Maternal Vaccination and Vaccine Hesitancy

Rand, Cynthia M.; Olson-Chen, Courtney

doi:10.1016/j.pcl.2022.11.004

Cited by 20 publications

(10 citation statements)

References 61 publications

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“…In our study, a small proportion of women said they did not receive an influenza or COVID-19 vaccine as they were not offered it. It is important that healthcare providers looking after pregnant women enhance vaccination rates by recommending eligible vaccines at each visit and focusing on the benefits to the health of the infant in conversations with patients [ 23 ]. Influenza vaccines in Ireland are usually offered between October and April.…”

Section: Discussionmentioning

confidence: 99%

Uptake rates and attitudes to influenza and COVID-19 vaccination in pregnancy – a prospective cohort study

et al. 2023

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Influenza and COVID-19 are highly prevalent RNA viruses. Pregnancy increases the frequency of severe maternal morbidity and mortality associated with these viruses. Vaccination plays an important role in protecting pregnant women and their infants from adverse outcomes. In this prospective study, we aimed to determine the vaccination uptake rate for influenza and COVID-19 in a pregnant population and to explore reasons why women remained unvaccinated. A prospective cohort study was conducted over a two-week period in December 2022 in the National Maternity Hospital, Dublin. There were 588 women surveyed over the 2-week period. Overall, 377 (57%) were vaccinated that year for seasonal influenza, a significant rise from 39% in a similar study in 2016. The majority (n = 488, 83%) of women reported receiving at least one COVID-19 vaccine. However only 132 (22%) received a COVID-19 vaccine in pregnancy, despite 76% (n = 466) stating they would be happy to receive it. Factors such as age, obesity, co-morbidities, ethnic group, and type of antenatal care received were shown to influence vaccination rates. We recommend that the importance of vaccination be stressed regularly to eligible patients at their antenatal clinic visits and where possible combining influenza/COVID-19 vaccination on the same day to improve uptake.

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Section: Discussionmentioning

confidence: 99%

Uptake rates and attitudes to influenza and COVID-19 vaccination in pregnancy – a prospective cohort study

et al. 2023

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“…This is not unexpected, as previous studies have shown that women are less likely to use drugs during pregnancy [ 18 , 19 ]. Moreover, the state of pregnancy itself—which is mostly considered as a factor to refuse any vaccine [ 20 , 21 ]—is combined with the lack of certainty and robust scientific evidence specifically regarding the COVID-19 vaccine.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Vaccine Hesitancy among Unvaccinated Adults: A Cross-Sectional Exploratory Analysis of Vaccination Intentions in Italy Related to Fear of Infection

Curzio,

Cori,

Bianchi

et al. 2023

Vaccines

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From the initial COVID-19 outbreak, Italy was the first Western country to be seriously affected by the pandemic. Understanding vaccine hesitancy can help efforts to achieve broad vaccination coverage. The objectives of this research were to determine the extent of vaccine hesitancy in Italy and to understand the characteristics of those segments of the population with some hesitancy. Between January and February 2021, 41,473 subjects answered the second questionnaire delivered in phase II of the web-based EPICOVID19 survey. Among the included adult volunteers living in Italy, 4653 (11.2%) reported having previously received at least one dose of the COVID-19 vaccine. In the sample of 36,820 respondents, all not vaccinated (age 51.1 ± 13.5; 59.7% female; 63.6% high level of education), the comparison between hesitant and inclined participants was accompanied by percentages and odds ratios. A total of 2449 individuals were hesitant (6.7% of the unvaccinated ones). Hesitancy was higher among women (OR = 1.48; 95%CI: 1.36–1.62); it was highest in the 50–59 and 40–49 age groups and among those with a lower educational level. A higher level of education was associated with a lower proportion of hesitancy (5.54%) compared with 9.44% among respondents with a low level of education (OR = 0.56; 95%CI: 0.46–0.68). Hesitancy was most common in subjects who did not report fear of infection (12.4%, OR = 4.0; 95%CI: 3.46–4.61). The results can guide the design of tailored information and communication campaigns through considering objective and subjective characteristics.

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“…Thus, Tc infection presents an underappreciated health risk, highlighting the potential for adverse outcomes in proceeding generations. Second, an immunoregulatory environment during pregnancy is believed to be essential for the growth and health of the fetus, yet inactivated influenza, Tdap, and COVID vaccines have proven to be immunogenic and offer substantial benefits against infections and disease for both mothers and infants 30 . Third, pathogen-based attenuated vaccines are shown to confer protection against smallpox, plague, and measles 31 , yet, previous findings from our laboratory indicate that primary Tc infection induces delayed and suboptimal T-cell immunity, which fails to provide an effective defense against re-infection 32 .…”

Section: Discussionmentioning

confidence: 99%

Subunit nanovaccine elicited T cell functional activation controls Trypanosoma cruzi mediated maternal and placental tissue damage and improves pregnancy outcomes in mice

Rios,

Lokugamage,

Choudhuri

et al. 2023

npj Vaccines

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This study investigated a candidate vaccine effect against maternal Trypanosoma cruzi (Tc) infection and improved pregnancy outcomes. For this, TcG2 and TcG4 were cloned in a nanoplasmid optimized for delivery, antigen expression, and regulatory compliance (nano2/4 vaccine). Female C57BL/6 mice were immunized with nano2/4, infected (Tc SylvioX10), and mated 7-days post-infection to enable fetal development during the maternal acute parasitemia phase. Females were euthanized at E12–E17 (gestation) days. Splenic and placental T-cell responses were monitored by flow cytometry. Maternal and placental/fetal tissues were examined for parasites by qPCR and inflammatory infiltrate by histology. Controls included age/immunization-matched non-pregnant females. Nano2/4 exhibited no toxicity and elicited protective IgG2a/IgG1 response in mice. Nano2/4 signaled a splenic expansion of functionally active CD4+ effector/effector memory (Tem) and central memory (Tcm) cells in pregnant mice. Upon challenge infection, nano2/4 increased the splenic CD4+ and CD8+T cells in all mice and increased the proliferation of CD4+Tem, CD4+Tcm, and CD8+Tcm subsets producing IFNγ and cytolytic molecules (PRF1, GZB) in pregnant mice. A balanced serum cytokines/chemokines response and placental immune characteristics indicated that pregnancy prevented the overwhelming damaging immune response in mice. Importantly, pregnancy itself resulted in a significant reduction of parasites in maternal and fetal tissues. Nano2/4 was effective in arresting the Tc-induced tissue inflammatory infiltrate, necrosis, and fibrosis in maternal and placental tissues and improving maternal fertility, placental efficiency, and fetal survival. In conclusion, we show that maternal nano2/4 vaccination is beneficial in controlling the adverse effects of Tc infection on maternal health, fetal survival, and pregnancy outcomes.

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Maternal Vaccination and Vaccine Hesitancy

Cited by 20 publications

References 61 publications

Uptake rates and attitudes to influenza and COVID-19 vaccination in pregnancy – a prospective cohort study

Uptake rates and attitudes to influenza and COVID-19 vaccination in pregnancy – a prospective cohort study

COVID-19 Vaccine Hesitancy among Unvaccinated Adults: A Cross-Sectional Exploratory Analysis of Vaccination Intentions in Italy Related to Fear of Infection

Subunit nanovaccine elicited T cell functional activation controls Trypanosoma cruzi mediated maternal and placental tissue damage and improves pregnancy outcomes in mice

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