scholarly journals SARS-CoV-2 infection and COVID-19 vaccination rates in pregnant women in Scotland

2022 ◽  
Author(s):  
Sarah J. Stock ◽  
Jade Carruthers ◽  
Clara Calvert ◽  
Cheryl Denny ◽  
Jack Donaghy ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Vaccine Coverage ◽  
Population Data ◽  
Population Level ◽  
Vaccine Uptake ◽  
Female Population ◽  
Background Rate ◽  
Vaccination Rates ◽  
Level Data ◽  
Critical Care Admission

AbstractPopulation-level data on COVID-19 vaccine uptake in pregnancy and SARS-CoV-2 infection outcomes are lacking. We describe COVID-19 vaccine uptake and SARS-CoV-2 infection in pregnant women in Scotland, using whole-population data from a national, prospective cohort. Between the start of a COVID-19 vaccine program in Scotland, on 8 December 2020 and 31 October 2021, 25,917 COVID-19 vaccinations were given to 18,457 pregnant women. Vaccine coverage was substantially lower in pregnant women than in the general female population of 18−44 years; 32.3% of women giving birth in October 2021 had two doses of vaccine compared to 77.4% in all women. The extended perinatal mortality rate for women who gave birth within 28 d of a COVID-19 diagnosis was 22.6 per 1,000 births (95% CI 12.9−38.5; pandemic background rate 5.6 per 1,000 births; 452 out of 80,456; 95% CI 5.1−6.2). Overall, 77.4% (3,833 out of 4,950; 95% CI 76.2−78.6) of SARS-CoV-2 infections, 90.9% (748 out of 823; 95% CI 88.7−92.7) of SARS-CoV-2 associated with hospital admission and 98% (102 out of 104; 95% CI 92.5−99.7) of SARS-CoV-2 associated with critical care admission, as well as all baby deaths, occurred in pregnant women who were unvaccinated at the time of COVID-19 diagnosis. Addressing low vaccine uptake rates in pregnant women is imperative to protect the health of women and babies in the ongoing pandemic.

scholarly journals COVID-19 vaccination rates and SARS-CoV-2 infection in pregnant women in Scotland

2021 ◽  
Author(s):  
Sarah Stock ◽  
Jade Carruthers ◽  
Clara Calvert ◽  
Cheryl Denny ◽  
Jack Donaghy ◽  
...  
Keyword(s):  
Critical Care ◽  
Pregnant Women ◽  
Hospital Admissions ◽  
Vaccine Coverage ◽  
Reproductive Age ◽  
Vaccine Uptake ◽  
Female Population ◽  
Background Rate ◽  
Vaccination Rates ◽  
In Pregnancy

Abstract We describe SARS-CoV-2 infection and COVID-19 vaccine uptake in Scotland in a prospective cohort of all pregnant women in Scotland drawn from national databases. As of mid-October 2021, the Covid-19 in pregnancy in Scotland (COPS) cohort included linked data on a total of 139,136 pregnancies in 126,749 women. Up to September 30, 2021, a total of 22,779 COVID-19 vaccinations had been administered to 16,229 pregnant women. Vaccine coverage was substantially lower in pregnant women than in the general female population of reproductive age (23.7% of women giving birth in September 2021 were fully vaccinated compared to 74.9 % in women 18-44 years). Of the 4,274 cases of COVID-19 in pregnancy (confirmed by SARS-CoV-2 viral reverse transcriptase polymerase chain reaction) between December 2020 (the month the COVID-19 vaccination programme started in Scotland) and September 2021 inclusive, 629 women (14.7%) were admitted to hospital and 89 (2.1%) were admitted to critical care. Of the COVID-19 cases occurring in pregnant women, 81.7% (3,491/4,274; 95% CI 80.5-82.8) were in unvaccinated women. Of the COVID-19 associated hospital admissions, 93.0% (585/629; 95% CI 90.7-94.8) were in women who were unvaccinated at the time of COVID-19 diagnosis. Of the COVID-19 associated critical care admissions 98.9% (88/89; 95% CI 93.9-100) were in women who were unvaccinated at the time of COVID-19 diagnosis. The extended perinatal mortality rate for women who gave birth within 28 days of COVID-19 diagnosis was 15.9 per 1000 births (95% CI 7.8 to 31.0; background rate in 2020 6.3 per 1,000 total births [95% CI 5.7-7.1]; background rate 2019 5.7 per 1,000 total births [95% CI 5.0-6.4]). All baby deaths occurred after pregnancies in women who were unvaccinated at the time of COVID-19 diagnosis. Addressing low vaccine uptake rates in pregnant women is imperative to protect the health of women and babies.

scholarly journals Methodology of Natsal-COVID Wave 1: a large, quasi-representative survey with qualitative follow-up measuring the impact of COVID-19 on sexual and reproductive health in Britain

2021 ◽  
Vol 6 ◽  
pp. 209
Author(s):  
Emily Dema ◽  
Andrew J Copas ◽  
Soazig Clifton ◽  
Anne Conolly ◽  
Margaret Blake ◽  
...  
Keyword(s):  
General Population ◽  
Reproductive Health ◽  
Sexual Behaviour ◽  
Sexual And Reproductive Health ◽  
Service Use ◽  
Population Data ◽  
Population Level ◽  
Level Data ◽  
The Impact

Background: Britain’s National Surveys of Sexual Attitudes and Lifestyles (Natsal) have been undertaken decennially since 1990 and provide a key data source underpinning sexual and reproductive health (SRH) policy. The COVID-19 pandemic disrupted many aspects of sexual lifestyles, triggering an urgent need for population-level data on sexual behaviour, relationships, and service use at a time when gold-standard in-person, household-based surveys with probability sampling were not feasible. We designed the Natsal-COVID study to understand the impact of COVID-19 on the nation’s SRH and assessed the sample representativeness. Methods: Natsal-COVID Wave 1 data collection was conducted four months (29/7-10/8/2020) after the announcement of Britain’s first national lockdown (23/03/2020). This was an online web-panel survey administered by survey research company, Ipsos MORI. Eligible participants were resident in Britain, aged 18-59 years, and the sample included a boost of those aged 18-29. Questions covered participants’ sexual behaviour, relationships, and SRH service use. Quotas and weighting were used to achieve a quasi-representative sample of the British general population. Participants meeting criteria of interest and agreeing to recontact were selected for qualitative follow-up interviews. Comparisons were made with contemporaneous national probability surveys and Natsal-3 (2010-12) to understand bias. Results: 6,654 participants completed the survey and 45 completed follow-up interviews. The weighted Natsal-COVID sample was similar to the general population in terms of gender, age, ethnicity, rurality, and, among sexually-active participants, numbers of sexual partners in the past year. However, the sample was more educated, contained more sexually-inexperienced people, and included more people in poorer health. Conclusions: Natsal-COVID Wave 1 rapidly collected quasi-representative population data to enable evaluation of the early population-level impact of COVID-19 and lockdown measures on SRH in Britain and inform policy. Although sampling was less representative than the decennial Natsals, Natsal-COVID will complement national surveillance data and Natsal-4 (planned for 2022).

scholarly journals 5. Improved Regression Estimation of a Multivariate Relationship with Population Data on the Bivariate Relationship

2005 ◽  
Vol 35 (1) ◽  
pp. 291-334 ◽  
Author(s):  
Mark S. Handcock ◽  
Michael S. Rendall ◽  
Jacob E. Cheadle
Keyword(s):  
White Women ◽  
Marital Fertility ◽  
Population Data ◽  
Population Level ◽  
Regression Coefficients ◽  
Sample Survey ◽  
Level Data ◽  
Multivariate Relationships ◽  
The Difference ◽  
Multivariate Relationship

Regression coefficients specify the partial effect of a regressor on the dependent variable. Sometimes the bivariate or limited multivariate relationship of that regressor variable with the dependent variable is known from population-level data. We show here that such population-level data can be used to reduce variance and bias about estimates of those regression coefficients from sample survey data. The method of constrained MLE is used to achieve these improvements. Its statistical properties are first described. The method constrains the weighted sum of all the covariate-specific associations (partial effects) of the regressors on the dependent variable to equal the overall association of one or more regressors, where the latter is known exactly from the population data. We refer to those regressors whose bivariate or limited multivariate relationships with the dependent variable are constrained by population data as being “directly constrained.” Our study investigates the improvements in the estimation of directly constrained variables as well as the improvements in the estimation of other regressor variables that may be correlated with the directly constrained variables, and thus “indirectly constrained” by the population data. The example application is to the marital fertility of black versus white women. The difference between white and black women's rates of marital fertility, available from population-level data, gives the overall association of race with fertility. We show that the constrained MLE technique both provides a far more powerful statistical test of the partial effect of being black and purges the test of a bias that would otherwise distort the estimated magnitude of this effect. We find only trivial reductions, however, in the standard errors of the parameters for indirectly constrained regressors.

scholarly journals Association between live childhood vaccines and COVID-19 outcomes: a national-level analysis

2021 ◽  
Vol 149 ◽  
Author(s):  
Chikara Ogimi ◽  
Pingping Qu ◽  
Michael Boeckh ◽  
Rachel A. Bender Ignacio ◽  
Sahar Z. Zangeneh
Keyword(s):  
Vaccine Coverage ◽  
Healthcare Access ◽  
National Level ◽  
Population Level ◽  
Summary Score ◽  
Strongly Correlated ◽  
Level Data ◽  
Community Transmission ◽  
Childhood Vaccines ◽  
Access And Quality

Abstract We investigated whether countries with higher coverage of childhood live vaccines [BCG or measles-containing-vaccine (MCV)] have reduced risk of coronavirus disease 2019 (COVID-19)-related mortality, while accounting for known systems differences between countries. In this ecological study of 140 countries using publicly available national-level data, higher vaccine coverage, representing estimated proportion of people vaccinated during the last 14 years, was associated with lower COVID-19 deaths. The associations attenuated for both vaccine variables, and MCV coverage became no longer significant once adjusted for published estimates of the Healthcare access and quality index (HAQI), a validated summary score of healthcare quality indicators. The magnitude of association between BCG coverage and COVID-19 death rate varied according to HAQI, and MCV coverage had little effect on the association between BCG and COVID-19 deaths. While there are associations between live vaccine coverage and COVID-19 outcomes, the vaccine coverage variables themselves were strongly correlated with COVID-19 testing rate, HAQI and life expectancy. This suggests that the population-level associations may be further confounded by differences in structural health systems and policies. Cluster randomised studies of booster vaccines would be ideal to evaluate the efficacy of trained immunity in preventing COVID-19 infections and mortality in vaccinated populations and on community transmission.

scholarly journals An evaluation of strategies to achieve greater than 90% coverage of maternal influenza and pertussis vaccines including an economic evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Michelle L. Giles ◽  
Kong Khai ◽  
Sushena Krishnaswamy ◽  
Karen Bellamy ◽  
Margaret Angliss ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Vaccine Coverage ◽  
Vaccine Uptake ◽  
New Model ◽  
Maternal Immunisation ◽  
The Cost ◽  
Maternal Influenza

Abstract Background Maternal immunisation is an essential public health intervention aimed at improving the health outcomes for pregnant women and providing protection to the newborn. Despite international recommendations, safety and efficacy data for the intervention, and often a fully funded program, uptake of vaccines in pregnancy remain suboptimal. One possible explanation for this includes limited access to vaccination services at the point of antenatal care. The aim of this study is to evaluate the change in vaccine coverage among pregnant women following implementation of a modified model of delivery aimed at improving access at the point of antenatal care, including an economic evaluation. Methods This prospective multi-centre study, using action research design, across six maternity services in Victoria, Australia, evaluated the implementation of a co-designed vaccine delivery model (either a pharmacy led model, midwife led model or primary care led model) supported by provider education. The main outcome measure was influenza and pertussis vaccine uptake during pregnancy and the incremental cost of the new model (compared to existing models) and the cost-effectiveness of the new model at each participating health service. Results Influenza vaccine coverage in 2019 increased between 50 and 196% from baseline. All services reduced their average cost per immunisation under the new platforms due to efficiencies achieved in the delivery of maternal immunisations. This cost saving ranged from $9 to $71. Conclusion Our study demonstrated that there is no ‘one size fits all’ model of vaccine delivery. Future successful strategies to improve maternal vaccine coverage at other maternity services should be site specific, multifaceted, targeted at the existing barriers to maternal vaccine uptake, and heavily involve local stakeholders in the design and implementation of these strategies. The cost-effectiveness analysis indicates that an increase in maternal influenza immunisation uptake can be achieved at a relatively modest cost through amendment of maternal immunisation platforms.

scholarly journals Maternal Vaccinations Coverage And Reasons For Non-Compliance - A Cross-Sectional Observational Study

2020 ◽  
Author(s):  
David Drezner ◽  
Michal Youngster ◽  
Hodaya Klainer ◽  
Ilan Youngster
Keyword(s):  
Observational Study ◽  
Pregnant Women ◽  
Vaccine Coverage ◽  
Vaccination Rate ◽  
Vaccine Uptake ◽  
Medical Providers ◽  
Cross Sectional ◽  
Factors Influencing ◽  
Vaccine Recommendations ◽  
Secondary Objective

Abstract Background: Maternal influenza and pertussis vaccination has been proven a safe and effective strategy to reduce maternal and infant morbidity and mortality. Though recommended, not all pregnant women receive these important vaccinations. We aimed to evaluate the vaccine coverage of maternal immunization in pregnancy for seasonal influenza and acellular pertussis and elucidate the reasons for non-vaccination among pregnant women. The secondary objective was to describe factors that affect vaccine uptake.Methods: A cross sectional observational study using anonymous questionnaires distributed to women in the maternity ward or pregnant women (>37 weeks) hospitalized in the high-risk ward, thru Nov 2017-June 2018.Results: Of 321 women approached, 313 were eligible and 290 questionnaires were retrieved (92.6%). We found a 75.9% (95% CI 0.71, 0.81) and 34.5% (95% CI 0.29, 0.40) vaccination rate for pertussis and influenza vaccines respectively. The most prominent reason for not receiving the pertussis vaccination was being under-informed (24%). Influenza vaccine was not received mainly due to concerns about vaccine efficacy (28%). Other factors influencing vaccination uptake included education, prior childbirth and vaccine recommendations made by the provider.Conclusion: Although maternal vaccination of pertussis and influenza is officially recommended, vaccine uptake is suboptimal. Our study suggests a central role for medical providers in diminishing the concerns about safety and efficacy, and presents novel factors influencing compliance rates, like seasonality and number of prior births.

P033 POPULATION-LEVEL HPV VACCINATION COVERAGE AMONG U.S. ADULT IBD PATIENTS: STILL NOT ENOUGH

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S65-S65
Author(s):  
Ryan Suk ◽  
Heetae Suk ◽  
Keith Sigel ◽  
Kalyani Sonawane ◽  
Ashish Deshmukh
Keyword(s):  
Vaccination Coverage ◽  
Hpv Vaccine ◽  
Vaccine Coverage ◽  
Hpv Vaccination ◽  
Age Groups ◽  
Population Level ◽  
Vaccine Uptake ◽  
Population Estimate ◽  
Age Group ◽  
Old Patients

Abstract Background Evidence suggests that the inflammatory bowel disease (IBD) patients may have an elevated risk of Human papillomavirus (HPV)-associated cancers when compared with those without IBD. HPV vaccination has been recommended for 11 to 26 years old males and females. Recently, the Centers for Disease Control and Prevention (CDC) has updated the guideline to include adults aged 27 to 45 who are not adequately vaccinated. To the best of our knowledge, population-level HPV vaccine uptake rates among patients with IBD remains unknown. Methods We used 2015–2016 National Health Information Survey (NHIS) data to assess the HPV vaccination coverage among people with IBD in the US. Weighted counts and percentages were estimated using survey design for the population-level results. We identified those who reportedly were told by a doctor or healthcare professional that they have IBD. Then we stratified the patients into two age groups: HPV-vaccine eligible age group (age 18–26) and newly approved age group (age 27–45). Our outcome was vaccine coverage status assessed as vaccine initiation age and number of doses. When the initiation age was less than 15, two doses were defined as “completed” and when the age was 15 and older, three doses were defined as “completed”. When the participants had initiated the vaccine but have not completed all the required doses according to their initiation age, it was defined as “incomplete” while no dose was defined as “no vaccine”. We estimated the coverage rate by age group and sex. We used Wald chi-square test to examine differences in completion rate by sex. Results We identified 951 participants (population estimate: 3,121,387) who self-reportedly had IBD. Among those, 51 persons (population estimate: 191,830) were HPV vaccine-eligible aged and 219 persons (population estimate: 859,711) were newly approved aged. Only 3.2% men while 63.2% of eligible women completed vaccination series as recommended. Eligible men had higher rates of incompletion compared to women (13.8% vs 1.3%). A higher proportion of vaccine-eligible men (83.0%) did not initiate the HPV vaccine compared to women (35.5%) (p=0.001). Among the newly approved age group, only 0.5% of men completed vaccine and 1.3% did not complete their doses. In women, 2.3% was complete with the doses and 9.6% initiated but did not complete the vaccine (p <0.001). Conclusion IBD patients might greatly benefit from receiving HPV vaccination given the possibly high risk of HPV-associated cancers. However, the coverage for vaccine-eligible IBD patients was not enough and much lower than the goal of 80% coverage in Healthy People 2020. Moreover, according to the updated guideline, 27 to 45 years old patients who are not adequately vaccinated would be able to catch up their vaccination. Further study needs to be focused on promoting and informing HPV vaccination in IBD patients, for both currently vaccine-eligible patients and those who are aged between 27 and 45 and not adequately vaccinated.

scholarly journals Association between live childhood vaccines and COVID-19 outcomes: a national-level analysis

2020 ◽  
Author(s):  
Chikara Ogimi ◽  
Pingping Qu ◽  
Michael Boeckh ◽  
Rachel A. Bender Ignacio ◽  
Sahar Z. Zangeneh
Keyword(s):  
Life Expectancy ◽  
Vaccine Coverage ◽  
Healthcare Access ◽  
National Level ◽  
Population Level ◽  
Summary Score ◽  
Level Data ◽  
Childhood Vaccines ◽  
Access And Quality ◽  
Cluster Randomized

AbstractWe investigated whether countries with higher coverage of childhood live vaccines [BCG or measles-containing-vaccine (MCV)] have reduced risk of COVID-19 related mortality, accounting for known systems differences between countries. In this ecological study of 140 countries using publicly available national-level data, higher vaccine coverage, representing estimated proportion of people vaccinated during the last 15 years, was associated with lower COVID-19 deaths. The associations attenuated for both vaccine variables, and MCV coverage became no longer significant once adjusted for a validated summary score accounting for life expectancy and healthcare quality indicators, the Healthcare access and quality index (HAQI). The magnitude of association between BCG coverage and COVID-19 death rate varied according to HAQI, and MCV coverage had little effect on the association between BCG and COVID-19 deaths. While there are associations between live vaccine coverage and COVID-19 outcomes, the vaccine coverage variables themselves were strongly correlated with COVID-19 testing rate, HAQI, and life expectancy. This suggests that the population-level associations may be further confounded by differences in structural health systems and policies. Cluster randomized studies of booster vaccines would be ideal to evaluate the efficacy of trained immunity in preventing COVID-19 infections and mortality in vaccinated individuals and on community transmission.

scholarly journals Maternal vaccinations coverage and reasons for non-compliance - a cross-sectional observational study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
David Drezner ◽  
Michal Youngster ◽  
Hodaya Klainer ◽  
Ilan Youngster
Keyword(s):  
Observational Study ◽  
Pregnant Women ◽  
Vaccine Coverage ◽  
Tertiary Hospital ◽  
Vaccination Rate ◽  
Vaccine Uptake ◽  
Cross Sectional ◽  
Factors Influencing ◽  
Vaccine Recommendations ◽  
Secondary Objective

Abstract Background Maternal influenza and pertussis vaccinations have been proven safe and effective in reducing maternal and infant morbidity and mortality. Though recommended, not all pregnant women receive these important vaccines. We aimed to evaluate the vaccine coverage of maternal immunization in pregnancy for seasonal influenza and acellular pertussis and elucidate the reasons for non-vaccination among pregnant women. The secondary objective was to describe factors that affect vaccine uptake. Methods A cross sectional observational study using anonymous questionnaires distributed to women in the maternity ward or pregnant women hospitalized in the high-risk ward, between Nov 2017 and June 2018, In an Israeli tertiary hospital. Results Of 321 women approached, 313 were eligible, with a total of 290 women completing the questionnaire (92.6%). We found a 75.9% (95% CI 71–81) and 34.5% (95% CI 29–40) vaccination rate for pertussis and influenza vaccines, respectively. The most prominent reason for not receiving the pertussis vaccine was being under-informed (24%). Influenza vaccine was not received mainly due to concerns about vaccine efficacy (28%). Other factors influencing vaccine uptake included education, prior childbirth and vaccine recommendations made by the provider. Conclusion Although maternal vaccination of pertussis and influenza is officially recommended, vaccine uptake is suboptimal. Our study suggests a central role for medical providers in diminishing the concerns about safety and efficacy, and presents novel factors influencing compliance rates, like seasonality and number of prior births.

scholarly journals Influenza Vaccine Coverage among Pregnant Women in a Public Hospital System during the 2009-2010 Pandemic Influenza Season

2012 ◽  
Vol 2012 ◽  
pp. 1-6
Author(s):  
Dean V. Coonrod ◽  
Blanca-Flor Jimenez ◽  
Amber N. Sturgeon ◽  
David Drachman
Keyword(s):  
Influenza Vaccine ◽  
Health System ◽  
Pregnant Women ◽  
Pandemic Influenza ◽  
Influenza Season ◽  
Vaccine Coverage ◽  
Safety Net ◽  
H1n1 Vaccine ◽  
Vaccination Rates ◽  
Coverage Rates

The purpose of this study was to compare influenza vaccination rates of pregnant women in a public safety-net health system to national coverage rates during the 2009-2010 pandemic influenza season. A chart review of a random sample of deliveries was undertaken to determine rates of coverage and predictors of vaccine coverage of women who obtained prenatal care and delivered in our health system. Rates were calculated from deliveries from when the vaccine was first available through April 30, 2010. Coverage rates were 54% for the seasonal influenza vaccine and 51% for the H1N1 vaccine. Race/ethnicity, insurance status and language spoken did not predict the receipt of either vaccine. When we included only births which occurred through March 12, 2010, as was done in a large population-based study, the rates were 61% and 59%, respectively. Our rates are about 10% higher than the rates reported in that study. Our comprehensive strategy for promoting vaccine coverage achieved higher vaccination rates in a safety-net health system, which serves groups historically less likely to be vaccinated, than those reported for the pregnant population at large.

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