COVID-19 vaccination in pregnancy: the impact of multimorbidity and smoking status on vaccine hesitancy, a cohort study of 25,111 women in Wales, UK.
COVID-19 vaccination in pregnancy: the impact of multimorbidity and smoking status on vaccine hesitancy, a cohort study of 25,111 women in Wales, UK.
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DOI：
10.1186/s12879-023-08555-8
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发表时间：
2023-09-11
影响因子：
3.7
通讯作者：
Brophy, Sinead
中科院分区：
文献类型：
--
作者：
Mhereeg, Mohamed;Jones, Hope;Kennedy, Jonathan;Seaborne, Mike;Parker, Michael;Kennedy, Natasha;Akbari, Ashley;Zuccolo, Luisa;Azcoaga-Lorenzo, Amaya;Davies, Alisha;Nirantharakumar, Krishnarajah;Brophy, Sinead
关键词：
多发病、吸烟和怀孕被确定为与SARS-CoV-2感染后更严重的结局相关的三个危险因素，因此，接种疫苗对患有多发病和吸烟史的孕妇至关重要。这项研究旨在利用电子健康记录(EHR)链接来检查多发病、吸烟状况和人口统计学(年龄、民族、贫困地区)对威尔士孕妇接种疫苗犹豫不决的影响。这项队列研究利用了安全匿名信息链接(SAIL)数据库中常规收集的个人级别、匿名化的人口规模关联数据。对2021年4月13日至2021年12月31日期间的孕妇进行了确认。生存分析被用来检查和比较怀孕期间接种疫苗的时间长度，方法是独立考虑多发病、吸烟状况以及抑郁症、糖尿病、哮喘和心血管疾病。该研究还使用从COX回归模型得出的风险比(HR)，评估了在独立条件下，联合和单独使用多发病、吸烟状况和人口统计学因素对摄取的变化。在人群队列中，8,203人(32.7%)在怀孕期间至少接种了一剂新冠肺炎疫苗，其中8,572人(34.1%)在整个随访期内仍未接种，8,336人(33.2%)在产后接种疫苗。30岁或30岁以上的妇女更有可能在怀孕期间接种疫苗。与非抑郁者相比，有抑郁者接种疫苗的可能性略高，但显著更高(HR = 为1.08，95%CI为1.03至1.14，p = 为0.002)。患有多病的妇女接种疫苗的可能性是无多病的妇女的1.12倍(HR = 为1.12，95%CI为1.04至1.19，p = 0.001)。现吸烟者和既往吸烟者的疫苗摄入量均显著低于从不吸烟者(HR = 分别为0.87，95%CI为0.81~0.94，p <； 为0.001，HR = 为0.92，95%CI为0.85~0.98，p = 为0.015)。生活在最贫困地区的人的摄取率也低于生活在最富裕地区的人(HR = 为0.89，95%CI为0.83至0.96，p = 为0.002)。生活在没有多发病的年轻妇女、现吸烟者和曾经吸烟者以及生活在较贫困地区的妇女接种疫苗的可能性较小，因此，可能需要对这些群体采取有针对性的疫苗接种方法。患有多发病的孕妇在怀孕期间对新冠肺炎的疫苗犹豫不决的情况略有减少，但在统计上有显著意义。网上版载有补充材料，可在10.1186/s12879-023-08555-8查阅。
Multimorbidity, smoking status, and pregnancy are identified as three risk factors associated with more severe outcomes following a SARS-CoV-2 infection, thus vaccination uptake is crucial for pregnant women living with multimorbidity and a history of smoking. This study aimed to examine the impact of multimorbidity, smoking status, and demographics (age, ethnic group, area of deprivation) on vaccine hesitancy among pregnant women in Wales using electronic health records (EHR) linkage. This cohort study utilised routinely collected, individual-level, anonymised population-scale linked data within the Secure Anonymised Information Linkage (SAIL) Databank. Pregnant women were identified from 13th April 2021 to 31st December 2021. Survival analysis was employed to examine and compare the length of time to vaccination uptake in pregnancy by considering multimorbidity, smoking status, as well as depression, diabetes, asthma, and cardiovascular conditions independently. The study also assessed the variation in uptake by multimorbidity, smoking status, and demographics, both jointly and separately for the independent conditions, using hazard ratios (HR) derived from the Cox regression model. Within the population cohort, 8,203 (32.7%) received at least one dose of the COVID-19 vaccine during pregnancy, with 8,572 (34.1%) remaining unvaccinated throughout the follow-up period, and 8,336 (33.2%) receiving the vaccine postpartum. Women aged 30 years or older were more likely to have the vaccine in pregnancy. Those who had depression were slightly but significantly more likely to have the vaccine compared to those without depression (HR = 1.08, 95% CI 1.03 to 1.14, p = 0.002). Women living with multimorbidity were 1.12 times more likely to have the vaccine compared to those living without multimorbidity (HR = 1.12, 95% CI 1.04 to 1.19, p = 0.001). Vaccine uptakes were significantly lower among both current smokers and former smokers compared to never smokers (HR = 0.87, 95% CI 0.81 to 0.94, p < 0.001 and HR = 0.92, 95% CI 0.85 to 0.98, p = 0.015 respectively). Uptake was also lower among those living in the most deprived areas compared to those living in the most affluent areas (HR = 0.89, 95% CI 0.83 to 0.96, p = 0.002). Younger women, living without multimorbidity, current and former smokers, and those living in the more deprived areas are less likely to have the vaccine, thus, a targeted approach to vaccinations may be required for these groups. Pregnant individuals living with multimorbidity exhibit a slight but statistically significant reduction in vaccine hesitancy towards COVID-19 during pregnancy. The online version contains supplementary material available at 10.1186/s12879-023-08555-8.
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DOI：
10.1093/ntr/ntab039
发表时间：
2021-08-18
期刊：
Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
影响因子：
--
作者：
Jackson SE;Paul E;Brown J;Steptoe A;Fancourt D
通讯作者：
Fancourt D
DOI：
10.1016/j.bbi.2021.03.008
发表时间：
2021-05
期刊：
Brain, behavior, and immunity
影响因子：
--
作者：
Robertson E;Reeve KS;Niedzwiedz CL;Moore J;Blake M;Green M;Katikireddi SV;Benzeval MJ
通讯作者：
Benzeval MJ
影响因子：
3.5
作者：
Wake AD
通讯作者：
Wake AD
影响因子：
3.5
作者：
Lyons RA;Jones KH;John G;Brooks CJ;Verplancke JP;Ford DV;Brown G;Leake K
通讯作者：
Leake K
影响因子：
82.9
作者：
Stock SJ;Carruthers J;Calvert C;Denny C;Donaghy J;Goulding A;Hopcroft LEM;Hopkins L;McLaughlin T;Pan J;Shi T;Taylor B;Agrawal U;Auyeung B;Katikireddi SV;McCowan C;Murray J;Simpson CR;Robertson C;Vasileiou E;Sheikh A;Wood R
通讯作者：
Wood R