https://research.birmingham.ac.uk/portal/files/132683945/1_s2.0_S2214109X21000796_main.pdf

Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis.

Background In most countries, healthcare workers (HCWs) represent a priority group for vaccination against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) due to their elevated risk of COVID-19 and potential contribution to nosocomial SARS-CoV-2 transmission. Concerns have been raised that HCWs from ethnic minority groups are more likely to be vaccine hesitant (defined by the World Health Organisation as refusing or delaying a vaccination) than those of White ethnicity, but there are limited data on SARS-CoV-2 vaccine hesitancy and its predictors in UK HCWs. Methods Nationwide prospective cohort study and qualitative study in a multi-ethnic cohort of clinical and non-clinical UK HCWs. We analysed ethnic differences in SARS-CoV-2 vaccine hesitancy adjusting for demographics, vaccine trust, and perceived risk of COVID-19. We explored reasons for hesitancy in qualitative data using a framework analysis. Findings 11,584 HCWs were included in the cohort analysis. 23% (2704) reported vaccine hesitancy. Compared to White British HCWs (21.3% hesitant), HCWs from Black Caribbean (54.2%), Mixed White and Black Caribbean (38.1%), Black African (34.4%), Chinese (33.1%), Pakistani (30.4%), and White Other (28.7%) ethnic groups were significantly more likely to be hesitant. In adjusted analysis, Black Caribbean (aOR 3.37, 95% CI 2.11 - 5.37), Black African (aOR 2.05, 95% CI 1.49 - 2.82), White Other ethnic groups (aOR 1.48, 95% CI 1.19 - 1.84) were significantly more likely to be hesitant. Other independent predictors of hesitancy were younger age, female sex, higher score on a COVID-19 conspiracy beliefs scale, lower trust in employer, lack of influenza vaccine uptake in the previous season, previous COVID-19, and pregnancy. Qualitative data from 99 participants identified the following contributors to hesitancy: lack of trust in government and employers, safety concerns due to the speed of vaccine development, lack of ethnic diversity in vaccine studies, and confusing and conflicting information. Participants felt uptake in ethnic minority communities might be improved through inclusive communication, involving HCWs in the vaccine rollout, and promoting vaccination through trusted networks. Interpretation Despite increased risk of COVID-19, HCWs from some ethnic minority groups are more likely to be vaccine hesitant than their White British colleagues. Strategies to build trust and dispel myths surrounding the COVID-19 vaccine in these communities are urgently required. Emphasis should be placed on the safety and benefit of SARS-CoV-2 vaccination in pregnancy and in those with previous COVID-19. Public health communications should be inclusive, non-stigmatising and utilise trusted networks. Funding UKRI-MRC and NIHR.

Ethnic differences in SARS-CoV-2 vaccine hesitancy in United Kingdom healthcare workers: Results from the UK-REACH prospective nationwide cohort study.

To assess the frequency and associated characteristics of COVID‐19 vaccine hesitancy among pregnant and postpartum individuals.

Characteristics and perceptions associated with COVID‐19 vaccination hesitancy among pregnant and postpartum individuals: A cross‐sectional study

Factors influencing Covid-19 vaccine acceptance across subgroups in the United States: Evidence from a conjoint experiment.

Background and Objectives: Pregnant women are more likely to develop a more severe course of COVID-19 than their non-pregnant peers. There are many arguments for the safety and efficacy of COVID-19 vaccines in pregnant women. The aim of this study is to conduct a systematic review concerning the approach of pregnant women towards vaccination against COVID-19, with particular regard to determinants of vaccination acceptance. Materials and Methods: Articles were reviewed in which the aim was to evaluate-via a survey or questionnaire-the acceptance and decision to undergo vaccination against COVID-19. The articles were subjected to review according to recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). Results: In various studies, the percentage of pregnant women accepting the COVID-19 vaccine was between 29.7% and 77.4%. The strongest factors co-existing with the acceptance of the COVID-19 vaccination in pregnancy were trust in the importance and effectiveness of the vaccine, explicit communication about the safety of COVID-19 vaccines for pregnant women, acceptance of other vaccinations such as those for influenza, belief in the importance of vaccines/mass vaccination in one's own country, anxiety about COVID-19, trust in public health agencies/health science, as well as compliance to mask guidelines. The remaining factors were older age, higher education, and socioeconomic status. Conclusions: This review allowed us to show that geographic factors (Asian, South American countries) and pandemic factors (different threats and risks from infection) significantly influence the acceptance of vaccines. The most significant factors affecting acceptance are those related to public awareness of the risk of infection, vaccine safety, and the way in which reliable information about the need and safety of vaccines is provided. Professional and reliable patient information by obstetricians and qualified medical personnel would significantly increase the level of confidence in vaccination against COVID-19.

The Approach of Pregnant Women to Vaccination Based on a COVID-19 Systematic Review.

https://academicworks.medicine.hofstra.edu/cgi/viewcontent.cgi?article=8688&context=articles

Professionally responsible coronavirus disease 2019 vaccination counseling of obstetrical and gynecologic patients.

The Exciting Potential for ChatGPT in Obstetrics and Gynecology.

Neonatal outcomes of births in freestanding birth centers and hospitals in the United States, 2016-2019.

Change in ectopic pregnancy presentations during the covid-19 pandemic.

The COVID-19 pandemic has abruptly affected every aspect of people's daily lives worldwide. Just like every other area, the medical field has been dramatically impacted by the need to care for a large number of patients while at the same time protecting staff, patients, and their families. Changes in the wake of the pandemic called for the prompt and extensive rechanneling and re-organization of resources. The pandemic has opened challenges and concerns for patient safety, starting with the early recognition that individuals, including medical staff, may spread the virus during the asymptomatic phase. Many healthcare facilities faced resource-limited settings, including challenges in the availability of personal protective equipment for healthcare providers. Additionally, the pandemic has disrupted medical education, both at the undergraduate and at the graduate levels, and according to many predictions, its effects may forever transform the ways medical education is delivered. In this chapter, we are exploring the history of medical education, describe changes in medical education experienced during the COVID-19 pandemic, and predict some of the considerations worth taking into account when envisioning the future of medical education.

Adi Katz

Papers

Professionally responsible coronavirus disease 2019 vaccination counseling of obstetrical and gynecologic patients.

The Exciting Potential for ChatGPT in Obstetrics and Gynecology.

Neonatal outcomes of births in freestanding birth centers and hospitals in the United States, 2016-2019.

Change in ectopic pregnancy presentations during the covid-19 pandemic.

A Shift in Medical Education During the COVID-19 Pandemic.