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Perelman AD, Trostle ME, Pecoriello J, Quinn GP, Roman AS, Penfield CA. Acceptance of Routine Vaccines in Pregnancy during the COVID-19 Pandemic. Am J Perinatol 2024; 41:e3059-e3064. [PMID: 37816391 DOI: 10.1055/a-2188-8511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
OBJECTIVE This study aimed to evaluate the rates of vaccination against infectious diseases (Tetanus, Diphtheria, and Pertussis [Tdap] and influenza) in pregnancy during the coronavirus disease 2019 (COVID-19) pandemic compared to contemporary historical controls. STUDY DESIGN This was a retrospective cohort study comparing rates of Tdap and influenza vaccination in pregnant people who received care at NYU Langone Health and delivered from September 1, 2020, to January 31, 2021 ("COVID cohort") to the same period the prior year ("2019 cohort"). Demographic information, trimester of initiation of prenatal care, insurance status, and medical comorbidities were evaluated. Outcomes were analyzed using chi-square, Fisher's exact test, and multivariable logistic regression, with significance of p < 0.05. RESULTS In total, 1,713 pregnant people were included. Compared to historical controls, the COVID cohort differed in age, race, timing of initiation of prenatal care, insurance status, and medical comorbidities. After adjusting for these covariates, pregnant people were significantly more likely to accept influenza vaccine in the COVID cohort (adjusted odds ratio [aOR] 1.7, 95% confidence interval [CI] 1.27-2.29) and had similar Tdap acceptance (aOR 1.5, 95% CI 0.99-2.17). However, this trend was not observed for the entire obstetric population; public insurance status and medical comorbidities were associated with lower vaccine rates during the pandemic. For those who had public insurance, rates of influenza vaccination decreased from 83% in 2019 to 40% during COVID (aOR 0.16, 95% CI 0.10-0.24) and for Tdap rates decreased from 93 to 54% (aOR 0.13, 95% CI 0.08-0.21). CONCLUSION During the COVID-19 pandemic era, pregnant people at large were more likely to accept the influenza vaccine. However, this trend did not apply to Tdap, and high-risk groups with public insurance and medical comorbidities. This study highlights potential disparities in vaccination rates, which need to be accounted for when evaluating national vaccine trends. These data support increased efforts in vaccine counseling for high-risk populations. KEY POINTS · Antenatal flu vaccination increased during the pandemic.. · Antenatal Tdap vaccination was unchanged during the pandemic.. · High-risk pregnant patients had decreased vaccine uptake.. · High-risk subgroups were not included in overarching vaccination trends..
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Affiliation(s)
- Allison D Perelman
- Department of Obstetrics & Gynecology, NYU Langone Health, New York, New York
| | - Megan E Trostle
- Department of Obstetrics & Gynecology, Division of Maternal Fetal Medicine, NYU Langone Health, New York, New York
| | - Jillian Pecoriello
- Department of Obstetrics & Gynecology, NYU Langone Health, New York, New York
| | - Gwendolyn P Quinn
- Department of Obstetrics & Gynecology, NYU Langone Health, New York, New York
| | - Ashley S Roman
- Department of Obstetrics & Gynecology, Division of Maternal Fetal Medicine, NYU Langone Health, New York, New York
| | - Christina A Penfield
- Department of Obstetrics & Gynecology, Division of Maternal Fetal Medicine, NYU Langone Health, New York, New York
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Filip G, Sala A, Modolo V, Arnoldo L, Brunelli L, Driul L. Vaccination: Adherence and Hesitancy among Pregnant Women for COVID-19, Pertussis, and Influenza Vaccines. Vaccines (Basel) 2024; 12:427. [PMID: 38675809 PMCID: PMC11054588 DOI: 10.3390/vaccines12040427] [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: 02/20/2024] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
In the realm of antenatal care, vaccinations serve as a cornerstone, crucial for safeguarding the health of both the mother and the fetus, while also extending protection to the newborn against communicable diseases. Nevertheless, vaccine adherence among pregnant women remains very low. The aim of our study was to evaluate the uptake of vaccines (influence, pertussis, and COVID-19) among women during pregnancy and to understand pregnant women's knowledge of vaccines and the diseases they protect against. The purpose was to investigate the reasons why pregnant women chose not to be vaccinated and to develop effective strategies for informing them about the importance of vaccination for both maternal and fetal safety. A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, "Ospedale Santa Maria della Misericordia" in Udine, from 1 December 2021 to 30 June 2022. During this period, a self-completed paper questionnaire was administered to women at the end of pregnancy or during the puerperium. A total of 161 questionnaires were collected. Higher educational level was found to be significantly associated with influenza vaccination uptake (p = 0.037, OR = 2.18, 95% CI 1.05-4.51). Similarly, for pertussis vaccination, adherence was mainly associated with higher educational level (p = 0.014, OR = 2.83, 95% CI 1.24-6.47), but also with Italian nationality (p = 0.003, OR = 3.36, 95% CI 1.56-8.43) and pregnancy attended by a midwife or private gynecologist (p = 0.028, OR = 0.39, 95% CI 0.17-0.90). Regarding the COVID-19 vaccine, the only factor positively influencing uptake was Italian nationality (p = 0.044, OR = 2.66, 95% CI 1.03-6.91). Women's fear that vaccines would endanger the fetus appeared to be the most important reason for refusing vaccinations. Simultaneously, patients also exhibited a desire to receive more information about maternal vaccination, particularly from their general physician or gynecologist. For this reason, it is imperative to enhance maternal vaccination counselling, making it a routine step in prenatal care from the first antenatal visit until the postpartum period.
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Affiliation(s)
- Gabriele Filip
- Department of Obstetrics and Gynaecology, ASUFC, Ospedale Santa Maria Della Misericordia, 33100 Udine, Italy;
| | - Alessia Sala
- Department of Medical Area, University of Udine, 33100 Udine, Italy; (A.S.); (V.M.); (L.A.); (L.B.)
| | - Veronica Modolo
- Department of Medical Area, University of Udine, 33100 Udine, Italy; (A.S.); (V.M.); (L.A.); (L.B.)
| | - Luca Arnoldo
- Department of Medical Area, University of Udine, 33100 Udine, Italy; (A.S.); (V.M.); (L.A.); (L.B.)
- Accreditation, Quality and Clinical Risk Unit, Friuli Centrale Healthcare University Trust, 33100 Udine, Italy
| | - Laura Brunelli
- Department of Medical Area, University of Udine, 33100 Udine, Italy; (A.S.); (V.M.); (L.A.); (L.B.)
- Accreditation, Quality and Clinical Risk Unit, Friuli Centrale Healthcare University Trust, 33100 Udine, Italy
| | - Lorenza Driul
- Department of Obstetrics and Gynaecology, ASUFC, Ospedale Santa Maria Della Misericordia, 33100 Udine, Italy;
- Department of Medical Area, University of Udine, 33100 Udine, Italy; (A.S.); (V.M.); (L.A.); (L.B.)
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Moschese V, De Angelis L, Capogna MV, Graziani S, Baglivo F, Pietropolli A, Miraglia Del Giudice M, Rizzo C. Vaccine hesitancy and knowledge regarding maternal immunization among reproductive age women in central Italy: a cross sectional study. Front Glob Womens Health 2023; 4:1237064. [PMID: 37779637 PMCID: PMC10539584 DOI: 10.3389/fgwh.2023.1237064] [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: 06/12/2023] [Accepted: 08/14/2023] [Indexed: 10/03/2023] Open
Abstract
Background Vaccination in pregnancy offers protection to the mother and the newborn. In Italy, influenza, pertussis, and COVID-19 vaccinations are recommended in pregnancy, but vaccination coverage is still far from the National Immunization Plan goals. We aimed to assess knowledge and attitude on maternal immunization in two groups of Italian women, in pregnancy and in reproductive age (non pregnant). Methods A cross sectional study on Italian childbearing age women gathering information on their knowledge on maternal immunization and attitudes to receiving influenza and pertussis vaccines in pregnancy was carried out at the University of Rome Tor Vergata, between September 2019 and February 2020. Logistic and multinomial regressions were chosen as statistical tests for our analysis. Results 1,031 women participated in the survey by answering the questionnaire. Out of these, 553 (53.6%) women were pregnant, and 478 (46.4%) were in the reproductive age. 37% (204/553) of pregnant women and 41% (198/476) of non pregnant women are aware of the existence of an immunization plan for pregnant women in Italy. The group with age between 20 and 30, for both pregnant women and women in the reproductive age, has a better knowledge of vaccination in pregnancy. Working status is a variable associated with more awareness about vaccination during pregnancy only for pregnant women (OR = 2.34, p < 0.00001). Educational status, trimester of pregnancy and knowledge on the topic are associated with vaccine hesitancy in our multivariate analysis for pregnant women. In the reproductive age group women who had a previous pregnancy are more likely to be hesitant towards vaccination in pregnancy, on the other hand the one with a higher knowledge and educational status are more likely to get vaccinated. Conclusions The study highlights the persistent vaccine hesitancy among Italian women of reproductive age and pregnant women. Despite healthcare providers being identified as a reliable source of information, their recommendations alone are insufficient to overcome vaccine hesitancy. Factors such as employment status, educational level, pregnancy trimester, and knowledge about vaccinations during pregnancy influence vaccine hesitancy. Tailored educational interventions and communication campaigns targeting these areas can help reduce vaccine hesitancy and promote maternal immunization.
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Affiliation(s)
- Viviana Moschese
- Pediatric Immunopathology and Allergology Unit, Tor Vergata University Hospital, University of Rome Tor Vergata, Rome, Italy
| | - Luigi De Angelis
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | | | - Simona Graziani
- Pediatric Immunopathology and Allergology Unit, Tor Vergata University Hospital, University of Rome Tor Vergata, Rome, Italy
| | - Francesco Baglivo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Adalgisa Pietropolli
- Section of Gynecology and Obstetrics, Department of Surgical Sciences, Tor Vergata University Hospital, University of Rome Tor Vergata, Rome, Italy
| | - Michele Miraglia Del Giudice
- Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Caterina Rizzo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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Rahimi-Sharbaf F, Shirazi M, Hessami K, Saleh M, Golshahi F, Saeedi S, Shirdel Abdolmaleki A, Mousavi Vahed SH, Nouri B, Sahebdel B. Radiofrequency Ablation and Intrauterine Transfusion in a Delayed Diagnosed Acardiac Twin Pregnancy. Case Rep Obstet Gynecol 2023; 2023:3243820. [PMID: 37680203 PMCID: PMC10482538 DOI: 10.1155/2023/3243820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 12/21/2022] [Accepted: 07/11/2023] [Indexed: 09/09/2023] Open
Abstract
Twin reversed arterial perfusion (TRAP) sequence or acardiac twin is a rare and severe complication of monochorionic multiple pregnancies. Acardiac twin accounts for 10% of all TRAP sequences, which is the most morphologically developed acardius. We present an undiagnosed TRAP sequence case up to 24 weeks of gestation who underwent successful amnioreduction, radiofrequency ablation (RFA), and intrauterine transfusion (IUT). During follow-up, hydrops of surviving co-twin disappeared, and fetal heart function improved. Finally, a healthy girl weighing 2400 g was born at 36 weeks of gestation. To our knowledge, this is the first reported acardiac twin pregnancy, which requires IUT, in addition to RFA, due to late diagnosis. Therefore, this case report presents successful management options for TRAP sequence cases diagnosed late in pregnancy.
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Affiliation(s)
- Fatemeh Rahimi-Sharbaf
- Department of Obstetrics and Gynecology, Maternal Fetal and Neonatal Research Center, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboobeh Shirazi
- Department of Obstetrics and Gynecology, Maternal Fetal and Neonatal Research Center, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamran Hessami
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
| | - Maasoumeh Saleh
- Department of Obstetrics and Gynecology, Maternal Fetal and Neonatal Research Center, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Golshahi
- Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Saeedi
- Department of Obstetrics and Gynecology, Maternal Fetal and Neonatal Research Center, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Behnaz Nouri
- Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Behrokh Sahebdel
- Department of Obstetrics and Gynecology, Maternal Fetal and Neonatal Research Center, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
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5
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Licata F, Romeo M, Riillo C, Di Gennaro G, Bianco A. Acceptance of recommended vaccinations during pregnancy: a cross-sectional study in Southern Italy. Front Public Health 2023; 11:1132751. [PMID: 37250080 PMCID: PMC10213683 DOI: 10.3389/fpubh.2023.1132751] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 04/05/2023] [Indexed: 05/31/2023] Open
Abstract
Background Vaccine administration is a recommended, safe, and effective measure to protect pregnant women against vaccine-preventable diseases (VPDs). Despite available guidance, maternal immunization rates for vaccination against influenza and with the reduced antigen content tetanus-diphtheria-acellular pertussis vaccine (Tdap) in Italy remain incredibly low. The primary goal of the study was to explore what Italian pregnant women knew about VPDs and immunization during pregnancy and what factors affected their decision to be vaccinated. Methods This cross-sectional study took place between October 2021 and April 2022 in the Southern part of Italy. All consecutive pregnant women, from those attending the selected facilities on randomly selected days, were approached to request participation. The inclusion criteria for participation were age ≥18 years, the ability to understand, speak, and read Italian, and being pregnant at any gestational age. The questionnaire, using a combination of checkboxes and free text answers, consisted of 32 items divided into five parts and lasted ~10 min. Results The results showed that 61% knew that the influenza vaccine is recommended and 48.7% knew that influenza could be risky during pregnancy; 74.1% wrongly reported that the Measles-Mumps-Rubella (MMR) vaccine is recommended during pregnancy. Seven out of 10 pregnant women believed that strong evidence supported the safety of vaccinations during pregnancy, and more than half (55.6%) thought they were at increased risk of severe illness with COVID-19. Women in the sample believed that vaccines received during pregnancy pose a risk of adverse events to the unborn child with a median value of 6 (IQR 3-9), on a scale ranging from 1 to 10. Similarly, the fear of contracting pertussis and influenza during pregnancy showed a median value of 6 (IQR 3-9) and 5 (IQR 3-8), respectively. Only 21.1% and 36.5% of women received influenza and Tdap vaccines during pregnancy. Conclusion Unrealistic risk perception with a negative attitude toward vaccines in pregnancy and a low percentage of vaccinated pregnant women confirm the urgency of training women to make informed choices to increase overall vaccine uptake.
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Perelli F, Turrini I, Giorgi MG, Renda I, Vidiri A, Straface G, Scatena E, D’Indinosante M, Marchi L, Giusti M, Oliva A, Grassi S, De Luca C, Catania F, Vizzielli G, Restaino S, Gullo G, Eleftheriou G, Mattei A, Signore F, Lanzone A, Scambia G, Cavaliere AF. Contrast Agents during Pregnancy: Pros and Cons When Really Needed. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416699. [PMID: 36554582 PMCID: PMC9779218 DOI: 10.3390/ijerph192416699] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/06/2022] [Accepted: 12/10/2022] [Indexed: 05/13/2023]
Abstract
Many clinical conditions require radiological diagnostic exams based on the emission of different kinds of energy and the use of contrast agents, such as computerized tomography (CT), positron emission tomography (PET), magnetic resonance (MR), ultrasound (US), and X-ray imaging. Pregnant patients who should be submitted for diagnostic examinations with contrast agents represent a group of patients with whom it is necessary to consider both maternal and fetal effects. Radiological examinations use different types of contrast media, the most used and studied are represented by iodinate contrast agents, gadolinium, fluorodeoxyglucose, gastrographin, bariumsulfate, and nanobubbles used in contrast-enhanced ultrasound (CEUS). The present paper reports the available data about each contrast agent and its effect related to the mother and fetus. This review aims to clarify the clinical practices to follow in cases where a radiodiagnostic examination with a contrast medium is indicated to be performed on a pregnant patient.
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Affiliation(s)
- Federica Perelli
- Azienda USL Toscana Centro, Gynecology and Obstetric Department, Santa Maria Annunziata Hospital, 50012 Florence, Italy
| | - Irene Turrini
- Azienda USL Toscana Centro, Gynecology and Obstetric Department, Santo Stefano Hospital, 59100 Prato, Italy
- Correspondence:
| | - Maria Gabriella Giorgi
- Azienda USL Toscana Centro, Gynecology and Obstetric Department, Santo Stefano Hospital, 59100 Prato, Italy
| | - Irene Renda
- Division of Obstetrics and Gynecology, Department of Biomedical, Experimental and Clinical Sciences, University of Florence, 50134 Florence, Italy
| | - Annalisa Vidiri
- School of Medicine, Catholic University of the Sacred Hearth, 00168 Rome, Italy
| | - Gianluca Straface
- Obstetrics and Gynecology Unit, Policlinico Abano Terme, 35031 Abano Terme, Italy
| | - Elisa Scatena
- Azienda USL Toscana Centro, Gynecology and Obstetric Department, Santo Stefano Hospital, 59100 Prato, Italy
| | - Marco D’Indinosante
- Azienda USL Toscana Centro, Gynecology and Obstetric Department, Santo Stefano Hospital, 59100 Prato, Italy
| | - Laura Marchi
- Azienda USL Toscana Centro, Gynecology and Obstetric Department, Santo Stefano Hospital, 59100 Prato, Italy
| | - Marco Giusti
- Azienda USL Toscana Centro, Gynecology and Obstetric Department, Santa Maria Annunziata Hospital, 50012 Florence, Italy
| | - Antonio Oliva
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Simone Grassi
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Carmen De Luca
- Teratology Information Service, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Francesco Catania
- Department of Obstetrics and Gynecology, Ospedale “Santa Maria Alla Gruccia”, 52025 Montevarchi, Italy
| | - Giuseppe Vizzielli
- Department of Medicinal Area (DAME) Clinic of Obstetrics and Gynecology, Santa Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, Italy
| | - Stefano Restaino
- Department of Medicinal Area (DAME) Clinic of Obstetrics and Gynecology, Santa Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, Italy
| | - Giuseppe Gullo
- IVF Public Center, Azienda Ospedaliera Ospedali Riuniti (AOOR) Villa Sofia Cervello, University of Palermo, 90146 Palermo, Italy
| | - Georgios Eleftheriou
- Poison Control Center and Teratology Information Service, Hospital Papa Giovanni XIII, 24127 Bergamo, Italy
| | - Alberto Mattei
- Azienda USL Toscana Centro, Gynecology and Obstetric Department, Santa Maria Annunziata Hospital, 50012 Florence, Italy
| | - Fabrizio Signore
- Obstetrics and Gynecology Unit, Santo Eugenio Hospital, 00144 Rome, Italy
- School of Medicine, Unicamillus University Rome, 00131 Rome, Italy
| | - Antonio Lanzone
- School of Medicine, Catholic University of the Sacred Hearth, 00168 Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Giovanni Scambia
- School of Medicine, Catholic University of the Sacred Hearth, 00168 Rome, Italy
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Anna Franca Cavaliere
- School of Medicine, Catholic University of the Sacred Hearth, 00168 Rome, Italy
- Division of Gynecology and Obstetrics Fatebenefratelli Isola Tiberina, 00186 Rome, Italy
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Marín-Cos A, Marbán-Castro E, Nedic I, Ferrari M, Crespo-Mirasol E, Ventura LF, Zamora BN, Fumadó V, Menéndez C, Martínez Bueno C, Llupià A, López M, Goncé A, Bardají A. "Maternal Vaccination Greatly Depends on Your Trust in the Healthcare System": A Qualitative Study on the Acceptability of Maternal Vaccines among Pregnant Women and Healthcare Workers in Barcelona, Spain. Vaccines (Basel) 2022; 10:vaccines10122015. [PMID: 36560425 PMCID: PMC9783547 DOI: 10.3390/vaccines10122015] [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: 10/20/2022] [Revised: 11/14/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open
Abstract
The World Health Organization (WHO) identified vaccine hesitancy as one of the top 10 threats to global health in 2019. Health promotion and education have been seen to improve knowledge and uptake of vaccinations in pregnancy. This qualitative study was conducted based on phenomenology, a methodological approach to understand first-hand experiences, and grounded theory, an inductive approach to analyse data, where theoretical generalisations emerge. Data were collected through semi-structured interviews with pregnant women attending antenatal care services and healthcare workers (HCWs) in Barcelona, Spain. Interviews were audio-recorded, transcribed, and coded, and notes were taken. Inductive thematic analysis was performed, and data were manually coded. Pertussis was reported as the most trusted vaccine among pregnant women due to its long-standing background as a recommended vaccine in pregnancy. The influenza vaccine was regarded as less important since it was perceived to cause mild disease. The COVID-19 vaccine was the least trustworthy for pregnant women due to uncertainties about effectiveness, health effects in the mid- and long-term, the fast development of the vaccine mRNA technology, and the perceptions of limited data on vaccine safety. However, the necessity to be vaccinated was justified by pregnant women due to the exceptional circumstances of the COVID-19 pandemic. The recommendations provided by HCW and the established relationship between the HCW, particularly midwives, and pregnant women were the main factors affecting decision-making. The role of mass media was perceived as key to helping provide reliable messages about the need for vaccines during pregnancy. Overall, vaccines administered during pregnancy were perceived as great tools associated with better health and improved quality of life. Pregnancy was envisioned as a vulnerable period in women's lives that required risk-benefits assessments for decision-making about maternal vaccinations. A holistic approach involving the community and society was considered crucial for health education regarding maternal vaccines in support of the work conducted by HCWs.
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Affiliation(s)
- Anna Marín-Cos
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
| | | | - Ivana Nedic
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
| | - Mara Ferrari
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
| | - Esther Crespo-Mirasol
- BCNatal—Barcelona Center of Maternal-Fetal and Neonatal Medicine, Department of Maternal-Fetal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, 08007 Barcelona, Spain
| | - Laia Ferrer Ventura
- ASSIR Esquerra, Gerència Territorial de Barcelona, Institut Català de la Salut, 08015 Barcelona, Spain
| | - Berta Noya Zamora
- ASSIR Esquerra, Gerència Territorial de Barcelona, Institut Català de la Salut, 08015 Barcelona, Spain
| | - Victoria Fumadó
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
| | - Clara Menéndez
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Barcelona, Spain
| | - Cristina Martínez Bueno
- ASSIR Barcelona Ciutat, Gerència Territorial de Barcelona, Institut Català de la Salut i Universitat de Barcelona, 08007 Barcelona, Spain
| | - Anna Llupià
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
- Department of Preventive Medicine and Epidemiology, Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain
| | - Marta López
- BCNatal—Barcelona Center of Maternal-Fetal and Neonatal Medicine, Department of Maternal-Fetal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, 08007 Barcelona, Spain
| | - Anna Goncé
- BCNatal—Barcelona Center of Maternal-Fetal and Neonatal Medicine, Department of Maternal-Fetal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, 08007 Barcelona, Spain
| | - Azucena Bardají
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Barcelona, Spain
- Correspondence:
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Shamoun R, Agosta P, Nabati S, Brannan GD, Haglin K, Thomas M. Impact of the COVID-19 Pandemic on the Rate of Influenza Vaccination in a Predominately African American Pregnant Population. Cureus 2022; 14:e30666. [DOI: 10.7759/cureus.30666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2022] [Indexed: 11/06/2022] Open
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9
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Marchi L, Vidiri A, Fera EA, Pallottini M, Perelli F, Gardelli M, Brunelli T, Poggetto PD, Martelli E, Straface G, Signore F, Fusco I, Vasarri PL, Scambia G, Cavaliere AF. SARS-CoV-2 IgG "heritage" in newborn: A credit of maternal natural infection. J Med Virol 2022; 95:e28133. [PMID: 36071636 PMCID: PMC9538415 DOI: 10.1002/jmv.28133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 08/27/2022] [Accepted: 08/31/2022] [Indexed: 01/11/2023]
Abstract
Description of transplacental passage of specific SARS-CoV-2 IgG from mothers who contracted natural infection to their newborns. Retrospective cohort analysis including pregnant women diagnosed with SARS-CoV-2 and their newborns both tested for SARS-CoV-2 specific IgG and IgM with antibody titration at delivery. Nasopharyngeal swab were taken from both mothers and neonates, and tested for SARS-CoV-2 using polymerase chain reaction (PCR). IgM and IgG were analyzed in maternal and neonatal serum of 143 mother-infant dyads. 86% of women with a positive SARS-CoV-2 PCR >14 days before delivery developed specific IgG and 84% of their infants showed transplacental passage of IgG. Pregnant women infected with SARS-CoV-2 achieve antibody seroconversion following the kinetics described in the general population, and transplacental transfer of IgG specific antibodies occurs. No conclusion can be drawn on passive immunity efficacy or duration.
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Affiliation(s)
- Laura Marchi
- Obstetrics and Gynecology Unit, Santo Stefano Hospital PratoAUSL Toscana CentroPratoItaly
| | - Annalisa Vidiri
- Department of Science of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCSUniversità Cattolica del Sacro CuoreRomaItaly
| | - Emanuele Arturo Fera
- Department of Woman and Child HealthAzienda Ospedaliero Universitaria CareggiFirenzeItaly
| | - Marta Pallottini
- Obstetrics and Gynecology Unit, Santo Stefano Hospital PratoAUSL Toscana CentroPratoItaly
| | - Federica Perelli
- Obstetrics and Gynecology Unit, Ospedale Santa Maria AnnunziataAUSL Toscana CentroFirenzeItaly
| | - Monica Gardelli
- Obstetrics and Gynecology Unit, Santo Stefano Hospital PratoAUSL Toscana CentroPratoItaly
| | - Tamara Brunelli
- Clinical Pathology and Microbiology Unit, Santo Stefano Hospital PratoAUSL Toscana CentroPratoItaly
| | - Paolo Dal Poggetto
- Paediatrics and Neonatology Unit, Santo Stefano Hospital PratoAUSL Toscana CentroPratoItaly
| | - Elena Martelli
- Paediatrics and Neonatology Unit, Santo Stefano Hospital PratoAUSL Toscana CentroPratoItaly
| | - Gianluca Straface
- Obstetrics and Gynecology UnitPoliclinico Abano TermeAbano TermeItaly
| | - Fabrizio Signore
- Obstetrics and Gynecology UnitSanto Eugenio HospitalRomaItaly,Division of Obstetrics and GynaecologyUnicamillus University RomeRomaItaly
| | - Ismaele Fusco
- Clinical Pathology and Microbiology Unit, Santo Stefano Hospital PratoAUSL Toscana CentroPratoItaly
| | - Pier Luigi Vasarri
- Paediatrics and Neonatology Unit, Santo Stefano Hospital PratoAUSL Toscana CentroPratoItaly
| | - Giovanni Scambia
- Department of Science of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCSUniversità Cattolica del Sacro CuoreRomaItaly
| | - Anna Franca Cavaliere
- Obstetrics and Gynecology Unit, Santo Stefano Hospital PratoAUSL Toscana CentroPratoItaly
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10
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COVID-19, Vaccination, and Female Fertility in the Czech Republic. Int J Mol Sci 2022; 23:ijms231810909. [PMID: 36142820 PMCID: PMC9501189 DOI: 10.3390/ijms231810909] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 11/03/2022] Open
Abstract
The fast-track process to approve vaccines against COVID-19 has raised questions about their safety, especially in relation to fertility. Over the last 2 years, studies have appeared monitoring female fertility, especially from assisted reproduction centers or in animal experiments. However, studies monitoring healthy populations are still limited. The aim of our study was to monitor the relevant parameters of female fertility (sex and other steroids, LH, FSH, SHBG, Antimüllerian hormone and antral follicle count) before and then 2-4 months after the third dose of vaccination against COVID-19 in a group of 25 healthy fertile woman. In addition, anti-SARS-CoV-2 and anti-SARS-CoV-2S antibodies were determined. We did not observe significant changes in the measured parameters before and after the third dose of vaccination. By comparing levels of the analytes with antibodies indicating a prior COVID-19 infection, we found that women who had experienced the disease had statistically lower levels of estrone, estradiol, SHBG and 5α-dihydroprogesterone, and conversely, higher levels of androgen active dehydroepiandrosterone and dihydrotestosterone. Our results confirm that vaccination does not affect female fertility, and that what fertile women should be worried about is not vaccination, but rather COVID-19 infection itself.
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11
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Oh KB, Doherty TM, Vetter V, Bonanni P. Lifting non-pharmaceutical interventions following the COVID-19 pandemic - the quiet before the storm? Expert Rev Vaccines 2022; 21:1541-1553. [PMID: 36039786 DOI: 10.1080/14760584.2022.2117693] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION In the first months of the novel coronavirus (COVID-19) pandemic that begun in 2020, non-pharmaceutical interventions (NPIs) have been adopted worldwide. However, the effects of NPI implementation go beyond slowing the spread of COVID-19. Here, we review the non-intended effects that may have arisen from prolonged application of NPIs. AREAS COVERED NPIs also affected the epidemiology of other infectious diseases, with unprecedentedly low circulation of several respiratory and gastrointestinal viruses being observed worldwide in 2020. While this was a welcome effect for already strained healthcare systems, prolonged low exposure to pathogens may result in an increased pool of individuals susceptible to certain diseases. Out-of-season or unusually intense outbreaks of non-vaccine preventable diseases have already been documented as NPIs were gradually eased. In the context of widespread and important disruptions in national vaccination programs during the early phase of the pandemic, the risk of vaccine-preventable disease resurgence after NPIs are lifted cannot be excluded either. EXPERT OPINION Awareness must be raised of the risk of vaccine-preventable disease resurgence, and efforts need to be made to mitigate this risk, where possible, by increasing vaccination coverage. Research and regulatory opportunities brought on by the COVID-19 pandemic should be seized.
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Affiliation(s)
| | | | | | - Paolo Bonanni
- Department of Health Sciences, University of Florence, Italy
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12
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Transplacental Transfer of Maternal Antibody against SARS-CoV-2 and Its Influencing Factors: A Review. Vaccines (Basel) 2022; 10:vaccines10071083. [PMID: 35891247 PMCID: PMC9318929 DOI: 10.3390/vaccines10071083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/01/2022] [Accepted: 07/02/2022] [Indexed: 01/07/2023] Open
Abstract
Since the beginning of the coronavirus disease 2019 (COVID-19) outbreak, the disease has rapidly become a global threat. The constant emergence of new variants has increased the difficulty of controlling this disease. Vaccination is still considered the most effective method to prevent COVID-19. Vaccination has expanded to include children aged 3–17 years old, and some countries have lowered the age of vaccination to 6 months (for example, the United States). However, children under 3 years old are still not able to be vaccinated in most countries. In this study, we summarize the COVID-19 vaccination status in pregnant women, comprehensively elaborate on the status of maternal immune response and maternal antibody transfer after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and vaccination, and further analyze the possible influencing factors of maternal antibody transfer according to the currently available evidence on the topic. It was concluded that pregnant women develop an immune response and produce antibodies that can be transmitted through the placenta after vaccination, but more data are needed to determine the transfer rate and duration of these maternal antibodies and potential factors. The results provide a scientific basis for studying the protective effect of maternal antibodies on infants, formulating a vaccination strategy for pregnant women, and preventing SARS-CoV-2 infection in infants.
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13
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Knowledge and Attitudes of Medical Students toward COVID-19 Vaccine in Saudi Arabia. Vaccines (Basel) 2022; 10:vaccines10040541. [PMID: 35455290 PMCID: PMC9027616 DOI: 10.3390/vaccines10040541] [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: 02/08/2022] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 12/28/2022] Open
Abstract
Medical students are the future caregivers of communities, and therefore it is important to rectify their misconceptions about the COVID-19 vaccine. We aimed to explore the knowledge and attitudes among medical students toward the COVID-19 vaccine in Saudi Arabia and to compare the level of knowledge between preclinical and clinical years. This epidemiological cross-sectional study of 1445 (47.3% were pre-clinical and 52.7% were clinical year) medical students was conducted at various universities in Saudi Arabia using a simple random sampling technique. The results revealed that 34.3% students did not know how the Pfizer vaccine worked, with a high proportion in preclinical students (69.4%). Almost 37% of participants thought that one could become infected with COVID-19 via the COVID-19 vaccine, and 67.1% of these students were pre-clinical. About 22.6% of students did not trust COVID-19 vaccine information from the health ministry, and the majority of them (79.8%) were pre-clinical. Vaccine hesitancy was shown by about 33.3% (n = 481) of subjects, and surprisingly, almost half of them (48.6%) thought that the COVID-19 vaccine involved conspiracy; the majority of them were pre-clinical (97.9%). The overall response of students indicates a significantly lower level of knowledge and increased negative attitudes of preclinical students toward the COVID-19 vaccine. However, the vast majority of students agreed on the importance of the COVID-19 vaccine to decrease the spread of the disease.
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14
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The Risk of Spontaneous Abortion Does Not Increase Following First Trimester mRNA COVID-19 Vaccination. J Clin Med 2022; 11:jcm11061698. [PMID: 35330023 PMCID: PMC8955378 DOI: 10.3390/jcm11061698] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/16/2022] [Accepted: 03/18/2022] [Indexed: 02/01/2023] Open
Abstract
Clinical trials for COVID-19 vaccines initially excluded pregnant women due to safety concerns, and when the vaccines were authorized for emergency use, they were not recommended for this population. However, observational studies discovered that pregnant women infected with COVID-19 have higher risks of negative pregnancy and delivery outcomes compared to non-pregnant women, raising the question of the risks–benefits of administering COVID-19 vaccines to pregnant women. By mid-2021, there was general consensus on the relative safety of COVID-19 vaccination during pregnancy; therefore, it is critical to investigate the safety issues related to these vaccines, considering the increasing acceptance among pregnant women. To address these concerns, we developed a research project to study the short-term effects and outcomes of COVID-19 vaccination during the first trimester of pregnancy. Our research followed an observational retrospective design for 12 months from the beginning of the vaccination campaign, and included 124 cases of spontaneous abortions and 927 ongoing pregnancies. The odds of spontaneous abortion were non-significant for both versions of the mRNA vaccine (Pfizer BNT162b2 AOR = 1.04, CI = 0.91–1.12; Moderna mRNA-1273 AOR = 1.02, CI = 0.89–1.08). Overall, our data indicated that the risk of spontaneous abortion after mRNA COVID-19 immunization during the first trimester of pregnancy is commensurate with the predicted risk in non-vaccinated pregnant women. These findings contribute to the growing body of information regarding the safety of mRNA COVID-19 vaccination during pregnancy.
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15
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Januszek S, Siwiec N, Januszek R, Kluz M, Lebed R, Toś P, Góra T, Plens K, Dąbrowski K, Sidorowicz M, Szcześniewska A, Barnaś E, Kalandyk-Osinko K, Darmochwal-Kolarz D, Kluz T. Approach of Pregnant Women from Poland and the Ukraine to COVID-19 Vaccination—The Role of Medical Consultation. Vaccines (Basel) 2022; 10:vaccines10020255. [PMID: 35214718 PMCID: PMC8880363 DOI: 10.3390/vaccines10020255] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 02/03/2022] [Accepted: 02/03/2022] [Indexed: 12/14/2022] Open
Abstract
There are many arguments for the safety and efficacy of COVID-19 vaccines in pregnancy. The aim of this study is to describe the level of vaccination acceptance, to find the factors that most influence the decision to vaccinate, and to describe the scale of changes in vaccination acceptance influenced by medical information on the safety, efficacy, and benefits of vaccination among pregnant women. A total of 300 patients completed the questionnaire, including 150 in Poland and 150 in the Ukraine. The level of vaccination acceptance was assessed before and after medical consultation. There were 53 (35.3%) patients with the intention to get vaccinated in Poland and 25 (16.7%) in the Ukraine. After consultation with a physician, this increased to 109 (72.6%) in Poland and 69 (46%) in the Ukraine. The main factors influencing the acceptance of vaccinations were the fear of harming the foetus (OR-0.119, CI-0.039–0.324 p < 0.001), complications in pregnancy (OR-0.073 CI-0.023–0.197 p < 0.001), and limitations in the vaccination programme (OR-0.026 CI-0.001–0.207 p < 0.001). Medical information about the safety, effectiveness and benefits of vaccinations among pregnant women, provided during a medical visit, may increase the acceptance of vaccinations by 105.6%, as among Polish patients, and by 176%, as among pregnant women from the Ukraine.
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Affiliation(s)
- Sławomir Januszek
- Department of Gynecology, Oncology and Obstetrics, Fryderyk Chopin University Hospital No. 1, 35-055 Rzeszów, Poland; (N.S.); (K.K.-O.); (T.K.)
- Department of Gynecology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszów University, 35-316 Rzeszów, Poland; (E.B.); (D.D.-K.)
- Correspondence: ; Tel.: +48-535860429
| | - Natalia Siwiec
- Department of Gynecology, Oncology and Obstetrics, Fryderyk Chopin University Hospital No. 1, 35-055 Rzeszów, Poland; (N.S.); (K.K.-O.); (T.K.)
| | - Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland;
| | - Marta Kluz
- Department of Pathology, Fryderyk Chopin University Hospital No. 1, 35-055 Rzeszów, Poland;
| | - Roman Lebed
- Khmelnytsky Regional Perinatal Centre, 29-016 Khmelnytskyi, Ukraine;
| | - Paweł Toś
- Department of Gynecology and Obstetrics, University Hospital No. 2, 35-301 Rzeszów, Poland;
| | - Tomasz Góra
- Department of Gynecology and Obstetrics, Jan Paweł II Hospital, 35-241 Rzeszów, Poland;
- Department of Obstetrics and Perinatology, Medical College, Jagiellonian University, 31-501 Kraków, Poland
| | | | - Krzysztof Dąbrowski
- Department of Perinatology, City Hospital in Ruda Śląska, Gynecology and Obstetrics, 41-717 Ruda Śląska, Poland; (K.D.); (M.S.)
| | - Marcin Sidorowicz
- Department of Perinatology, City Hospital in Ruda Śląska, Gynecology and Obstetrics, 41-717 Ruda Śląska, Poland; (K.D.); (M.S.)
| | - Aleksandra Szcześniewska
- Departament of Perinatology and Gynecology, Polish Mother’s Memorial Hospital Research Institute, 93-338 Łodź, Poland;
| | - Edyta Barnaś
- Department of Gynecology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszów University, 35-316 Rzeszów, Poland; (E.B.); (D.D.-K.)
| | - Katarzyna Kalandyk-Osinko
- Department of Gynecology, Oncology and Obstetrics, Fryderyk Chopin University Hospital No. 1, 35-055 Rzeszów, Poland; (N.S.); (K.K.-O.); (T.K.)
- Department of Gynecology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszów University, 35-316 Rzeszów, Poland; (E.B.); (D.D.-K.)
| | - Dorota Darmochwal-Kolarz
- Department of Gynecology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszów University, 35-316 Rzeszów, Poland; (E.B.); (D.D.-K.)
- Department of Gynecology and Obstetrics, University Hospital No. 2, 35-301 Rzeszów, Poland;
| | - Tomasz Kluz
- Department of Gynecology, Oncology and Obstetrics, Fryderyk Chopin University Hospital No. 1, 35-055 Rzeszów, Poland; (N.S.); (K.K.-O.); (T.K.)
- Department of Gynecology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszów University, 35-316 Rzeszów, Poland; (E.B.); (D.D.-K.)
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16
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A Knowledge, Attitude, and Perception Study on Flu and COVID-19 Vaccination during the COVID-19 Pandemic: Multicentric Italian Survey Insights. Vaccines (Basel) 2022; 10:vaccines10020142. [PMID: 35214601 PMCID: PMC8875897 DOI: 10.3390/vaccines10020142] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 01/21/2023] Open
Abstract
In January 2020, Chinese health authorities identified a novel coronavirus strain never before isolated in humans. It quickly spread across the world, and was eventually declared a pandemic, leading to about 310 million confirmed cases and to 5,497,113 deaths (data as of 11 January 2022). Influenza viruses affect millions of people during cold seasons, with high impacts, in terms of mortality and morbidity. Patients with comorbidities are at a higher risk of acquiring severe problems due to COVID-19 and the flu—infections that could impact their underlying clinical conditions. In the present study, knowledge, attitudes, and opinions of the general population regarding COVID-19 and influenza immunization were evaluated. A multicenter, web-based, cross-sectional study was conducted between 10 February and 12 July 2020, during the first wave of SARS-CoV-2 infections among the general population in Italy. A sample of 4116 questionnaires was collected at the end of the study period. Overall, 17.5% of respondents stated that it was unlikely that they would accept a future COVID-19 vaccine (n = 720). Reasons behind vaccine refusal/indecision were mainly a lack of trust in the vaccine (41.1%), the fear of side effects (23.4%), or a lack of perception of susceptibility to the disease (17.1%). More than 50% (53.8%; n = 2214) of the sample participants were willing to receive flu vaccinations in the forthcoming vaccination campaign, but only 28.2% of cases had received it at least once in the previous five seasons. A higher knowledge score about SARS-CoV-2/COVID-19 and at least one flu vaccination during previous influenza seasons were significantly associated with the intention to be vaccinated against COVID-19 and influenza. The continuous study of factors, determining vaccination acceptance and hesitancy, is fundamental in the current context, in regard to improve vaccination confidence and adherence rates against vaccine preventable diseases.
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17
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Gertz A, Rader B, Sewalk K, Brownstein JS. Emerging Socioeconomic Disparities in COVID-19 Vaccine Second-Dose Completion Rates in the United States. Vaccines (Basel) 2022; 10:121. [PMID: 35062782 PMCID: PMC8780621 DOI: 10.3390/vaccines10010121] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/30/2021] [Accepted: 01/11/2022] [Indexed: 11/16/2022] Open
Abstract
Although COVID-19 vaccination plans acknowledge a need for equity, disparities in two-dose vaccine initiation have been observed in the United States. We aim to assess if disparity patterns are emerging in COVID-19 vaccination completion. We gathered (n = 843,985) responses between February and November 2021 from a web survey. Individuals self-reported demographics and COVID-19 vaccination status. Dose initiation and completion rates were calculated incorporating survey weights. A multi-variate logistic regression assessed the association between income and completing vaccination, accounting for other demographics. Overall, 57.4% initiated COVID-19 vaccination, with 84.5% completing vaccination. Initiation varied by income, and we observed disparities in completion by occupation, race, age, and insurance. Accounting for demographics, higher incomes are more likely to complete vaccination than lower incomes. We observe disparities in completion across annual income. Differences in COVID-19 vaccination completion may lead to two tiers of protection in the population, with certain sub-groups being better protected from future infection.
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Affiliation(s)
- Autumn Gertz
- Computational Epidemiology Laboratory, Boston Children’s Hospital, Boston, MA 02115, USA; (A.G.); (B.R.); (K.S.)
| | - Benjamin Rader
- Computational Epidemiology Laboratory, Boston Children’s Hospital, Boston, MA 02115, USA; (A.G.); (B.R.); (K.S.)
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
| | - Kara Sewalk
- Computational Epidemiology Laboratory, Boston Children’s Hospital, Boston, MA 02115, USA; (A.G.); (B.R.); (K.S.)
| | - John S. Brownstein
- Computational Epidemiology Laboratory, Boston Children’s Hospital, Boston, MA 02115, USA; (A.G.); (B.R.); (K.S.)
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
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18
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Makowska M, Boguszewski R, Podkowińska M. Trust in Medicine as a Factor Conditioning Behaviors Recommended by Healthcare Experts during the COVID-19 Pandemic in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010605. [PMID: 35010859 PMCID: PMC8744838 DOI: 10.3390/ijerph19010605] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/31/2021] [Accepted: 01/03/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Due to the COVID-19 pandemic, public health experts have faced the challenge of convincing people to change their everyday habits. This study aims to evaluate the impact of trust in medicine on Polish citizens' adherence to recommended behaviors. METHODS An online survey was conducted on a quota sample of adult Poles (n = 1072) during the second wave of COVID-19. RESULTS The trust-in-medicine index was created from statements relating to trust in healthcare professionals, vaccines, and medicines. This index showed that 27.1% of respondents expressed low trust, 36.7% expressed moderate trust, and 36.3% expressed high trust. The recommended behavior index was created from nine statements. This index showed that 15.8% of respondents had low adherence, 38.2% had moderate adherence, and 46.0% had high adherence to the healthcare experts' recommendations. One-way analysis of variance showed that people with a high trust had significantly higher scores on the recommended behavior index when compared to people with a moderate or low trust. CONCLUSIONS This study suggests that those responsible for health policy should put more effort into building trust not only in health professionals, but also in pharmaceutical companies. We also determined the socio-demographic features of people to whom such actions of trust building should be directed.
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19
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Chao MJ, Menon C, Elgendi M. Effect of COVID-19 vaccination on the menstrual cycle. Front Med (Lausanne) 2022; 9:1065421. [PMID: 36590952 PMCID: PMC9802578 DOI: 10.3389/fmed.2022.1065421] [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: 10/20/2022] [Accepted: 11/22/2022] [Indexed: 12/23/2022] Open
Abstract
Numerous anecdotal accounts and qualitative research studies have reported on post-vaccination menstrual irregularities in women of reproductive age. However, none have quantified the impact. This is the first systematic review and meta-analysis to quantify and characterize the menstrual irregularities associated with vaccination for women of reproductive age. A search on July 20, 2022, retrieved articles published between December 1, 2019, and July 1, 2022, from MEDLINE, Embase, and Web of Science. The included articles were studies with full texts written in English that reported on menstrual irregularities for vaccinated vs. unvaccinated women of reproductive age. The quality of the studies was evaluated using the Study Quality Assessment Tool for Observation Cohort and Cross-Sectional Studies. Four observational studies were included. Review Manager was used to generating a forest plot with odds ratios (ORs) at the 95% confidence interval (CI), finding statistically significant associations between vaccination and menstrual irregularities for 25,054 women of reproductive age (OR = 1.91, CI: 1.76-2.07) with a significant overall effect of the mean (Z = 16.01, p < 0.0001). The studies were heterogeneous with significant dispersion of values (χ2 = 195.10 at df = 3, p < 0.00001, I 2 = 98%). The findings of this systematic review and meta-analysis are limited by the availability of quantitative data. The results have implications for treating women of reproductive age with menstrual irregularities and informing them about the potential side effects of vaccinations.
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Affiliation(s)
- Melissa Jung Chao
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Carlo Menon
- Biomedical and Mobile Health Technology Lab, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Mohamed Elgendi
- Biomedical and Mobile Health Technology Lab, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
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20
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Zimand-Sheiner D, Kol O, Frydman S, Levy S. To Be (Vaccinated) or Not to Be: The Effect of Media Exposure, Institutional Trust, and Incentives on Attitudes toward COVID-19 Vaccination. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12894. [PMID: 34948501 PMCID: PMC8702102 DOI: 10.3390/ijerph182412894] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 11/17/2022]
Abstract
The COVID-19 vaccine has become a strategic vehicle for reducing the spread of the pandemic. However, the uptake of the vaccine by the public is more complicated than simply making it available. Based on social learning theory, this study examines the role of communication sources and institutional trust as barriers and incentives as motivators of people's attitudes toward vaccination and actual vaccination. Data were collected via an online panel survey among Israelis aged 18-55 and then analyzed using structural equation modeling (SEM). Findings show that social media trust negatively mediates the effect of exposure to information on the vaccine on attitudes toward vaccination. However, mass media trust and institutional trust positively mediate this relationship. Incentives were effective motivators for forming positive attitudes and moderating the effect of institutional trust on attitude toward vaccination. This study facilitates a deeper understanding of health communication theory in pandemics and makes important recommendations for practitioners and policy makers.
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Affiliation(s)
| | - Ofrit Kol
- School of Communication, Ariel University, Ariel 40700, Israel;
| | - Smadar Frydman
- Doctoral School, Jaume I University, 12071 Castelló de la Plana, Spain;
| | - Shalom Levy
- Department of Economics and Business Administration, Ariel University, Ariel 40700, Israel;
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