加拿大孕妇对 SARS-CoV-2 疫苗的接种情况和犹豫原因：一项前瞻性队列研究。
SARS-CoV-2 vaccine uptake and reasons for hesitancy among Canadian pregnant people: a prospective cohort study.
机构信息
Centre hospitalier universitaire Sainte-Justine Research Centre (Gorgui, Bérard, Gomez); Faculty of Pharmacy (Gorgui, Bérard), Université de Montréal; Mother and Children's Infectious Diseases Centre (Atallah, Boucoiran), CHU Sainte-Justine, Université de Montréal, Montréal, Que.; Hospices Civils de Lyon (Atallah), Hôpital Femme Mère Enfant, Department of Prenatal Diagnosis, Université Claude Bernard Lyon 1, Lyon, France; Department of Obstetrics and Gynecology (Atallah), and School of Public Health (Boucoiran), Université de Montréal, Montréal, Que.; Faculty of Medicine (Boucoiran, Bérard), Université Claude Bernard Lyon 1, Lyon, France.
Centre hospitalier universitaire Sainte-Justine Research Centre (Gorgui, Bérard, Gomez); Faculty of Pharmacy (Gorgui, Bérard), Université de Montréal; Mother and Children's Infectious Diseases Centre (Atallah, Boucoiran), CHU Sainte-Justine, Université de Montréal, Montréal, Que.; Hospices Civils de Lyon (Atallah), Hôpital Femme Mère Enfant, Department of Prenatal Diagnosis, Université Claude Bernard Lyon 1, Lyon, France; Department of Obstetrics and Gynecology (Atallah), and School of Public Health (Boucoiran), Université de Montréal, Montréal, Que.; Faculty of Medicine (Boucoiran, Bérard), Université Claude Bernard Lyon 1, Lyon, France
出版信息
CMAJ Open. 2022 Dec 6;10(4):E1034-E1043. doi: 10.9778/cmajo.20210273. Print 2022 Oct-Dec.
BACKGROUND
Several vaccines against SARS-CoV-2 have been developed and approved at an unparalleled speed. Given that SARS-CoV-2 vaccines are recommended to pregnant people, our aim was to quantify vaccination uptake, and describe vaccination hesitancy and behavioural attitudes surrounding SARS-CoV-2 vaccination in pregnancy in Canada.
METHODS
The CONCEPTION study is an ongoing international study started in June 2020, evaluating the impact of the COVID-19 pandemic on the health of pregnant people and their children. For this study, pregnant people recruited from Apr. 20, 2021, to Feb. 8, 2022, and residing in Canada were invited to complete a Web-based survey. In addition to all CONCEPTION variables, data on vaccine uptake as well as personal knowledge of COVID-19 severity in pregnancy and of SARS-CoV-2 vaccine safety and efficacy were collected. Marginal risk differences and adjusted odds ratios (ORs) were calculated to assess determinants of SARS-CoV-2 vaccination during pregnancy.
RESULTS
From Apr. 20, 2021, to Feb. 8, 2022, 603 pregnant people were recruited and gave consent, of which 83.7% ( = 505) were vaccinated and 16.3% ( = 98) were not vaccinated against SARS-CoV-2. Uptake of the influenza vaccine in 2020/21 was a significant predictor of being vaccinated against SARS-CoV-2 or intention to be vaccinated (marginal risk difference 3.2%, 95% confidence interval [CI] 3.0% to 3.3%, adjusted OR 4.43, 95% CI 2.32 to 9.25), and being employed (marginal risk difference 11.2%, 95% CI 10.6% to 11.9%, adjusted OR 2.17, 95% CI 1.03 to 4.35) increased the likelihood of being vaccinated against SARS-CoV-2. Self-assessed knowledge of COVID-19 severity and vaccine efficacy was not associated with vaccine uptake.
INTERPRETATION
Among the Canadian pregnant people who responded to this study, vaccine uptake against SARS-CoV-2 was high. However, our results underscore the importance of improving knowledge transfer about the efficacy of SARS-CoV-2 vaccines in pregnancy to guide vaccination efforts.
背景
针对严重急性呼吸系统综合征冠状病毒 2 型（SARS-CoV-2）已经开发并批准了几种疫苗，其速度之快前所未有。鉴于 SARS-CoV-2 疫苗被推荐给孕妇使用，我们的目的是量化加拿大孕妇对 SARS-CoV-2 疫苗的接种率，并描述她们对 SARS-CoV-2 疫苗接种的犹豫态度和相关行为。
方法
该研究是一项正在进行的国际研究，于 2020 年 6 月开始，评估了 COVID-19 大流行对孕妇及其子女健康的影响。在这项研究中，从 2021 年 4 月 20 日至 2022 年 2 月 8 日期间，招募了居住在加拿大的孕妇，并邀请她们完成一项基于网络的调查。除了所有 CONCEPTION 变量外，还收集了疫苗接种率以及个人对 COVID-19 在妊娠期间严重程度的认识、对 SARS-CoV-2 疫苗安全性和有效性的认识等数据。计算边际风险差异和调整后的优势比（OR），以评估妊娠期间接种 SARS-CoV-2 疫苗的决定因素。
结果
从 2021 年 4 月 20 日至 2022 年 2 月 8 日期间，共招募了 603 名孕妇，并同意参与研究，其中 83.7%（505 人）接种了 SARS-CoV-2 疫苗，16.3%（98 人）未接种 SARS-CoV-2 疫苗。2020/2021 年接种流感疫苗是接种 SARS-CoV-2 疫苗或打算接种 SARS-CoV-2 疫苗的显著预测因素（边际风险差异 3.2%，95%置信区间[CI]为 3.0%至 3.3%，调整后的 OR 为 4.43，95%CI 为 2.32 至 9.25），就业（边际风险差异 11.2%，95%CI 为 10.6%至 11.9%，调整后的 OR 为 2.17，95%CI 为 1.03 至 4.35）增加了接种 SARS-CoV-2 疫苗的可能性。自我评估的 COVID-19 严重程度和疫苗效力知识与疫苗接种率无关。
解释
在对这项研究做出回应的加拿大孕妇中，接种 SARS-CoV-2 疫苗的比例很高。然而，我们的研究结果强调了改善妊娠期间 SARS-CoV-2 疫苗效力知识传播的重要性，以指导疫苗接种工作。
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