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Tsiaousi I, Psarris A, Theodora M, Antsaklis P, Sindos M, Koutroumanis P, Zacharakis D, Daskalakis G. COVID-19 Vaccination Acceptance During Pregnancy in Europe. Cureus 2024; 16:e63562. [PMID: 39087190 PMCID: PMC11289694 DOI: 10.7759/cureus.63562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2024] [Indexed: 08/02/2024] Open
Abstract
Pregnant women have been shown to have a higher risk of SARS-CoV-2 infection. Vaccination against the infection is the most effective strategy for preventing both severe disease and related complications. Nevertheless, vaccination hesitancy among pregnant women is an important issue affecting vaccine uptake and a major challenge for Public Health, as high rates of hesitancy can lead to complete refusal of vaccination, with health implications not only for the mother but also for the fetus. Based on the above, this review aims to capture the rates of vaccination against COVID-19 in pregnancy among European countries, from August 2020 to May 2022, as well as to highlight the predictive factors of its acceptance among pregnant women in these countries. The review of the available literature found that in Europe the acceptance of vaccination against COVID-19 among pregnant women varies with rates ranging from 21.3% to 87% for at least one dose and from 29.5% to 82.7%, for two doses of vaccine. Higher maternal education level, older age at pregnancy, previous vaccination against influenza and pertussis, positive attitude towards vaccines, and acceptance of vaccines during pregnancy are the most frequently reported positive predictors that are associated with higher vaccination rates. The information obtained from this study can contribute in the future, during epidemics or pandemics that may occur, to the development of targeted medical and communication strategies for the effective promotion of vaccination programs and the greatest possible coverage of the population, especially those belonging to vulnerable groups such as pregnant women.
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Affiliation(s)
- Ioanna Tsiaousi
- 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Alexandros Psarris
- 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Marianna Theodora
- 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Panagiotis Antsaklis
- 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Michael Sindos
- 1st Department of Obstetrics and Gynecology, General Hospital of Athens "Alexandra", National and Kapodistrian University of Athens, Athens, GRC
| | - Pelopidas Koutroumanis
- 1st Department of Obstetrics and Gynecology, General Hospital of Athens "Alexandra" National and Kapodistrian University of Athens, Athens, GRC
| | - Dimitris Zacharakis
- 1st Department of Obstetrics and Gynecology, General Hospital of Athens "Alexandra", National and Kapodistrian University of Athens, Athens, GRC, Athens, GRC
| | - George Daskalakis
- 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical School, Athens, GRC
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Rahbeni TA, Satapathy P, Itumalla R, Marzo RR, Mugheed KAL, Khatib MN, Gaidhane S, Zahiruddin QS, Rabaan AA, Alrasheed HA, Al-Subaie MF, Al Kaabil NA, Alissa M, Ibrahim AAAL, Alsaif HA, Naser IH, Rustagi S, Kukreti N, Dziedzic A. COVID-19 Vaccine Hesitancy: Umbrella Review of Systematic Reviews and Meta-Analysis. JMIR Public Health Surveill 2024; 10:e54769. [PMID: 38687992 PMCID: PMC11062401 DOI: 10.2196/54769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/16/2024] [Accepted: 01/22/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND The unprecedented emergence of the COVID-19 pandemic necessitated the development and global distribution of vaccines, making the understanding of global vaccine acceptance and hesitancy crucial to overcoming barriers to vaccination and achieving widespread immunization. OBJECTIVE This umbrella review synthesizes findings from systematic reviews and meta-analyses to provide insights into global perceptions on COVID-19 vaccine acceptance and hesitancy across diverse populations and regions. METHODS We conducted a literature search across major databases to identify systematic reviews and meta-analysis that reported COVID-19 vaccine acceptance and hesitancy. The AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews) criteria were used to assess the methodological quality of included systematic reviews. Meta-analysis was performed using STATA 17 with a random effect model. The data synthesis is presented in a table format and via a narrative. RESULTS Our inclusion criteria were met by 78 meta-analyses published between 2021 and 2023. Our analysis revealed a moderate vaccine acceptance rate of 63% (95% CI 0.60%-0.67%) in the general population, with significant heterogeneity (I2 = 97.59%). Higher acceptance rates were observed among health care workers and individuals with chronic diseases, at 64% (95% CI 0.57%-0.71%) and 69% (95% CI 0.61%-0.76%), respectively. However, lower acceptance was noted among pregnant women, at 48% (95% CI 0.42%-0.53%), and parents consenting for their children, at 61.29% (95% CI 0.56%-0.67%). The pooled vaccine hesitancy rate was 32% (95% CI 0.25%-0.39%) in the general population. The quality assessment revealed 19 high-quality, 38 moderate-quality, 15 low-quality, and 6 critically low-quality meta-analyses. CONCLUSIONS This review revealed the presence of vaccine hesitancy globally, emphasizing the necessity for population-specific, culturally sensitive interventions and clear, credible information dissemination to foster vaccine acceptance. The observed disparities accentuate the need for continuous research to understand evolving vaccine perceptions and to address the unique concerns and needs of diverse populations, thereby aiding in the formulation of effective and inclusive vaccination strategies. TRIAL REGISTRATION PROSPERO CRD42023468363; https://tinyurl.com/2p9kv9cr.
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Affiliation(s)
- Tahani Al Rahbeni
- Molecular Toxicology and Genetics, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Prakasini Satapathy
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | | | - Roy Rillera Marzo
- Faculty of Humanities and Health Sciences, Curtin University, Miri Sarawak, Malaysia
| | - Khalid A L Mugheed
- Molecular Toxicology and Genetics, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Mahalaqua Nazli Khatib
- Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Shilpa Gaidhane
- One Health Centre (COHERD), Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education, Wardha, India
| | - Quazi Syed Zahiruddin
- South Asia Infant Feeding Research Network, Division of Evidence Synthesis, School of Epidemiology and Public Health and Research, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, India
| | - Ali A Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur, Pakistan
| | - Hayam A Alrasheed
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Maha F Al-Subaie
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- Research Center, Dr Sulaiman Alhabib Medical Group, Riyadh, Saudi Arabia
| | - Nawal A Al Kaabil
- College of Medicine and Health Science, Khalifa University, Abu Dhabi, United Arab Emirates
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company (SEHA), Abu Dhabi, United Arab Emirates
| | - Mohammed Alissa
- Department of Medical Laboratory, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | | | | | - Israa Habeeb Naser
- Medical Laboratories Techniques Department, AL-Mustaqbal University, Babil, Iraq
| | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, India
| | - Neelima Kukreti
- School of Pharmacy, Graphic Era Hill University, Dehradun, India
| | - Arkadiusz Dziedzic
- Department of Conservative Dentistry with Endodontics, Medical University of Silesia, Katowice, Poland
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Patel A, Puglisi JL, Patel S, Tarn DM. COVID-19 Vaccine Acceptance in Pregnant Women in the United States: A Systematic Review and Meta-Analysis. J Womens Health (Larchmt) 2024; 33:453-466. [PMID: 38112561 DOI: 10.1089/jwh.2023.0498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
Purpose: Pregnant women are vulnerable to Coronavirus Disease 2019 (COVID-19) complications, yet may hesitate to get vaccinated. It is important to identify racial/ethnic and other individual characteristics associated with COVID-19 vaccine acceptance in the United States during pregnancy. Methods: We searched PubMed, Embase, and Web of Science for articles published through January 2023 for keywords/terms related to immunization, COVID-19, and pregnancy, and performed a systematic review and meta-analysis to examine characteristics associated with vaccine acceptance. Results: Of 1,592 articles, 23 met inclusion criteria (focused on pregnant women in the United States, and their willingness or hesitation to vaccinate). Twenty-two of the studies examined receipt of ≥1 COVID-19 vaccine dose and/or intention to vaccinate, while one examined vaccine hesitancy. Vaccine acceptance rates ranged from 7% to 78.3%. Meta-analyses demonstrated that compared with Whites, Hispanics (odds ratios [OR] 0.72; 95% confidence interval [CI] 0.58-0.91) and Blacks (OR 0.44; 95% CI 0.30-0.63) had less COVID-19 vaccine acceptance, while Asians (OR 1.78; 95% CI 1.10-2.88) had greater vaccine acceptance. College graduation or more (OR 3.25; 95% CI 2.53-4.17), receipt or intention to receive the influenza vaccine (OR 3.46; 95% CI 2.22-5.41), and at least part-time employment (OR 2.12; 95% CI 1.66-2.72) were significantly associated with vaccine acceptance. Conclusions: COVID-19 vaccine nonacceptance in pregnant women is associated with Hispanic ethnicity and Black race, while acceptance is associated with Asian race, college education or more, at least part-time employment, and acceptance of the influenza vaccine. Future COVID-19 vaccination campaigns can target identified subgroups of pregnant women who are less likely to accept vaccination.
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Affiliation(s)
- Amy Patel
- College of Medicine, California Northstate University, Elk Grove, California, USA
| | - Jose L Puglisi
- Department of Basic Science, College of Medicine, California Northstate University, Elk Grove, California, USA
| | - Seeta Patel
- College of Letters and Sciences, University of California, Los Angeles, Los Angeles, California, USA
| | - Derjung M Tarn
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
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Simsekoglu N, Akyuz E, Guven R, Pasin O. Attitudes toward COVID-19 vaccines during pregnancy and breastfeeding. Front Public Health 2024; 12:1286891. [PMID: 38496391 PMCID: PMC10940332 DOI: 10.3389/fpubh.2024.1286891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 02/20/2024] [Indexed: 03/19/2024] Open
Abstract
Background Although vaccination is one of the most effective means of controlling the spread of COVID-19, public concerns and indecision about vaccination still continue. Because pregnant and breastfeeding individuals are at high risk for severe outcomes in case of infections, determining their level of hesitation and attitude toward COVID-19 vaccines will guide the management of the disease. This study aimed to determine pregnant and breastfeeding women's levels of hesitation and attitude toward COVID-19 vaccines as well as their related factors. Methods The sample of this descriptive research consisted of 103 pregnant or breastfeeding individuals who were seen at the obstetrics and gynecology outpatients clinic of a state hospital in Istanbul, Turkey. The data were collected using a 'demographic data form', the 'Vaccine Hesitancy Scale in Pandemic', and the 'Attitudes toward COVID-19 Vaccine Scale'. The research data were analyzed with appropriate statistical methods. Results The mean age of the participants was 29.71 ± 4.75, 51% were pregnant, and 74.8% had received the COVID-19 vaccine. The mean score of the 'Vaccination Hesitancy Scale in Pandemic' was 30.83 ± 6.91, and the mean score for the 'Attitude Scale toward the COVID-19 Vaccine' was 25.50 ± 5.20. A significant difference was found between the total score of the 'Vaccine Hesitation Scale in the Pandemic' and the mean score of the 'Lack of Confidence' sub-dimension between the 'working status' and the 'influenza vaccination' status. In terms of the mean score of the 'Risk' sub-dimension, a significant difference was found between the 'period of vaccination' (p < 0.05). According to the mean total score of the 'Attitude Towards COVID-19 Vaccine Scale', there was a significant difference between the 'smoking' status. There was a significant difference in the 'Positive Attitude' sub-dimension in terms of the 'flu vaccination' status. There was a significant difference in the 'Negative Attitude' sub-dimension in terms of the 'chronic disease' status. A positive correlation was found between the total scores of the scales. Conclusion It was concluded that although the participants had a high level of hesitation toward the COVID-19 vaccine, they had a positive attitude. The results obtained will be guided in determining the strategies to be developed for these specific groups in future pandemics.
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Affiliation(s)
- Nesibe Simsekoglu
- Department of Home Patient Care, Hamidiye Vocational School of Health Services, University of Health Sciences, Istanbul, Turkey
| | - Enes Akyuz
- Department of Biophysics, Faculty of International Medicine, University of Health Sciences, Istanbul, Turkey
| | - Rabia Guven
- Division of Obstetrics and Gynaecology, Beykoz State Hospital, Istanbul, Turkey
| | - Ozge Pasin
- Department of Biostatistics, Faculty of Medicine, Bezmialem University, Istanbul, Turkey
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Wu J, Cao B, Liao J, Li Y, Lu G, Gong F, Lin G, Zhao M. Navigation of Knowledge: the Impact of COVID-19 on Pregnancy-a Bibliometric Analysis. Reprod Sci 2023; 30:3548-3562. [PMID: 37488404 DOI: 10.1007/s43032-023-01312-x] [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: 04/28/2023] [Accepted: 07/14/2023] [Indexed: 07/26/2023]
Abstract
Since the outbreak of COVID-19, countries around the world have faced huge economic and social burdens. SARS-COV-2 may exist in nature for a long time due to the diversity of its different variants. Pregnant women and newborns as vulnerable groups will suffer serious health threats. Bibliometrics as a method of summarizing publications can be used to extract important achievements and hot topics in this field. We search the target publications from the Web of Science Core collection database, and then use Microsoft Office Excel, CiteSpace, R, Scimago, and VOSviewer for visual analysis. Finally, we included 1709 publications from 2998 institutions in 104 countries. The number of publications has exploded since the COVID-19 pandemic in 2019. Among them, the USA, China, Britain, and Italy have higher quantity and quality. We identified important journals, authors, keywords, and references in this field. Anxiety, stress, risk of pregnancy complications, and vaccine safety and acceptance have received extensive attention from scholars during the COVID-19 pandemic and will continue to be urgent issues to be addressed in the future. Most of the current studies fall into the category of case reports and clinical data analysis. COVID-19 has been linked to serious pregnancy complications and mental illness, and vaccination during pregnancy is recommended to protect both mother and fetus. Further large-scale cohort studies and discovery of molecular mechanisms are needed in this field.
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Affiliation(s)
- Jingrouzi Wu
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, Hunan, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, China
| | - Buzi Cao
- Hunan Normal University School of Medicine, Changsha, Hunan, China
| | - Jingnan Liao
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, Hunan, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, China
| | - Yuan Li
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, China
| | - Guangxiu Lu
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, Hunan, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, China
| | - Fei Gong
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, Hunan, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, China
| | - Ge Lin
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, Hunan, China.
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, China.
| | - Mingyi Zhao
- Pediatric Department of the 3rd Xiangya Hospital, Central South University, Changsha, Hunan, China.
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Woestenberg PJ, de Feijter M, Bergman JEH, Lutke LR, Passier AJLM, Kant AC. Maternal first trimester COVID-19 vaccination and risk of major non-genetic congenital anomalies. Birth Defects Res 2023; 115:1746-1757. [PMID: 37737482 DOI: 10.1002/bdr2.2251] [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: 07/12/2023] [Revised: 08/21/2023] [Accepted: 09/06/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Information regarding the risk of early pregnancy COVID-19 vaccination on the development of major congenital anomalies in the offspring is still limited. Here, we study the association between any COVID-19 vaccination during the 1st trimester and at least one major non-genetic congenital anomaly in the offspring. METHODS We used data from the Dutch Pregnancy Drug Register, an ongoing cohort study. We selected participants with a pregnancy that ended after at least 20 weeks gestation. Pregnant participants self-reported their COVID-19 vaccination status and the presence of congenital anomalies in the offspring. We used logistic regression analyses to study the association between 1st trimester COVID-19 vaccination (gestational week 2 + 0 to 12 + 6) and the risk of at least one major non-genetic congenital anomaly in the offspring. Clustering of anomalies on the ICD10 level by 1st trimester COVID-19 vaccination status was explored using Fisher exact tests. RESULTS We included 3721 participants of whom 795 (21.4%) were COVID-19 vaccinated during the 1st trimester. The percentage of participants who gave birth to a child with at least one major non-genetic congenital anomaly was comparable between participants who were 1st trimester vaccinated (1.1%) and participants who were not (1.2%) (adjusted odd ratio 0.78 [95% confidence interval 0.35-1.71]). We found no clustering of major non-genetic congenital anomalies by 1st trimester COVID-19 vaccination status (p > .05). CONCLUSIONS There were no indications of an increased risk of major non-genetic congenital anomalies in the offspring after maternal 1st trimester COVID-19 vaccination. Our findings suggest COVID-19 vaccines are safe during early pregnancy.
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Affiliation(s)
- Petra J Woestenberg
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, the Netherlands
| | - Maud de Feijter
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, the Netherlands
| | - Jorieke E H Bergman
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - L Renée Lutke
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Agnes C Kant
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, the Netherlands
- Department of Clinical Pharmacology and Toxicology, Leiden University Medical Centre, Leiden, the Netherlands
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Triunfo S, Iannuzzi V, Podda M, Pedrina D, Gemelli S, Marconi AM. Reducing vaccine hesitancy in pregnancy by the health literacy model inclusive of modern communication tools. Arch Gynecol Obstet 2023; 308:1391-1393. [PMID: 37552285 DOI: 10.1007/s00404-023-07138-x] [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: 03/05/2023] [Accepted: 07/01/2023] [Indexed: 08/09/2023]
Abstract
Albeit the vaccination is one of the most successful and cost-effective public health interventions, reluctance or refusal to vaccinate represents one of the ten threats to global health by the World Health Organization. Additional efforts to promote vaccination are required for at higher risk categories, such as pregnant women. Our approach supports the role of a clear and transparent communication by using efficient interventions and educational strategies to increase both willingness and confidence for preventable diseases in neonates and infants by vaccinations in pregnancy.
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Affiliation(s)
- Stefania Triunfo
- Department of Obstetrics and Gynecology, ASST Santi Paolo Carlo, University of Milan, Milan, Italy.
| | - Veronica Iannuzzi
- Department of Obstetrics and Gynecology, ASST Santi Paolo Carlo, University of Milan, Milan, Italy
| | - Martina Podda
- Department of Obstetrics and Gynecology, ASST Santi Paolo Carlo, University of Milan, Milan, Italy
| | - Deborah Pedrina
- Department of Obstetrics and Gynecology, ASST Santi Paolo Carlo, University of Milan, Milan, Italy
| | - Simona Gemelli
- Department of Obstetrics and Gynecology, ASST Santi Paolo Carlo, University of Milan, Milan, Italy
| | - Anna Maria Marconi
- Department of Obstetrics and Gynecology, ASST Santi Paolo Carlo, University of Milan, Milan, Italy
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Triunfo S, Perossini S, Burdin E, De Angeli EC, Francesi M, Garolfi A, Moretti J, Paruscio I, Tassielli M, Tremolada M, Gemelli S, Pedrina D, Marconi AM. Increasing Vaccine Uptake during Pregnancy by Using Prenatal Education Classes: An Effective Tool for Health Communication and Promotion. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1466. [PMID: 37761427 PMCID: PMC10529209 DOI: 10.3390/children10091466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/10/2023] [Accepted: 08/26/2023] [Indexed: 09/29/2023]
Abstract
Childbirth education classes represent an antenatal tool for supporting pregnant women and couples in increasing knowledge on pregnancy, delivery, breastfeeding, and newborn care. The aim of this study was to investigate the impact of an additional lesson during the prenatal course regarding the advantage of vaccination to mitigation of maternal anxiety. An observational study was designed that included participants in childbirth education classes and compared courses enhanced by the extra lesson on vaccination during pregnancy versus those who did not receive it. Assessment of the impact of prenatal educational on vaccination was measured by using validated questionnaires (State-Trait Anxiety Inventory, STAI; Perceived Stress Scale, PSS; World Health Organization- Five Well-Being Index, WHO-5). A total of 145 pregnant women participated to the investigation by answering to the online survey. Of them, 33 patients (22.8%) belonged to the course without a lesson on vaccine, while 112 (77.2%) participated to online prenatal education that included an additional meeting on the usefulness of getting vaccinated during pregnancy. No statistical differences were found between study groups in terms of demographics and perinatal outcomes. Participants in the enriched course reported lower basal anxiety levels than those without the vaccine lesson (STAI-State, normal score < 40, 30 vs. 19%, p-value 0.041; STAI-State, mild score 40-50, 78 vs. 67%, p-value 0.037). With reference to the prior two weeks, maternal wellbeing level was improved by the added class (score > 13 as measurement of wellbeing: 62% vs. 80%, p-value < 0.05). Moderate perceived stress assessed by PSS was found in those pregnant women without prenatal education on vaccination (64 vs. 50%, p-value 0.042). The introduction of a lesson regarding vaccination during pregnancy in the program of prenatal education courses improved maternal anxiety levels and wellbeing, in addition to reducing perceived stress.
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Affiliation(s)
- Stefania Triunfo
- Department of Obstetrics and Gynecology, ASST Santi Paolo e Carlo, S. Paolo University Hospital, Università degli Studi di Milano, 20122 Milan, Italy; (S.P.); (E.B.); (E.C.D.A.); (M.F.); (A.G.); (J.M.); (I.P.); (M.T.); (M.T.); (S.G.); (D.P.); (A.M.M.)
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Kherfan T, Sallam M. Prospective Attitudes towards Respiratory Syncytial Virus (RSV) Vaccination: Validation of a Survey Instrument among Young Females in Jordan Pending Vaccine Authorization. Vaccines (Basel) 2023; 11:1386. [PMID: 37631954 PMCID: PMC10459998 DOI: 10.3390/vaccines11081386] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/11/2023] [Accepted: 08/18/2023] [Indexed: 08/28/2023] Open
Abstract
In May 2023, the U.S. FDA advisors endorsed Pfizer's pregnancy-administered vaccine (branded ABRYSVO) to protect infants from respiratory syncytial virus (RSV) infection. Vaccination can reduce the burden of RSV-related respiratory disease, with previous studies showing its substantial medical and financial burden in Jordan. However, pregnant women may exhibit hesitancy to get vaccinated due to concerns about potential risks to themselves or their fetuses. This study aimed to assess the acceptance of the RSV vaccine among young females and identify the determinants influencing their decision using a newly constructed instrument. A survey instrument was developed and validated, comprising 26 items to measure RSV vaccine acceptance. A cross-sectional study design was employed, with data collection from a sample of females aged 18 to 45 residing in Jordan during 5-6 July 2023, using a convenient approach via an online distributed questionnaire. The final study sample comprised 315 respondents, with 67.6% who have heard of RSV before the study. If the vaccine was safe, effective, and provided freely, 70.2% showed willingness to get the RSV vaccine, 15.2% resisted, and 14.6% were hesitant. Principal component analysis identified six internally consistent sub-scales with the following suggested themes: Advice, Burden, Conspiracy, Dangers, Efficiency, and Fear, comprising 21 items collectively as assigned as the "ABCDEF" scale for RSV vaccine acceptance. RSV vaccine acceptance in this study was associated with the advice and fear constructs. The validated survey instrument successfully captured important determinants of RSV vaccine acceptance among young females. RSV vaccine promotion efforts should focus on the following: enhancing vaccine education, improving trust in healthcare institutions and providers, reducing burdens through resolving cost issues and focusing on the role of social support, addressing safety concerns, and tailoring communication strategies to effectively promote the benefits of the vaccine. These insights can inform public health policies and interventions aiming to promote RSV vaccination and mitigate the burden of RSV-related diseases among infants. Follow-up studies are recommended with pregnant women as the target group to assess their attitude towards RSV vaccination and to confirm the validity of the conceived ABCDEF survey instrument.
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Affiliation(s)
- Tleen Kherfan
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
- Department of Translational Medicine, Faculty of Medicine, Lund University, 22184 Malmö, Sweden
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Pawłowska M, Pokorska-Śpiewak M, Talarek E, Mania A, Hasiec B, Żwirek-Pytka E, Stankiewicz M, Stani M, Frańczak-Chmura P, Szenborn L, Zaleska I, Chruszcz J, Majda-Stanisławska E, Dryja U, Gąsiorowska K, Figlerowicz M, Mazur-Melewska K, Faltin K, Ciechanowski P, Peregrym M, Łasecka-Zadrożna J, Rudnicki J, Szczepańska B, Pałyga-Bysiecka I, Rogowska E, Hudobska-Nawrot D, Domańska-Granek K, Sybilski A, Kucharek I, Franczak J, Sobolewska-Pilarczyk M, Kuchar E, Wronowski M, Paryż M, Kalicki B, Toczyłowski K, Sulik A, Niedźwiecka S, Flisiak R, Marczyńska M. Clinical Course and Severity of COVID-19 in 940 Infants with and without Comorbidities Hospitalized in 2020 and 2021: The Results of the National Multicenter Database SARSTer-PED. J Clin Med 2023; 12:jcm12072479. [PMID: 37048562 PMCID: PMC10095202 DOI: 10.3390/jcm12072479] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/10/2023] [Accepted: 03/23/2023] [Indexed: 04/14/2023] Open
Abstract
This study aimed to analyze the differences in severity and clinical characteristics of COVID-19 in infants hospitalized in Poland in 2021, when the dominance of variants of concern (VOCs) alpha and delta was reported, compared to 2020, when original (wild) SARS-CoV-2 was dominant (III-IV vs. I-II waves of the pandemic, respectively). In addition, the influence of the presence of comorbidities on the clinical course of COVID-19 in infants was studied. This multicenter study, based on the pediatric part of the national SARSTer database (SARSTer-PED), included 940 infants with COVID-19 diagnosed between March 1, 2020, and December 31, 2021, from 13 Polish inpatient centers. An electronic questionnaire, which addressed epidemiological and clinical data, was used. The number of hospitalized infants was significantly higher in 2021 than in 2020 (651 vs. 289, respectively). The analysis showed similar lengths of infant hospitalization in 2020 and 2021, but significantly more children were hospitalized for more than 7 days in 2020 (p < 0.009). In both analyzed periods, the most common route of infection for infants was household contact. There was an increase in the percentage of comorbidities, especially prematurity, in children hospitalized in 2021 compared to 2020. Among the clinical manifestations, fever was predominant among children hospitalized in 2021 and 2020. Cough, runny nose, and loss of appetite were significantly more frequently observed in 2021 (p < 0.0001). Severe and critical conditions were significantly more common among children with comorbidities. More infants were hospitalized during the period of VOCs dominance, especially the delta variant, compared to the period of wild strain dominance, even though indications for hospitalization did not include asymptomatic patients during that period. The course of COVID-19 was mostly mild, characterized mainly by fever and respiratory symptoms. Comorbidities, particularly from the cardiovascular system and prematurity, were associated with a more severe course of the disease in infants.
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Affiliation(s)
- Małgorzata Pawłowska
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, 85-067 Bydgoszcz, Poland
| | - Maria Pokorska-Śpiewak
- Department of Children's Infectious Diseases, Medical University of Warsaw; Regional Hospital of Infectious Diseases in Warsaw, 02-091 Warsaw, Poland
| | - Ewa Talarek
- Department of Children's Infectious Diseases, Medical University of Warsaw; Regional Hospital of Infectious Diseases in Warsaw, 02-091 Warsaw, Poland
| | - Anna Mania
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Barbara Hasiec
- Department of Children's Infectious Diseases, Provincial Jan Boży Hospital in Lublin, 20-400 Lublin, Poland
| | - Elżbieta Żwirek-Pytka
- Department of Children's Infectious Diseases, Provincial Jan Boży Hospital in Lublin, 20-400 Lublin, Poland
| | - Magdalena Stankiewicz
- Department of Children's Infectious Diseases, Provincial Jan Boży Hospital in Lublin, 20-400 Lublin, Poland
| | - Martyna Stani
- Department of Children's Infectious Diseases, Provincial Jan Boży Hospital in Lublin, 20-400 Lublin, Poland
| | - Paulina Frańczak-Chmura
- Department of Children's Infectious Diseases, Provincial Jan Boży Hospital in Lublin, 20-400 Lublin, Poland
| | - Leszek Szenborn
- Department of Pediatrics and Infectious Diseases, Wroclaw Medical University, 50-367 Wrocław, Poland
| | - Izabela Zaleska
- Department of Pediatrics and Infectious Diseases, Wroclaw Medical University, 50-367 Wrocław, Poland
| | - Joanna Chruszcz
- Department of Pediatrics and Infectious Diseases, Wroclaw Medical University, 50-367 Wrocław, Poland
| | - Ewa Majda-Stanisławska
- Department of Pediatric Infectious Diseases, Medical University of Lodz, 90-419 Łódź, Poland
| | - Urszula Dryja
- Department of Pediatric Infectious Diseases, Medical University of Lodz, 90-419 Łódź, Poland
| | - Kamila Gąsiorowska
- Department of Pediatric Infectious Diseases, Medical University of Lodz, 90-419 Łódź, Poland
| | - Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Katarzyna Mazur-Melewska
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Kamil Faltin
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Przemysław Ciechanowski
- Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin, 71-455 Szczecin, Poland
| | - Michał Peregrym
- Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin, 71-455 Szczecin, Poland
| | - Joanna Łasecka-Zadrożna
- Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin, 71-455 Szczecin, Poland
| | - Józef Rudnicki
- Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin, 71-455 Szczecin, Poland
| | | | | | - Ewelina Rogowska
- Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland
| | | | | | - Adam Sybilski
- 2nd Department of Pediatrics, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland
- Department of Pediatrics and Neonatology with Allergology Center, Central Clinical Hospital of the Ministry of the Interior, 02-507 Warsaw, Poland
| | - Izabela Kucharek
- 2nd Department of Pediatrics, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland
- Department of Pediatrics and Neonatology with Allergology Center, Central Clinical Hospital of the Ministry of the Interior, 02-507 Warsaw, Poland
| | - Justyna Franczak
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, 85-067 Bydgoszcz, Poland
| | - Małgorzata Sobolewska-Pilarczyk
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, 85-067 Bydgoszcz, Poland
| | - Ernest Kuchar
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Michał Wronowski
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Maria Paryż
- Department of Pediatrics, Pediatric Nephrology and Allergology, Military Institute of Medicine, 01-755 Warsaw, Poland
| | - Bolesław Kalicki
- Department of Pediatrics, Pediatric Nephrology and Allergology, Military Institute of Medicine, 01-755 Warsaw, Poland
| | - Kacper Toczyłowski
- Department of Pediatric Infectious Diseases, Medical University of Bialystok, 15-089 Białystok, Poland
| | - Artur Sulik
- Department of Pediatric Infectious Diseases, Medical University of Bialystok, 15-089 Białystok, Poland
| | - Sławomira Niedźwiecka
- Department of Pediatric Infectious Diseases, Pomeranian Center of Infectious Diseases and Tuberculosis in Gdańsk, 80-214 Gdańsk, Poland
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-089 Białystok, Poland
| | - Magdalena Marczyńska
- Department of Children's Infectious Diseases, Medical University of Warsaw; Regional Hospital of Infectious Diseases in Warsaw, 02-091 Warsaw, Poland
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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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Current Evidence to Guide Practice, Policy, and Research: COVID-19 Vaccination During Pregnancy. J Obstet Gynecol Neonatal Nurs 2023; 52:159-167. [PMID: 36736376 PMCID: PMC9874045 DOI: 10.1016/j.jogn.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Pregnant and lactating women continue to have some of the lowest levels of vaccine uptake despite COVID-19 vaccine recommendations. It is important to consider why COVID-19 vaccine uptake has lagged counter to robust evidence on vaccine benefits, including concerns about vaccine safety and effectiveness. In this column, I present a summary of research findings, limitations, future directions, and a compilation of guidelines and recommendations from professional and governmental organizations.
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Taskou C, Sarantaki A, Beloukas A, Georgakopoulou VΕ, Daskalakis G, Papalexis P, Lykeridou A. Knowledge and Attitudes of Healthcare Professionals Regarding Perinatal Influenza Vaccination during the COVID-19 Pandemic. Vaccines (Basel) 2023; 11:vaccines11010168. [PMID: 36680013 PMCID: PMC9863632 DOI: 10.3390/vaccines11010168] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/30/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
Immunizations during pregnancy are an important aspect of perinatal care. Although the influenza vaccine during pregnancy is safe, vaccination rates are low. According to research data, one of the reasons for the low vaccination rates among pregnant women is that they do not receive a clear recommendation from healthcare providers. This study aims to record the knowledge and attitudes about influenza vaccination and investigate healthcare professionals' recommendations during the perinatal period. A cross-sectional study was conducted with convenience sampling in Athens, Greece. Our purposive sample included 240 midwives, Ob/Gs, and pediatricians. Data were collected using an appropriate standardized questionnaire with information about demographics, attitudes towards influenza vaccination, and knowledge about the influenza virus and peripartum vaccination. Statistical analysis was conducted using IBM SPSS-Statistics version 26.0. This study identifies the reasons for the lack of vaccine uptake including a wide range of misconceptions or lack of knowledge about influenza infection, lack of convenient access to get vaccinated, etc. Misconceptions about influenza and influenza vaccines could be improved by better education of healthcare workers. Continuing professional education for health professionals is necessary to improve the level of knowledge, prevent negative beliefs, and promote preventive and therapeutic practices.
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Affiliation(s)
- Chrysoula Taskou
- Midwifery Department, University of West Attica, 12243 Athens, Greece
- Correspondence:
| | | | - Apostolos Beloukas
- Molecular Microbiology & Immunology Laboratory, Department of Biomedical Sciences, University of West Attica, 11521 Athens, Greece
- National AIDS Reference Centre of Southern Greece, University of West Attica, 12243 Athens, Greece
| | | | - Georgios Daskalakis
- 1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece
| | - Petros Papalexis
- Unit of Endocrinology, 1st Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece
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