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Ayouni I, Mbangiwa T, Amponsah-Dacosta E, Noll S, Kagina BM, Muloiwa R. Acceptance and uptake of vaccines against tetanus, influenza, pertussis, and COVID-19 among pregnant and postpartum women in low- and middle-income countries: a systematic review and meta-analysis protocol. Syst Rev 2024; 13:227. [PMID: 39237969 PMCID: PMC11375862 DOI: 10.1186/s13643-024-02645-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 08/22/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND Pregnant women, fetuses, and neonates are particularly vulnerable to vaccine-preventable diseases (VPDs). These VPDs are associated with high morbidity and mortality among expectant mothers and their fetuses and neonates. Vaccination during pregnancy can protect the expectant mother from VPDs to which she may be especially vulnerable while pregnant. In addition, the passive transfer of maternal neutralizing immunoglobulin G (IgG) and secretory immunoglobulin A (IgA) also protects the fetus against congenital infections and may further protect the neonate from infection during the first few months of life. Despite this, coverage of recommended maternal vaccines remains suboptimal globally, especially in resource-constrained settings. Determinants of vaccine acceptance and uptake are frequently understudied in low- and middle-income countries (LMICs) and among specific groups such as pregnant and postpartum women. This proposed systematic review will assess the acceptance and uptake of vaccines against tetanus, influenza, pertussis, and COVID-19 among pregnant and postpartum women in LMICs. METHODS A Boolean search strategy employing common and medical subject heading (MeSH) terms for tetanus, influenza, pertussis, and COVID-19 vaccines, as well as vaccine acceptance, hesitancy, together with uptake, pregnancy, and postpartum, will be used to search electronic databases for relevant literature published between 2009 and 2024. Only studies conducted in LMICs that investigated determinants of acceptance, hesitancy, and uptake of tetanus, influenza, pertussis, and COVID-19 vaccines among pregnant and postpartum women will be eligible for inclusion in the review. The quality and the risk of bias of all eligible full-text articles will be assessed using the Joanna Briggs Institute's (JBI) critical appraisal tools. DISCUSSION This protocol proposes a systematic review and meta-analysis that aims to assess the uptake of maternal vaccines and to systematically appraise and quantify determinants of the acceptance and uptake of recommended vaccines during pregnancy and postpartum in LMICs. A better understanding of these factors and how they influence maternal vaccine decision-making will enable public health practitioners as well as global and national policymakers to design more effective interventions as we look towards expanding the scope and reach of maternal immunization programs.
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Affiliation(s)
- Imen Ayouni
- Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
- Vaccines for Africa Initiative, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - Tshepiso Mbangiwa
- Vaccines for Africa Initiative, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Edina Amponsah-Dacosta
- Vaccines for Africa Initiative, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Susanne Noll
- Vaccines for Africa Initiative, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Benjamin M Kagina
- Vaccines for Africa Initiative, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Rudzani Muloiwa
- Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
- Vaccines for Africa Initiative, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Braimah JA, Achore M, Dery F, Ayanore MA, Bisung E, Kuuire V. Do self-rated health and previous vaccine uptake influence the willingness to accept MPOX vaccine during a public health emergency of concern? A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003564. [PMID: 39146333 PMCID: PMC11326589 DOI: 10.1371/journal.pgph.0003564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 07/12/2024] [Indexed: 08/17/2024]
Abstract
Monkeypox (MPOX) was declared a global public health emergency of international concern in July 2022. Vaccinations may be an essential strategy to prevent MPOX infections and reduce their impact on populations, especially among at-risk populations. However, less is known about the factors associated with people's willingness to accept the MPOX vaccine in resource-constrained settings. In this study, we examine the associations between self-rated health, previous vaccine uptake, and people's willingness to accept the MPOX vaccine using cross-sectional data from four major cities in Ghana. The data were analyzed using descriptive and logistic regression techniques. We found that the acceptance of the MPOX vaccine is generally low (approximately 32%) in Ghana. The regression analysis reveals that individuals who did not receive vaccines in the past are much less likely to get the MPOX vaccine (AOR:.28; 95% CI:.62-2.37). The association between self-rated health and vaccine acceptance (AOR: 1.22; 95% CI:.62-2.37) disappeared after we accounted for covariates. Based on these findings, we conclude that vaccine uptake history may be critical to people's uptake of the MPOX vaccine.
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Affiliation(s)
- Joseph Asumah Braimah
- Department of Public Health, St. Lawrence University, Canton, New York, United States of America
| | - Meshack Achore
- Department of Population Health, Hofstra University, Hempstead, New York, United States of America
| | - Florence Dery
- Department of Geography, Geomatics & Environment, University of Toronto, Mississauga, Ontario, Canada
| | - Martin A Ayanore
- Department of Health Policy Planning and Management, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Elijah Bisung
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Vincent Kuuire
- Department of Geography, Geomatics & Environment, University of Toronto, Mississauga, Ontario, Canada
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McCarron M, Yau TS, Griffin C, Marcenac P, Ebama MS, Lafond KE, Igboh LS, Duca LM, Bino S, Bettaieb J, Dhaouadi S, Sahakyan G, Cherkaoui I, Alj L, Coulibaly D, Lutwama JJ, Douba A, N'Gattia A, Khanthamaly V, Tengbriacheu C, Patthammavong C, Lambach P, Otorbaeva D, Azziz-Baumgartner E, Bresee JS. Do pregnant persons want influenza vaccines? Knowledge, attitudes, perceptions, and practices toward influenza vaccines in 8 low- and middle-income countries. J Infect Dis 2024:jiae340. [PMID: 38954648 DOI: 10.1093/infdis/jiae340] [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: 03/06/2024] [Revised: 06/25/2024] [Accepted: 06/28/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND While vaccination is the most effective way to prevent influenza infection and adverse outcomes, and despite WHO recommendations to vaccinate pregnant persons, access to seasonal influenza vaccines remains low. We explored knowledge, attitudes, and practices of pregnant persons about seasonal influenza vaccines to inform actions to improve vaccine uptake among this priority population. METHODS We pooled individual-level data from cross-sectional surveys assessing pregnant persons' attitudes toward seasonal influenza vaccines in eight low- and middle-income countries during 2018-2019. The eight countries used a standard protocol and questionnaire to measure attitudes and intents toward influenza vaccination. We stratified by country-level (presence/absence of a national influenza vaccination program, country income group, geographic region) and individual-level factors. FINDINGS Our analysis included 8,556 pregnant persons from eight low- and middle-income countries with and without seasonal influenza vaccination programs. Most pregnant persons (6,323, 74%) were willing to receive influenza vaccine if it was offered for free. Willingness differed by presence of an existing influenza vaccination program; acceptance was higher in countries without influenza vaccination programs (2,383, 89%) than in those with such programs (3,940, 67%, p < 0.001). INTERPRETATION Most pregnant persons in middle-income countries, regardless of influenza vaccination program status, were willing to be vaccinated against influenza if the vaccine was provided free of charge. National investments in influenza vaccination programs may be well-received by pregnant persons, leading to averted illness both in pregnant persons themselves and in their newborn babies. FUNDING US Centers for Disease Control and Prevention.
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Affiliation(s)
| | - Tat S Yau
- US Centers for Disease Control and Prevention, USA
| | | | | | | | | | | | | | | | - Jihene Bettaieb
- Laboratory of transmission control and immunobiology of infection, Institut Pasteur de Tunis, Tunisia
| | - Sonia Dhaouadi
- National Observatory of New and Emerging Diseases, Tunis, Tunisia
| | | | | | | | | | | | - Alfred Douba
- National Institute of Public Hygiene, Abidjan, Cote d'Ivoire
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Lanza-León P, Cantarero-Prieto D, Pascual-Sáez M. Exploring trends and determinants of basic childhood vaccination coverage: Empirical evidence over 41 years. PLoS One 2024; 19:e0300404. [PMID: 38512892 PMCID: PMC10956826 DOI: 10.1371/journal.pone.0300404] [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: 10/13/2023] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
Vaccination is widely considered to be one of the most important prevention measures as a health strategy. This paper examines trends in basic childhood vaccination coverage and which country and time-dependent determinants may have influenced childhood immunization rates (1-dose BCG, 1- and 3-dose DTP (diphtheria, tetanus, pertussis), 1-dose measles, and 3-dose polio) between 1980 and 2020 across 94 countries. We identify economic, inequality, demographic, health, education, labor market, environmental, and political stability factors of immunization. To do this, we use data from the annual WHO and United Nations International Children's Emergency Fund (UNICEF) coverage estimates. The empirical analysis consists of generalized estimating equation models to assess relationships between immunization rates and socioeconomic factors. Additionally, we follow the Barro and Sala-i-Martín approach to identify conditional convergence. Our findings show the strongest positive statistically significant association between immunization rates and GDP per capita, as well as births attended by skilled health staff. Moreover, our research demonstrates conditional convergence, indicating that countries converge towards different steady states. The present study brings new insights to investigating the determinants of childhood vaccination coverage and provides significant implications for health policies.
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Affiliation(s)
- Paloma Lanza-León
- Departamento de Economía, Universidad de Cantabria, Santander, Spain
- Health Economics Research Group, Valdecilla Biomedical Research Institute—IDIVAL Santander, Spain
| | - David Cantarero-Prieto
- Departamento de Economía, Universidad de Cantabria, Santander, Spain
- Health Economics Research Group, Valdecilla Biomedical Research Institute—IDIVAL Santander, Spain
- Santander Financial Institute—SANFI, Santander, Spain
| | - Marta Pascual-Sáez
- Departamento de Economía, Universidad de Cantabria, Santander, Spain
- Health Economics Research Group, Valdecilla Biomedical Research Institute—IDIVAL Santander, Spain
- Santander Financial Institute—SANFI, Santander, Spain
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Lopatynsky-Reyes EZ, Chacon-Cruz E, Greenberg M, Clemens R, Costa Clemens SA. Influenza Vaccination during Pregnancy: A Descriptive Study of the Knowledge, Beliefs, and Practices of Mexican Gynecologists and Family Physicians. Vaccines (Basel) 2023; 11:1383. [PMID: 37631951 PMCID: PMC10459716 DOI: 10.3390/vaccines11081383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/04/2023] [Accepted: 08/16/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Influenza in pregnancy is associated with elevated morbidity and mortality. Influenza vaccines are safe and effective in pregnancy. There are no Mexican surveys of physicians on knowledge, beliefs, and practices towards influenza and influenza immunization during pregnancy. METHODS A 32-question descriptive survey was conducted, addressing the general knowledge of influenza as well as beliefs and practices regarding influenza vaccination during pregnancy among Mexican physicians responsible for prenatal care, traditionally Obstetricians (OBGYNs) and Family Physicians (FPs). RESULTS A total of 206 surveys were available, 98 (47.6%) from OBGYNs and 108 (52.4%) from FPs, representing an estimated 2472 daily pregnancy consultations. In total, 54 of the 206 respondents (26.2%) were not aware that influenza is more severe during pregnancy, 106 of the 206 respondents (51.5%) ignored the potential side effects of influenza infection on the fetus, and 56.8% did not know when to vaccinate pregnant women. Pregnancy as a risk factor for developing influenza complications was only known by 99 of the 206 respondents (48.1%), and 6.1% believed that vaccination does not confer protection to the fetus. CONCLUSIONS The current beliefs of Mexican OBGYNs and FPs for both influenza morbidity and mortality, and the importance of influenza vaccination during pregnancy are suboptimal. The drivers of these beliefs should be assessed to improve influenza vaccination recommendations, as knowledge alone is not sufficient.
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Affiliation(s)
| | - Enrique Chacon-Cruz
- Institute for Global Health, University of Siena, 53100 Siena, Italy; (E.C.-C.); (S.A.C.C.)
- Think Vaccines LLC, Houston, TX 77005, USA
| | | | - Ralf Clemens
- International Vaccine Institute (IVI), Seoul 08826, Republic of Korea;
| | - Sue Ann Costa Clemens
- Institute for Global Health, University of Siena, 53100 Siena, Italy; (E.C.-C.); (S.A.C.C.)
- Department of Pediatrics, University of Oxford, Oxford OX1 2JD, UK
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Cox E, Sanchez M, Taylor K, Baxter C, Crary I, Every E, Futa B, Adams Waldorf KM. A Mother's Dilemma: The 5-P Model for Vaccine Decision-Making in Pregnancy. Vaccines (Basel) 2023; 11:1248. [PMID: 37515063 PMCID: PMC10383354 DOI: 10.3390/vaccines11071248] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Pregnant women are a highly vaccine-resistant population and face unique circumstances that complicate vaccine decision-making. Pregnant women are also at increased risk of adverse maternal and neonatal outcomes to many vaccine-preventable diseases. Several models have been proposed to describe factors informing vaccine hesitancy and acceptance. However, none of these existing models are applicable to the complex decision-making involved with vaccine acceptance during pregnancy. We propose a model for vaccine decision-making in pregnancy that incorporates the following key factors: (1) perceived information sufficiency regarding vaccination risks during pregnancy, (2) harm avoidance to protect the fetus, (3) relationship with a healthcare provider, (4) perceived benefits of vaccination, and (5) perceived disease susceptibility and severity during pregnancy. In addition to these factors, the availability of research on vaccine safety during pregnancy, social determinants of health, structural barriers to vaccine access, prior vaccine acceptance, and trust in the healthcare system play roles in decision-making. As a final step, the pregnant individual must balance the risks and benefits of vaccination for themselves and their fetus, which adds greater complexity to the decision. Our model represents a first step in synthesizing factors informing vaccine decision-making by pregnant women, who represent a highly vaccine-resistant population and who are also at high risk for adverse outcomes for many infectious diseases.
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Affiliation(s)
- Elizabeth Cox
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA 98195, USA
| | - Magali Sanchez
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA 98195, USA
| | - Katherine Taylor
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA 98195, USA
| | - Carly Baxter
- School of Medicine, University of Washington, Seattle, WA 98195, USA
| | - Isabelle Crary
- School of Medicine, University of Washington, Seattle, WA 98195, USA
| | - Emma Every
- School of Medicine, University of Washington, Seattle, WA 98195, USA
| | - Brianne Futa
- School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Kristina M Adams Waldorf
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA 98195, USA
- Department of Global Health, University of Washington, Seattle, WA 98195, USA
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Nichol B, McCready JL, Steen M, Unsworth J, Simonetti V, Tomietto M. Barriers and facilitators of vaccine hesitancy for COVID-19, influenza, and pertussis during pregnancy and in mothers of infants under two years: An umbrella review. PLoS One 2023; 18:e0282525. [PMID: 36862698 PMCID: PMC9980804 DOI: 10.1371/journal.pone.0282525] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/17/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Vaccination during pregnancy has been repeatedly demonstrated to be safe and effective in protecting against infection and associated harms for the mother, developing baby, and subsequent infant. However, maternal vaccination uptake remains low compared to the general population. OBJECTIVES An umbrella review to explore the barriers and facilitators to Influenza, Pertussis and COVID-19 vaccination during pregnancy and within 2 years after childbirth, and to inform interventions to encourage uptake (PROSPERO registration number: CRD42022327624). METHODS Ten databases were searched for systematic reviews published between 2009 and April 2022 exploring the predictors of vaccination or effectiveness of interventions to improve vaccination for Pertussis, Influenza, or COVD-19. Both pregnant women and mothers of infants under two years were included. Barriers and facilitators were organised using the WHO model of determinants of vaccine hesitancy through narrative synthesis, the Joanna Briggs Institute checklist assessed review quality, and the degree of overlap of primary studies was calculated. RESULTS 19 reviews were included. Considerable overlap was found especially for intervention reviews, and the quality of the included reviews and their primary studies varied. Sociodemographic factors were specifically researched in the context of COVID-19, exerting a small but consistent effect on vaccination. Concerns around the safety of vaccination particularly for the developing baby were a main barrier. While key facilitators included recommendation from a healthcare professional, previous vaccination, knowledge around vaccination, and communication with and support from social groups. Intervention reviews indicated multi-component interventions involving human interaction to be most effective. CONCLUSION The main barriers and facilitators for Influenza, Pertussis and COVID-19 vaccination have been identified and constitute the foundation for policy development at the international level. Ethnicity, socioeconomic status, concerns about vaccine safety and side effects, and lack of healthcare professionals' recommendations, are the most relevant factors of vaccine hesitancy. Adapting educational interventions to specific populations, person-to-person interaction, healthcare professionals' involvement, and interpersonal support are important strategies to improve uptake.
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Affiliation(s)
- Bethany Nichol
- Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Jemma Louise McCready
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Mary Steen
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - John Unsworth
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Valentina Simonetti
- Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Marco Tomietto
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
- Visiting Professor, University of Bari “Aldo Moro”, Bari, Italy
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Regan AK, Fiddian-Green A. Protecting pregnant people & infants against influenza: A landscape review of influenza vaccine hesitancy during pregnancy and strategies for vaccine promotion. Hum Vaccin Immunother 2022; 18:2156229. [PMID: 36535646 PMCID: PMC10019833 DOI: 10.1080/21645515.2022.2156229] [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: 12/24/2022] Open
Abstract
Before COVID-19, influenza vaccines were the most widely recommended vaccine during pregnancy worldwide. In response to immunization during pregnancy, maternal antibodies offer protection against potentially life-threatening disease in both pregnant people and their infants up to six months of age. Despite this, influenza vaccine hesitancy is common, with few countries reporting immunization rates in pregnant people above 50%. In this review, we highlight individual, institutional, and social factors associated with influenza vaccine hesitancy during pregnancy. In addition, we present an overview of the evidence evaluating interventions to address influenza vaccine hesitancy during pregnancy. While some studies have indicated promising results, no single intervention has consistently effectively increased influenza vaccine uptake during pregnancy. Using a social-ecological model of health framework, future strategies addressing multiple levels of vaccine hesitancy will be needed to realize the potential health benefits of prenatal immunization programs.
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Affiliation(s)
- Annette K Regan
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA.,Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Alice Fiddian-Green
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA
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Madewell ZJ, Chacón-Fuentes R, Badilla-Vargas X, Ramirez C, Ortiz MR, Alvis-Estrada JP, Jara J. Knowledge, attitudes, and practices regarding seasonal influenza vaccination during pregnancy in Costa Rica: A mixed-methods study. Vaccine 2022; 40:6931-6938. [PMID: 36280562 PMCID: PMC10656696 DOI: 10.1016/j.vaccine.2022.10.023] [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: 05/02/2022] [Revised: 10/03/2022] [Accepted: 10/05/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Influenza increases stillbirth risk, morbidity and mortality in pregnant women. Vaccination protects pregnant women against severe disease and indirectly protects their infants, but coverage among pregnant women remains low worldwide. We aimed to describe knowledge, attitudes, and practices (KAP) regarding seasonal influenza vaccination among postpartum women and prenatal care physicians in Costa Rica. METHODS We conducted cross-sectional KAP surveys to women one to three days after childbirth at Costa Rican Social Security Fund maternity hospitals, and obstetricians and general practitioners who provided prenatal care in 2017. Principal components analysis, multiple imputation, and logistic regression were used to examine associations between influenza vaccination and demographics, prenatal care, and sources of information-separately for postpartum women and physicians. We also held two focus groups of six healthcare workers each to further describe vaccination KAP. RESULTS We surveyed 642 postpartum women and 146 physicians in maternity hospitals in five Costa Rican provinces of whom 85.5 % (95 % CI: 82.6 %-88.0 %) and 57.9 % (95 % CI: 49.6 %-65.7 %) were vaccinated for influenza, respectively. Factors associated with influenza vaccination for postpartum women included tetanus vaccination (aOR: 3.62, 95 % CI: 1.89-6.92); received vaccination recommendations from clinicians during prenatal check-ups (aOR: 3.39, 95 % CI: 2.06-5.59); had other children in household vaccinated for influenza (aOR: 2.25, 95 % CI: 1.08-4.68); and secondary/university education (aOR: 0.15-0.31) with no formal education as reference. For postpartum women, reasons for vaccination were perceived benefits for mother and infant, whereas not being offered vaccines was most cited for non-vaccination. Most prenatal care physicians recommended influenza vaccines during prenatal check-ups but believed vaccination causes flu-like symptoms. CONCLUSION Vaccination campaigns and provisions of free vaccines effectively increased knowledge and coverage among women in Costa Rica. To improve access, women should be offered vaccines during prenatal care appointments. Educating healthcare workers about vaccine benefits for themselves and patients is needed to mitigate safety concerns.
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Affiliation(s)
- Zachary J Madewell
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala.
| | - Rafael Chacón-Fuentes
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | | | | | - Maria-Renee Ortiz
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | | | - Jorge Jara
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
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10
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Swed S, Alibrahim H, Bohsas H, Shoib S, Hasan MM, Motawea KR, Albuni MK, Battikh E, Sawaf B, Elkalagi NKH, Mohamed Alsharief Ahmed S, Mohammed Sharif Ahmed E, Khairy LT, Bakkour A, Hadi Hussein Muwaili A, Abubaker Abdalla Abdelmajid F, Hadi Hussein Muwaili D, Elsayed M, Ahmad S, Lee KY. Parents' acceptance to vaccinate children against COVID-19: A Syrian online survey. Front Public Health 2022; 10:955362. [PMID: 36311581 PMCID: PMC9610112 DOI: 10.3389/fpubh.2022.955362] [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: 06/07/2022] [Accepted: 08/22/2022] [Indexed: 01/24/2023] Open
Abstract
After the widespread of COVID-19 virus worldwide, vaccination targeted reducing spread of cases and mortality rates. However, vaccination hesitancy was observed among the communities worldwide. Vaccination hesitancy involved parents regarding the decision of vaccinating their children- After obtaining ethical approval, an online cross-sectional study was conducted from 1 March to 22 April 2021 to evaluate the parents' acceptance of vaccinating their children against the COVID-19 virus in Syria. Data were analyzed using descriptive and multivariate logistic regression analysis in IBM, SPSS V. 28.0 package program (IBM Corporation, Armonk, NY, USA). Among 283 participants, 105 participants agreed to vaccinate their children, and 178 were not. A significant correlation between age and vaccine willingness was found (P-value < 0.0001*), especially in the age group between 18 and 30 years old (45.2%). Parents who accepted vaccinating themselves were more willing to vaccinate their children (34.6%). According to our results, there is a greater need to enhance awareness and knowledge programs about the vaccine's effectiveness and encourage parents to accept giving the vaccine to their children.
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Affiliation(s)
- Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo, Syria
| | | | - Haidara Bohsas
- Faculty of Medicine, Aleppo University, Aleppo, Syria,*Correspondence: Haidara Bohsas
| | - Sheikh Shoib
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital, Srinagar, Kashmir, India
| | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | | | | | - Elias Battikh
- Department of Internal Medicine, Damascus University, Damascus, Syria
| | - Bisher Sawaf
- Department of Internal Medicine, Syrian Private University, Damascus, Syria
| | | | | | | | - Lina Taha Khairy
- Faculty of Medicine, The National Ribat University, Al Khurtum, Sudan
| | - Agyad Bakkour
- Faculty of Medicine, Albaath University, Homs, Syria
| | | | | | | | - Mohamed Elsayed
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany,Department of Psychiatry, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Shoaib Ahmad
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital, Srinagar, Kashmir, India
| | - Ka Yiu Lee
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
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Halemani K, Dhiraaj S, Latha T, Mishra P, Issac A. The prevalence of COVID vaccine acceptance among pregnant women: A systematic review and meta-analysis. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022; 17:None. [PMID: 39139518 PMCID: PMC11320410 DOI: 10.1016/j.cegh.2022.101144] [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: 07/14/2022] [Revised: 09/03/2022] [Accepted: 09/06/2022] [Indexed: 11/24/2022] Open
Abstract
COVID pandemic has massively hit every nook of the world. Millions of people were infected and lost their lives to the deadly pandemic. This novel virus destroyed the essential healthcare service globally. Mass vaccination is the only option to halt the virus transmission. This study aimed to estimate the acceptance of the COVID vaccine among pregnant women and breastfeeding mothers. Method: We followed Cochrane collaboration guidelines and the PRISMA reporting system. Studies were identified through a systematic search of indexed articles in Medline (PubMed), Clinical key, Google Scholar, Cochrane Library, and CINAHL databases until March 10, 2022, 26,995 articles were identified in the initial search and 24 articles were included in the review. Result: Twenty four studies comprise 22,947 pregnant and 11,022 breastfeeding women. About 54% of pregnant women and 59% of breastfeeding mothers intended to take the COVID vaccination. Among the pregnant mothers, 21% with comorbidities, 14% in the first trimester, 34% in the second trimester, and 51% in the third trimester were willing to take the COVID vaccine. Risks of infections and comorbidities were the reasons for acceptance of the COVID vaccine in pregnant women. Similarly, adverse effects and safety concerns were top indicators for the rejection of the COVID vaccine. Conclusion: The acceptance of COVID vaccination among pregnant women and breastfeeding mothers are not satisfactory. Therefore, timely guidance would help to address the negative perceptions of vaccines among pregnant women.
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Affiliation(s)
- Kurvatteppa Halemani
- College of Nursing, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sanjay Dhiraaj
- Department of Anesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Thimmappa Latha
- College of Nursing, All India Institute of Medical Sciences, Kalyani, West-Bengal, India
| | - Prabhakar Mishra
- Department of Bio-statistics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Alwin Issac
- College of Nursing, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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McDonald CR, Weckman AM, Wright JK, Conroy AL, Kain KC. Developmental origins of disease highlight the immediate need for expanded access to comprehensive prenatal care. Front Public Health 2022; 10:1021901. [PMID: 36504964 PMCID: PMC9730730 DOI: 10.3389/fpubh.2022.1021901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/01/2022] [Indexed: 11/25/2022] Open
Abstract
The prenatal environment plays a critical role in shaping fetal development and ultimately the long-term health of the child. Here, we present data linking prenatal health, via maternal nutrition, comorbidities in pregnancy (e.g., diabetes, hypertension), and infectious and inflammatory exposures, to lifelong health through the developmental origins of disease framework. It is well-established that poor maternal health puts a child at risk for adverse outcomes in the first 1,000 days of life, yet the full health impact of the in utero environment is not confined to this narrow window. The developmental origins of disease framework identifies cognitive, neuropsychiatric, metabolic and cardiovascular disorders, and chronic diseases in childhood and adulthood that have their genesis in prenatal life. This perspective highlights the enormous public health implications for millions of pregnancies where maternal care, and therefore maternal health and fetal health, is lacking. Despite near universal agreement that access to antenatal care is a priority to protect the health of women and children in the first 1,000 days of life, insufficient progress has been achieved. Instead, in some regions there has been a political shift toward deprioritizing maternal health, which will further negatively impact the health and safety of pregnant people and their children across the lifespan. In this article we argue that the lifelong health impact attributed to the perinatal environment justifies policies aimed at improving access to comprehensive antenatal care globally.
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Affiliation(s)
- Chloe R McDonald
- Sandra A. Rotman (SAR) Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Toronto, ON, Canada
| | - Andrea M Weckman
- Sandra A. Rotman (SAR) Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Toronto, ON, Canada
| | - Julie K Wright
- Sandra A. Rotman (SAR) Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Andrea L Conroy
- Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Kevin C Kain
- Sandra A. Rotman (SAR) Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Tropical Disease Unit, Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON, Canada
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