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COVID-19 vaccination in pregnancy: views and vaccination uptake rates in pregnancy, a mixed methods analysis from SAIL and the Born-In-Wales Birth Cohort

Mohamed Mhereeg, Hope Jones, Jonathan Kennedy, Mike Seaborne Orcid Logo, Michael Parker, Tash Kennedy Kennedy, SARAH BEESON, Ashley Akbari Orcid Logo, Luisa Zuccolo Orcid Logo, Alisha Davies Orcid Logo, Sinead Brophy Orcid Logo

BMC Infectious Diseases, Volume: 22, Issue: 1

Swansea University Authors: Mohamed Mhereeg, Hope Jones, Jonathan Kennedy, Mike Seaborne Orcid Logo, Michael Parker, Tash Kennedy Kennedy, SARAH BEESON, Ashley Akbari Orcid Logo, Sinead Brophy Orcid Logo

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DOI (Published version): 10.1186/s12879-022-07856-8

Abstract

BackgroundVaccine hesitancy amongst pregnant women has been found to be a concern during past epidemics. This study aimed to (1) estimate COVID-19 vaccination rates among pregnant women in Wales and their association with age, ethnicity, and area of deprivation, using electronic health record (EHR)...

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Published in: BMC Infectious Diseases
ISSN: 1471-2334
Published: Springer Science and Business Media LLC 2022
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This study aimed to (1) estimate COVID-19 vaccination rates among pregnant women in Wales and their association with age, ethnicity, and area of deprivation, using electronic health record (EHR) data linkage, and (2) explore pregnant women&#x2019;s views on receiving the COVID-19 vaccine during pregnancy using data from a survey recruiting via social media (Facebook, Twitter), through midwives, and posters in hospitals (Born-In-Wales Cohort).MethodsThis was a mixed-methods study utilising routinely collected linked data from the Secure Anonymised Information Linkage (SAIL) Databank (Objective 1) and the Born-In-Wales Birth Cohort participants (Objective 2). Pregnant women were identified from 13th April 2021 to 31st December 2021. Survival analysis was utilised to examine and compare the length of time to vaccination uptake in pregnancy, and variation in uptake by; age, ethnic group, and deprivation area was examined using hazard ratios (HR) from Cox regression. Survey respondents were women who had a baby during the COVID-19 pandemic or were pregnant between 1st November 2021 and 24th March 2022 and participating in Born-In-Wales. Codebook thematic analysis was used to generate themes from an open-ended question on the survey.ResultsPopulation-level data linkage (objective 1): Within the population cohort, 8203 (32.7%) received at least one dose of the COVID-19 vaccine during pregnancy, 8572 (34.1%) remained unvaccinated throughout the follow-up period, and 8336 (33.2%) received the vaccine postpartum. Younger women (&lt;&#x2009;30 years) were less likely to have the vaccine, and those living in areas of high deprivation were also less likely to have the vaccine (HR&#x2009;=&#x2009;0.88, 95% CI 0.82 to 0.95). Asian and Other ethnic groups were 1.12 and 1.18 times more likely to have the vaccine in pregnancy compared with White women (HR&#x2009;=&#x2009;1.12, 95% CI 1.00 to 1.25) and (HR&#x2009;=&#x2009;1.18, 95% CI 1.03 to 1.37) respectively. Survey responses (objective 2): 207 (69%) of participants stated that they would be happy to have the vaccine during pregnancy. The remaining 94 (31%) indicated they would not have the vaccine during pregnancy. Reasons for having the vaccine included protecting self and baby, perceived risk level, and receipt of sufficient evidence and advice. Reasons for vaccine refusal included lack of research about long-term outcomes for the baby, anxiety about vaccines, inconsistent advice/information, and preference to wait until after the pregnancy.ConclusionPotentially only 1 in 3 pregnant women would have the COVID-19 vaccine during pregnancy, even though 2 in 3 reported they would have the vaccination, thus it is critical to develop tailored strategies to increase its acceptance rate and decrease vaccine hesitancy. A targeted approach to vaccinations may be required for groups such as younger people and those living in higher deprivation areas.</abstract><type>Journal Article</type><journal>BMC Infectious Diseases</journal><volume>22</volume><journalNumber>1</journalNumber><paginationStart/><paginationEnd/><publisher>Springer Science and Business Media LLC</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>1471-2334</issnElectronic><keywords>COVID-19 vaccination, Pregnancy, Vaccine uptake, Vaccine hesitancy, SAIL</keywords><publishedDay>12</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-12-12</publishedDate><doi>10.1186/s12879-022-07856-8</doi><url/><notes>Availability of data and materials:The data that support the fndings of this study are available from SAIL, but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permissionof SAIL.</notes><college>COLLEGE NANME</college><department>Medicine</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>PMSC</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>This work was funded by the National Core Studies, an initiative funded by UKRI, NIHR and the Health and Safety Executive. The COVID-19 Longitudinal Health and Wellbeing National Core Study was funded by the Medical Research Council (MC_PC_20030). SVK acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_ UU_00022/2) and the Scottish Government Chief Scientist Ofce (SPHSU17).</funders><projectreference/><lastEdited>2022-12-30T13:56:53.6709994</lastEdited><Created>2022-12-13T10:19:06.0292907</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Mohamed</firstname><surname>Mhereeg</surname><order>1</order></author><author><firstname>Hope</firstname><surname>Jones</surname><order>2</order></author><author><firstname>Jonathan</firstname><surname>Kennedy</surname><orcid/><order>3</order></author><author><firstname>Mike</firstname><surname>Seaborne</surname><orcid>0000-0002-4921-7556</orcid><order>4</order></author><author><firstname>Michael</firstname><surname>Parker</surname><order>5</order></author><author><firstname>Tash Kennedy</firstname><surname>Kennedy</surname><order>6</order></author><author><firstname>SARAH</firstname><surname>BEESON</surname><order>7</order></author><author><firstname>Ashley</firstname><surname>Akbari</surname><orcid>0000-0003-0814-0801</orcid><order>8</order></author><author><firstname>Luisa</firstname><surname>Zuccolo</surname><orcid>0000-0002-7049-3037</orcid><order>9</order></author><author><firstname>Alisha</firstname><surname>Davies</surname><orcid>0000-0002-8066-7264</orcid><order>10</order></author><author><firstname>Sinead</firstname><surname>Brophy</surname><orcid>0000-0001-7417-2858</orcid><order>11</order></author></authors><documents><document><filename>62162__26143__4671a1df8225492a9cb73cc0ed715720.pdf</filename><originalFilename>62162.pdf</originalFilename><uploaded>2022-12-30T13:55:44.4566406</uploaded><type>Output</type><contentLength>1343613</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; Crown 2022. 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spelling 2022-12-30T13:56:53.6709994 v2 62162 2022-12-13 COVID-19 vaccination in pregnancy: views and vaccination uptake rates in pregnancy, a mixed methods analysis from SAIL and the Born-In-Wales Birth Cohort ef78c0301f61ea4c72dd0670e61f72df Mohamed Mhereeg Mohamed Mhereeg true false 3fbf9b2f03a3a8f507dd35e9068bd485 Hope Jones Hope Jones true false 08163d1f58d7fefcb1c695bcc2e0ef68 Jonathan Kennedy Jonathan Kennedy true false fcc7ece0f04577ad5f283b00dd7f52cf 0000-0002-4921-7556 Mike Seaborne Mike Seaborne true false a4dfe07a6b18fdf6d537962b8f24fbdf Michael Parker Michael Parker true false 3f6f07de33204db4c0ab665fb4b36367 Tash Kennedy Kennedy Tash Kennedy Kennedy true false f016cf98776b56b51944dda8c2a9b749 SARAH BEESON SARAH BEESON true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 84f5661b35a729f55047f9e793d8798b 0000-0001-7417-2858 Sinead Brophy Sinead Brophy true false 2022-12-13 PMSC BackgroundVaccine hesitancy amongst pregnant women has been found to be a concern during past epidemics. This study aimed to (1) estimate COVID-19 vaccination rates among pregnant women in Wales and their association with age, ethnicity, and area of deprivation, using electronic health record (EHR) data linkage, and (2) explore pregnant women’s views on receiving the COVID-19 vaccine during pregnancy using data from a survey recruiting via social media (Facebook, Twitter), through midwives, and posters in hospitals (Born-In-Wales Cohort).MethodsThis was a mixed-methods study utilising routinely collected linked data from the Secure Anonymised Information Linkage (SAIL) Databank (Objective 1) and the Born-In-Wales Birth Cohort participants (Objective 2). Pregnant women were identified from 13th April 2021 to 31st December 2021. Survival analysis was utilised to examine and compare the length of time to vaccination uptake in pregnancy, and variation in uptake by; age, ethnic group, and deprivation area was examined using hazard ratios (HR) from Cox regression. Survey respondents were women who had a baby during the COVID-19 pandemic or were pregnant between 1st November 2021 and 24th March 2022 and participating in Born-In-Wales. Codebook thematic analysis was used to generate themes from an open-ended question on the survey.ResultsPopulation-level data linkage (objective 1): Within the population cohort, 8203 (32.7%) received at least one dose of the COVID-19 vaccine during pregnancy, 8572 (34.1%) remained unvaccinated throughout the follow-up period, and 8336 (33.2%) received the vaccine postpartum. Younger women (< 30 years) were less likely to have the vaccine, and those living in areas of high deprivation were also less likely to have the vaccine (HR = 0.88, 95% CI 0.82 to 0.95). Asian and Other ethnic groups were 1.12 and 1.18 times more likely to have the vaccine in pregnancy compared with White women (HR = 1.12, 95% CI 1.00 to 1.25) and (HR = 1.18, 95% CI 1.03 to 1.37) respectively. Survey responses (objective 2): 207 (69%) of participants stated that they would be happy to have the vaccine during pregnancy. The remaining 94 (31%) indicated they would not have the vaccine during pregnancy. Reasons for having the vaccine included protecting self and baby, perceived risk level, and receipt of sufficient evidence and advice. Reasons for vaccine refusal included lack of research about long-term outcomes for the baby, anxiety about vaccines, inconsistent advice/information, and preference to wait until after the pregnancy.ConclusionPotentially only 1 in 3 pregnant women would have the COVID-19 vaccine during pregnancy, even though 2 in 3 reported they would have the vaccination, thus it is critical to develop tailored strategies to increase its acceptance rate and decrease vaccine hesitancy. A targeted approach to vaccinations may be required for groups such as younger people and those living in higher deprivation areas. Journal Article BMC Infectious Diseases 22 1 Springer Science and Business Media LLC 1471-2334 COVID-19 vaccination, Pregnancy, Vaccine uptake, Vaccine hesitancy, SAIL 12 12 2022 2022-12-12 10.1186/s12879-022-07856-8 Availability of data and materials:The data that support the fndings of this study are available from SAIL, but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permissionof SAIL. COLLEGE NANME Medicine COLLEGE CODE PMSC Swansea University This work was funded by the National Core Studies, an initiative funded by UKRI, NIHR and the Health and Safety Executive. The COVID-19 Longitudinal Health and Wellbeing National Core Study was funded by the Medical Research Council (MC_PC_20030). SVK acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_ UU_00022/2) and the Scottish Government Chief Scientist Ofce (SPHSU17). 2022-12-30T13:56:53.6709994 2022-12-13T10:19:06.0292907 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Mohamed Mhereeg 1 Hope Jones 2 Jonathan Kennedy 3 Mike Seaborne 0000-0002-4921-7556 4 Michael Parker 5 Tash Kennedy Kennedy 6 SARAH BEESON 7 Ashley Akbari 0000-0003-0814-0801 8 Luisa Zuccolo 0000-0002-7049-3037 9 Alisha Davies 0000-0002-8066-7264 10 Sinead Brophy 0000-0001-7417-2858 11 62162__26143__4671a1df8225492a9cb73cc0ed715720.pdf 62162.pdf 2022-12-30T13:55:44.4566406 Output 1343613 application/pdf Version of Record true © Crown 2022. This article is licensed under a Creative Commons Attribution 4.0 International License true eng http://creativecommons.org/licenses/by/4.0/
title COVID-19 vaccination in pregnancy: views and vaccination uptake rates in pregnancy, a mixed methods analysis from SAIL and the Born-In-Wales Birth Cohort
spellingShingle COVID-19 vaccination in pregnancy: views and vaccination uptake rates in pregnancy, a mixed methods analysis from SAIL and the Born-In-Wales Birth Cohort
Mohamed Mhereeg
Hope Jones
Jonathan Kennedy
Mike Seaborne
Michael Parker
Tash Kennedy Kennedy
SARAH BEESON
Ashley Akbari
Sinead Brophy
title_short COVID-19 vaccination in pregnancy: views and vaccination uptake rates in pregnancy, a mixed methods analysis from SAIL and the Born-In-Wales Birth Cohort
title_full COVID-19 vaccination in pregnancy: views and vaccination uptake rates in pregnancy, a mixed methods analysis from SAIL and the Born-In-Wales Birth Cohort
title_fullStr COVID-19 vaccination in pregnancy: views and vaccination uptake rates in pregnancy, a mixed methods analysis from SAIL and the Born-In-Wales Birth Cohort
title_full_unstemmed COVID-19 vaccination in pregnancy: views and vaccination uptake rates in pregnancy, a mixed methods analysis from SAIL and the Born-In-Wales Birth Cohort
title_sort COVID-19 vaccination in pregnancy: views and vaccination uptake rates in pregnancy, a mixed methods analysis from SAIL and the Born-In-Wales Birth Cohort
author_id_str_mv ef78c0301f61ea4c72dd0670e61f72df
3fbf9b2f03a3a8f507dd35e9068bd485
08163d1f58d7fefcb1c695bcc2e0ef68
fcc7ece0f04577ad5f283b00dd7f52cf
a4dfe07a6b18fdf6d537962b8f24fbdf
3f6f07de33204db4c0ab665fb4b36367
f016cf98776b56b51944dda8c2a9b749
aa1b025ec0243f708bb5eb0a93d6fb52
84f5661b35a729f55047f9e793d8798b
author_id_fullname_str_mv ef78c0301f61ea4c72dd0670e61f72df_***_Mohamed Mhereeg
3fbf9b2f03a3a8f507dd35e9068bd485_***_Hope Jones
08163d1f58d7fefcb1c695bcc2e0ef68_***_Jonathan Kennedy
fcc7ece0f04577ad5f283b00dd7f52cf_***_Mike Seaborne
a4dfe07a6b18fdf6d537962b8f24fbdf_***_Michael Parker
3f6f07de33204db4c0ab665fb4b36367_***_Tash Kennedy Kennedy
f016cf98776b56b51944dda8c2a9b749_***_SARAH BEESON
aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
84f5661b35a729f55047f9e793d8798b_***_Sinead Brophy
author Mohamed Mhereeg
Hope Jones
Jonathan Kennedy
Mike Seaborne
Michael Parker
Tash Kennedy Kennedy
SARAH BEESON
Ashley Akbari
Sinead Brophy
author2 Mohamed Mhereeg
Hope Jones
Jonathan Kennedy
Mike Seaborne
Michael Parker
Tash Kennedy Kennedy
SARAH BEESON
Ashley Akbari
Luisa Zuccolo
Alisha Davies
Sinead Brophy
format Journal article
container_title BMC Infectious Diseases
container_volume 22
container_issue 1
publishDate 2022
institution Swansea University
issn 1471-2334
doi_str_mv 10.1186/s12879-022-07856-8
publisher Springer Science and Business Media LLC
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
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description BackgroundVaccine hesitancy amongst pregnant women has been found to be a concern during past epidemics. This study aimed to (1) estimate COVID-19 vaccination rates among pregnant women in Wales and their association with age, ethnicity, and area of deprivation, using electronic health record (EHR) data linkage, and (2) explore pregnant women’s views on receiving the COVID-19 vaccine during pregnancy using data from a survey recruiting via social media (Facebook, Twitter), through midwives, and posters in hospitals (Born-In-Wales Cohort).MethodsThis was a mixed-methods study utilising routinely collected linked data from the Secure Anonymised Information Linkage (SAIL) Databank (Objective 1) and the Born-In-Wales Birth Cohort participants (Objective 2). Pregnant women were identified from 13th April 2021 to 31st December 2021. Survival analysis was utilised to examine and compare the length of time to vaccination uptake in pregnancy, and variation in uptake by; age, ethnic group, and deprivation area was examined using hazard ratios (HR) from Cox regression. Survey respondents were women who had a baby during the COVID-19 pandemic or were pregnant between 1st November 2021 and 24th March 2022 and participating in Born-In-Wales. Codebook thematic analysis was used to generate themes from an open-ended question on the survey.ResultsPopulation-level data linkage (objective 1): Within the population cohort, 8203 (32.7%) received at least one dose of the COVID-19 vaccine during pregnancy, 8572 (34.1%) remained unvaccinated throughout the follow-up period, and 8336 (33.2%) received the vaccine postpartum. Younger women (< 30 years) were less likely to have the vaccine, and those living in areas of high deprivation were also less likely to have the vaccine (HR = 0.88, 95% CI 0.82 to 0.95). Asian and Other ethnic groups were 1.12 and 1.18 times more likely to have the vaccine in pregnancy compared with White women (HR = 1.12, 95% CI 1.00 to 1.25) and (HR = 1.18, 95% CI 1.03 to 1.37) respectively. Survey responses (objective 2): 207 (69%) of participants stated that they would be happy to have the vaccine during pregnancy. The remaining 94 (31%) indicated they would not have the vaccine during pregnancy. Reasons for having the vaccine included protecting self and baby, perceived risk level, and receipt of sufficient evidence and advice. Reasons for vaccine refusal included lack of research about long-term outcomes for the baby, anxiety about vaccines, inconsistent advice/information, and preference to wait until after the pregnancy.ConclusionPotentially only 1 in 3 pregnant women would have the COVID-19 vaccine during pregnancy, even though 2 in 3 reported they would have the vaccination, thus it is critical to develop tailored strategies to increase its acceptance rate and decrease vaccine hesitancy. A targeted approach to vaccinations may be required for groups such as younger people and those living in higher deprivation areas.
published_date 2022-12-12T04:21:34Z
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