Pinkney Jodian A, Bogart Laura M, Carroll Kamali N, Bryan Lenroy, Witter Givana, Ashour Dina, Shebl Fatma M, Hurtado Rocio M, Goldfarb Ilona T, Hyle Emily P, Psaros Christina, Ojikutu Bisola O
Medical Practice Evaluation Center, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
Open Forum Infect Dis. 2023 Apr 13;10(5):ofad201. doi: 10.1093/ofid/ofad201. eCollection 2023 May.
Despite high rates of coronavirus disease 2019 (COVID-19)-related maternal mortality, Jamaica currently has little data on COVID-19 vaccine uptake among pregnant women.
We conducted a cross-sectional, web-based survey of 192 reproductive-aged women in Jamaica from February 1 to 8, 2022. Participants were recruited from a convenience sample of patients, providers, and staff at a teaching hospital. We assessed self-reported COVID-19 vaccination status and COVID-19-related medical mistrust (operationalized as vaccine confidence, government mistrust, and race-based mistrust). We used multivariable modified Poisson regression to test the association between vaccine uptake and pregnancy.
Of 192 respondents, 72 (38%) were pregnant. Most (93%) were Black. Vaccine uptake was 35% in pregnant women versus 75% in nonpregnant women. Pregnant women were more likely to cite healthcare providers versus the government as trustworthy sources of COVID-19 vaccine information (65% vs 28%). Pregnancy, low vaccine confidence, and government mistrust were associated with a lower likelihood of COVID-19 vaccination (adjusted prevalence ratio [aPR] = 0.68 [95% confidence interval {CI}, .49-.95], aPR = 0.61 [95% CI, .40-.95], and aPR = 0.68 [95% CI, .52-.89], respectively). Race-based mistrust was not associated with COVID-19 vaccination in the final model.
Pregnancy, low vaccine confidence, and government mistrust were associated with a lower likelihood of COVID-19 vaccination among reproductive-aged women in Jamaica. Future studies should evaluate the efficacy of strategies proven to improve maternal vaccination coverage, including standing "opt-out" vaccination orders and collaborative provider and patient-led educational videos tailored for pregnant individuals. Strategies that decouple vaccine messaging from government agencies also warrant evaluation.
尽管2019冠状病毒病（COVID-19）相关的孕产妇死亡率很高，但牙买加目前几乎没有关于孕妇接种COVID-19疫苗的数据。
2022年2月1日至8日，我们对牙买加192名育龄妇女进行了一项基于网络的横断面调查。参与者来自一家教学医院的患者、医护人员和工作人员的便利样本。我们评估了自我报告的COVID-19疫苗接种状况以及与COVID-19相关的医疗不信任（具体表现为疫苗信心、对政府的不信任和基于种族的不信任）。我们使用多变量修正泊松回归来检验疫苗接种与怀孕之间的关联。
在192名受访者中，72人（38%）怀孕。大多数（93%）为黑人。孕妇的疫苗接种率为35%，而非孕妇为75%。孕妇比政府更有可能将医疗保健提供者视为COVID-19疫苗信息的可靠来源（65%对28%）。怀孕、疫苗信心低和对政府的不信任与接种COVID-19疫苗的可能性较低相关（调整患病率比[aPR]=0.68[95%置信区间{CI}，0.49 - 0.95]，aPR = 0.61[95% CI，0.40 - 0.95]，以及aPR = 0.68[95% CI，0.52 - 0.89]）。在最终模型中，基于种族的不信任与COVID-19疫苗接种无关。
怀孕、疫苗信心低和对政府的不信任与牙买加育龄妇女接种COVID-19疫苗的可能性较低相关。未来的研究应评估已被证明可提高孕产妇疫苗接种覆盖率的策略的有效性，包括常设“默认同意”疫苗接种命令以及为孕妇量身定制的由医护人员和患者主导的合作教育视频。将疫苗宣传与政府机构脱钩的策略也值得评估。
