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Çetin K, Sögüt SC. The relationship between vaccine hesitancy and health literacy in pregnant women: a cross-sectional study. BMC Womens Health 2024; 24:361. [PMID: 38907226 PMCID: PMC11191248 DOI: 10.1186/s12905-024-03148-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 05/15/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Pregnancy; It is an important process that directly affects the mother and the fetus, where women benefit more from health services and the need for health-related decision-making and information increases. It is very important to determine and improve the health literacy level of these women. The study determined the relationship between vaccine hesitancy and health literacy in pregnant women. METHODS It is a cross-sectional type of research. The research was carried out in a state hospital. The online form was sent to 230 pregnant women. Ethics committee, institution and scale permissions were obtained for the study. The data of the study were collected online by using the questionnaire prepared by scanning the literature, the Anti-Vaccination Scale and the Health Literacy Scale. Statistical analyzes of the data were performed using the SPSS version 25 program. RESULTS The Vaccine Hesitancy Scale score of the pregnant women was 55.53 ± 10.15, whereas their Health Literacy Scale score was 98.57 ± 21.48. Health literacy was associated with the sociodemographic and obstetric characteristics of the pregnant women. Educational status, economic status, place of residence, and family structure were associated with vaccine hesitancy. CONCLUSIONS It was determined that there was a negative correlation between the anti-vaccination scale scores of the pregnant women and the health literacy scale scores. As a result, it was determined that the anti-vaccination level of the pregnant women was moderate and the health literacy level was sufficient. It can be recommended to provide appropriate trainings and counseling to target groups, which will increase the health literacy level of pregnant women.
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Affiliation(s)
- Kübra Çetin
- Midwife, Tekirdag Dr. İsmail Fehmi Cumalıoğlu City Hospital, Tekirdağ, Turkey
| | - Seda Cangöl Sögüt
- Department of Midwifery, Faculty of Health Sciences, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
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Xie S, Monteiro K, Gjelsvik A. Influenza vaccine during pregnancy, recommendations from healthcare providers, and race/ethnicity in the United States. Arch Gynecol Obstet 2024:10.1007/s00404-023-07366-1. [PMID: 38300355 DOI: 10.1007/s00404-023-07366-1] [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: 11/22/2023] [Accepted: 12/26/2023] [Indexed: 02/02/2024]
Abstract
OBJECTIVES We examined racial/ethnic differences in the association between influenza vaccine recommendations from healthcare providers and maternal vaccination uptake. METHODS This cross-sectional study examined data from the Pregnancy Risk Assessment Monitoring System. We categorized respondents as non-Hispanic (NH) Whites, NH-Blacks, NH-Asians, American Indians/Alaska Natives, NH Other non-Whites, and Hispanics. We conducted multivariable logistical regression models to evaluate adjusted odds ratios (AOR) and 95% confidence intervals (CI). Covariates included maternal age, marital status, education, insurance status before pregnancy, the number of previous live births, the number of prenatal care visits, and smoking status during pregnancy. RESULTS The prevalences of receiving influenza vaccine recommendations from healthcare providers and maternal vaccine were 80.01% and 50.42%, respectively. NH-Blacks are less likely to receive provider recommendations (AOR = 0.82; 95%CI 0.77-0.87) and be vaccinated (AOR = 0.76; 95%CI 0.72-0.80) than NH-Whites. Receiving provider recommendations was significantly associated with increased maternal influenza vaccine uptake (AOR = 15.50; 95% CI 14.51-16.55). The associations were significant for all racial/ethnic groups, with the highest among NH-Asians (AOR = 22.04; 95% CI 17.88-27.16) and the lowest among NH Other non-Whites (AOR = 11.07; 95% CI 8.25-14.86). Within NH-Asians, effectiveness among Chinese was highest (AOR = 29.39; 95% CI 18.10-47.71). CONCLUSIONS Racial/ethnic disparities in maternal influenza vaccine uptake and receiving vaccine recommendations from healthcare providers persisted. Further studies on the racial/ethnic disparities in maternal vaccination were warranted and tailored strategies are required to reduce this health disparity.
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Affiliation(s)
- Shuai Xie
- School of Public Health, Brown University, Providence, RI, USA.
| | | | - Annie Gjelsvik
- School of Public Health, Brown University, Providence, RI, USA
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Cubizolles C, Barjat T, Chauleur C, Bruel S, Botelho-Nevers E, Gagneux-Brunon A. Evaluation of intentions to get vaccinated against influenza, COVID 19, pertussis and to get a future vaccine against respiratory syncytial virus in pregnant women. Vaccine 2023; 41:7342-7347. [PMID: 37957038 DOI: 10.1016/j.vaccine.2023.10.067] [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: 04/25/2023] [Revised: 08/13/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023]
Abstract
INTRODUCTION Pregnant women (PW) are at increased risk of complications due to seasonal influenza and Covid-19. Immunization during pregnancy against pertussis and respiratory syncytial virus (RSV) protects newborns from severe diseases. Our aim was to assess intentions to get vaccinated against seasonal influenza, COVID-19, pertussis and RSV in PW and to identify factors associated with intentions. METHODS Cross-sectional survey in PW followed at a University Hospital in France assessing their knowledge, and attitudes toward vaccination against influenza, Covid-19, and RSV during pregnancy. Primary outcome was intention to receive each vaccine or potential vaccine. Univariable and multivariable analysis were carried out to identify factors associated with intentions to get vaccinated for each vaccine. RESULTS Among the 1199 PW followed during the study period, 310 completed the questionnaire. Intentions to get vaccinated were respectively 43.9 %, 36.8 %, 36.1 % and 39.4 % against influenza, Covid-19, pertussis and RSV. Overall confidence in vaccines using 5C-model, recommendation by a healthcare professional (HCP), good knowledge about diseases and vaccines and previous influenza vaccination were associated with flu vaccine acceptance with respective adjusted odds ratios and 95 % Confidence Intervals (aOR) 1.69 (1.09-2.61) by one-point increase in confidence score, 4.89 (2.24-10.7), 1.56 by one-point increase in knowledge score (1.26-1.93), 13.5 and (5.3-34.3). Confidence was also associated with Covid-19 and RSV vaccine acceptance with respective aOR and 95 % CI 2.63 (1.7-4.07) and 1.92 (1.3-2.84). For pertussis, previous flu vaccination or pertussis vaccination in the last 5 years were predictors of pertussis vaccine acceptance during the pregnancy with respective aOR and 95 % CI 1.97 (1.1-3.84) and 2.9 (1.6-5.18). CONCLUSION Confidence is associated with seasonal influenza, COVID-19 and RSV vaccines acceptance in pregnant women. Receiving a recommendation from a HCP was strongly associated with acceptance of influenza vaccine. Recent vaccination against pertussis was not a barrier to pertussis vaccine acceptance during pregnancy.
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Affiliation(s)
- Charlotte Cubizolles
- Department of General Practice, Faculty of Medicine Jacques Lisfranc, University of Lyon, Saint-Etienne, France
| | - Tiphaine Barjat
- Department of Gynecology and Obstetrics, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne, France; INSERM U1059 SAINBIOSE, Université Jean Monnet, Saint-Étienne, France
| | - Céline Chauleur
- Department of Gynecology and Obstetrics, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne, France; INSERM U1059 SAINBIOSE, Université Jean Monnet, Saint-Étienne, France
| | - Sébastien Bruel
- Department of General Practice, Faculty of Medicine Jacques Lisfranc, University of Lyon, Saint-Etienne, France; CIC INSERM 1408, CHU de Saint-Etienne, France
| | - Elisabeth Botelho-Nevers
- Service d'Infectiologie, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France; Groupe Immunité des Muqueuses et Agents Pathogènes, EA 3064, Université Jean-Monnet, Université de Lyon, CHU de Saint-Étienne, 42000 Saint-Étienne, France; CIC INSERM 1408, CHU de Saint-Etienne, France; Centre International de Recherche en Infectiologie, Team GIMAP, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, France; Chaire PREVACCI, Institut PRESAGE, Université Jean Monnet, Saint-Etienne, France
| | - Amandine Gagneux-Brunon
- Service d'Infectiologie, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France; CIC INSERM 1408, CHU de Saint-Etienne, France; Centre International de Recherche en Infectiologie, Team GIMAP, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, France; Chaire PREVACCI, Institut PRESAGE, Université Jean Monnet, Saint-Etienne, France.
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Hong EY, Kulkarni K, Gosavi A, Wong HC, Singh K, Kale AS. Assessment of knowledge and attitude towards influenza and pertussis vaccination in pregnancy and factors affecting vaccine uptake rates: a cross-sectional survey. Singapore Med J 2023; 64:513-516. [PMID: 34544209 PMCID: PMC10476924 DOI: 10.11622/smedj.2021097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 06/22/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Eliane Yuting Hong
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Kanaka Kulkarni
- School of Medicine, University of Leeds, Leeds, England, United Kingdom
| | - Arundhati Gosavi
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Hung Chew Wong
- Biostatistics Unit, Research Support Unit, National University Health System, Singapore
| | - Kuldip Singh
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Anita Sugam Kale
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
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Dhakal R, Shapkota S, Shrestha P, Adhikari P, Nepal S. Pregnant women's awareness, perception, and acceptability of COVID-19 vaccine attending antenatal clinics in Bharatpur, Nepal. PLoS One 2023; 18:e0278694. [PMID: 36920992 PMCID: PMC10016669 DOI: 10.1371/journal.pone.0278694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 11/21/2022] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Vaccine is the cost-effective and reliable public health intervention to combat the emerging COVID-19 pandemic. The vaccination is considered safe and effective at any stage of pregnancy; however, pregnant women show more vaccine hesitation than the general population. This study aims to assess pregnant women's awareness, perception, and acceptability of COVID-19 vaccine attending antenatal clinics. METHODS An institutional-based cross-sectional analytical study design was used to assess the acceptance of the COVID-19 vaccine and associated factors among pregnant women between Feb-1 to March-30-2022 at antenatal clinics of Bharatpur Chitwan using systematic random sampling. A semi-structured interview schedule was used to collect data from 644 respondents. Collected data were analysed using descriptive and inferential statistics like the Pearson chi-square test and logistic regression analysis. RESULTS The COVID-19 vaccine acceptance was found to be 22% and ethnicity (AOR = 1.826; 95% CI = 1.215-2.745), education level (AOR = 1.773; 95%CI = 1.025-3,068;), history of COVID-19 infection (AOR = 3.63; 95% CI = 1.323-9.956;), number of child (AOR = 5.021; 95% CI 1.989-12.677;), trimester (week of pregnancy) (AOR = 2.437; 95% CI 1.107-5.366) and level of perception (AOR = 2.152; 95% CI 1.109-4.178) were found to be statistically significant for acceptance of COVID-19 vaccine among pregnant mother. CONCLUSIONS In this study, low levels of vaccine acceptance were found. Several influential factors like occupation, history of COVID-19 infection, number of pregnancies, week of gestation, and level of attitude were found to be significant for acceptance of COVID-19 vaccine among pregnant women. Everyone needs vaccine acceptance to get herd immunity and reduce the COVID-19 infection. But Vaccine hesitancy is one of the significant threats to the COVID-19 rollout and successful pandemic mitigation. Therefore, properly disseminating information and removing misperceptions about the COVID-19 vaccine is necessary to raise the acceptance.
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Affiliation(s)
- Radha Dhakal
- Department of Nursing, Shree Medical and Technical College, Bharatpur Chitwan, Nepal
- * E-mail:
| | - Sushma Shapkota
- Department of Public Health, Shree Medical and Technical College, Bharatpur Chitwan, Nepal
| | - Parita Shrestha
- Department of Nursing, Chitwan Medical College, Bharatpur Chitwan, Nepal
| | - Prativa Adhikari
- Department of Nursing, Chitwan Medical College, Bharatpur Chitwan, Nepal
| | - Shobhana Nepal
- Department of Nursing, Shree Medical and Technical College, Bharatpur Chitwan, Nepal
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Kaya Odabaş R, Demir R, Taspinar A. Knowledge and attitudes of pregnant women about Coronavirus vaccines in Turkiye. J OBSTET GYNAECOL 2022; 42:3484-3491. [PMID: 36369924 DOI: 10.1080/01443615.2022.2144174] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this cross-sectional study was to determine pregnant women's knowledge and attitudes regarding coronavirus vaccines in Turkiye. The research population consisted of 400 pregnant women who applied to a public hospital in this city. The data of the study was collected with the 'Personal Information Form' and 'Attitudes Towards COVID-19 Vaccine Scale'. Only 2% of the pregnant women stated that they wanted to receive coronavirus vaccines in their current pregnancy and 9.5% wanted it during the postpartum period. It has been concluded that the vast majority of pregnant women have insufficient knowledge and negative thoughts about coronavirus vaccines and the place where they live and their thoughts on the safety of coronavirus vaccines affect their positive attitudes about coronavirus vaccines.IMPACT STATEMENTWhat is already known on this subject? Many epidemics in history have been controlled or eliminated with vaccines. However, there is still insufficient evidence about the effects of coronavirus infection and vaccines on pregnant women.What do the results of this study add? As a result, it was found that the vast majority of pregnant women had insufficient knowledge and negative thoughts about coronavirus vaccines and very few of them wanted to receive the coronavirus vaccine during pregnancy and the postpartum period.What are the implications of these findings for clinical practice and/or further research? In the light of these findings, it is recommended that increase the vaccination rates in pregnant women by turning existing negative attitudes towards coronavirus vaccines in pregnant women into positive ones, providing accurate and effective information by health professionals and the media to eliminate negative attitudes caused by lack of information in pregnant women, conducting more studies on obstacles to increasing vaccine acceptance during pregnancy, and conducting studies on the subject with wider audiences and regions.
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Affiliation(s)
| | - Rukiye Demir
- Faculty of Health Sciences, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Ayten Taspinar
- Faculty of Health Sciences, Aydın Adnan Menderes University, Aydın, Turkey
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Chong CY, Tan NWH, Yung CF, Li J, Kam KQ, Nadua K, Maiwald M, Sultana R, Thoon KC. Effectiveness of maternal pertussis vaccination in Singapore: A test-negative case-control study. Vaccine 2022; 40:6570-6574. [PMID: 36216649 DOI: 10.1016/j.vaccine.2022.09.087] [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: 03/28/2022] [Revised: 08/15/2022] [Accepted: 09/28/2022] [Indexed: 01/27/2023]
Abstract
Pertussis vaccination (Tdap -Tetanus-diphtheria-acellular pertussis) for pregnant women has been recommended since November 2017 in Singapore. In this prospective test-negative case-control study from 2018 to 2019, we aimed to evaluate vaccine effectiveness (VE) against pertussis infection and pertussis-related intensive care unit (ICU) admission according to Tdap (Tetanus-diphtheria-acellular pertussis) during pregnancy and/or infant pertussis vaccination. A total of 58 children (26 cases, 32 controls) were recruited with 4 ICU admissions. The median age was 3 months (interquartile range [IQR] 1.50-4.56 months). Overall, 25.9 % of mothers had received antenatal Tdap vaccination and 43.1 % of infants received pertussis vaccination, majority only 1 dose. Tdap in pregnancy alone without infant vaccine or with 0-1 infant dose had a VE of 97.62 % (95 % confidence interval [CI] 53.25-99.88 %), 98.17 % (95 %CI 66.61-99.9 %) respectively, against pertussis infection and 71.9 % (95 %CI 0.0-98.64), 75.86 % (95 % CI 0.0-98.78) respectively, against ICU admissions. Conclusion: Maternal Tdap vaccination was highly protective against infant pertussis and should be routinely recommended for all pregnant women.
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Affiliation(s)
- Chia-Yin Chong
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore; Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore 308232, Singapore.
| | - Natalie Woon-Hui Tan
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore; Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore 308232, Singapore.
| | - Chee-Fu Yung
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore; Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore 308232, Singapore.
| | - Jiahui Li
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore; Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore 308232, Singapore.
| | - Kai-Qian Kam
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore; Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore 308232, Singapore.
| | - Karen Nadua
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore; Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore 308232, Singapore.
| | - Matthias Maiwald
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore; Department of Microbiology and Immunology, National University of Singapore, 5 Science Drive 2, Singapore 117545, Singapore.
| | - Rehena Sultana
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore.
| | - Koh Cheng Thoon
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore; Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore 308232, Singapore.
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Knowledge attitudes and practices toward seasonal influenza vaccine among pregnant women during the 2018/2019 influenza season in Tunisia. PLoS One 2022; 17:e0265390. [PMID: 35316299 PMCID: PMC8939791 DOI: 10.1371/journal.pone.0265390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 03/01/2022] [Indexed: 11/20/2022] Open
Abstract
Background The uptake and acceptance of the influenza vaccine (IV) among pregnant women remain unknown in Tunisia despite the increased influenza-related complications and death. The present study aimed to assess the IV uptake and acceptability and to describe related knowledge and attitudes among pregnant women in Tunisia. Methods A cross-sectional study was conducted in 84 Tunisian healthcare facilities over a period of three months (from March to May 2019). All pregnant women aged ≥18 years who sought antenatal care in related health structures were included in this study based on a multistage self-weighted sampling. We measured knowledge and attitudes towards the IV and assessed factors related to willingness for its uptake. Results The questionnaire was completed by 1157 pregnant women. More than half of the participants (60.2%; 95% confidence interval [CI] [57.3%–63.0%]) reported awareness about the IV. Among included PW, only 4.6%; 95% CI [3.5%–6.1%] received it during their current pregnancy. However, (36.8%; 95% CI [34.0%–39.6%]) declared their willingness to receive the vaccine in the next pregnancy. Recommendation by healthcare providers, identified to be the most trustful source of information, was the main reason for acceptance. However, the intention to accept the IV by pregnant women was significantly associated with such recommendation and perceived safety and effectiveness of this vaccine. Conclusion Antenatal care visits are a precious opportunity that should not be missed by health care providers and especially gynecologists to promote the IV uptake by pregnant women in Tunisia.
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Corbeau M, Mulliez A, Chenaf C, Eschalier B, Lesens O, Vorilhon P. Trends of influenza vaccination coverage in pregnant women: a ten-year analysis from a French healthcare database. Sci Rep 2022; 12:7153. [PMID: 35505069 PMCID: PMC9062868 DOI: 10.1038/s41598-022-11308-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 03/11/2022] [Indexed: 11/09/2022] Open
Abstract
Pregnant women have a high risk of severe influenza, associated with obstetrical complications. The World Health Organization (WHO) has recommended influenza vaccination for all pregnant women since 2012. The vaccination coverage remains low worldwide, and in Europe, due to a lack of proposition from the health care providers, and a high refusal rate from the women. The primary aim of this study was to estimate the influenza vaccination coverage (IVC) in a population of pregnant women in France, and to analyse its evolution from 2009 to 2018. The secondary objective was to describe the vaccinated population and to find determinants associated with the vaccination. This retrospective cohort study is based on the EGB French health care database, a representative sample of the French population containing data from the health insurance system. All pregnant women who delivered medically or spontaneously over the 2009–2018 period were included. In the 2009–2018 period, only 1.2% pregnant women were vaccinated against influenza (n = 875/72,207; 95% CI 1.14–1.30). The IVC slightly increased after the 2012 WHO recommendation, from 0.33 to 1.79% (p < 0.001) but remained extremely low (4.1% in 2018). Women younger than 25 years old had a low coverage (0.6%) whereas women over 35 years old were more likely to get the influenza vaccine (1.7%; OR: 2.82, 95% CI 2.14–3.71). The vaccination behavior was not influenced by multifetal pregnancy or parity, but socio-economically deprived women were less likely to be vaccinated (OR: 0.81, 95% CI: 0.67–0.98). Women with pre-existing medical conditions had an overall higher vaccination rate (2.5%; OR: 2.32, 95% CI: 1.94–2.77). The vaccine was mainly prescribed by family physicians (58%). Influenza vaccination in pregnant women in France remains very low, particularly in younger, healthy women, and measures such as information campaigns towards pregnant women and studies of the knowledge, attitudes, and practices of the health care professionals need to be undertaken to improve the coverage.
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Affiliation(s)
- Mélodie Corbeau
- Department of General Practice, Faculty of Medicine, University Clermont Auvergne, 28 Place Henri Dunant, 63001, Clermont-Ferrand, France
| | - Aurélien Mulliez
- Biostatistics Unit (Clinical Research and Innovation Department), University Hospital Clermont-Ferrand, Clermont-Ferrand, France
| | - Chouki Chenaf
- Service de Pharmacologie Médicale, Centres Addictovigilance et Pharmacovigilance, Université Clermont Auvergne, CHU Clermont-Ferrand, Clermont-Ferrand, France.,Université Clermont Auvergne, INSERM, U1107 "Neuro-Dol", Clermont-Ferrand, France
| | - Bénédicte Eschalier
- Department of General Practice, Faculty of Medicine, University Clermont Auvergne, 28 Place Henri Dunant, 63001, Clermont-Ferrand, France
| | - Olivier Lesens
- Infectious and Tropical Diseases Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Philippe Vorilhon
- Department of General Practice, Faculty of Medicine, University Clermont Auvergne, 28 Place Henri Dunant, 63001, Clermont-Ferrand, France. .,Biostatistics Unit (Clinical Research and Innovation Department), University Hospital Clermont-Ferrand, Clermont-Ferrand, France. .,Université Clermont Auvergne, ACCePPT, Clermont-Ferrand, France.
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Alhendyani F, Jolly K, Jones LL. Views and experiences of maternal healthcare providers regarding influenza vaccine during pregnancy globally: A systematic review and qualitative evidence synthesis. PLoS One 2022; 17:e0263234. [PMID: 35143531 PMCID: PMC8830613 DOI: 10.1371/journal.pone.0263234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 01/17/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The World Health Organization (WHO) recommends that pregnant women receive influenza vaccination; however, uptake of the vaccine remains low. Maternity health care professionals (MHCPs) play an important role in motivating pregnant women to receive the influenza vaccine. However, factors such as MHCPs' views and knowledge about the vaccine, and time constraints due to workload may influence MHCPs' practices and opinions about women receiving the influenza vaccine during pregnancy. To date, the qualitative evidence exploring MHCPs' views and experiences around influenza vaccine uptake in pregnant women has not been synthesised. AIM To systematically review and thematically synthesise qualitative evidence that explores the views and experiences of MHCPs involved in the provision of the maternal influenza vaccine worldwide. METHODS Five databases (MEDLINE, EMBASE, PsycINFO, CINAHL, Web of Science) were searched, supplemented with searches of included paper reference lists and grey literature. Study selection was conducted by up to three researchers applying pre-specified inclusion/exclusion criteria. Quality assessment was undertaken, data were extracted, coded and synthesised to develop descriptive and analytical themes. RESULTS Eight studies involving 277 participants were included. Seventeen descriptive themes were interpreted, embedded within six analytical themes. MHCPs perceived that maternal influenza vaccination delivery can be facilitated by trusting relationships, good communication, knowledge about the vaccine leading to confidence in recommending vaccine, electronic vaccination prompts, and presence of national guidelines. However, workload, time constraints, MHCP's perception of pregnant women's concerns, and social/cultural/environmental influences could prevent the likelihood of delivery of influenza vaccine. Knowledgeable MHCPs who were regularly updated about vaccination based on scientific evidence were more confident when discussing and recommending the influenza vaccine to pregnant women. In addition, the presence of national policies and guidelines and electronic prompts for maternal influenza vaccination would enhance the delivery of the vaccine. CONCLUSION Our findings suggest that approaches to enhance the vaccination uptake rate in pregnant women include addressing MHCPs barriers to discussing influenza vaccination through education, sufficient time for discussions, and electronic prompts about vaccination, as well as evidence based local and national guidelines.
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Affiliation(s)
- Fatemah Alhendyani
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- Department of Public Health, Ministry of Health, Kuwait, State of Kuwait
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Laura L. Jones
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
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Hibshi AM, Fallatah AN, AlOwid FK, AlHarbi NM, AlJohani SS, AlEnazi AF, AlAlawi DK. Comparison of Vaccine Acceptance between COVID- 19 and Seasonal Influenza among Pregnant Women, in Saudi Arabia. INTERNATIONAL JOURNAL OF PHARMACEUTICAL RESEARCH AND ALLIED SCIENCES 2022. [DOI: 10.51847/yplotdoc0c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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12
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Ledlie S, Gandhi‐Banga S, Shrestha A, Mallett Moore T, Khromava A. Exposure to quadrivalent influenza vaccine during pregnancy: Results from a global pregnancy registry. Influenza Other Respir Viruses 2022; 16:90-100. [PMID: 34520127 PMCID: PMC8692812 DOI: 10.1111/irv.12897] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 08/05/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The Fluzone® Quadrivalent (IIV4, Sanofi Pasteur) Pregnancy Registry was created to monitor vaccine safety during pregnancy (clinicaltrials.gov, NCT01945424). Here, we describe maternal, pregnancy, obstetrical and neonatal outcomes after vaccine exposure in pregnant women between August 2013 and September 2019. METHODS All women exposed to IIV4 during their pregnancy were eligible for inclusion. Outcomes were prospective (reported following vaccine exposure but before knowledge of pregnancy outcome ascertained through prenatal tests) or retrospective (prenatal tests were undertaken before the exposure was reported). RESULTS Among 239 IIV4 vaccine exposure reports received, there were 105 prospective and 10 retrospective reports of maternal adverse events (AEs). The most frequent prospectively reported maternal AEs were medication errors (expired product [n = 8, 3.8%]; extra dose [n = 7, 3.3%]) and injection site pain (n = 7, 3.3%). Among 62 prospectively reported pregnancy and obstetrical events with available follow-up information, seven AEs were reported, four (6.4%) of which were spontaneous abortions. A further seven AEs were reported among the 29 retrospective pregnancy and obstetrical events with available follow-up information. Among neonatal outcomes (15 prospective; 28 retrospective), >85% were reported as full-term births. One premature birth was reported prospectively. Four other neonatal AEs were reported, all retrospectively: two cases of talipes (club foot), one central nervous system anomaly and one atrial septal defect. All infants with available information had normal APGAR scores at 5 minutes. CONCLUSIONS The frequency of AEs following exposure to IIV4 during pregnancy did not indicate new safety concerns.
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Affiliation(s)
- Shaleesa Ledlie
- Epidemiology and Benefit RiskSanofi PasteurNorth YorkOntarioCanada
| | | | - Anju Shrestha
- Global PharmacovigilanceSanofi PasteurSwiftwaterPennsylvaniaUSA
| | | | - Alena Khromava
- Epidemiology and Benefit RiskSanofi PasteurNorth YorkOntarioCanada
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13
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Toth JM, Nsiah I, Nair S, Ramachandran S. Association between a usual source of care and influenza vaccination rates among pregnant women. Pharmacoepidemiol Drug Saf 2021; 31:361-369. [PMID: 34888983 DOI: 10.1002/pds.5394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 11/21/2021] [Accepted: 12/06/2021] [Indexed: 11/08/2022]
Abstract
PURPOSE Pregnant women and infants less than 6 months of age have a higher risk of complications from influenza. Vaccination is recommended for pregnant women to decrease risk of infection and hospitalizations between both the women themselves and infants. However, vaccination rates remain low in pregnant women. The objective of this study was to determine the association between having a usual source of care and seasonal influenza vaccination rates among women who were pregnant between 2012 and 2016. METHODS A retrospective study was conducted using pooled data from the 2012-2016 Medical Expenditure Panel Survey. Frequencies of seasonal influenza vaccinations and other sociodemographic factors were estimated. A multivariable log-binomial regression model was used to examine the association between having a usual source of care and seasonal influenza vaccination rates. RESULTS The weighted influenza vaccination rate among pregnant women was 54.5%. About one third did not have a usual source of care. The adjusted prevalence ratio of receiving an influenza vaccine for pregnant women without a usual source of care was 0.76 (95% confidence interval = 0.60-0.98). The top three main reasons for not having a usual source of care were being seldom or never sick (55.7%), not having health insurance (10.6%), and having recently moved to an area (9.9%). CONCLUSIONS Pregnant women without a usual source of care had significantly lower probability of being vaccinated against seasonal influenza. Improving access to care through greater insurance coverage, addressing cost barriers, and providing patient education may help improve vaccination rates in this population.
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Affiliation(s)
- Jennifer M Toth
- Department of Pharmacy Administration, University of Mississippi, Oxford, Mississippi, USA
| | - Irene Nsiah
- Department of Pharmacy Administration, University of Mississippi, Oxford, Mississippi, USA
| | - Sonam Nair
- Department of Pharmacy Administration, University of Mississippi, Oxford, Mississippi, USA.,ICON plc, Tennessee, USA
| | - Sujith Ramachandran
- Department of Pharmacy Administration, University of Mississippi, Oxford, Mississippi, USA
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14
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Wang R, Tao L, Han N, Liu J, Yuan C, Deng L, Han C, Sun F, Chi L, Liu M, Liu J. Acceptance of seasonal influenza vaccination and associated factors among pregnant women in the context of COVID-19 pandemic in China: a multi-center cross-sectional study based on health belief model. BMC Pregnancy Childbirth 2021; 21:745. [PMID: 34732157 PMCID: PMC8564270 DOI: 10.1186/s12884-021-04224-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 10/20/2021] [Indexed: 01/15/2023] Open
Abstract
Background Seasonal influenza can circulate in parallel with coronavirus disease (COVID-19) in winter. In the context of COVID-19 pandemic, the risk of co-infection and the burden it poses on healthcare system calls for timely influenza vaccination among pregnant women, who are the priority population recommended for vaccination. We aimed to evaluate the acceptance of influenza vaccination and associated factors among pregnant women during COVID-19 pandemic, provide evidence to improve influenza vaccination among pregnant women, help reduce the risk of infection and alleviate the burden of healthcare system for co-infected patients. Methods We conducted a multi-center cross-sectional study among pregnant women in China. Sociodemographic characteristics, health status, knowledge on influenza, attitude towards vaccination, and health beliefs were collected. Locally weighted scatterplot smoothing regression analysis was used to evaluate the trends in the acceptance of influenza vaccine. Logistic regression was applied to identify factors associated with vaccination acceptance. Results The total acceptance rate was 76.5% (95%CI: 74.8–78.1%) among 2568 pregnant women enrolled. Only 8.3% of the participants had a history of seasonal influenza vaccination. In the logistic regression model, factors associated with the acceptance of influenza vaccine were western region, history of influenza vaccination, high knowledge of influenza infection and vaccination, high level of perceived susceptibility, perceived benefit, cues to action and low level of perceived barriers. Among 23.5% of the participants who had vaccine hesitancy, 48.0% of them were worried about side effect, 35.6% of them lacked confidence of vaccine safety. Conclusions Our findings highlighted that tailored strategies and publicity for influenza vaccination in the context of COVID-19 pandemic are warranted to reduce pregnant women’s concerns, improve their knowledge, expand vaccine uptake and alleviate pressure for healthcare system. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04224-3.
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Affiliation(s)
- Ruitong Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, No.49 Huayuan North Road, Haidian District, Beijing, 100083, China
| | - Na Han
- Tongzhou Maternal and Child Health Hospital, No.38 Yuqiao Middle Road, Tongzhou District, Beijing, 101100, China
| | - Jihong Liu
- The Second Affiliated Hospital of Kunming Medical University, No. 374 Dianmian Avenue, Kunming, 650101, Yunnan Province, China
| | - Chuanxiang Yuan
- Qianjiang Maternal and Child Health Hospital, 122 Jiefang Road, Qianjiang City, 43100, Hubei Province, China
| | - Lixia Deng
- Qianjiang Central Hospital, No. 22 Zhanghua Middle Road, Qianjiang City, 433100, Hubei Province, China
| | - Chunhua Han
- Qujing Maternal and Child Health Hospital, No. 371 liaokuo South Road, Qilin District, Qujing City, 655000, Yunnan Province, China
| | - Fenglan Sun
- Shexian Maternal and Child Health Hospital, No. 237 Zhenxing Road, shecheng Town, Shexian City, 056400, Hebei Province, China
| | - Liqun Chi
- Haidian Maternal and Child Health Hospital, No. 33 Haidian South Road, Haidian District, Beijing, 100080, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China. .,National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China.
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15
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Tao L, Wang R, Liu J. Comparison of Vaccine Acceptance Between COVID-19 and Seasonal Influenza Among Women in China: A National Online Survey Based on Health Belief Model. Front Med (Lausanne) 2021; 8:679520. [PMID: 34150811 PMCID: PMC8211886 DOI: 10.3389/fmed.2021.679520] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/04/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Influenza could circulate in parallel with COVID-19. Studies focusing on the comparison of vaccine acceptance between COVID-19 and seasonal influenza are lacking. The aim of the study was to assess and compare vaccine acceptance of COVID-19 and influenza among reproductive women in China, in order to better understand and address factors associated with vaccine acceptance and to provide guidance for targeted measures to promote vaccination. Methods: A national anonymous cross-sectional survey on COVID-19 and influenza vaccine acceptance among reproductive women aged 18–49 years in China was conducted online based on health belief model, a model widely used to evaluate health beliefs. Sociodemographic characteristics, health status, knowledge, attitude, and health beliefs related to COVID-19 and influenza infection and vaccination were retrieved. Pearson's χ2 test was used to compare the vaccine acceptance by the factors mentioned above. Multivariable logistic regression was used to assess the adjusted associations of factors related to vaccine acceptance. Paired t-test was used to compare scores of health beliefs between influenza and COVID-19 vaccinations. Results: COVID-19 vaccine acceptance rate among reproductive women was 90.3% (95% CI 89.2–91.3%), which was significantly higher than influenza vaccine acceptance rate (85.5%, 95% CI: 84.2–86.7%). Influenza and COVID-19 vaccine acceptance both had the trends to decrease with age (all p < 0.05). Living in the western region, young age, a high level of knowledge scores on disease and vaccines, a high level of perceived susceptibility, a high level of cues to action, and a low level of perceived barriers were positively associated with both COVID-19 and influenza vaccine acceptance (all p < 0.05), while influenza vaccination history was additionally associated with influenza vaccine acceptance (p < 0.05). Conclusions: Our findings suggest that tailored public health measures are needed to improve reproductive women's knowledge of COVID-19, influenza, and vaccines to alleviate women's vaccine hesitancy and expand vaccine uptake.
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Affiliation(s)
- Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Ruitong Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing, China.,Peking University Institute for Global Health and Development, Peking University, Beijing, China
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16
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Karafillakis E, Francis MR, Paterson P, Larson HJ. Trust, emotions and risks: Pregnant women's perceptions, confidence and decision-making practices around maternal vaccination in France. Vaccine 2021; 39:4117-4125. [PMID: 34099326 DOI: 10.1016/j.vaccine.2021.05.096] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 05/25/2021] [Accepted: 05/28/2021] [Indexed: 12/24/2022]
Abstract
Maternal vaccination is an important strategy to reduce maternal and newborn mortality and morbidity. Yet, vaccination uptake is suboptimal in many countries, including France. This mixed-method study aimed to identify factors influencing maternal vaccination, exploring pregnant women's perceptions, confidence, and decision-making processes in France. Maternal vaccination uptake was positively associated with awareness of maternal vaccines, confidence in vaccine effectiveness and receiving a recommendation from a healthcare professional. A trusting relationship with healthcare professionals was observed as crucial for women during pregnancy. Even if women considered themselves as sole decision-makers, healthcare professionals' role in decision-making was viewed as substantial. Pregnancy can be a complex time for assessing risks, which was evident in the strong emotional reactions to maternal vaccination and anxieties about safety. As new maternal vaccines are developed, it is crucial to consider women's values, risk perceptions and emotions in the development of strategies to support acceptance of maternal vaccination.
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Affiliation(s)
- E Karafillakis
- Vaccine Confidence Project, Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Topical Medicine, UK.
| | - M R Francis
- Vaccine Confidence Project, Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Topical Medicine, UK
| | - P Paterson
- Vaccine Confidence Project, Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Topical Medicine, UK
| | - H J Larson
- Vaccine Confidence Project, Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Topical Medicine, UK
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17
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Tao L, Wang R, Han N, Liu J, Yuan C, Deng L, Han C, Sun F, Liu M, Liu J. Acceptance of a COVID-19 vaccine and associated factors among pregnant women in China: a multi-center cross-sectional study based on health belief model. Hum Vaccin Immunother 2021; 17:2378-2388. [PMID: 33989109 DOI: 10.1080/21645515.2021.1892432] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background: Vaccine hesitancy has been recognized as an urgent public health issue. We aimed to explore the acceptance of a COVID-19 vaccine and related factors among pregnant women, a vulnerable population for vaccine-preventable diseases.Methods: A multi-center cross-sectional study among pregnant women was conducted in five provinces of mainland China from November 13 to 27, 2020. We collected sociodemographic characteristics, attitude, knowledge, and health beliefs on COVID-19 vaccination. Locally weighted scatterplot smoothing regression analysis was used to assess the trends of vaccination acceptance. Multivariable logistic regression was performed to identify factors related to vaccination acceptance.Results: Among the 1392 pregnant women, the acceptance rate of a COVID-19 vaccine were 77.4% (95%CI 75.1-79.5%). In the multivariable regression model, the acceptance rate was associated with young age (aOR = 1.87, 95% CI: 1.20-2.93), western region (aOR = 2.73, 95% CI: 1.72-4.32), low level of education (aOR = 2.49, 95% CI: 1.13-5.51), late pregnancy (aOR = 1.49, 95% CI: 1.03-2.16), high knowledge score on COVID-19 (aOR = 1.05, 95% CI: 1.01-1.10), high level of perceived susceptibility (aOR = 2.18, 95% CI: 1.36-3.49), low level of perceived barriers (aOR = 4.76, 95% CI: 2.23-10.18), high level of perceived benefit (aOR = 2.18, 95% CI: 1.36-3.49), and high level of perceived cues to action (aOR = 15.70, 95% CI: 8.28-29.80).Conclusions: About one quarters of pregnant women have vaccine hesitancy. Our findings highlight that targeted and multipronged efforts are needed to build vaccine literacy and confidence to increase the acceptance of a COVID-19 vaccine during the COVID-19 pandemic, especially for vulnerable populations.
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Affiliation(s)
- Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Ruitong Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Na Han
- Department of Obstetrics, Tongzhou Maternal and Child Health Hospital, Beijing, China
| | - Jihong Liu
- Department of Obstetrics, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Chuanxiang Yuan
- Department of Obstetrics, Qianjiang Maternal and Child Health Hospital, Qianjiang City, Hubei Province, China
| | - Lixia Deng
- Department of Obstetrics, Qianjiang Central Hospital, Qianjiang City, Hubei Province, China
| | - Chunhua Han
- Department of Obstetrics, Qujing Maternal and Child Health Hospital, Qujing City, Yunnan Province, China
| | - Fenglan Sun
- Department of Obstetrics, Shexian Maternal and Child Health Hospital, Shexian City, Hebei Province, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing, China
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18
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Regan AK, Munoz FM. Efficacy and safety of influenza vaccination during pregnancy: realizing the potential of maternal influenza immunization. Expert Rev Vaccines 2021; 20:649-660. [PMID: 33832397 DOI: 10.1080/14760584.2021.1915138] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Introduction: Pregnant women are at higher risk of severe complications following influenza infection compared to the general population. Influenza vaccination during pregnancy can offer direct protection to pregnant women and passive immunity to infants up to 6 months of age via maternal antibodies. Pregnant women are a high priority group for influenza immunization.Areas covered: This review provides an overview of the basis for recommending influenza vaccine to pregnant women, current immunization policies, the evidence supporting the safety and effectiveness of maternal vaccination, and future research needed. We conducted a search of PubMed for articles describing the safety or efficacy of influenza vaccines administered during pregnancy. Published articles from inception to 17 November 2020 were reviewed.Expert opinion: Experimental and observational evidence support the efficacy, effectiveness and safety of influenza immunization during pregnancy. These data support the continued provision of inactivated influenza vaccine to pregnant women, as recommended by global immunization policies. To achieve success with maternal influenza immunization programs, further work is needed to inform policy development in low- and middle-income settings and implementation and promotion in high-income settings.
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Affiliation(s)
- Annette K Regan
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, United States.,Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, United States.,Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia
| | - Flor M Munoz
- Department of Pediatrics, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, United States.,Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, United States
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19
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Okoli GN, Reddy VK, Al-Yousif Y, Neilson CJ, Mahmud SM, Abou-Setta AM. Sociodemographic and health-related determinants of seasonal influenza vaccination in pregnancy: A systematic review and meta-analysis of the evidence since 2000. Acta Obstet Gynecol Scand 2021; 100:997-1009. [PMID: 33420724 DOI: 10.1111/aogs.14079] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/12/2020] [Accepted: 12/31/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Vaccination is considered to be the most practical and effective preventative measure against influenza. It is highly recommended for population subgroups most at risk of developing complications, including pregnant women. However, seasonal influenza vaccine uptake remains suboptimal among pregnant women, even in jurisdictions with universal vaccination. We summarized the evidence on the determinants of seasonal influenza vaccine uptake during pregnancy to better understand factors that influence vaccine uptake among pregnant women. MATERIAL AND METHODS We systematically searched MEDLINE, Embase and CINAHL from January 2000 to February 2020 for publications in English reporting on sociodemographic and/or health-related determinants of seasonal influenza vaccine uptake during pregnancy. Two reviewers independently included studies. One reviewer extracted data and assessed study quality, and another reviewer checked extracted data and study quality assessments for errors. Disagreements were resolved through consensus, or a third reviewer. We meta-analyzed using the inverse variance, random-effects method, and reported the odds ratios (OR) and 95% confidence intervals (CI). RESULTS From 1663 retrieved citations, we included 36 studies. The following factors were associated with increased seasonal influenza vaccine uptake: Older age (20 studies: OR 1.13, 95% CI 1.07-1.20), being nulliparous (13 studies: OR 1.26, 95% CI 1.15-1.38), married (8 studies: OR 1.11, 95% CI 1.07-1.15), employed (4 studies: OR 1.13, 95% CI 1.02-1.24), a non-smoker (8 studies: OR 1.25, 95% CI 1.04-1.51) and having prenatal care (3 studies: OR 3.36, 95% CI 2.25-5.02), a chronic condition (6 studies: OR 1.30, 95% CI 1.17-1.44), been previously vaccinated (9 studies: OR 4.88, 95% CI 3.14-7.57) and living in a rural area (9 studies: OR 1.09, 95% CI 1.05-1.14). Compared with being black, being white was also associated with increased seasonal influenza vaccine uptake (11 studies: OR 1.30, 95% CI 1.20-1.41). CONCLUSIONS The evidence suggests that several sociodemographic and health-related factors may determine seasonal influenza vaccination in pregnancy, and that parity, history of influenza vaccination, prenatal care and comorbidity status may be influential.
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Affiliation(s)
- George N Okoli
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,George & Fay Yee Center for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada.,Vaccine and Drug Evaluation Center, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Viraj K Reddy
- George & Fay Yee Center for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Yahya Al-Yousif
- George & Fay Yee Center for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Christine J Neilson
- Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Salaheddin M Mahmud
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Vaccine and Drug Evaluation Center, University of Manitoba, Winnipeg, Manitoba, Canada.,Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ahmed M Abou-Setta
- George & Fay Yee Center for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada.,Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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20
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Erazo CE, Erazo CV, Grijalva MJ, Moncayo AL. Knowledge, attitudes and practices on influenza vaccination during pregnancy in Quito, Ecuador. BMC Public Health 2021; 21:72. [PMID: 33413252 PMCID: PMC7791889 DOI: 10.1186/s12889-020-10061-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 12/13/2020] [Indexed: 02/07/2023] Open
Abstract
Background Vaccination is the most effective way to prevent infection and severe outcomes caused by influenza viruses in pregnant women and their children. In Ecuador, the coverage of seasonal influenza vaccination in pregnant women is low. The aim of this study was to assess the knowledge, attitudes, and practices (KAP) of pregnant women toward influenza vaccination in Quito-Ecuador. Methods A cross-sectional study enrolled 842 women who delivered at three main public gynecological-obstetric units of the Metropolitan District of Quito. A questionnaire regarding demographics, antenatal care, risk conditions and knowledge, attitudes and practices related to influenza vaccination was administered. We examined factors associated with vaccination using log-binomial regression models. Results A low vaccination rate (36.6%) against influenza was observed among pregnant women. The factors associated with vaccination included the recommendations from health providers (adjusted PR: 15.84; CI 95% 9.62–26.10), belief in the safety of the influenza vaccine (adjusted PR: 1.53; CI 95% 1.03–2.37) and antenatal care (adjusted PR: 1.21; CI 95% 1.01–1.47). The most common reasons for not vaccinating included the lack of recommendation from health care providers (73.9%) and lack of access to vaccine (9.0%). Conclusions Health educational programs aimed at pregnant women and antenatal care providers have the most potential to increase influenza vaccination rates. Further studies are needed to understand the barriers of health care providers regarding influenza vaccination in Ecuador. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-10061-4.
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Affiliation(s)
- Carlos E Erazo
- Centro de Investigación para la Salud en América Latina (CISeAL), Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Apartado, 1701-2184, Quito, Ecuador
| | - Carlos V Erazo
- Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Apartado, 1701-2184, Quito, Ecuador
| | - Mario J Grijalva
- Centro de Investigación para la Salud en América Latina (CISeAL), Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Apartado, 1701-2184, Quito, Ecuador.,Department of Biomedical Sciences, Infectious and Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, 45701, USA
| | - Ana L Moncayo
- Centro de Investigación para la Salud en América Latina (CISeAL), Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Apartado, 1701-2184, Quito, Ecuador.
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21
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Le XTT, Nguyen HT, Le HT, Do TTT, Nguyen TH, Vu LG, Nguyen CT, Hoang MT, Tran BX, Latkin CA, Ho CSH, Ho RCM. Rural-urban differences in preferences for influenza vaccination among women of childbearing age: implications for local vaccination service implementation in Vietnam. Trop Med Int Health 2020; 26:228-236. [PMID: 33164300 DOI: 10.1111/tmi.13515] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Pregnant women and new mothers are among the most vulnerable to seasonal influenza; however, little is known about their preferences for flu vaccination. We examined the rural-urban differences in uptake, demand and willingness to pay (WTP) for influenza vaccination among women of childbearing age, to assess the feasibility of implementing locally produced vaccines in Vietnam. METHODS A cross-sectional study was performed in both urban and rural areas of Hanoi in 2018. Socio-demographic characteristics, history of vaccination, demand and WTP for influenza vaccines were obtained. A multivariate logistic regression model was employed to identify the associated factors. RESULTS Of 750 participants, 29.9% had had flu shots in the current or previous flu season and 64.3% indicated demand for this vaccine. The median of the maximum amount of WTP for influenza vaccination services was US$ 8.5 (IQR: 8.5-17.0). Women living in rural areas had a significantly lower uptake and higher demand, and were willing to pay less than women in urban locations (21.1% vs. 36.6%; 69% vs. 60.2%; and US $8.5 vs. US $11.7, respectively). For urban participants, factors associated with higher demand and WTP for flu shots included having ANC in health facilities and having been vaccinated against influenza in the past; for rural women, these factors were having suffered from influenza and hearing about it. CONCLUSIONS This study informs the feasibility of implementing locally produced influenza vaccines in Vietnam. Educational programs, along with counselling services and government subsidies, should be implemented to improve the coverage, demand and WTP for the vaccine.
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Affiliation(s)
- Xuan T T Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Hien T Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Huong T Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Toan T T Do
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Thang H Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Linh G Vu
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Cuong T Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.,Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Men T Hoang
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.,Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Bach X Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.,Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Cyrus S H Ho
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Institute for Health Innovation and Technology, National University of Singapore, Singapore
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22
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Influenza Vaccination Experiences of Pregnant Women as a Predictor of the Intention to Become Vaccinated in Future Pregnancies in Spain. Vaccines (Basel) 2020; 8:vaccines8020291. [PMID: 32527002 PMCID: PMC7350003 DOI: 10.3390/vaccines8020291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/26/2020] [Accepted: 06/05/2020] [Indexed: 11/16/2022] Open
Abstract
A good perception of the vaccines administered during pregnancy favors immunization coverage, which is still not optimal for the influenza vaccine. To understand the predisposition towards vaccination in future pregnancies, a study was performed that evaluated the experiences of women with the vaccine or influenza. A cross-sectional study was conducted through telephone interviews given to a total of 683 postpartum women in two health departments from the Valencia Community (Spain). This interview asked about their intention of becoming vaccinated in future pregnancies and whether they were favor or against vaccination. Most of them, 98.5% (n = 673 [95% CI: 97.6–99.4]) (p < 0.001) declared having received the systematic vaccines throughout their lives. The ones who were vaccinated against influenza, 91.9% (n = 387 [95% CI: 89.2–94.6]) (p < 0.001) manifested they would do so in future pregnancies. The probability of future non-vaccination was modeled, which was related to an unfavorable opinion towards vaccines (OR = 4.07 [95% CI: 2.01–8.24]) (p < 0.001), having suffered from influenza during pregnancy (OR = 3.84 [95% CI: 1.41–10.42]) (p < 0.05), and not having been vaccinated during previous pregnancies (OR = 38.47 [95% CI: 23.58–62.76]) (p < 0.001). Vaccination during pregnancy increases the intent of vaccination in the future.
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23
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Pullagura GR, Violette R, Houle SK, Waite NM. Shades of gray in vaccination decisions – Understanding community pharmacists’ perspectives of, and experiences with, influenza vaccine hesitancy in Ontario, Canada. Vaccine 2020; 38:2551-2558. [DOI: 10.1016/j.vaccine.2020.01.085] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 01/24/2020] [Accepted: 01/28/2020] [Indexed: 02/01/2023]
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24
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Bartolo S, Deliege E, Mancel O, Dufour P, Vanderstichele S, Roumilhac M, Hammou Y, Carpentier S, Dessein R, Subtil D, Faure K. Determinants of influenza vaccination uptake in pregnancy: a large single-Centre cohort study. BMC Pregnancy Childbirth 2019; 19:510. [PMID: 31856752 PMCID: PMC6924067 DOI: 10.1186/s12884-019-2628-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 11/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although vaccination of pregnant women against influenza is recommended, the vaccination rate remains low. We conducted a study to identify determinants of influenza vaccination uptake in pregnancy in order to identify strategies to improve seasonal influenza vaccination rates. METHODS Prospective observational hospital-based study in the French hospital performing the highest number of deliveries, located in the city of Lille, among all women who had given birth during the 2014-2015 influenza season. Data were collected through a self-completed questionnaire and from medical files. The vaccination uptake was self-reported. Determinants of vaccination uptake were identified using logistic regression analysis. RESULTS Of the 2045 women included in the study, 35.5% reported that they had been vaccinated against influenza during their pregnancy. The principal factors significantly associated with greater vaccination uptake were previous influenza vaccination (50.9% vs 20.2%, OR 4.1, 95% CI 3.1-5.5), nulliparity (41.0% vs 31.3%, OR 2.5, 95% CI 1.7-3.7), history of preterm delivery < 34 weeks (43.4% vs 30.3%, OR 2.3, 95% CI 1.1-4.9), the mother's perception that the frequency of vaccine complications for babies is very low (54.6% vs 20.6%, OR 1.1, 95% CI 0.5-2.2), the mother's good knowledge of influenza and its vaccine (61.7% vs 24.4%, OR 3.1, 95% CI 2.2-4.4), hospital-based prenatal care in their first trimester of pregnancy (55.0% vs 30.2%, OR 2.1, 95% CI 1.2-3.7), vaccination recommendations during pregnancy by a healthcare worker (47.0% vs 2.7%, OR 18.8, 95% CI 10.0-35.8), receipt of a vaccine reimbursement form (52.4% vs 18.6%, OR 2.0, 95% CI 1.5-2.7), and information from at least one healthcare worker about the vaccine (43.8% vs 19.1%, OR 1.8, 95% CI 1.3-2.6). CONCLUSIONS Our findings suggest that in order to increase flu vaccination compliance among pregnant women, future public health programmes must ensure cost-free access to vaccination, and incorporate education about the risks of influenza and the efficacy/safety of vaccination and clear recommendations from healthcare professionals into routine antenatal care.
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Affiliation(s)
- Stéphanie Bartolo
- University Lille, EA 2694 : épidémiologie et qualité des soins, pôle recherche aile Est 2ème étage, 59 045 cedex, 1 Place de Verdun, 59 000 Lille, France
- Douai hospital, route de Cambrai, -, 10740 - 59507 Douai Cedex, BP France
| | - Emilie Deliege
- University Lille, CHU Lille, Pôle Femme Mère Nouveau-né, Avenue Eugène Avinée, 59000 Lille, France
| | - Ophélie Mancel
- University Lille, CHU Lille, Pôle Femme Mère Nouveau-né, Avenue Eugène Avinée, 59000 Lille, France
| | - Philippe Dufour
- University Lille, CHU Lille, Pôle Femme Mère Nouveau-né, Avenue Eugène Avinée, 59000 Lille, France
| | - Sophie Vanderstichele
- University Lille, CHU Lille, Pôle Femme Mère Nouveau-né, Avenue Eugène Avinée, 59000 Lille, France
| | - Marielle Roumilhac
- University Lille, CHU Lille, Pôle Femme Mère Nouveau-né, Avenue Eugène Avinée, 59000 Lille, France
| | - Yamina Hammou
- University Lille, CHU Lille, Pôle Femme Mère Nouveau-né, Avenue Eugène Avinée, 59000 Lille, France
| | - Sophie Carpentier
- University Lille, CHU Lille, Pôle Femme Mère Nouveau-né, Avenue Eugène Avinée, 59000 Lille, France
| | - Rodrigue Dessein
- University Lille, EA7366, Recherche Translationelle Relation Hôte-Pathogènes, Faculté de Médecine Pôle Recherche 5 ème étage Ouest, 1 Place de Verdun, 59045 Lille, France
| | - Damien Subtil
- University Lille, EA 2694 : épidémiologie et qualité des soins, pôle recherche aile Est 2ème étage, 59 045 cedex, 1 Place de Verdun, 59 000 Lille, France
- University Lille, CHU Lille, Pôle Femme Mère Nouveau-né, Avenue Eugène Avinée, 59000 Lille, France
| | - Karine Faure
- University Lille, EA7366, Recherche Translationelle Relation Hôte-Pathogènes, Faculté de Médecine Pôle Recherche 5 ème étage Ouest, 1 Place de Verdun, 59045 Lille, France
- University Lille, CHU Lille, Service de Maladies Infectieuses, rue Michel Polonowski, 59000 Lille, France
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