahdavi
- Advanced Therapy Medicinal Product (ATMP) Department, Breast Cancer Research Center, Motamed Cancer Institute, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran.,Recombinant Vaccine Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Immunotherapy Group, The Institute of Pharmaceutical Science (TIPS), Tehran University of Medical Science, Tehran, Iran
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30
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Casey SM, Burrowes SAB, Hall T, Dobbins S, Ma M, Bano R, Yarrington C, Schechter-Perkins EM, Garofalo C, Drainoni ML, Perkins RB, Pierre-Joseph N. Healthcare workers' attitudes on mandates, incentives, and strategies to improve COVID-19 vaccine uptake: A mixed methods study. Hum Vaccin Immunother 2022; 18:2144048. [PMID: 36411988 DOI: 10.1080/21645515.2022.2144048] [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: 11/23/2022] Open
Abstract
Healthcare workers are a trusted health information source and are uniquely positioned to reduce the burden of the COVID-19 pandemic. The purpose of this sequential exploratory mixed methods study was to understand attitudes of healthcare workers working in Massachusetts during the COVID-19 pandemic regarding strategies to improve COVID-19 vaccine utilization, including vaccine mandates and incentives. Fifty-two individuals completed one-on-one interviews between April 22nd and September 7th, 2021. The survey was developed based on findings from the interviews; 209 individuals completed the online survey between February 17th and March 23rd, 2022. Both the interview and survey asked about attitudes toward COVID-19 vaccine and booster mandates, incentives, and strategies to improve vaccination rates. Most participants were female (79%-interview, 81%-survey), Caucasian (56%, 73%), and worked as physicians (37%, 34%) or nurses (10%, 18%). Overall, nuanced attitudes regarding vaccine and booster mandates were expressed; many supported mandates to protect their patients' health, others emphasized personal autonomy, while some were against mandates if job termination was the consequence of declining vaccines. Similarly, views regarding vaccine incentives differed; some considered incentives helpful, yet many viewed them as coercive. Strategies believed to be most effective to encourage vaccination included improving accessibility to vaccination sites, addressing misinformation, discussing vaccine safety, tailored community outreach via trusted messengers, and one-on-one conversations between patients and healthcare workers. Healthcare workers' experiences with strategies to improve utilization of COVID-19 vaccines and boosters have implications for public health policies. Generally, efforts to improve access and education were viewed more favorably than incentives and mandates.
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Affiliation(s)
- Sharon M Casey
- Department of Obstetrics and Gynecology, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Shana A B Burrowes
- Section of Infectious Diseases, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Taylor Hall
- Graduate of Medical Sciences, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Sidney Dobbins
- Epidemiology and Statistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Mengyu Ma
- Epidemiology and Statistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Ruqiyya Bano
- Epidemiology and Statistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Christina Yarrington
- Department of Obstetrics and Gynecology, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Elissa M Schechter-Perkins
- Department of Emergency Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Christopher Garofalo
- Department of Family Medicine and Department of Obstetrics and Gynecology, Sturdy Memorial Hospital, Attleboro, Massachusetts, USA.,Family Medicine Associates of South Attleboro, South Attleboro, Massachusetts, USA
| | - Mari-Lynn Drainoni
- Section of Infectious Diseases, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA.,Department of Health Law Policy & Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Rebecca B Perkins
- Department of Obstetrics and Gynecology, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Natalie Pierre-Joseph
- Department of Pediatrics, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
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Manca TA, Sadarangani M, Halperin SA, Langley JM, McClymont E, MacDonald SE, Top KA. Vaccine regulation should require and enforce the inclusion of pregnant and breastfeeding women in prelicensure clinical trials. Hum Vaccin Immunother 2022; 18:2104019. [PMID: 35880903 DOI: 10.1080/21645515.2022.2104019] [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: 12/15/2022] Open
Abstract
Exclusion of pregnant and breastfeeding women from the pivotal randomized controlled trials for COVID-19 vaccines that led to emergency regulatory approval created gaps in data needed for vaccine policy, healthcare provider recommendations, and women's decisions about vaccination. We argue that such knowledge gaps increase potential for vaccine hesitancy and misinformation relating to the health of women and infants, and that these gaps in evidence are avoidable. Over several decades, ethical and scientific guidance, scholarship, and advocacy in favor of pregnant and breastfeeding women's participation in clinical development of vaccines has accumulated. Guidance on how to include pregnant and breastfeeding women in vaccine trials ethically and safely predates the COVID-19 pandemic but has yet to be routinely incorporated in vaccine development. We highlight the important role regulatory authorities could play in requiring that pregnant and breastfeeding women be eligible as volunteer participants in prelicensure vaccine trials for products that are expected to be used in this population. Inclusion of pregnant and breastfeeding populations in clinical trials leading to market approval or emergency use authorization should be undertaken early or concurrently at the time of trials in the general population.
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Affiliation(s)
- Terra A Manca
- Canadian Center for Vaccinology, IWK Health, Nova Scotia Health and Dalhousie University, Halifax, Canada.,Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Scott A Halperin
- Canadian Center for Vaccinology, IWK Health, Nova Scotia Health and Dalhousie University, Halifax, Canada.,Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - Joanne M Langley
- Canadian Center for Vaccinology, IWK Health, Nova Scotia Health and Dalhousie University, Halifax, Canada
| | - Elisabeth McClymont
- Department of Pediatrics, University of British Columbia, Vancouver, Canada.,Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
| | - Shannon E MacDonald
- Faculty of Nursing, University of Alberta, Edmonton, Canada.,School of Public health, University of Alberta, Edmonton, Canada
| | - Karina A Top
- Canadian Center for Vaccinology, IWK Health, Nova Scotia Health and Dalhousie University, Halifax, Canada.,Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, Canada
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Patient-Guided Talking Points to Address COVID-19 and General Vaccine Hesitancy. PHARMACY 2022; 10:pharmacy10050137. [PMID: 36287458 PMCID: PMC9611272 DOI: 10.3390/pharmacy10050137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/10/2022] [Accepted: 10/13/2022] [Indexed: 11/25/2022] Open
Abstract
Vaccination remains one of the most effective ways to limit spread of disease. Waning public confidence in COVID-19 vaccines has resulted in reduced vaccination rates. In fact, despite vaccine availability, many individuals choose to delay COVID-19 vaccination resulting in suboptimal herd immunity and increased viral mutations. A number of qualitative and quantitative studies have been conducted to identify, understand, and address modifiable barriers and factors contributing to COVID-19 vaccine hesitancy among individuals with access to vaccine. Vaccine confidence may be improved through targeted patient–provider discussion. More patients are turning to pharmacists to receive their vaccinations across the lifespan. The primary goal of this commentary is to share evidence-based, patient talking points, tailored by practicing pharmacists, to better communicate and address factors contributing to vaccine hesitancy and reduced vaccine confidence.
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33
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Dellino M, Lamanna B, Vinciguerra M, Tafuri S, Stefanizzi P, Malvasi A, Di Vagno G, Cormio G, Loizzi V, Cazzato G, Tinelli R, Cicinelli E, Pinto V, Daniele A, Maiorano E, Resta L, De Vito D, Scacco S, Cascardi E. SARS-CoV-2 Vaccines and Adverse Effects in Gynecology and Obstetrics: The First Italian Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013167. [PMID: 36293746 PMCID: PMC9603573 DOI: 10.3390/ijerph192013167] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/03/2022] [Accepted: 10/11/2022] [Indexed: 05/15/2023]
Abstract
The most common effects reported by the Italian Medicine Agency following administration of SARS-CoV-2 vaccine are myalgia, soreness to the arm of inoculation, fever, and asthenia. To date, there are no specific and official reports registered by the Italian Medicine Agency on possible alterations of the menstrual cycle, or of the female reproductive system, following the vaccine. Actually, clinical experience showed a spread of transient adverse drug reactions of the menstrual cycle, following the administration of all COVID-19 vaccine types, both mRNA and Adenovirus vectored ones. In this work, we conducted the first retrospective study on Italian patients vaccinated for SARS-CoV-2 in the period between April 2021 and April 2022, to report the onset of menstrual changes after the vaccine in order to understand: etiology, duration of possible adverse effects, and the extent of the phenomenon. We recruited 100 women aged 18-45, vaccinated for SARS-CoV-2, who were asked to complete a questionnaire consisting of 12 multiple choice questions about the effects of the vaccine on the reproductive system. Thirty-seven of them received three doses of the vaccine, while the remaining 63 received two doses. Symptoms such as delayed menstruation and abnormal uterine bleeding (metrorrhagia, menometrorrhagia, and menorrhagia) were generally reported within the first three weeks of vaccination, especially after the second dose, with a percentage of 23% and 77%, respectively. These preliminary data suggest that this problem may be broader and deserving of further investigation in the future.
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Affiliation(s)
- Miriam Dellino
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
- Clinic of Obstetrics and Gynecology, “San Paolo” Hospital, ASL Bari, 70132 Bari, Italy
| | - Bruno Lamanna
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
- Fetal Medicine Research Institute, King’s College Hospital, London SE5 9RS, UK
| | - Marina Vinciguerra
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
| | - Silvio Tafuri
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
| | - Pasquale Stefanizzi
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
| | - Antonio Malvasi
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
| | - Giovanni Di Vagno
- Clinic of Obstetrics and Gynecology, “San Paolo” Hospital, ASL Bari, 70132 Bari, Italy
| | - Gennaro Cormio
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
| | - Vera Loizzi
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
| | - Gerardo Cazzato
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
- Department of Emergency and Organ Transplantation, Pathology Section, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Raffaele Tinelli
- Department of Obstetrics and Gynecology, “Valle d’Itria” Hospital, 74015 Martina Franca, Italy
| | - Ettore Cicinelli
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
| | - Vincenzo Pinto
- Department of Biomedical Sciences and Human Oncology, Obstetrics and Gynecology Section, Policlinic of Bari, University of Bari “Aldo Moro”, Piazza Aldo Moro, 70100 Bari, Italy
| | - Antonella Daniele
- Experimental Oncology, Center for Study of Heredo-Familial Tumors, IRCCS Istituto Tumori “Giovanni Paolo II” Bari, 70124 Bari, Italy
| | - Eugenio Maiorano
- Department of Emergency and Organ Transplantation, Pathology Section, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Leonardo Resta
- Department of Emergency and Organ Transplantation, Pathology Section, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Danila De Vito
- Department of Basic Medical Sciences and Neurosciences, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Salvatore Scacco
- Department of Basic Medical Sciences and Neurosciences, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy
- Correspondence: (S.S.); (E.C.)
| | - Eliano Cascardi
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
- Pathology Unit, FPO-IRCCS Candiolo Cancer Institute, Str. Provinciale 142 km 3.95, 10060 Candiolo, Italy
- Correspondence: (S.S.); (E.C.)
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Demir R, Kaya Odabaş R. A systematic review to determine the anti-vaccination thoughts of pregnant women and the reasons for not getting vaccinated. J OBSTET GYNAECOL 2022; 42:2603-2614. [PMID: 36018038 DOI: 10.1080/01443615.2022.2114327] [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: 01/06/2023]
Abstract
The aim of this study was to determine the anti-vaccination thoughts of pregnant women and the reasons for not getting vaccinated. In this study, data was obtained by retrospectively scanning the cross-sectional and qualitative studies published in the databases of 'PubMed, Cochrane, EBSCOhost, ULAKBİM and Google Scholar' in Turkish and English languages between 2011-2021. The PRISMA method was used in the preparation of the systematic review. In the studies reviewed, it was determined that the rate of pregnant women who were against the vaccine ranged from 6.2% to 98.6%, and the opinions of pregnant women against vaccination and the reasons for not getting vaccinated are presented under seven themes. The results of the study were considered important in terms of showing that quality and important studies were carried out in the literature on the subject and that the data were presented.IMPACT STATEMENTWhat is already known on this subject? Today, with the global coronavirus pandemic, vaccines and their effects are on the agenda again. Especially in pregnant women, opposition to vaccination and not getting vaccinated have emerged for various reasons.What do the results of this study add? The anti-vaccine thoughts of the pregnant women and the reasons for not getting vaccinated were mostly as follows: insufficient level of knowledge, mistrust of vaccines, perception of low infection risk, misconceptions and beliefs about the safety, content, side effects and efficacy of vaccines, worry and fear about the side effects of vaccines, the thought that the vaccine will harm herself and the baby, causes arising from healthcare professionals, financial, temporal and logistical barriers.What the implications are of these findings for clinical practice and/or further research? Scientific studies that can provide comprehensive and strong evidence about vaccine hesitancy and its causes, methods of increasing social approval in vaccination, and solutions should be proposed in the light of these researches in the fight against vaccine rejection.
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Affiliation(s)
- Rukiye Demir
- Department of Midwifery, Faculty of Health Sciences, Canakkale Onsekiz Mart University, Canakkale, Turkiye
| | - Resmiye Kaya Odabaş
- Department of Midwifery, Faculty of Health Sciences, Kocaeli University, Kocaeli, Turkiye
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35
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Mattocks KM, Kroll-Desrosiers A, Moore Simas TA, Bastian LA, Marteeny V, Walker L, Sheahan K, Elwy AR. Examining Pregnant Veterans' Acceptance and Beliefs Regarding the COVID-19 Vaccine. J Gen Intern Med 2022; 37:671-678. [PMID: 36042080 PMCID: PMC9427157 DOI: 10.1007/s11606-022-07588-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 04/01/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pregnant persons have received mixed messages regarding whether or not to receive COVID-19 vaccines as limited data are available regarding vaccine safety for pregnant and lactating persons and breastfeeding infants. OBJECTIVE The aims of this study were to examine pregnant Veteran's acceptance of COVID-19 vaccines, along with perceptions and beliefs regarding vaccine safety and vaccine conspiracy beliefs. DESIGN AND PARTICIPANTS We conducted a cross-sectional survey of pregnant Veterans enrolled in VA care who were taking part in an ongoing cohort study at 15 VA medical centers between January and May 2021. MAIN MEASURES Pregnant Veterans were asked whether they had been offered the COVID-19 vaccine during pregnancy, and whether they chose to accept or refuse it. Additional questions focused on perceptions of COVID-19 vaccine safety and endorsements of vaccine knowledge and conspiracy beliefs. Logistic regression was utilized to examine predictors of acceptance of a vaccine during pregnancy. KEY RESULTS Overall, 72 pregnant Veterans were offered a COVID-19 vaccine during pregnancy; over two-thirds (69%) opted not to receive a vaccine. Reasons for not receiving a vaccine included potential effects on the baby (64%), side effects for oneself (30%), and immunity from a past COVID-19 infection (12%). Those who received a vaccine had significantly greater vaccine knowledge and less belief in vaccine conspiracy theories. Greater knowledge of vaccines in general (aOR: 1.78; 95% CI: 1.2-2.6) and lower beliefs in vaccine conspiracies (aOR: 0.76; 95% CI: 0.6-0.9) were the strongest predictors of acceptance of a COVID-19 vaccine during pregnancy. CONCLUSIONS Our study provides important insights regarding pregnant Veterans' decisions to accept the COVID-19 vaccine, and reasons why they may choose not to accept the vaccine. Given the high endorsement of vaccine conspiracy beliefs, trusted healthcare providers should have ongoing, open discussions about vaccine conspiracy beliefs and provide additional information to dispel these beliefs.
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Affiliation(s)
- Kristin M Mattocks
- VA Central Western Massachusetts Healthcare System, Birch Building, Room 112, 421 North Main Street, Leeds, MA, 01053, USA. .,University of Massachusetts Medical School, Worcester, MA, USA.
| | - Aimee Kroll-Desrosiers
- VA Central Western Massachusetts Healthcare System, Birch Building, Room 112, 421 North Main Street, Leeds, MA, 01053, USA.,University of Massachusetts Medical School, Worcester, MA, USA
| | | | - Lori A Bastian
- VA Connecticut Healthcare System, West Haven, CT, USA.,Yale University School of Medicine, New Haven, CT, USA
| | - Valerie Marteeny
- VA Central Western Massachusetts Healthcare System, Birch Building, Room 112, 421 North Main Street, Leeds, MA, 01053, USA
| | - Lorrie Walker
- VA Central Western Massachusetts Healthcare System, Birch Building, Room 112, 421 North Main Street, Leeds, MA, 01053, USA
| | | | - A Rani Elwy
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, USA.,Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, MA, USA
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Asratie MH, Kassie BA, Belay DG, Endalew M, Gashaw M, Assegie GM. Perception of risk regarding the use of COVID-19 vaccine among pregnant women in Motta town and Hulet Eji Enese district, northwest Ethiopia. PLoS One 2022; 17:e0269591. [PMID: 36001590 PMCID: PMC9401104 DOI: 10.1371/journal.pone.0269591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 05/24/2022] [Indexed: 11/18/2022] Open
Abstract
Background COVID-19 vaccination during pregnancy is a common practice in developing countries like Ethiopia. Despite there being a rumor from the community that the use of COVID-19 vaccination during pregnancy is associated with many pregnancy adverse outcomes. However, there is a paucity of empirical evidence on the perception of risk COVID-19 vaccination during pregnancy in Ethiopia. This study assessed the perception of risk COVID-19 vaccination during pregnancy and associated factors in Motta town and Hulet Eji Enese district, northwest Ethiopia. Methods A community-based cross-sectional study was conducted from December 12 to February 12, 2021. A total of 851 women’ were selected using the stratified cluster sampling technique. Data were collected by face-to-face interview using a semi-structured pretested and interviewer-administered questionnaire. A multivariable logistic regression model was fitted to identify factors associated with the perception of risk COVID-19 vaccination during pregnancy. The adjusted odds ratio (AOR) with a 95% confidence interval at a p-value of ≤ 0.05 was used to declare the level of significance. Results Perception of risk COVID-19 vaccination during pregnancy was 34.2% (95%CI (Confidence Interval): 31–37). Unplanned pregnancy (AOR = 3.66; 95%CI: 2.31–5.81), long travel time to the nearby health care facility (AOR: 4.57; 95% CI: 2.34–8.91), have no formal education (AOR: 3.15; 95%CI: 1.71–5.79), attending secondary educational level (AOR: 5.18; 95% CI: 2.17–12.4), no ANC (Antenatal Care) service utilization (AOR: 7.07; 95% CI: 4.35–11.5) and negative attitude towards COVID-19 vaccination (AOR: 6.05; 95%CI: 3.88–9.43) were significantly associated with the perception of risk COVID-19 vaccination during pregnancy. Conclusions Most of the participants perceive COVID-19 vaccination during pregnancy as a risk for the outcome of pregnancy. Designing strategies to increase women’s educational status, promoting the need for maternal and child health services, and awareness creation regarding COVID-19 vaccination will have a great role in changing the perception of pregnant women. Therefore, the government should design public health programs targeting the identified factor, and should minimize the perception of risk acquiring infection from COVID-19 vaccine to improve maternal and neonatal health outcome.
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Affiliation(s)
- Melaku Hunie Asratie
- Department of Women’s and Family Health, School of Midwifery, College of Medicine and Health sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Belayneh Ayanaw Kassie
- Department of Women’s and Family Health, School of Midwifery, College of Medicine and Health sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Human Anatomy, College of medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mastewal Endalew
- Department of Environmental and Occupational Health, and Safety, Institute of Public Health, College of Medicine and Health sciences, University of Gondar, Gondar, Ethiopia
| | - Moges Gashaw
- Department of Physiotherapy, School of Medicine, College of Medicine and Health sciences, University of Gondar, Gondar, Ethiopia
| | - Getnet Melak Assegie
- Department of Economics, School of Economics and Management, University of Ferrara, Ferrara, Italy
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Adverse Events following Immunization with COVID-19 Vaccines: A Narrative Review. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2911333. [PMID: 36017393 PMCID: PMC9398801 DOI: 10.1155/2022/2911333] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/08/2022] [Accepted: 07/20/2022] [Indexed: 12/14/2022]
Abstract
Numerous COVID-19 vaccines are being administered to people around the world. Adverse events following immunization (AEFI) with COVID-19 vaccines have been reported by health care workers as well as surveillance bodies. A wealth of information on the efficacy and safety of vaccines exists in the literature, and the knowledge in this sector is growing exponentially. A narrative literature review was conducted on sources accessed from PubMed, Google Scholar, and Cochrane Review from March 2021 to July 2021. This review is aimed at describing AEFI associated with currently available COVID-19 vaccines, with an emphasis on narrating probable AEFI, and at assisting in a better understanding of the COVID-19 vaccines.
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Shakery Boroujeni M, Azizian M, Bahrami M, Kheradmand A, Tavoosi N, Rostamiyan Z, Forouharnejad K, Ahmadian S, Naamipouran I, Kiaei M. Immunoglobulin transmission to infants born to mothers with COVID-19. INTERNATIONAL JOURNAL OF PHYSIOLOGY, PATHOPHYSIOLOGY AND PHARMACOLOGY 2022; 14:267-271. [PMID: 36161256 PMCID: PMC9490207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 06/28/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND COVID-19 infection is a severe condition in pregnant women. Previous studies have suggested that anti-COVID-19 antibodies may be able to be transmitted from mother to fetus, which in itself is a protective factor in infants against the disease. However, few studies have been done in this area. In the present study, we aimed to investigate the presence of anti-COVID-19 antibodies in infants born to symptomatic and asymptomatic mothers with positive COVID-19 test. METHODS This is a cross-sectional study performed in 2021 in Abadan on neonates, born to symptomatic and asymptomatic mothers with positive COVID-19 test. All pregnant women over the age of 38 weeks with positive PCR tests for COVID-19 were included. We collected five cc of blood from the umbilical cord of neonates immediately after birth. The samples were sent to the laboratory in laboratory tubes to measure the anti-COVID-19 IgM and IgG levels. RESULTS We evaluated data of 20 neonates born to mothers with symptomatic COVID-19 and 10 neonates born to asymptomatic mothers with positive COVID-19 tests. In symptomatic groups, sixteen neonates (80%) had positive IgG antibodies and the mothers of all these neonates had positive antibodies. The mean IgG levels in infants was 73.26 ± 12.54 RU/ml and the mean IgM levels were 14.29 ± 3.71 RU/ml. Among neonates born to mothers with no symptoms, 7 neonates (70%) had positive IgG antibody. All mothers had positive antibodies. The mean IgG levels in infants were 74.50 ± 11.37 RU/ml and the mean IgM levels was 12.49 ± 2.88 RU/ml. There were no significant differences between two groups of neonates regarding positivity of IgG and antibody levels (P>0.05 for all). CONCLUSION 80% of infants born to mothers with COVID-19 pneumonia had positive IgG levels that were in line with the previous reports.
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Affiliation(s)
| | - Maryam Azizian
- School of Medicine, Kerman University of Medical SciencesKerman, Iran
| | - Mahshid Bahrami
- Department of Radiology, Isfahan University of Medical SciencesIsfahan, Iran
| | - Azin Kheradmand
- Department of Pathology, Shahid Beheshti University of Medical ScienceTehran, Iran
| | - Nooshin Tavoosi
- Department of Midwifery, School of Nursing and Midwifery, Islamic Azad University Shahrekord BranchShahrekord, Iran
| | - Zeynab Rostamiyan
- School of Medicine, Isfahan University of Medical SciencesIsfahan, Iran
| | | | - Sarina Ahmadian
- School of Medicine, Isfahan University of Medical SciencesIsfahan, Iran
| | - Iman Naamipouran
- Department of Immunology, Faculty of Medicine, Ahvaz Jundishapur University of Medical SciencesAhvaz, Iran
| | - Mehdi Kiaei
- Department of Anesthesiology, Abadan Faculty of Medical ScienceAbadan, Iran
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Briller JE, Aggarwal NR, Davis MB, Hameed AB, Malhamé I, Mahmoud Z, McDonald EG, Moraes de Oliveira G, Quesada O, Scott NS, Sharma J. Cardiovascular Complications of Pregnancy-Associated COVID-19 Infections. JACC: ADVANCES 2022; 1:100057. [PMID: 35967591 PMCID: PMC9364954 DOI: 10.1016/j.jacadv.2022.100057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/17/2022] [Accepted: 06/27/2022] [Indexed: 11/25/2022]
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Hagrass AI, Almadhoon HW, Al-Kafarna M, Almaghary BK, Nourelden AZ, Fathallah AH, Hasan MT, Mohammed YA, Al-Nabahin AO, Wafi DS, Ismail IO, Hamam YA, Sayad R, Hamouda M, Zaazouee MS, Ragab KM. Maternal and neonatal safety outcomes after SAR-CoV-2 vaccination during pregnancy: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2022; 22:581. [PMID: 35864455 PMCID: PMC9302221 DOI: 10.1186/s12884-022-04884-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/27/2022] [Indexed: 12/01/2022] Open
Abstract
Background and objective More than five million individuals died because of problems connected to COVID-19. SARS-Cov-2 poses a particular challenge to expectant mothers, who comprise one of the most vulnerable segments of the population. Our aim is to demonstrate the maternal and neonatal safety of the COVID-19 vaccine during pregnancy. Methods We searched PubMed, Cochrane Library, Scopus, Web of Science (WOS), Embase, Ovid, MedRxiv, and BioRxiv databases from inception till December 2021 and then updated it in April 2022. Additionally, we searched ClinicalTrials.gov, Research Square and grey literature. Cohort, case–control studies, and randomized controlled trials detecting the safety of the Covid-19 vaccine during pregnancy were included. We used the Cochrane tool and Newcastle–Ottawa Scale to assess the risk of bias of the included studies and the GRADE scale to assess the quality of evidence. A meta-analysis was conducted using review manager 5.4. Results We included 13 studies with a total number of 56,428 patients. Our analysis showed no statistically significant difference in the following outcomes: miscarriage (1.56% vs 0.3%. RR 1.23; 95%CI 0.54 to 2.78); length of maternal hospitalization (MD 0.00; 95%CI -0.08 to 0.08); puerperal fever (1.71% vs 1.1%. RR 1.04; 95%CI 0.67 to 1.61); postpartum hemorrhage (4.27% vs 3.52%. RR 0.84; 95%CI 0.65 to 1.09); instrumental or vacuum-assisted delivery (4.16% vs 4.54%. RR 0.94; 95%CI 0.57 to 1.56); incidence of Apgar score ≤ 7 at 5 min (1.47% vs 1.48%. RR 0.86; 95%CI 0.54 to 1.37); and birthweight (MD -7.14; 95%CI -34.26 to 19.99). Conclusion In pregnancy, the current meta-analysis shows no effect of SAR-CoV-2 vaccination on the risk of miscarriage, length of stay in the hospital, puerperal fever, postpartum hemorrhage, birth weight, or the incidence of an Apgar score of ≤ 7 at 5 min.
Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04884-9.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Aya Osama Al-Nabahin
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Al-Azhar University, Gaza, Palestine
| | - Dalia Sami Wafi
- Faculty of Medicine, Al-Quds University, Abu-Dies, Jerusalem, Israel
| | | | - Yaser Aref Hamam
- Faculty of Medicine, Al-Quds University, Abu-Dies, Jerusalem, Israel
| | - Reem Sayad
- Faculty of Medicine, Assiut University, Assiut, Egypt
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The impact of coronavirus on reproduction: contraceptive access, pregnancy rates, pregnancy delay, and the role of vaccination. F&S REVIEWS 2022; 3:190-200. [PMID: 35663280 PMCID: PMC9150907 DOI: 10.1016/j.xfnr.2022.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 05/20/2022] [Accepted: 05/25/2022] [Indexed: 11/28/2022]
Abstract
It is important to closely examine trends in reproduction during a pandemic because it provides not only the foundation for an improved future response but also crucial insights regarding the disparate impact across different races and socioeconomic classes. The coronavirus disease 2019 pandemic is a prime example of the impact a pandemic can have on a nation’s reproductive health. Contraception and abortion access became more difficult with more barriers to access, likely contributing to increasing unintended pregnancy rates. Underrepresented minorities and vulnerable populations were disproportionately affected by the virus on their reproductive health as well as by the virus itself. As the first ever messenger ribonucleic acid vaccine in conjunction with the lack of inclusion of pregnant and peripartum women in initial studies and conflicting and misinformation on social media, the initial role of the coronavirus disease 2019 vaccine in women of reproductive age was unclear. Further research inclusive of this group of women has led to the consensus by major medical societies to recommend vaccination of women regardless of pregnancy or lactating status. Examining these topics in depth will lead to the development of strategies that can be employed to mitigate the negative effects on reproductive health during the current pandemic and can also be applied to future strategic plans to prevent similar negative outcomes.
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The effect of COVID 19 vaccination on kidney recipients. Transpl Immunol 2022; 74:101658. [PMID: 35777613 PMCID: PMC9238056 DOI: 10.1016/j.trim.2022.101658] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/25/2022] [Accepted: 06/25/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Nearly one year from the onset of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, safe and effective vaccines began distribution around the world. This study aimed to assess the rate of COVID-19 disease among vaccinated kidney transplant patients and the types of symptoms found within them. DESIGN This cross-sectional study was performed at the transplant ward and Organ Procurement Unit of Sina Hospital, Tehran, Iran. As a sample size, 159 cadavers' kidney recipients received two doses of the Sinopharm SARS-CoV-2 vaccine. The required data were collected using a checklist via conducting a face-to-face interview. RESULTS The mean age of the vaccinated participants was 49.44 ± 13.87 years old. There were 73 (45.91%) vaccinated cases of SARS-CoV-2 infection during the study period, 18 cases (12.6%) occurred among fully vaccinated individuals, and 53 cases (33.3%) were among individuals who had received only one dose of vaccine. 45% of the fully vaccinated patients (received 2 doses vaccine) contracted SARS-CoV-2 from their families; 35% were infected through participation in social events (35%). There was a significant difference in disease severity levels between the fully vaccinated group and the one-dose vaccinated (p < 0.023). The severe disease occurred in 2 patients after vaccination, who were subsequently admitted to the hospital. There was a significant difference between the number of kidney transplant days and infection with SARS-CoV-2 before (P = 0.15) and after vaccination (p < 0.015). CONCLUSION Even after vaccination, kidney recipients are still at the risk of contracting SARS-CoV-2. In addition to these results, the efficacy of vaccination in preventing death caused by SARS-CoV-2 was confirmed.
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Laguila Altoé A, Marques Mambriz AP, Cardozo DM, Valentini Zacarias JM, Laguila Visentainer JE, Bahls-Pinto LD. Vaccine Protection Through Placenta and Breastfeeding: The Unmet Topic in COVID-19 Pandemic. Front Immunol 2022; 13:910138. [PMID: 35720385 PMCID: PMC9203883 DOI: 10.3389/fimmu.2022.910138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/09/2022] [Indexed: 01/10/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has turned pregnant women’s healthcare into a worldwide public health challenge. Although initial data did not demonstrate pregnancy as a more susceptible period to severe outcomes of acute severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) infection, there are an increasing number of reports showing that not only pregnant women might be at significantly higher risk than non-pregnant women by COVID-19 but also the fetus. These findings may be related to adaptive changes that occur during pregnancy, such as the reduction in the residual respiratory capacity, the decrease in viral immune responses, and the increased risk for thromboembolic events. Additionally, despite the SARS-CoV-2 vertical transmission evidence being uncommon, maternal illness severity might reflect serious perinatal and neonatal outcomes. Thus, protecting the maternal–fetal dyad against COVID-19 is critical. Even though pregnant women initially were excluded from vaccine trials, several studies have provided safety and efficacy of the overall vaccine COVID-19 platforms. Vaccination during pregnancy becomes a priority and can generate benefits for both the mother and newborn: maternal neutralizing antibodies are transmitted through the placenta and breastfeeding. Moreover, regarding passive immunization, human milk contains other bioactive molecules and cells able to modulate the newborn’s immune response, which can be amplified after the vaccine. Nonetheless, many issues remain to be elucidated, considering the magnitude of the protective immunity transferred, the duration of the induced immunity, and the optimal interval for pregnant immunization. In this review, we assessed these unmet topics supported by literature evidence regarding the vaccine’s immunogenicity, pregnancy immune heterogeneity, and the unique human milk antiviral features.
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Affiliation(s)
- Ariane Laguila Altoé
- Department of Basic Health Science, Laboratory of Immunogenetics, State University of Maringa, Maringa, Brazil
- Department of Medicine, State University of Maringa, Maringa, Brazil
| | - Anna Paula Marques Mambriz
- Department of Clinical Analysis and Biomedicine, Postgraduate Program in Biosciences and Physiopathology, State University of Maringa, Maringa, Brazil
| | | | - Joana Maira Valentini Zacarias
- Department of Basic Health Science, Laboratory of Immunogenetics, State University of Maringa, Maringa, Brazil
- Department of Clinical Analysis and Biomedicine, Postgraduate Program in Biosciences and Physiopathology, State University of Maringa, Maringa, Brazil
| | - Jeane Eliete Laguila Visentainer
- Department of Basic Health Science, Laboratory of Immunogenetics, State University of Maringa, Maringa, Brazil
- Department of Clinical Analysis and Biomedicine, Postgraduate Program in Biosciences and Physiopathology, State University of Maringa, Maringa, Brazil
| | - Larissa Danielle Bahls-Pinto
- Department of Basic Health Science, Laboratory of Immunogenetics, State University of Maringa, Maringa, Brazil
- *Correspondence: Larissa Danielle Bahls-Pinto,
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Literature Review of Mothers Diagnosed With COVID-19 and the Impact on Breastfeeding Their Newborns. Nurs Womens Health 2022; 26:234-241. [PMID: 35551888 PMCID: PMC9611848 DOI: 10.1016/j.nwh.2022.03.010] [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: 09/20/2021] [Revised: 03/04/2022] [Accepted: 03/29/2022] [Indexed: 01/09/2023]
Abstract
In early 2020, newborns were separated from their mothers who were diagnosed with COVID-19 infection. The purpose of this literature review is to examine the current evidence to determine if the transmission of COVID-19 infection to the neonate increases if newborns are directly breastfed by mothers who are positive for COVID-19 infection. There were 28 studies conducted in seven countries, with 10 of those studies conducted in the United States. In total, 5,123 neonates were born to mothers diagnosed with COVID-19, with 3,872 neonates determined to have been breastfed or provided mixed feeding including breast milk. Overall, 2.35% (91/3,872) of the newborns tested positive, and all recovered from COVID-19 infection. As frontline health care providers, nurses are instrumental in offering support and education on the risks and benefits of breastfeeding for individuals diagnosed with COVID-19.
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Gangi R, Corrias A, Pintus R, Marcialis MA, Fanos V. What to Expect from COVID-19 and from COVID-19 Vaccine for Expecting or Lactating Women. Pediatr Rep 2022; 14:262-275. [PMID: 35736656 PMCID: PMC9228525 DOI: 10.3390/pediatric14020034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/29/2022] [Accepted: 05/10/2022] [Indexed: 12/21/2022] Open
Abstract
Recent studies identified pregnancy as a high-risk condition for the development of maternal-fetal complications in the case of the SARS-CoV-2 infection. Therefore, the scientific community is now considering pregnant women a "fragile" category that should be vaccinated with high priority. The number of pregnant women undergoing hospitalization since summer 2021, including Intensive Care Unit admission, is growing, as well as the risk of preterm birth. Evidence from both animals and humans suggest that, similarly to other vaccines routinely administered in pregnancy, COVID-19 vaccines are not crossing the placenta, do not increase the risk of miscarriage, preterm birth, stillbirth, the birth of small gestational age neonates, as well as the risk of congenital abnormalities. To date, the World Health Organization and scientific literature are promoting and encouraging the vaccination of all pregnant and lactating women. The aim of our narrative review is to present the available literature regarding this issue with the aim to provide appropriate answers to the most frequent requests, doubts, and fears that have led many expecting and lactating women not to become vaccinated during this pandemic period.
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Affiliation(s)
- Roberta Gangi
- School of Pediatrics, University of Cagliari, 09124 Cagliari, Italy; (R.G.); (A.C.)
| | - Angelica Corrias
- School of Pediatrics, University of Cagliari, 09124 Cagliari, Italy; (R.G.); (A.C.)
| | - Roberta Pintus
- Department of Surgery, University of Cagliari and Neonatal Intensive Care Unit, AOU di Cagliari, 09124 Cagliari, Italy; (M.A.M.); (V.F.)
- Correspondence:
| | - Maria Antonietta Marcialis
- Department of Surgery, University of Cagliari and Neonatal Intensive Care Unit, AOU di Cagliari, 09124 Cagliari, Italy; (M.A.M.); (V.F.)
| | - Vassilios Fanos
- Department of Surgery, University of Cagliari and Neonatal Intensive Care Unit, AOU di Cagliari, 09124 Cagliari, Italy; (M.A.M.); (V.F.)
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The Benefits of Vaccination against SARS-CoV-2 during Pregnancy in Favor of the Mother/Newborn Dyad. Vaccines (Basel) 2022; 10:vaccines10060848. [PMID: 35746456 PMCID: PMC9228905 DOI: 10.3390/vaccines10060848] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/16/2022] [Accepted: 05/24/2022] [Indexed: 12/14/2022] Open
Abstract
When the first vaccines against SARS-CoV-2 emerged, pregnant women were excluded from clinical trials, so vaccine recommendations were initially adjourned, with late initiation for this populational category. The present study aims to quantify the serum and breastmilk values of SARS-CoV-2 spike protein antibodies in both the mother and her newborn after complete vaccination during pregnancy. Ninety-one vaccinated patients were included, some of whom presented COVID-19 infection during pregnancy. In the delivery room, venous blood was collected from the mother and umbilical cord blood from her offspring. All samples were processed using the ECLIA (electrochemiluminescence) method. Breastmilk was collected and tested during the third postnatal day. The highest maternal serum values were 19,523 U/mL (detection limit > 0.8 U/mL) and in breastmilk, 206.7 U/mL. Every single newborn had antibody values higher than 0, with a mean serum value (M = 5288.37, SD = 5661.49) significantly higher than 0, t(90) = 8.91, p < 0.001. Consequently, this study intents to emphasize the importance of vaccination against SARS-CoV-2 during pregnancy. This double kind of neonatal protection, attained by placental and breastmilk transfer, can be accomplished by encouraging vaccination, breastfeeding, bonding, and providing maternal empowerment to participate in her infant’s care.
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Priyadarshini S, Rath SK, Verma C, Das A. Poorer Obstetrics Outcomes During the Second Wave of COVID-19 in India. J Obstet Gynaecol India 2022; 72:402-408. [PMID: 35528222 PMCID: PMC9065234 DOI: 10.1007/s13224-022-01641-y] [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: 12/15/2021] [Accepted: 02/20/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Outcomes of pregnancy in COVID 19-infected mothers are worse than in the general population. Due to immunological changes, antenatal women are more vulnerable to severe complications. The India has experienced two waves of the disease. We analysed whether the second wave of the disease had affected pregnancy outcomes differently by comparing pregnancy outcomes with those of the first wave.
Materials and Method The study population included all the women delivered in the same tertiary centre during both the waves. Maternal outcome parameters include maternal oxygen requirement, maternal ICU admission and maternal death. Foetal outcome parameters include APGAR scores, preterm deliveries and NICU admissions, maternal and foetal outcome parameters between the first and the second waves were compared. Results Demographic parameters were similar in both the waves of COVID 19. No significant differences were found in pre-pregnancy comorbidities, high-risk pregnancies and mode of deliveries between the two waves. Maternal oxygen requirement increased in the second wave [first wave 6(4.7%) vs second wave 25(40.3%) (p-value < 0.001)]. There was also a significant increase in ICU admission [4(3.1%) vs 8(12.9%)], which was in positive correlation with maternal oxygen requirement during the second wave (r = 0.81, p < 0.001). However, there was no significant difference in maternal death [2(1.6%) vs 2(3.2%)]. No significant change noted in neonatal outcomes except for an increase in neonatal sepsis [0 vs 5(8.1%)]. Conclusion Mothers had more severe diseases during the second wave. But this did not translate into significant increase in maternal mortality and poor neonatal outcomes, possibly due to better preparedness.
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Affiliation(s)
- Subhadra Priyadarshini
- Research and Development, Kalinga Institute of Medical Science, KIIT Deemed to Be University, Bhubaneswar, Odisha India
| | - Sudhanshu Kumar Rath
- Department of Obstetrics and Gynecology, Kalinga Institute of Medical Science, KIIT Deemed to Be University, Bhubaneswar, Odisha India
| | - Chandini Verma
- Department of Obstetrics and Gynecology, Kalinga Institute of Medical Science, KIIT Deemed to Be University, Bhubaneswar, Odisha India
| | - Asima Das
- Department of Obstetrics and Gynecology, Kalinga Institute of Medical Science, KIIT Deemed to Be University, Bhubaneswar, Odisha India
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Odeh-Natour R, Shapira M, Estrada D, Freimann S, Tal Y, Atzmon Y, Bilgory A, Aslih N, Abu-Raya YS, Shalom-Paz E. Does mRNA SARS-CoV-2 vaccine in the follicular fluid impact follicle and oocyte performance in IVF treatments? Am J Reprod Immunol 2022; 87:e13530. [PMID: 35220640 PMCID: PMC9111235 DOI: 10.1111/aji.13530] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 02/15/2022] [Accepted: 02/19/2022] [Indexed: 01/09/2023] Open
Abstract
Problem The COVID‐19 pandemic has many clinical manifestations. Rapid vaccine development raised concerns and speculations about future fertility outcomes and vaccine safety. We evaluated the effect of Pfizer‐BioNTech mRNA SARS‐CoV‐2 vaccine on IVF treatment, oocyte and embryo quality, and pregnancy outcomes. Method of study This prospective, observational cohort study was conducted in a referral IVF Unit, 3/2021‐5/2021. We aimed to recruit all women undergoing IVF/ICSI cycles from 3/1–4/30/2021, 2‐8 weeks after the second vaccination, and to analyze 50–60 samples in the 2‐month period. Patients were categorized according to serum antibody levels: positive for spike (S), positive for nucleotide (N), or negative for both. On the day of ovum pick‐up, follicular fluid and blood samples were analyzed for anti‐nucleotide (anti‐N) antibodies, and anti‐spike (anti‐S) antibodies, hormonal profile, C‐reactive protein (CRP) and other metabolic parameters. Results Of 59 women enrolled, 37 reported being vaccinated and 22 were not. We found 97% correlation between anti‐S and anti‐N in the blood and the follicular fluid. Follicular fluid was analyzed based on antibody categorization. All IVF treatment parameters in the follicular fluids and serum were comparable, except CRP was significantly elevated among patients with anti‐N antibodies (2.29 [1.42–6.08] vs. 4.11 [1.62–5.75] vs. 1.44 [.36–8.33]; p < .001). Pregnancy outcomes were comparable (44% vs. 33% vs. 50%; p = .97). Conclusion mRNA SARS‐CoV‐2 vaccine did not appear to affect treatment outcomes or ovarian reserves in the subsequent IVF cycle.
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Affiliation(s)
- Rasha Odeh-Natour
- Laniado Hospital, Department of Obstetrics and Gynecology, Netanya, Israel
| | - Maanit Shapira
- Laboratory Division, Hillel Yaffe Medical Center, Hadera, Israel.,Ruth and Bruce Rappaport School of Medicine, The Technion-Institute of Technology, Haifa, Israel
| | - Daniela Estrada
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Sarit Freimann
- Laboratory Division, Hillel Yaffe Medical Center, Hadera, Israel
| | - Yana Tal
- Laboratory Division, Hillel Yaffe Medical Center, Hadera, Israel
| | - Yuval Atzmon
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Asaf Bilgory
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Nardin Aslih
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Yasmin Shibli Abu-Raya
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Einat Shalom-Paz
- Ruth and Bruce Rappaport School of Medicine, The Technion-Institute of Technology, Haifa, Israel.,IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
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49
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Simmons LA, Whipps MDM, Phipps JE, Satish NS, Swamy GK. Understanding COVID-19 vaccine uptake during pregnancy: 'Hesitance', knowledge, and evidence-based decision-making. Vaccine 2022; 40:2755-2760. [PMID: 35361501 PMCID: PMC8947956 DOI: 10.1016/j.vaccine.2022.03.044] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 03/02/2022] [Accepted: 03/18/2022] [Indexed: 11/30/2022]
Abstract
Background A key mitigation strategy to the COVID-19 pandemic has been the development and roll-out of vaccines. However, pregnant and lactating people were not included in initial vaccine trials and this population is hesitant to receive the vaccine, despite contrary recommendations from the American College of Obstetrics and Gynecology and the Centers for Disease Control and Prevention. Understanding the reasons behind this hesitancy is vital to promote vaccine uptake. Methods We surveyed pregnant people in California from December 2020 to January 2021 (n = 387) to describe cognitions and decision-making regarding COVID-19 vaccination. Using descriptive, regression-based analyses, we examined rates of planned uptake and reasoning among individuals who reported COVID-19 vaccine hesitancy. Results Overall, the pregnant Californians that we surveyed were aware of the COVID-19 vaccines. Of 387 participants, 43% reported planning to get the vaccine as soon as possible. The remaining 57% were hesitant: 27% responded that they would not receive the vaccine. Some demographic features did predict more COVID-19 vaccine hesitancy, particularly younger age (AOR = 0.95, p = 0.025) and living in a less urban context (AOR = 0.80, p = 0.041). Essential worker status also was associated with vaccine hesitancy. Having had, or intending to have, a flu vaccine was negatively associated with COVID-19 vaccine hesitancy (p < 0.001). The most commonly reported reason for COVID-19 vaccine hesitancy was “I don’t know enough about the vaccine.” Low levels of self-reported knowledge were highly predictive of hesitancy. Conclusions Terms like “vaccine hesitance” and “anti-vax” do not adequately characterize decisions regarding delaying COVID-19 vaccination. Rather, these decisions are largely based on the lack of knowledge about the impacts of vaccination on pregnancy, fetal development, and later child wellbeing. This lack of knowledge should be countered by conversations between individual healthcare providers and their pregnant patients, and better inclusion of pregnant people and children in vaccine trials.
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Affiliation(s)
- Leigh Ann Simmons
- University of California, Davis, Department of Human Ecology, Perinatal Origins of Disparities Center, 1 Shields Ave, Davis, CA 95616, United States.
| | - Mackenzie D M Whipps
- University of California, Davis, Department of Human Ecology, Perinatal Origins of Disparities Center, 1 Shields Ave, Davis, CA 95616, United States
| | - Jennifer E Phipps
- University of California, Davis, Department of Human Ecology, Perinatal Origins of Disparities Center, 1 Shields Ave, Davis, CA 95616, United States
| | - Nikita S Satish
- University of California, Davis, Department of Human Ecology, Perinatal Origins of Disparities Center, 1 Shields Ave, Davis, CA 95616, United States
| | - Geeta K Swamy
- Duke University School of Medicine, Department of Obstetrics and Gynecology, 40 Duke Medicine Circle, Durham, NC 27705, United States
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50
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Magnus MC, Örtqvist AK, Dahlqwist E, Ljung R, Skår F, Oakley L, Macsali F, Pasternak B, Gjessing HK, Håberg SE, Stephansson O. Association of SARS-CoV-2 Vaccination During Pregnancy With Pregnancy Outcomes. JAMA 2022; 327:1469-1477. [PMID: 35323851 PMCID: PMC8949721 DOI: 10.1001/jama.2022.3271] [Citation(s) in RCA: 79] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
IMPORTANCE Data about the safety of vaccines against SARS-CoV-2 during pregnancy are limited. OBJECTIVE To examine the risk of adverse pregnancy outcomes after vaccination against SARS-CoV-2 during pregnancy. DESIGN, SETTING, AND PARTICIPANTS This registry-based retrospective cohort study included 157 521 singleton pregnancies ending after 22 gestational weeks from January 1, 2021, until January 12, 2022 (Sweden), or January 15, 2022 (Norway). The Pregnancy Register in Sweden and the Medical Birth Registry of Norway were linked to vaccination and other registries for identification of exposure and background characteristics. EXPOSURES Data on mRNA vaccines-BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna)-and 1 viral vector vaccine-AZD1222 (AstraZeneca)-were collected from national vaccination registries. MAIN OUTCOMES AND MEASURES The risk of preterm birth and stillbirth was evaluated using Cox regression models, with gestational day as the time metric and vaccination as a time-dependent exposure variable. The risk of small for gestational age, low Apgar score, and neonatal care admission was evaluated using logistic regression. Random-effects meta-analysis was used to combine results between countries. RESULTS Among the 157 521 singleton births included in the study (103 409 in Sweden and 54 112 in Norway), the mean maternal age at the time of delivery was 31 years, and 28 506 (18%) were vaccinated against SARS-CoV-2 (12.9% with BNT162b2, 4.8% with mRNA-1273, and 0.3% with AZD1222) while pregnant. A total of 0.7%, 8.3%, and 9.1% of individuals delivering were vaccinated during the first, second, and third trimester, respectively. Vaccination against SARS-CoV-2 was not significantly associated with increased risk of preterm birth (6.2 vs 4.9 per 10 000 pregnancy days; adjusted hazard ratio [aHR], 0.98 [95% CI, 0.91 to 1.05]; I2 = 0%; P for heterogeneity = .60), stillbirth (2.1 vs 2.4 per 100 000 pregnancy days; aHR, 0.86 [95% CI, 0.63 to 1.17]), small for gestational age (7.8% vs 8.5%; difference, -0.6% [95% CI, -1.3% to 0.2%]; adjusted OR [aOR], 0.97 [95% CI, 0.90 to 1.04]), low Apgar score (1.5% vs 1.6%; difference, -0.05% [95% CI, -0.3% to 0.1%]; aOR, 0.97 [95% CI, 0.87 to 1.08]), or neonatal care admission (8.5% vs 8.5%; difference, 0.003% [95% CI, -0.9% to 0.9%]; aOR, 0.97 [95% CI, 0.86 to 1.10]). CONCLUSIONS AND RELEVANCE In this population-based study conducted in Sweden and Norway, vaccination against SARS-CoV-2 during pregnancy, compared with no SARS-CoV-2 vaccination during pregnancy, was not significantly associated with an increased risk of adverse pregnancy outcomes. The majority of the vaccinations were with mRNA vaccines during the second and third trimesters of pregnancy, which should be considered in interpreting the findings.
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Affiliation(s)
- Maria C. Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Anne K. Örtqvist
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Obstetrics and Gynecology, Visby County Hospital, Visby, Sweden
| | - Elisabeth Dahlqwist
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Rickard Ljung
- Swedish Medical Products Agency, Uppsala, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Fredrik Skår
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Laura Oakley
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ferenc Macsali
- Department of Health Registry Research and Development, Norwegian Institute of Public Health, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Björn Pasternak
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Håkon K. Gjessing
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Siri E. Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Olof Stephansson
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Women’s Health, Division of Obstetrics, Karolinska University Hospital, Stockholm, Sweden
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