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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

Background: Vaccine 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 records (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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URI: https://cronfa.swan.ac.uk/Record/cronfa60652
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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 records (EHR) 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). Methods: This was a mixed-methods study utilising routinely collected linked data from the Secure Anonymised Information Linkage (SAIL) (Objective 1) and the Born-In-Wales Birth Cohort participants (Objective 2). Survival analysis was utilised to examine and compare the length of time to vaccination uptake in pregnancy, and variation in uptake by; age, ethnicity, and deprivation area was examined using hazard ratios (HR) from Cox regression. Codebook thematic analysis was used to generate themes from an open-ended question on the survey. Results: Population-level data linkage (objective 1): Within the population cohort, 32.7% (n = 8,203) were vaccinated (at least one dose of the vaccine) during pregnancy, 34.1% (n = 8,572) remained unvaccinated throughout follow-up period, and 33.2% (n = 8,336) received the vaccine postpartum. Younger women (&lt; 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 to women of White ethnicity (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): 69% of participants stated that they would be happy to have the vaccine during pregnancy (n = 207). The remainder, 31%, indicated that they would not have the vaccine during pregnancy (n = 94). 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. Conclusion: Potentially 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 to decrease vaccine hesitancy. A targeted approach to vaccinations may be required for groups such as younger people and those living in higher deprivation level 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>http://dx.doi.org/10.1186/s12879-022-07856-8</url><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 Office (SPHSU17).</funders><projectreference/><lastEdited>2023-07-27T15:33:50.5124606</lastEdited><Created>2022-07-27T17:02:32.7752265</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>60652__28002__fae972b10ac64a8dba6f98b505a9b8ad.pdf</filename><originalFilename>60652.VOR.pdf</originalFilename><uploaded>2023-06-28T15:09:05.6751677</uploaded><type>Output</type><contentLength>1343613</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© Crown 2022. 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spelling v2 60652 2022-07-27 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 2022-07-27 PMSC Background: Vaccine 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 records (EHR) 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). Methods: This was a mixed-methods study utilising routinely collected linked data from the Secure Anonymised Information Linkage (SAIL) (Objective 1) and the Born-In-Wales Birth Cohort participants (Objective 2). Survival analysis was utilised to examine and compare the length of time to vaccination uptake in pregnancy, and variation in uptake by; age, ethnicity, and deprivation area was examined using hazard ratios (HR) from Cox regression. Codebook thematic analysis was used to generate themes from an open-ended question on the survey. Results: Population-level data linkage (objective 1): Within the population cohort, 32.7% (n = 8,203) were vaccinated (at least one dose of the vaccine) during pregnancy, 34.1% (n = 8,572) remained unvaccinated throughout follow-up period, and 33.2% (n = 8,336) 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 to women of White ethnicity (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): 69% of participants stated that they would be happy to have the vaccine during pregnancy (n = 207). The remainder, 31%, indicated that they would not have the vaccine during pregnancy (n = 94). 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. Conclusion: Potentially 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 to decrease vaccine hesitancy. A targeted approach to vaccinations may be required for groups such as younger people and those living in higher deprivation level 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 http://dx.doi.org/10.1186/s12879-022-07856-8 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 Office (SPHSU17). 2023-07-27T15:33:50.5124606 2022-07-27T17:02:32.7752265 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 60652__28002__fae972b10ac64a8dba6f98b505a9b8ad.pdf 60652.VOR.pdf 2023-06-28T15:09:05.6751677 Output 1343613 application/pdf Version of Record true © Crown 2022. Distributed under the terms of a Creative Commons Attribution 4.0 License (CC BY 4.0). true eng https://creativecommons.org/licenses/by/4.0/ 196
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
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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
url http://dx.doi.org/10.1186/s12879-022-07856-8
document_store_str 1
active_str 0
description Background: Vaccine 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 records (EHR) 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). Methods: This was a mixed-methods study utilising routinely collected linked data from the Secure Anonymised Information Linkage (SAIL) (Objective 1) and the Born-In-Wales Birth Cohort participants (Objective 2). Survival analysis was utilised to examine and compare the length of time to vaccination uptake in pregnancy, and variation in uptake by; age, ethnicity, and deprivation area was examined using hazard ratios (HR) from Cox regression. Codebook thematic analysis was used to generate themes from an open-ended question on the survey. Results: Population-level data linkage (objective 1): Within the population cohort, 32.7% (n = 8,203) were vaccinated (at least one dose of the vaccine) during pregnancy, 34.1% (n = 8,572) remained unvaccinated throughout follow-up period, and 33.2% (n = 8,336) 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 to women of White ethnicity (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): 69% of participants stated that they would be happy to have the vaccine during pregnancy (n = 207). The remainder, 31%, indicated that they would not have the vaccine during pregnancy (n = 94). 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. Conclusion: Potentially 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 to decrease vaccine hesitancy. A targeted approach to vaccinations may be required for groups such as younger people and those living in higher deprivation level areas.
published_date 2022-12-12T15:33:45Z
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